Taking Flecainide. Noticed Pauses In EKG Result. Suggestions

Posted on Thu, 16 May 2013

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

Thu, 16 May 2013 Answered on

Wed, 5 Jun 2013 Last reviewed on

Question : Hello sir. I just sent you a message the other day concerning the EP and flecainide. I went to get my 24 hr. holter results today. I have had several of these over the past few years. This one after being on the flecainide for around 2 weeks showed a 1.1 second pause on the EKG. They said this is nothing to be concerned with but I am quite concerned. They said that this was not an issue until 3-4 second pauses. The problem is that I never had any pauses on my ekgs until the one taken after the flecainide. Also the other day I woke up feeling as if I was being suffocated or held down. Like I had to fight to wake up and breath. It was a strange sleep paralysis thing. Now though I am concerned that this could have been another pause that caused that to happen. Do you think it's just an anomaly that I should ignore or do you think this could be something more serious like a reaction to the flecainide?

Highest Regards,

XXXXXXX

Answered by Dr. Joan F. Tryzelaar (51 minutes later)

Hi XXXXXXX
I have no way of knowing whether these symptoms are related to your heart and/or flecainide, or a panic reaction. There are two ways to go forward:
1. You ask for a Holter monitor test (Read more here: WWW.WWWW.WW . This will show how many pauses occur and how long they last. You may have longer lasting pauses that have not been recorded previously. That alone might prompt stopping the flecainide.
2. You are obviously very uncomfortable with flecainide. You need to discuss this with your cardiologist and he/she needs to explain to you why it is vital to at least continue with flecainide till the EP study is performed and what would happen if it is stopped. Maybe the EP study can be rescheduled to an earlier date!
Hope this helps,
Dr T

Above answer was peer-reviewed by : Dr. Mohammed Kappan