hi guys
So the dr has taken me off propafenone after being on for a few years and doing well with episodes being around 9 months apart. Started me on multaq and now episodes every 3 weeks, actually in af now for second day. My INR is 2.3 so can I wait until 7 days before going for the dreaded cardioversion? Propafenone was stopped because even though calcium score was 0 there was a blockage in RHS coronary artery that he said was stable and didn’t want to touch. Advice appreciated folks thanks
Hi,
I was always under the impression an INR reading ( of any value ) was related to a patient taking Warfarin ( Coumadin ). Might be wrong of course but as a previous long term Warfarin user that's what I was always told. Didn't know it applied to other drugs.
So, are you also taking Warfarin ?
Hi, yes I am on warfarin. Dr says I couldn’t continue the propafenone because of the blockage in coronary artery. The question I’m asking is I am now on day 3 in af and really don’t want to have to get cardioversion . Is it ok to leave it for 7 days to see if I self convert before going to hospital. And am I safe with my INR being 2.3 due to me being on warfarin?
I am not on, nor have I ever been prescribed propafenone, so can't comment on that. Back in the days when I was using Warfarin I had to have a number of surgical proceedures at different times. The most challenging was knee replacement surgery. I was told to stop Warfarin 6 days before surgery. It took me all of the 6 days to get my INR from around 2.7 down to an INR of 1.9 ( about that normal non Warfarin patient ). As soon as I was awake back in my room I was given two doses of Fragmin ( a bridging anticoagulant ) then at my normal time in the evening I resumed Warfarin. No problems at all.
Thinking back over the years I've been on this forum I cannot say that I've ever read where a cardioversion has lasted permanently. Not sure if that helps re Warfarin and INR. I would have expected your INR Clinic to be offering the correct advice.
I was placed on Propafenone after my third ablation which was almost four years ago. I am still taking it 150mg x 2. I am confused why you were changed to Multag since both drugs have issues in taking. In research, I found there are six anti -arrhythmic drugs, so there were others to choose from. Multag is not doing a good job if you have episodes every three weeks compared to Propafenone, plus if you have to have a cardioversion, you have even gone persistent or believe you are going persistent. I also don't get the question you are asking.
Hi, dr said I couldn’t be on propafenone now because they found a blockage in right coronary artery and said multaq would be safer. Day 3 now in af and don’t know what to do
Call 111
"Safer" is a general term. I would ask what it means in this situation. Are you dealing with a cardiologist or an EP?
My cryo lasted only a few months then I ended up with an RF. My EP contact me right away when my Monitor let them know I was out of rhythm again and I was back within days. The RF lasted a year before I needed more. I was on multaq for a couple of years without incident. I was put on it immediately even before the diagnosis along with my anticoagulant.
let the doctor know maybe it just needs to be readjusted then again happy for you There are many others to pick from. We are all different
as far as cardioversion mine lasted 3 1/2 weeks It was wonderful while it lasted. They put me right in for another one with plans to keep me and put me on tikisin ? Sp they had complete failure and then some everything else was canceled They are limited to three attempts during one and they all failed
Less than two months later, I got a pacemaker, best thing that ever happened so if that day ever comes, don’t be afraid
After my ablation, I started on Multaq and about 4 days later went back into AFIB. I had to have a cardioversion to return to normal sinus rhythm. This is the only time a cardioversion worked for more than a few days. I think it was because of the Multaq. Multaq works better if it has been in your system for a few days, and you achieve NSR.
Multaq also does not work for everyone. But it also has the least amount of side effects. This is probably why it was chosen to start with. Give it some time and try a cardioversion if needed. But also inquire about other options for your situation. Unfortunately there is no one thing that works for everyone.
thankyou, I’m now at day 3 in af with a hr below 90 so should I wait until the 7 days are up to see if it reverts on its own or should I go for cardioversion before the 7 days are up? Thanks
So I am not a doctor, but if your rate is controlled below 90 and on anticoagulants it should be alright to wait. With that said, my EP would prefer me to go in at 3–4 days or if I hit an HR of 130 for a few hours. For reference, I am in the US. I have persistent AF with RVR and I usually try to wait it out. But my rule of thumb is if the burden reaches a point I am truly miserable and fell fed up, I will go to the ER or at least call my EP for more guidance. Managing AFIB and the stuff that comes along with it is tricky at the best of times. My personal advice is to do what you think is best for you. I asked for clear guidance from my EP and try to follow it as best I can. But if I feel alright overall I will wait a little longer, or If I feel too bad I will go sooner.
Our circumstances are a bit different as I had Paroxysmal AF & a multifocal atrial tachycardia. I was given Multaq initially & converted in a couple days. However once at home another few days it kicked up again. When I didn't self convert my EP cardio added ranolazine. He told me we would know in 20 mins. if it would work & almost to the minute I converted. That ranolazine made a world of difference.
To answer your question about how long to wait, according to my doc it really does depend on how you feel. If you are feeling chest pain, shortness of breath, feeling faint etc then by all means go to your ER. I agree your care should be managed by an EP cardio. Perhaps you can start looking for one now, regardless if you decide to ride this out at home or not, they will give you a better treatment plan. Good Luck !
Hi, thanks for reply, at present I’m taking 400mg of multaq x 2 per day, 2.5mg bisoporol 1 x per day and 7mg of warfarin pd. it normally converts after about 6/9 hours but this time I’m now in my 4th day. HR is below 90 at rest and sometimes as low as 60. When I start moving around it will jump to 100/105 but that’s about as high as it gets. I’m under the care of a cadiologist /ep so he just says if you need to get back to sinus just go to your A&E. failed ablation due to not being able to get a route to the heart due to anatomical variant so he tells me the only other way is open heart surgery something I’m not wanting if I can avoid. I’m in Northern Ireland so technology and options are limited. As you know it’s just a pain and I know it won’t kill me but just so annoying and upsetting your life. Thanks for listening
Multaq Side Effects
multaq
Propafenone 325
