I Am Presently On 300 Mg Of Flecainide And 50

Posted on Thu, 3 Oct 2019

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Thu, 3 Oct 2019 Answered on

Last reviewed on

Question : I am presently on 300 mg of flecainide and 50 mg metropolo tatrate for pacs and pvcs. it is not very effective, so they are switching me to rythmol 425 mg. Is it usually more effective in controlling pvcs or pacs?

Answered by Dr. Ilir Sharka (1 hour later)

Brief Answer:
Flecainide and Rythmol have similar effects.

Detailed Answer:
Hello!

Welcome on - Ask a Doctor - service!

After passing carefully through your concern, I would like to explain that although sometimes it is worth to try using several anti-arrhythmic drugs hoping to achieve a beneficial response, in your case both drugs are almost equally effective at suppressing extra-systolic arrhythmia.

So, as Flecainide has not been very effective, probably Rythmol will not make the change (in fact they belong to the same anti-arrhythmics class, with the same pharmacological properties).

Coming to this point, it would be necessary to investigate a possible cause of cardiac arrhythmia (cardiac ischemia, an underlying cardiomyopathy, a metabolic disorder, etc.)

For a better understanding of a possible arrhythmogenic myocardial focus a cardiac magnetic resonance imagine test is recommended.

In addition, a provocative (stress) cardiac imagine test would be helpful.

You should discuss with your attending cardiologist on the above mentioned issues.

Hope to have been helpful to you!

In case of any further questions, feel free t oask me again.

Kind regards,

Dr. Iliri Sharka
cardiologist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ilir Sharka (28 minutes later)

I have already had multiple tests done and they have determined I have a structurally sound heart. i had atrial fib. about 10 years ago but it was ablated. Are their any medications I should talk to my electrophysiologist about.

Answered by Dr. Ilir Sharka (8 hours later)

Brief Answer:
Opinion as follows:

Detailed Answer:
Hello again!

First it is necessary to properly define the exact structural cardiac disorder, whether it is a valvular disorder, a certain cardiomyopathy or other. In such way it would be possible to decide the right therapeutic strategy. This would be a more safe alternative before getting to the world of antiarrhythmics.

I highly recommend you discussing with your cardiologist on the possibility of performing a cardiac magnetic resonance imagine test as it would be helpful in this regard.

Wishing you good health!

Regards,

Dr. Ilir Sharka
cardiologist

Above answer was peer-reviewed by : Dr. Kampana