Had cryo ablation in 2014. Pretty much stopped the episodes except when over exertion triggered a short bout. 100mg of Flecainide would restore NSR within an hour or two.

I started taking 50 mg of flec each day to keep things in line. Gradually the episodes came more frequently but an extra dose of flec took care of it.

At regular cardiology appt I was advised to take 100mg of flec but it seemed that my episodes were coming more frequently. My EP recommended I either have another ablation or increase flec to the max of 150mg bid. I opted for the increased flec and was ready to take it when I finally connected the dots and put the pill back. Decided to quit flec altogether.

That was over a month ago. I've been in nsr ever since. I check the kardia to be sure but I was highly symptomatic when in afib, high chaotic HR with the "fish flopping" sensation in chest and frequent urination. No question that the beast at least up to now has gone into hibernation.

I remembered reading something about the possibility that flec can be pro-arrhythmic and mentioned it to my EP, who dismissed it while prescribing the 150 mg.


It's either a one-off or afib might return. Either way I thought it was potentially significant enough to share.

That is a question for a consulting cardio who has your record. Jstill might have some suggestions.

I had heat ablation last month. In and out of Afib/NSR until about the last 3-weeks when NSR was predominant. A few weird readings (on the Kardia) but Cardiologist called them normal and said it showed scatter? But, they put me on Amioderone after ablation. I am hoping to get off it soon as both Cardiologist I have had said it is not a good long term drug. Will keep the Flecainide in mind next time I visit Cardiologist.

Goal is NSR and no drugs!

Good luck to you

How is your sleep? The reason I ask is that I was diagnosed with sleep apnea, and after going on a CPAP, my episodes of AFIB virtually disappeared.

I think I was stressing my heart so much with the up to 60 times per hour of stopping breathing that it triggered that.

May be worth checking into?

quote:

Originally posted by urbanwarrior238:
I had heat ablation last month. In and out of Afib/NSR until about the last 3-weeks when NSR was predominant. A few weird readings (on the Kardia) but Cardiologist called them normal and said it showed scatter? But, they put me on Amioderone after ablation. I am hoping to get off it soon as both Cardiologist I have had said it is not a good long term drug. Will keep the Flecainide in mind next time I visit Cardiologist.

Goal is NSR and no drugs!

Good luck to you

Ablation, RF or cryo, is a major assault on the heart. Amio is usually prescribed during the 3 month blanking period but it's a nasty drug. I'm sure they'll take you off in a couple months. Is your kardia a 2 or 6 lead? Sometimes it will say Unclassified which means they have no idea!

Hopefully your ablation was successful and you'll enjoy NSR with no need for flec or any other drug.

quote:

Originally posted by RogB:

quote:

Originally posted by urbanwarrior238:
I had heat ablation last month. In and out of Afib/NSR until about the last 3-weeks when NSR was predominant. A few weird readings (on the Kardia) but Cardiologist called them normal and said it showed scatter? But, they put me on Amioderone after ablation. I am hoping to get off it soon as both Cardiologist I have had said it is not a good long term drug. Will keep the Flecainide in mind next time I visit Cardiologist.

Goal is NSR and no drugs!

Good luck to you

Ablation, RF or cryo, is a major assault on the heart. Amio is usually prescribed during the 3 month blanking period but it's a nasty drug. I'm sure they'll take you off in a couple months. Is your kardia a 2 or 6 lead? Sometimes it will say Unclassified which means they have no idea!

Hopefully your ablation was successful and you'll enjoy NSR with no need for flec or any other drug.

I have the 6-lead Kardia. Several Doctors told me as the scar tissue forms, the bad signals cant get thru and better NSR shows as time goes by. Seems to be holding true. And you are right about the unclassified or WQRS readings. Both Cardiologist, after reading the Kardia, said they were normal readings. I think Kardia errs on the side of caution.

Just checked and NSR!!

Thanks

My Doc put me on Multac. He said it's the safe version of Ameodreone.

Bob

NSR = Normal Sinus Rhythm.

