Brief Answer: please see below Detailed Answer: Dear Sir We use three kind of medications in treatment of AF (atrial fibrillation). 1. The medication to prevent formation of clot in left atrium (LA) {the receiving or back part on left side of heart}. The clot formation in LA may lead to its migration to various body part and cause damage like stroke. These medications are either aspirin (or related drugs) or anticoagulants (warfarin & related drugs). You are having BABY Bayer for same. 2. The second class of drugs is to control your heart rate (ventricular rate). These include beta-blockers (like metoprolol), calcium channel blockers , digoxin and amiodarone (not so effective). These drugs do not change AF to normal rhythm. 3. Third class of drugs tend to convert AF to nornal sinus rhythm. These include propafenone, flacanide, amiodarone, dofetilide etc. The strategy to choose between the last two group of drugs depends upon many things and clinical scenario. Hope this helps. Please ask your further queries. Waiting. Sincerely Sukhvinder

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Brief Answer: yes , there is a possibility of interaction Detailed Answer: Dear sir Literature says that escitalopram may adversly interact with flecanide as well as metoprolol. The exact incidence of interaction, degree of interaction & degree of its effects are not very well known but a number of guidelines and manufacturer's prescribing information forbid there concomitant use or recommend use with utmost precaution (depending upon clinical circumstances). you may go through the following links for detailed information on the issue. It is said that levels of both metoprolol and flecanide may increase with use of escitalopram. https://online.epocrates.com/u/0000/flecainide/Drug+Interactions http://www.medsafe.govt.nz/profs/datasheet/l/Lexaprotab.pdf http://www.drugline.se/questions/en/23244/?query=mesh:%22flecainide%22 https://www.ncbi.nlm.nih.gov/books/NBK82914/ However, the interactions do not occur in all patients and may not be clinically significant in all. At times it is a necessity for treating physician. Your physician is in best position to decide about the issue. Please do discuss with him. Sincerely Sukhvinder

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