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Stopping antiarrhythmics prior to ablation?

9 Replies

I've been told that I should stop my propafenone a few days prior to ablation. As I am getting breakthrough AF for an hour or so every few days whilst on the medication I was concerned about this plan, so the nurse I spoke with said that I could take the smallest amount I could manage with.

I don't want to risk being in AF for a couple of days by stopping medication because that will just encourage further AF. On the other hand I don't want to do anything that might work against a successful ablation.

I'm interested to know what advice about stopping or reducing anti-arrhythmic drugs pre-ablation was given to other folk, and if any reason was given.

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9 Replies
wilsond profile image
wilsond

You have to stop antiarryhmic drugs completely for a period beforehand,so that the full effect of them has gone before the ablation, otherwise the team can't track the source of the problem as well. You need to give them the best 'view' possible for the best result. A few days of AF is unpleasant I know but worth it.

Jalia profile image
Jalia

I went into fast AF on the morning of an ablation . Obviously helps EP to see where the problem lies!

JeanetteH profile image
JeanetteH in reply to Jalia

Yes I went into AF on the motning of the ablation but it went off before I got to the hospital.

Buffafly profile image
Buffafly

I had to stop Propafenone before my ablation.

Hilianna profile image
Hilianna

I am having a catheter ablation on Wednesday 3rd May and have been told to continue with my anti-coagulant. It was actually emphasized that I follow this advice because I thought it would have been better to stop it! Like a good patient I have followed their advice but am somewhat confused now after reading your post..........

in reply to Hilianna

My understanding is that anti-coagulants are generally continued up to the day of ablation as it's been shown that this is beneficial.

I've got to stop my anti-arrhythmics 3 days before the procedure, but I am to continue to take my apixaban (anti-coagulant) until the day of the procedure, and to remain on it for at least 3 months post-procedure.

mjames1 profile image
mjames1

It varies per ep and what type of ablation they are doing. I was told to only hold flecainide and thinner the morning of the procedure. Then continue on with both per regular schedule until ep says stop. I would do what they say because this is what apparently works best for your ep. I would ask, however, what to do if I go into afib prior. Do I try to convert with propafenone at home or do I just lower my rate with a rate drug and show up in afib.

Jim

Cookie24 profile image
Cookie24

I had your concerns about stopping Propafenone before ablation. I was in and out of atypicalflutter and afib. I followed the instructions and stopped. Ironically, I was in sinus rhythm going into the OR.

Hilianna profile image
Hilianna

I have read a bit of the blurb on one of the web sites. They mention that it depends on the nature of the ablation and which anti-coagulant you are taking. Also, of interest, it advised that it is a good idea to be on an anticoagulant during and after the procedure, because that is the time when you are most likely to go into a fib. Something to think about. x

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