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Taking flecainide. Noticed pauses in EKG result. Suggestions

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Cardiac Surgeon
Practicing since : 1972
Answered : 9 Questions
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,

Posted Mon, 3 Jun 2013 in Hypertension and Heart Disease
Answered by Dr. Joan F. Tryzelaar 51 minutes later
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
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