My partner has AF and was on a daily dose of bisoprolol 5mg, amiodarone 200mg, aspirin 75mg and allopurinol for gout. Last week, the specialist has taken him off the amiodarone because he has been on it too long, and is now talking about putting him on propafenone if the AF recurs, or AF ablation.
We see the specialist next week and just wanted any feedback on the drug and what sort of questions we should be asking during the consultation.
Thanks.
JayEm
I have been taking Propafenone for quite a while now. I think it is a great idea to get them off of amiodarone. It is probably the best drug available for AF but has the worst side effects for long term use. Propafenone (Rythmol) has worked well for me but about 4 or 5 months ago started getting less and less effective. I have read from many others and was told by my EP that most who have AF will go from drug to drug over the years. I was told that the average life span of a drugs effectiveness for AF was 2 to 3 years So I chose to have the ablation done 6 weeks ago instead of switching to another drug. It was the best choice I have ever made. Most people get very nervous when told about the ablation (I was one of them) but after having the procedure I would do it again if it was needed. I just went to sleep and when I woke up it was over. I was pretty tired for a few weeks but other than that had no real pain or discomfort. I had a few attacks the first 3 weeks after the ablation but they were so mild that I wasn't sure if I was even having them (my normal AF attacks were always pretty severe). Since then I either haven't had any attacks OR they are so mild that I can't tell they are happening. It normally takes about 3 to 4 months for the scar material to build up and stop the attacks but I saw immediate results..
You stated "if the AF recurs".. It will... AF doesn't go away and no drug will cure it, drugs can only hold it off. When you stop the drug the AF will return. And the longer you have AF, the worse it gets and will happen more often. Also the longer you have it, The less chance that a surgical procedure (ablation, maze, mini maze, cox maze and others) can cure it.
Is your specialist an EP? Ask them the length of time that they expect the propafenone to work and then what they will do after that time. Ask them what they believe the outcome of an ablation would be. My EP went over all of the options and gave me an idea of the future with each. In the end it looked like everything would eventually lead back to a surgical procedure and the longer I waited the less chance it would work.
Search, Read, Learn and educate yourself on this condition and treatments and the choices will become easier.
Tim
Thanks for this, Tim, and to everyone else for their input. We had our appointment and asked the questions you suggested. We now have to do some thinking and make some decisions.
The problem is whether or not to have the ablation. The specialist has suggested that this is where we are leading. It's just that reading the accounts of some of the contributors to this page, we wonder whether my partner is bad enough to warrant it. It may well be that the amiodarone has masked the symptoms, but he has led a normal life since diagnosis with few, if any, problems. Given that the condition is progressive, and from what I have gathered, ablation has the best outcome in the early stages when the heart if fit and healthy, we are debating whether to go ahead with the ablation anyway before there is any deterioration. When he was with the consultant, they did an ECG and his heart rate was up.
Any further views would be much appreciated.
JayEm
Same here JayEm. I have had AF for a little over a year. I also got ablation on 3/25. Went very well, NO pain at all. Same as Tim. Some tiredness, but doing great. No episodes of afib since Thank God!!!! Of course like he said it takes 3 mo to know the full outcome but the experience for me was good. My EP also explained this is a progressive problem so I went ahead as well and got it done. Good luck to you both and I will be praying for you.
Tim- it's good to hear your still doing well. Yay. Your in my prayers as well!!!
Naomi
I agree with most of what Tim has said but add the following. The drugs do not loose effectiveness as such, It is the AF getting more common(worse) that is the problem. There are no receptors for these drugs in the way that an addictive drug has so the body can't "get used to it". I was on propafanone for about three years whilst going through my three ablations and it did help considerably and I know of a number of people post ablation who take it to control ectopics but ablation would be my first choice any time.
I must also point out that aspirin has little value in stroke prevention for patients with AF whilst retaining the ability to cause harm in the form of gastric bleeding. .( Prof Gregory LIp and others) . It is amazing the number of doctors who are not up to speed on this and still prescribe it. Proper anticoagulation by warfarin or one of the more modern anticoagulants is essential if you have any raised stroke risk under the Chads2 or Chasd2Vasc2 charts.
Bob
Permanent AF can be reversed by cardioversion, mine was in my 70's. I'd been in AF for over a year when it worked for me. Still taking flecainide and aspirin though.
I have had AF for the last 5 Years, after 4 Carioversion my Consult has recomended a pace maker
I am on warfrin, biosofenel, amiodrone and ( candisarten ( Blood Presure Teblet ))
does anyonoe have any doubts about a pacemaker
Grateful for any Feedback on PVI Ablation Please
AV Node ablation, I've read that much I am lost on the benefit
Curing AF naturally?
Amiodarone
Dronedarone 
