I have been taking 100 mg of flecainide twice a day with 50 mg of metropolol for 2 years after my paroxymal AF resulted in a TIA. The AF is much better but the concern is my heart rate is now as low as 44 when resting and 75-80 when exercising. Normal heart rate is 50 -55.
Can flecainide result in too low a heart rate?
Question posted by JAFY2 on 6 June 2011
Last updated on 12 August 2021 by Daughter2021
My Dad had a TIA in his 80's from an Afib/Aflutter episode. He also had some hypertension and PVC's and so he was put on Metoprolol, Flecainide, and Eliqis. He is now on ONLY Flecainide 50 mg BID and Eliqis BID because the metoprolol caused him to have significant bradycardia to 44 beats per minute seen on few days of at-home Holter monitoring. That low pulse still wasn't enough for the cardiologist to stop it, but just reduce/adjust the dose. But then he had orthostatic hypotension (low BP with standing up) documented in a specialist doctor's office. Looking back, he had a couple of falls when he was on metoprolol that were probably directly from low pulse/low BP episodes during the day. How did they finally realize and how did he get off metoprolol completely? He saw a geriatric specialist before a gallbladder surgery and she did an orthostatic blood pressure check that was very significant. (?Wasn't caught or wasn't done in the regular cardiologist's office)
His systolic BP dropped to only 88 upon standing and pulse in 50's! They quickly gave him things to drink and a snack and told him to discontinue the metoprolol. Amazingly he was still answering questions and only acting a little tired. At his age 89/90 years, said the geriatric specialist, his systolic BP SHOULD be in a 'high' range to be normal: 140 to something like 190 was FINE. So he didn't need anything to lower blood pressure at all. Metoprolol causes bradycardia. Metoprolol causes orthostatic hypotension. It wasn't needed. He has been doing fine, but still has some episodes of a lower BP (not so low as when he was on metoprolol but systolic 110) and so maybe also has some side effects from the Flecainide, or weakening of his heart muscle overall. This taught me that the "very old" are in a completely different category from other people and it's very easy to wrongly continue medicines "just because" he has taken them for a long time. After this happened to my Dad, I met a 93-year-old veteran, the father of our local minister, who told me that when he was 92 and had hypertension that he had a stroke. After his stroke rehab, he stopped his prescription metoprolol because it gave him low blood pressure, and at this point he is just 'going natural' on aspirin and good diet and he can exercise and is feeling so much better. Not saying that is the best thing, because to prevent stroke Eliqis is stronger, but getting off the metoprolol was a positive step for both of these two 'very old' men! I don't know your age, but for anyone on metoprolol, I strongly suggest a geriatric specialist opinion for older people, and a second opinion for others ages. Incidentally, my Dad is overweight and the minister's Dad is a normal or light weight.
Five months ago, I found I had AFlib. You don't say if you are on blood thinners. I was put on Warfrain. Also, Metoprolol 25 mg twice day. This is for the AFlib and high blood pressure. I limit Vit K foods and take a multi vit and mineral that does not have vit K. Iam doing great. Hardly know I have AFlib. Good Luck. I just found this site. If you have any more questions,just post. Hope I can help.
- Flecainide uses and safety info
- Flecainide information for Healthcare Professionals (includes dosage details)
- Side effects of Flecainide (detailed)
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