Propranolol as a PIP for Paroxysmal Afib

[BigArnie]

Hi folks,

Has anyone tried this approach as an alternative PIP to Flecainide (which I really don't get on with at all)?

Please share any experiences, good or bad!

Many thanks

[BobD Volunteer]

Being a beta blocker, this drug would not normally be prescribed as a PIP.

[BigArnie in reply to BobD]

Hi Bob, as well as being a beta blocker, it also has some Sodium channel blocking effects (class I) and is also delivered quickly into the bloodstream. This would seem to make it potentially a good PIP.

[Hidden]

I was prescribed this to use as when needed, and it worked for me very well. I'll add that was a very long time ago.

[BigArnie in reply to Hidden]

Thank you, can you remember how quickly it used to terminate the episodes?

[lettingoffsteam in reply to BigArnie]

That depended but within half an hour.

[Hidden in reply to BigArnie]

It worked every time in roughly 30 minutes. My symptom was fast heart rate.

[BigArnie in reply to Hidden]

Thanks that sounds promising!

[lettingoffsteam]

My GP prescribed propranolol as a PIP but my cardiologist put me on a regular dose which I'm still on now and which works well for me.

[BigArnie in reply to lettingoffsteam]

Thank you. Did you find that it worked well at terminating episodes when used as a PIP?

[lettingoffsteam in reply to BigArnie]

Yes definitely.

[Jfbould1]

I’m running a “trial” as we speak. So far, I haven’t felt any drawbacks, but then again no significant benefits either vs flec. 100mg usually works but not always. Takes several hours to take effect. So quite similar to flec. Not at all convinced regular dosing of either one is better than no drugs at all in terms of overall stability of NSR day to day, speaking for myself only, of course. But that could be because I’ve entered a new phase of diminished effectiveness for both, which was always on the horizon. I was very stable w flec and then w propafenone earlier last year before trying out amiodarone. That didn’t work at all for me. Haven’t been able to get back to stability with either of the others since.

[BigArnie in reply to Jfbould1]

Interesting. I find that Flec usually works for me between 30 - 120 mins. The problem is it was a disaster as a daily medication and as a PIP it makes me feel bad for a couple of days and also seems to make me more prone to follow up episodes.

[ublong]

I have used Propafenone as a PIP for years. It usually takes about 12 hours (2 doses of 150 mg) to get back to NSR. A Fib or the uninvited guest as my cardiologist calls it raises its ugly head about twice a month.Propafenone makes me feel fatigued and slightly nauseated for a day but it’s manageable. I am taking Eliquis every day.

My first A Fib episode sent me to the ER where

I was given Rythmol/Propafenone intravenously. It took a few hours to get back into NSR. My cardiologist then prescribed it to use as a PIP.

[BigArnie in reply to ublong]

Gosh, 12 hours would not be great for me, but then we all react differently and my episode frequency is greater.

[Clarrie]

I was on Propanolol but when diagnosed with AF taken off of it and put onto Bisoprolol. This didn't help my AF so am now on Sotalol as I could not tolerate Flecainide. I take 140mg of Sotalol twice a day and take an extra one as a PIP when I go into AF.

[BigArnie in reply to Clarrie]

Interesting. I struggle with Flec also and my cardiologist have me Sotalol as an alternative PIP. Thing is he prescribe just 40mg which has no impact whatsoever. I will be talking to him about Propranolol tomorrow and also perhaps about a higher dose of Sotalol.

[Karendeena in reply to Clarrie]

Clarrie does sotalol work for you without side effects? I am on 40mg twice s day, was going well for a month then 'bang' without warning went into fast afib last Saturday which went on until early hours Monday morning when I went back into NSR. I haven't been told I can take an extra one so I will ask the question when I see my EP on 8th Feb.

[Clarrie in reply to Karendeena]

Hi Karendeena

I do not have any side effects with Sotalol but still get episodes of AF every 7-10 days which last up to 36 hours but am able to carry on as normal. I take an extra 80mg of Sotalol when I go into AF which cardiologist told me I could.

[Karendeena in reply to Clarrie]

Hiya, do your episodes make you feel anxious? My heart takes off at a very fast pace and then tends to jump about, going fast and slow but irregular. By the time I go back into NSR I am wiped out

[Clarrie in reply to Karendeena]

I usually wake up from sleeping in AF with a fast heart rate of around 140. I feel it at first but take the extra 80mg of Sotalol and then don't usually feel it unless laying down. I sleep propped up when I have an attack. I now have a pacemaker as was passing out when I went back into NSR and don't have any ill effects at all and can carry on as normal.

[Karendeena in reply to Clarrie]

Thanks Carrie, I haven't been told I can take an extra sotalol when having an attack but I will ask my EP when I see him on 8th Feb. I used to take an extra Flecainide when I was on that, bug found that flec was actually making my episodes more frequent

[Mama48]

I take 40 mg propanolol when I have an AF episode, it generally calms it down within an hour, if it doesn’t I take another 40 mg which does the trick. I am 5 months post an ablation for atrial tachycardia so am hoping that I still need the scar tissue to form! ( have had 3 episodes in last 5 months)

[BigArnie in reply to Mama48]

Thank you, that is another positive one that I would be pretty happy with! Any side effects from the Propanolol? (and do you take anything daily?)

[Mama48 in reply to BigArnie]

No side effects felt. I am on rivaroxaban daily, I don’t take anything else for my AF.

[Visacrem]

Forgive me but im a newcomer with Afib. Please what does PIP stand for or mean.Thank you.

[baba in reply to Visacrem]

PIP= "Pill in pocket"

Medication taken only as required rather that regularly.

healthunlocked.com/afassoci...

[Visacrem in reply to baba]

Thank you baba, feel so silly now but I even done an Internet search. Much appreciated.

[baba in reply to Visacrem]

No need to feel silly.

I hate abbreviations.

You will get to know the ones regularly used on the forum.

It seems to be an "AF thing."

As required medication is more commonly prescribed as PRN.

PRN= The PRN prescription stands for 'pro re nata,' which means that the administration of medication is not scheduled, instead, the prescription is taken as needed.