flipperdo - I had paroximal (sp) AFIB and was prescribed Propafenone. I did not have an initial monitoring period. I was told that if your heart was in good condition, other than the infrequent AFIB episodes, you didn't need it. I had no problem with Propafenone.

Jim

I'm sure you'll get alot of answers. But Rythmol is related to the Beta Blocker class of drugs for slowing your heart rate. It is considered quite safe,
and no hopitalaztion is needed to start it.

I use proponlol, a beta blocker as a pip. Works great for me.

It was suggested by my EP that I utilize Flecainide as a PIP choice. I was not hospitalized for any testing with this decision. It "is" my understanding however that certain heart rhythm drugs, blood thinners, etc. to be used "long term" do require testing of the patient as it is not a one shot gig like the PIP and the long term build up (half lifes etc.) in one's system - is a different equation.

After my ablation (Oct 27/11) for lone paroxysmal afib did not work I was put on propafenone. ( with no hospitalization to see my reaction). I was on it every 8 hrs and it worked very well in stopping my afib, however, I had such bad cramps, diarrhea, and constipation that my cardiologist took me off it. I was flying down to the States and started with afib just before the flight so on my own took a propafenone as a PIP, it worked in one hour and in one hour and 5 minutes I was having GI tract issues again. I survived a 4 hour flight somehow and the rest of the time was fine. So propafenone works and if you can tolerate it that is great.

Great replies so far! Thanks for sharing your personal experiences with me. From what I've read about propafenone, it seems to be a solid choice for the PIP approach and has a good overall safety record for someone with paroxysmal AFIB with no underlying heart condition. Your replies confirm that information.

Hopefully, the two pills that I carry in my wallet will stay there for several more years!

Flipperdo, first of all welcome. The PIP approach definitely works for some of us and I used it too after first being diagnosed .

Actually I kind of still use it, even tough I had an ablation 9 months ago. You see I still carry Sotalol with me wherever I go , just in case. Superstition, craziness on my part, who knows, Afib seems to remain part of my life, and probably for always.

Wishing you all the best.

Hi Flipperdoodle,
Well, actually, I am surprised that EPs give people hardcore drugs (XXX) like Propafenone and/or Flacainide as PIP (pill in the pocket).

I am not a doctor, but you are 100% correct about this kind of drugs must be given during a hospital stay since they can bring out very bad and sometime fatal afib in some people. Flacainide did it to me. The 2nd day after taking it, I went to the worst afib ever. It lasted 10 hours and I had to go to ER.

The concept of PIP is that it should be a fast acting pill, which brings down the heart rate and should have minimal side effect on your blood pressure.


Way back, one cardio gave me Propranolol, which clears the body within 4 hours. It is an old beta blocker type medicine. It does not affect the blood pressure so much. So, it is great if you have normal blood pressure. Propranolol works for me very well. It brings down the rate within 30 minutes or less and I go to NSR within an hour or so with no side effect.

You have been lucky that Propafenone agreed with you. But, I think it is totally overkill for what you have. I think you should try just a simple rate control medicine like Propranolol or Atenolol rather than a "XXX" rated (hardcore) medicine like Propafenone :-)

Also, if I were you, I would fire both my EP and cardio since they seem to be very careless and overkill in medicine usage. 10 years ago, I fired an EP since he wanted to put me on Sotatol (the same type of drug as Propafenone) at home. That is being careless.

Again, according to a research from AHA about 10 years ago, for miost people, a simple rate control drug is much safer for afib than the drug like Flacainide and Propafenone. Sure, in some people the rate control drug might not be sufficient. In my opinion, in your case, they should try some simple rate control drug first and not to jump into a drug like Propafenone (similarto heavy gun, cruise missiles, B52 bomber). Just my opinion, go easy and simple first.

Food for thoughts.
Scott

flipperdoodle:

If you want to check out your EPs credentials, look on the Heart Rhythm Society's Website:

http://www.hrsonline.org/

On the left, click on "Find a Specialist". You can search by name or location. Look at the letters after his/her name also. It doesn't mean they are perfect, but it is a starting point.

Fellow of the Heart Rhythm Society (FHRS)
The FHRS designation distinguishes qualified Heart Rhythm Society members among health care providers for their specialization in electrophysiology, clarifies the referral process and serves as a credential of quality care for patients, media and government. FHRS members are characterized by advanced training, certification and/or prominence in research.
Certified Cardiac Device Specialist (CCDS)
Physicians earning the CCDS have demonstrated a mastery of competency, knowledge and skills in cardiac pacing. They typically specialize in device therapy and implant pacemakers and ICDs.
Certified Electrophysiology Specialist (CEPS)
Physicians earning the CEPS certification have demonstrated a mastery of competency, knowledge and skills in cardiac electrophysiology. They typically specialize in cardiac arrhythmias, ablation and electrophysiological studies.

petey

Scotty could tZZ has made some interesting points. It's amazing that each of these med.s rhythm or rate etc. effects everyone so differently. Ideally, I guess it would be best to monitor a patient if there is a chance they could have adverse effects with the drug.

I must say that I think it needs to be understood that this whole PIP thingy/gig is certainly not a fix all in every situation or can it be always assumed that it will be. The fact that it has worked so well for many as has been shared here is fantastic. Knock on wood,..... ;)

Click on Propafenone or Rhythmol in our messages: Propafenone belongs to the group of medicines known as antiarrhythmics. It is used to treat abnormal heart rhythms.

Propafenone produces its helpful effects by slowing nerve impulses in the heart and making the heart tissue less sensitive.

There is a chance that propafenone may cause new heart rhythm problems or make worse those that already exist. Since similar medicines have been shown to cause severe problems in some patients, propafenone is only used to treat serious heart rhythm problems. Discuss this possible effect with your doctor.

This medicine is available only with your doctor's prescription.

Common Brand Names:
Rythmol

Rythmol SR

Another website:

You may begin taking propafenone in a hospital so that your doctor can monitor you carefully as your body gets used to the medication. Your doctor may start you on a low dose of propafenone and gradually increase your dose, not more often than once every 5 days.

Propafenone may control your irregular heartbeat, but will not cure it. Continue to take propafenone even if you feel well. Do not stop taking propafenone without talking to your doctor. Your heartbeat may become irregular if you suddenly stop taking propafenone.

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001020/

petey

I take Metoprolol, a beta blocker, and it works fine for me. It does not take me out of afib, but it lowers my heart rate. I've been using it for a yr. and got the OK to use it for the next 6 mos. I consider it safe. I get afib about once a month. Since staying completely away from the wine, the months are getting a bit longer!