Is it advisable to take Flecainide for A-Fib?

Question

Hello doctor,

I am 50 years old with PAF. My first A-Fib was five years ago. I converted on my own. It went away for five years and at the year's end, I started a keto diet and went into A-Fib twice, and converted on my own. Started keto again and went into A-fib twice again and converted on my own. My cardiologist has me on 50 mg of Flecainide twice a day. I am also on Prozac 20 mg and Trazodone 400 mg. I am concerned about developing Prolonged QT, and I am not sure if Flecainide is really necessary. I am worried about what Flecainide will do to my heart. I have a healthy heart otherwise. 60 resting heart rate and 95/70 BP.

Answer 1

Hello,

Welcome to icliniq.com.

I passed carefully through your medical history and would like to explain that you are right when you worry about your current medications. Both Prozac and Flecainide increase QTc interval and may predispose to arrhythmia. I would recommend stopping continuing their concomitant use. Probably it would be better to start withdrawing them both. But if it is not possible for the moment, you should discuss with your attending doctor to keep the most indispensable drug which in your case seems to be Prozac. In addition, also Trazodone may potentiate the above pro-arrhythmic effect (increase QTc interval). Coming to this point, it would be wise to stop a keto diet for the moment, and also Flecainide. An adjustment of Prozac with Trazodone combination is recommended, for minimizing the potential adverse effects. You should also check thyroid hormone levels, just to be sure they do not influence the recent appearance of atrial fibrillation episodes.

Is it advisable to take Flecainide for A-Fib?

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