u/twente_bassie

For about two weeks now, I’ve been having AFib episodes almost every evening. During the day I feel completely fine, no symptoms at all. But when I sit down to relax and especially when I’m drifting off to sleep, it often kicks in.

It usually starts with some palpitations and a slightly more forceful heartbeat, and then suddenly it flips into AFib. The timing is very consistent, almost always in that “in-between” phase when I’m falling asleep.

I won’t be able to see a cardiologist for another three weeks, and in the meantime I’m trying to understand my options. I’ve been reading about Flecainide and wondering if it could help stop these episodes.

So I have a couple of questions: • What are your experiences with Flecainide for stopping AFib episodes, especially when they occur like this (mostly at night)? • What side effects should I realistically expect?

And a second concern: • My stroke risk score is around 0–1 (only mildly elevated blood pressure, otherwise healthy), so I haven’t been prescribed blood thinners. But now that these episodes are happening every night, does that significantly increase my risk? • Should I still push to discuss anticoagulation with my doctor despite the low score?

Thanks a lot for any insights or personal experiences.

I’m a healthy, sporty male with a healthy body weight and a very clean lifestyle. I exercise a lot, eat lots of green vegetables, fish, salads and smoothies, don’t smoke, don’t use drugs and barely drink alcohol. I do have a stressful job, though overall my life is actually pretty relaxed and good.

Since September last year I’ve had episodes of atrial fibrillation (AFib). At first it happened only occasionally and always converted back on its own after a few hours. But recently it suddenly escalated and I’ve now had three episodes in three days. AFib was officially documented at urgent care and I’ve been referred to a cardiologist, but my appointment is still about three weeks away.

What’s strange is that I sometimes feel it coming before it starts. A fluttering sensation, some chest pressure, and then suddenly it kicks in. Yesterday I noticed that if I stayed active or walked around, it stayed away, but once I sat down and relaxed on the couch, it started anyway.

My questions: • Is it normal for AFib to suddenly come in clusters, with several episodes in a short period without obvious triggers? • Do other people recognize the feeling that you can feel it “coming on” before it actually starts? • I was prescribed Metoprolol 50 mg, but no blood thinners because my CHA2DS2-VASc score is considered low. Still, I worry about blood clots. Can a patient choose to take blood thinners anyway even with a low score? • I have to wait about three weeks before seeing the cardiologist. Would you wait that long or contact the clinic again because of the sudden increase in episodes? • Is Flecainide sometimes used as a short-term option to get things under control while waiting for a cardiology appointment?