Experience with discontinuing 1-C ant... - Atrial Fibrillati...

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Experience with discontinuing 1-C antiarrhythmics (flecainide or propafenone)

frazeej profile image
7 Replies

After 2+ years of therapy, because of recently discovered structural damage to my heart, I have been advised to discontinue my propafenone. I am not happy with this as the control of my afib has been very good. I have lost 37lb (>15% body weight) and hope that will benefit my previous afib burden.

Anyone’s experience would be helpful, as regards a slow taper or sudden cessation of the propafenone, or any other 1-C antiarrhythmic.

JimF

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BobD profile image
BobDVolunteer

I took several weeks to taper off propafanone but I was on very high dose.

mav7 profile image
mav7

Best to consult with your doctor and follow his guidance for withdrawal.

wilsond profile image
wilsond

I was told by a well meaning GP to stop Flecanide overnight so I could be given medication for back pain. Straight into AF( damn annoying as had been in nsr for 8 months past ablation) at the weekend ,naturally. My EP who I contacted in the Monday,was aghast. Never to suddenly stop flecanide, and other similar drugs !

So my advice is to taper off gradually, following your medics advice, is best.

What is the plan to control your AF if not these anti arrhythmia meds?

frazeej profile image
frazeej in reply towilsond

The taper down hasn’t gone well as afib was back for 4 hours today, so back to original dosing. Think the back up plan is Tykosin, as my cardio guy is apparently in love with it. Downside is 3 days in a crappy hospital while they play with the dosing. I would prefer low dose amiodarone, but I think I would have to change doctors for that.

opal11uk profile image
opal11uk

Went from Disopyramide to Propanolol and no problem thankfully

secondtry profile image
secondtry

I would ask your trusted medic but in your shoes he/she would have to come up with a very strong argument against a slow taper off for me to follow their advice.

cuore profile image
cuore

I also take Propafenone and did try to come off of it after a year of an ablation by tapering for a few weeks only. It didn't work for me ,and I went into persistent for 49 days before converting to NRS. So I am still taking Propafenone, four years after the ablation (my third) because I can get bouts of AF.

I could not find any research on tapering despite my extensive research. But, I believe it's the book "The AF Cure" which mentions a 6 month period. I interpret that to be reduce a little for 6 months, then reduce again for another 6 months until stopping. Disclaimer: this is my interpretation of what I read.

That time period is in the back of my mind, but have not tried it because I do get short bouts of AF at times. I intend to bring it up with my EP whether I can try that and use the Propafenone as a PIP after tapering to zero.

Do let me know if you find any research on tapering other than the above.

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According to EP JOHN MANDROLA, MD "AF-rhythm drugs (propafenone, flecainide for example) often make atrial flutter worse."

http://www.drjohnm.org/2013/08/atrial-flutter-15-facts-you-may-want-to-know/ "11. Rhythm control...

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