Propafenone

Hi everyone. Just had my 3rd fast AF event in 8weeks requiring chemical cardioversion with fleicanide IV. I never know how long to leave my very irregular and fast heart beat before I go to A/E .

I am now home and resting. The last event came on while I was swimming which is unusual for me as all my other attacks have been whilst at rest.

My question is I have now been discharged from hospital with a 300mg dose of propafenone to take if I go back into fast AF to try and stop a hospital admission. Has anyone used this medication like 'A pill in the pocket' before. I know fleicanide can be used but not heard of this drug before nor had the staff on the discharge ward I was on. It was a cardiologist who suggested it. I am on Bisoprolol and warfarin as well as Bp medications.

I am scheduled for an ablation on the 9th December. Prior to this admission I was undecided about going ahead with it after reading some of the negative comments about ablation. I am now determined to go ahead with it and put my trust in my EP.

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  • Yes, I was on propafenone for 2-3 years a decade ago and it worked very well in that I had virtually 100% steady heart (previously I had 24/7 AF). But it affected my memory very badly after a while and had to have an ablation to get off it.

    The brand was Arythmol. Later on, I also tried Accord, but it made me feel badly depressed within days. Both should be the same I suppose but not for me.

    Koll

  • Hi Sharon

    I am on Propafenone, though take 2x150g a day (300g in total) but can go up to 4x150g a day not as a pill in the pocket. I was put on it after leaving hospital after one fast AF episode that left me in a persistent flutter and was going to have a cardioversion. After 36 hours it converted me back to NSR. I have tried Flecainide as a pill in the pocket but didn't work for me. It's not entirely successful at keeping me out of fast AF, I still have episodes (every few weeks) and am awaiting an ablation same as you (8th Nov). I had a number of hospital admissions for fast AF episodes and it was beyond a joke. I can't take beta blockers cos of a slow resting heart rate. Propafenone doesn't seem to give me any issues or side effects.

    As part of the trial and error that is finding the right drug for you I have now reached a stage where I take 2x150g Propafenone daily, morning and night. If I go into fast AF I take Metoprolol to put me in rate control, it can take 12 hours and 2 doses but saves me going to A&E as they would only do this and possibly admit me, this can last days (usually about a week). When I convert back to NSR I have to stop taking the Metoprolol immediately because of my low heart rate.

    My cardiologist and EP are happy if I am in AF so long as my heart rate gets below 100 (usually about 100bpm once taken the Metoprolol), although I am then stuck in a Atrial Flutter for days it is fairly regular and can't feel palpiations and main issue is feeling tired with heart going at that rate.

    I was against ablation but am feeling at the moment I can't carry on with the frequency and severity of epiosdes so like you I have made that decision. I hope it is the right one for us both.

    Jo

  • Thank you for your input. Let's keep in touch about our ablation recovery it will be good to compare and support each other.

  • Forgot to say I was on 2 x 150mgs propafenone (Arythmol) a day.

  • Sharon if your heart is structurally normal and its just an electrical problem (my ablations yielded a 90% success rate) go for it!

  • Thank you so much for that. I have been told that 1st time ablutions are only 50% effective so it s good to hear that. I am worried that my AF could be even worse after the ablation as someone was on this forum.

  • Some first ablations I think are very successful but I think EPs tend to be cautious and do too little rather than too much. Ablation is a bold step forward that we take in the knowledge that the success rate is usually somewhere around 70%. There are a lot of shades of grey in the other 30%. Ask your EP what hopes he has for you. I have no regrets and feel I have improved very significantly since my ablation in March. Although I haven't been totally AF free, it has only crept in occasionally and I have completely given up flecainide which pleases me very much indeed as I was on 300mgs a day. I feel very much better off.

  • PS I wasn't happy taking so much flecainide on a daily basis and would have preferred to have it as a pill-in-the-pocket. I think cure may be better than prevention.

  • Hi I have Propefanone as pill in pocket, have only used it once after being in A.F for a couple of hours. Worked well. Best wishes Kath

  • Thank you. Hopefully I won't need to use it but I hope if I do it works as well as for you.

  • Well I've just had my second one and am fine after both! Read my posts Loo53 and Loo61 :-)

  • PS2.... I also forgot to say that my ablation 10 years ago was a total success. Kept me clear for 8+ years, now got something else but still no AF, or not much anyhow. My 2nd ablation was aborted because the small amount of AF I had coming back, had gone away, so they didn't do anything.

    One was done under GA and one under sedative only and both were a breeze.

    K

  • I took propafanone as PIP with no problems.My only side effect was a metallic taste in my mouth but it was preferable to AF. I really don;t know why people are so worried about ablation I had three and would have another tomorrow if needed.

    Bob

  • I take Propafenone 3x150 daily in separate doses and it's working very well, touch wood. We tried a variety of meds before that and this is by far the most successful...but that's just for me! The number of 'tired' days has decreased significantly and I haven't had Koll's scary problem of memory loss...but then I'm 69 and can't remember where I left my mobile...........aaaaargh!

  • I have been given Biosoprolol as a pill in the pocket. I would recommend ablation (I've had four!) I'm far better although not absolutely - still have one every four/five months, but they are nowhere as bad as they used to be. I would sometimes have to sit completely still for up to eight hours as they were so bad.

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