RogB, your personal impression from stopping flecainide should not be discounted in my opinion.
Just as a quick summary: a fib by itself can usually be tolerated as long as (1) patient is on anticoagulation, these days Eliquis or an alternative, and (2) heart rate is controlled, at least under 100, preferably in the 70's or so.
The death rate from those treated with rate control (as above) vs. rhythm control (with ablation and/or antiarrhythmics) is about the same.

Some people are very symptomatic when in AF, others unaware. I find the Kardia Mobile device extremely useful, as is the Apple Watch, especially those with the capability of taking an ECG.

My wife recently had her first episode of AF; it lasted 24 hours. After 6 hours we went to the ED expecting carddioversion, but she said she had been having symptoms the previous two nights and we couldn't be sure it wasn't AF, so cardioversion was postponed, she was started on metoprolol and Eliquis. Then the next morning she converted.
Interestingly her Apple Watch SE, the cheaper model, picked up and reported the AF even though it doesn't do an ECG. It senses the pulse by pulse plethysmography.

The Kardia device was diagnostic in her case, and documented that her symptoms improved remarkably when the heart rate went from 124 to the 80's.

We will continue to monitor her for AF.

There is an ongoing trial called REACT-AF, in which subjects are given an Apple Watch for monitoring AF if they have paroxysmal (not continuous) AF. The idea is to see if having patients take anticoagulation only when they have an AF episode lasting hours, then stoping after a month, will give similar mortality results to continued anticoagulation. Anticoagulation, although now convenient compared with the old warfarin, still has risk of bleeding into the brain which is catastrophic.
We're hoping that my wife can fall into this group that rarely has AF and we can stop the Eliquis is she does not have recurrence, or has it only rarely. This is NOT currently standard practice, but the science behind this trial is very sound.

^^^Plethysmography – A new word for me.

“Plethysmography measures changes in volume in different parts of the body. The test may be done to check for blood clots in the arms and legs. It is also done to measure how much air you can hold in your lungs.”
https://medlineplus.gov/ency/a...20in%20your%20lungs.

“Digital pulse plethysmography as a non-invasive method for predicting drug-induced changes in left ventricular preload”
https://pubmed.ncbi.nlm.nih.gov/8803519/

quote:

Ablation, RF or cryo, is a major assault on the heart.

I've had aFib for several years now, going back to ~2015. Undiagnosed until around 2020 and on meds to control that with good results.

I work for a radiology group (I'm not a doc) and discussed ablation options with senior interventional members of our group and, armed with that information, my cardiologist in a frank discussion. One advantage of working for docs for 30+ years is they no longer intimidate me, which makes it easier to push back. Well, they don't intimidate me much, but they still blister me in any intellectual challenge!

My takeaway was while this can work, it is nothing like a stent or other sorts of succeed-or-fail procedure. It's a best-effort attempt at creating sufficient and specific enough scar tissue at the right spot to affect the heart behavior in the desired way. It might work, it might not, and you might have to do this 1, 2 or more times to get the desired result. All with possible complications of the procedure itself, in addition to the not insignificant risk of general anesthesia each time.

With that I decided to delay what was initially presented as an easy-button remedy until that was the only or best option. Meds have worked, and I'm glad not to have gone another direction for now.

I went into AFib Oct 1st, ER the next morning. I was admitted and they tried meds to flip it but no go. Had a cardio version Oct 6th and went home the 7th.

Back into AFib Oct 11th and another cardio version on the 13th.

I have been on Amiodarone, metoprolol, and Eliquis sine then and am scheduled for a cryoablation Nov 27.

The first week on Amiodarone was 400 mg a day then down to 200 mg. Very tired and larthigic with a low resting heart rate. I reached out to my cardiologist and EP and they said I can cut it to 200 mg every other day if I wanted. I stayed with the 200 mg per day but finally went to 100 mg per day.

A bit better but my resting heart rate is still about 44-45 bpm.

I start chemo this month for bladder cancer as well.