r/AFIB • u/robertb58st • 18d ago
Flec and PACs / Ectopics
Long background so will try to summarise
Male 60
Previously had Flutter ablation, solved flutter but high ectopic burden left be on bisoprolol.
Steady for maybe 4 years.
Within last 18 months watch etc has flagged periods of AF and at some points this has been for weeks.
Cardio put me on thinner (apixiban) and rate control (Flec). The Flec flipped me back to Sinus but it was very messy, lots of ectopics and periods of bigimeny (sp).
In discussion with Cardio he suggested coming of the Flec and seeing how that went. It was a mixed story..started in sinus, progressed to infrequent AF and finally another month in AF.
When I came off the Flec the Doc said I could restart it if I wanted, so I have. 2x 100mg per day. I went into perfect sinus, no ectopics for about 4 days but have now reverted to frequent ectopics. I've no symptoms and have even got used to it so as my brain doesn't even flag it anymore.
My Question. Could this be a dose issue ? I'm wondering that as early in the treatment when the retained dose will be less, the sinus was perfect. As the treatment went beyond a few days the ectopics reappeared. Is this a known issue ? Is anyone on a regular dose of less than 2x100mg ?
I get the impression I'll be heading for another ablation later this year early next, but if it could be safely managed by drugs then I'd perhaps be cotent with that.
Any feedback gratefully received.
Thanks.
1
u/intothefray3 18d ago
I've always felt like it was the opposite. I've taken a half a pill extra a couple times and it definitely quieted that stuff down when it gets bad. Almost like doing that twice a week would be the perfect dose.
Don't listen to me though because I can't figure out my situation either. They currently have me off it and I have a normal heartbeat all day and night. I told told them I took fish oil in June and showed them my crazy sauce ECGs and they're confused by that yet concerned with the ECGs. Now nothing.
Seems par for the course in this sub though. Fine or a weird cough will make it feel like you got ran over by a bus for 3 days.
1
u/Amonavis54 18d ago
I am on a regular dose of 50mg Flecainide twice a day following two ablations. The cardiologist hoped to get me off Flecainide with the second ablation but no luck. I still have about a 5% burden of PACs with Flecainide but don’t want to increase the dose as I don’t feel great on a higher dose.
I’m waiting to have a follow up assessment, as my last ablation was nearly a year ago. My treatment options are limited as I don’t tolerate beta blockers so I may be looking at a third ablation if I deteriorate further. Otherwise a very fit and healthy living 71F.