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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Is The Medication For Arrhythmia?

I am using Tambacor (Flecainide 200 mg CR) to regulate/control arrhythmia. Is this med, in any other form, an effective remedy for this condition? I was prescribed this medication by a cardiologist at a large and well known hospital in Africa. It worked. My days were smooth with no racing heart or thuds and anxiousness... although it did take a week to get used to it - dizziness and weakness for 5 days then, a smooth and uneventful 5 weeks followed. The cardiologist said You will feel better in a week . I certainly did. Last week I ran out of the 200gm CR. I had it replaced with the twice daily 100mg dose. I took the 200 mg CR for six weeks. I was thinking something so effective would be available in NS. This drug, Flecainide, as a 200 mg CR is not available in Nova Scotia. I am taking 100Mg tablets twice a day at meals morning and evening. It has no positive effect. I feel the symptoms of racing irregular beats etc., for three hours after the 100mg pill. Can you help?
Wed, 2 Sep 2015
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Cardiologist,  's  Response
Hello. Thank you for your question and welcome to HCM. I understand your concern.

All the above mentioned side effects can be caused by flecainide usage. Flecainide, class I-A antiarrhythmic drug, exerts its action by prolonging phase 0 and 3 of the action potential of the heart. It also has a dangerous, serious side effect, which is prolonging the QT interval in the EKG, which can predispose to an arrhythmia called torsades de pointes, and comprises the proarrhythmic, paradoxical, side effect of the drug. Flecainide controlled release is proven slightly more effective by some studies conducted in the past, but the effect on supraventricular cardiac arrhythmia should be the same even with the 100 mg twice a day. In my experience and in our clinic's experience in treating supraventricular arrhythmias, flecainide is the third choice in treating such disorders, after amiodarone and propafenone. Always speaking about the usage of antiarrhythmics. Therefore, I would recommend you to consult a cardiologist, and an EKG should be done. Also, a possible switching to an another antiarrhythmic drug should be discussed. Amiodarone has possible systemic side effects, especially on the thyroid gland, because a good part of its content is from iodine. But, it is an effective antiarrhythmic and the risk for torsades de pointes, according to the studies available, is much lower than with flecainide.

I hope I was helpful with my answer. Wish you a good health.

Kind regards,
Dr. Meriton
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What Is The Medication For Arrhythmia?

Hello. Thank you for your question and welcome to HCM. I understand your concern. All the above mentioned side effects can be caused by flecainide usage. Flecainide, class I-A antiarrhythmic drug, exerts its action by prolonging phase 0 and 3 of the action potential of the heart. It also has a dangerous, serious side effect, which is prolonging the QT interval in the EKG, which can predispose to an arrhythmia called torsades de pointes, and comprises the proarrhythmic, paradoxical, side effect of the drug. Flecainide controlled release is proven slightly more effective by some studies conducted in the past, but the effect on supraventricular cardiac arrhythmia should be the same even with the 100 mg twice a day. In my experience and in our clinic s experience in treating supraventricular arrhythmias, flecainide is the third choice in treating such disorders, after amiodarone and propafenone. Always speaking about the usage of antiarrhythmics. Therefore, I would recommend you to consult a cardiologist, and an EKG should be done. Also, a possible switching to an another antiarrhythmic drug should be discussed. Amiodarone has possible systemic side effects, especially on the thyroid gland, because a good part of its content is from iodine. But, it is an effective antiarrhythmic and the risk for torsades de pointes, according to the studies available, is much lower than with flecainide. I hope I was helpful with my answer. Wish you a good health. Kind regards, Dr. Meriton