My first visit to the EP

I saw my EP today and they informed me that the 30 day event monitor showed that I had 2 events that lasted less than 10 seconds. He said there were two options that he recommended. (1) Start on Propafenone (RYTHMOL) 150mg 3 times a day. He said it will not cure the AF but it might prevent it. He said if it does not or if the side effects are to bad we go to option number two. He also did an EKG and wants me back in a week for a second one. I guess he wants to check to see if there is any changes after I start on the medication.

(2) Option 2, is he will perform an Cardiac ablation and go in through both the left and right groin.

I will of course do as he has requested but was wondering if anyone here has taken this medication and did it help or harm them? I realize we all are different so results vary. Also is this normal to try medicine first?

16 Replies

  • Yes it is normal to start medicine first although my personal opinion is the less drugs I put in my body the happier I am.

    There was a post with a link about a week ago to a lecture given by Prof Schilling on the latest thinking on treatment options and why - you would find this very useful information for both treatment options.

  • I agree that the less medication one can get by on the better. I would love to be pill free but for the time being it looks like I need them. Thanks for the post.


    There were also some videos posted by Dr Day - look back over the posts on page 2 of posts as there are quite a lot of threads you may find useful.

  • I took propafanone up to the time after my third ablation when the AF was stopped. The only side effect was a strange metallic taste but I was on much higher dose than you are.

  • Before you agree to ablation try to get rid of it by understanding why you are getting it. Check for sleep apnea. Monitor your diet, do regular exercise, take extra magnesium, etc.

  • Thanks Viraja, as Bob has often said some of us wind up living a healthy life style because of it. I was checked for sleep apnea 3 years ago and everything was fine. Could be I need another one. I started the magnesium, garlic, flax-seed oil and multivitamins, a couple of months ago. Up to then it was hit and miss and I have a daily exercise program (walking) twice a day. I have not found the trigger yet.

  • Don't get too hung up on what the trigger is; my experience is that what seems to "trigger" an episode one time does not always trigger it on other occasions. Good example is MSG -- I thought an episode was triggered by MSG (Chinese food), but I've eaten it since on several occasions without ever triggering another episode! Same with alcohol. I've come to the conclusion that the heart (atria) has a mind of its own and afib isn't triggered by the same thing each time.

  • Thanks for the advise, I have given up on what causes it. Like you said it has a mind of it's own. Right now I am learning from all of you and putting into practice all the good advise posted on this forum. They say experience is the best teacher and there is plenty here.

  • Let me get this straight. You had two "events" in 30 days, lasting less than 10 seconds (separately or combined, you don't say which). And your doc wants you to start taking drugs.

    What's the problem?

    Why did you have an event monitor in the first place?

    What exactly are these "events" and how do they affect you?

    Is some information is missing, which would point to a serious condition calling for some kind of intervention? If not, I have to wonder why you're even thinking about treatment of any kind. Before my ablation, I'd have been delighted to have only two brief arrhythmias in a month.

  • I think treatment options differ slightly in US, it seems to me that US doctors often treat more aggressively than UK Doctors.

  • You are correct CDreamer, some of the doctors jump right on the problem and others take a wait and see approach. I was a little surprised at the two options, and I guess I could have asked that we do nothing, and see how I get along. I went with the EP suggestions and if I thought for a second that I could wish this thing away, I would do it. Thanks for your reply.

  • As I understand it there was two separate events. It feels like a thump in my chest and when I feel my pulse it feels like a skipped beat. As stated the EP, said they last for less than 10 seconds and the heart goes right back into normal rhythm. The HR will get up to 147 bpm I was told but they don't effect me that much. Maybe the thinking here is the sooner they start treatment the better the chances of a good outcome. I guess I have what they call PAF. The heart center I go to is named after my cardio and he has 3 other cardio's and 3 Electrophysiologists working with him. I did not like the idea of medication much either but he gave me the 2 options listed above and wanted to try medication first and if that does not work then ablation. I took my first pill today at 1:00PM, so will see how it goes. BTW are you Afib free now?

  • I took two Propafenone a day for many years, worked well and not many side effects. But, very big but, I had much more extreme symptoms than you. That is a very powerful drug for a few runs of ectopics?

    I was shocked to hear what your EP proposed. I am sorry to be so cynical but I think we know how the big centre was paid for!

  • Thanks Buffafly, I agree with you. It was a surprise to me that he recommended meds. I was thinking it would be a wait and see if it gets worst. I remember the nurse saying something about Atrial tachycardia, with HR 147. From reading on here it appears that AFib does not cure it's self and gets worst over time. How many MG of Propafenone did you take per day. What if the medication does not work and they want to do an ablation. I am not sure that is a bridge I want to cross. Of course all this is new to me and I am still learning. As Bob says knowledge is power, and I need all I can get.

  • I took 300mg a day but I am quite a small person. I had an ablation in Dec because of tachybrady syndrome developing, which meant it was not safe to continue my meds.

  • Hallo

    Like Vira says, I would also first try something natural, and as I can understand there is a standard magnesium blood test and also a "better" magnesium test, ask your Dr about that one or this forum. For many people magnesium alone can cure their Afib.

    I can understand the Dr's point of view, because they say Afib begets Afib, but like Kodaska said maybe your Dr has other concerns or just very careful.

    But if push comes to shove, don't worry too much about an ablation because many of us here have had it and for me it worked wonders and I believe for many others too.

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