more AF episodes

I have been getting more AF episodes, it was always easy to know when I was in AF, now it is more difficult, at times I can tell but when sitting down and resting it doesn't feel like it. I have a pacer and sent in my pacer results this afternoon, I called for the results and was told that I was in AF now and at least 3 times since the 9th of Nov. but they said I am in it off and on and they also said that my pacer may be under reporting. We spoke about blood thinners and they want me to get my blood drawn to determine about taking a blood thinner, my blood platelets are a little before the low end of the scale, so they will send a script to where I am to get my blood drawn. I guess I have come to the end of the road and will have to consider taking the dreaded blood thinner.

I also was told not to take my pill in the pocket (Propafenone) as taking it while in AF could cause a stroke----now isn't that something, we talk about a "pill in a pocket" on this site, who is right?

Liz

"I also was told not to take my pill in the pocket (Propafenone) as taking it while in AF could cause a stroke----now isn't that something, we talk about a "pill in a pocket" on this site, who is right? "

This issue of not taking an Anti-Arrythmic (PIP or not) to try to convert of of AFIB, for fear of causing a Stroke, has come up several times in the last several years. Physician Liability concerns may be at play here. To be 100% safe one would only take an AAM, <48 hours from AFIB onset, or after a TEE was performed to check the Atria for Clots. Personally this notion didn't stop me from trying AAM (PIP), because I know I am very low risk for getting a Clot, and I have had about 20 TEE's done over the years, and there was never a Clot present. It would depend on if you thought you were at high risk of Clot formation.

The thing is you probably will convert out on your own anyway sooner or later, so that risk would still be there, and the longer your in AFIB, the greater the risk of getting a Clot.

Anti-Fib is right. It's not that propafenone could cause a stroke directly but rather that it will put you back in normal rhythm, and that's when any clot that has formed in your left atrium would be pumped out. It's the same reason they won't cardiovert people who've been in afib for 48+ hours without doing a TEE first.

As he pointed out, you'll probably convert on your own eventually anyway, so their caution is a little strange. I have to agree there's probably some defensive medicine going on there because if they were really serious about stroke risk, they would do a TEE or just start you on an anticoagulant immediately.

Since you weren't even aware of how often you're in afib, it's apparently asymptomatic for you. So I think you're right that you've hit the end of the road and need to start an anticoagulant. Silent afib is how people end up with strokes because they don't realize how much they're in afib and it's more than they think. And although I think their concerns are overblown, since it is asymptomatic I'd probably do as they say and skip the propafenone until you've been on an anticoagulant for 3 weeks, which is the usual length of time it takes for clots to be dissolved by the body.

Thanks Antifib and Carey:

I have always taken an extra Propafenone when I was in AF it has been about 20 years that I have been doing this. I am concerned that I am not sure when I am in AF, I know that something isn't right, but I thought that I was getting some PVCs.

Liz

Fortunately, your pacemaker will give you the facts no matter what you feel (or don't feel). You're very lucky to have gotten by for 20 years with nothing more than propafenone. Few of us go that long before afib turns ugly and exceeds the drug's ability to control it.

Do you know what blood test they're doing? There isn't usually any sort of testing required for NOACs.

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Elizabeth
I have always taken an extra Propafenone when I was in AF it has been about 20 years that I have been doing this.

Clarifying Liz, you take Propafenone on a daily basis to stay in NSR, then take an extra Propafenone when you are in afib to help you convert?

I believe Propafenone has beta blocking characteristics. Wondered if you felt (at least previously when you knew you were in afib) if your triggers were vagal or adrenergic?

Best,

George

George:

I used to take one tab. of Propafenone (150 mg.) on a regular basis until the last 6 months--taking an extra 1/2 tab. of Propafenone when I got AF made my heart rate strange like it was struggling to beat and I felt weak, I just quit taking the Propafenone everyday. However when I got AF (which was usually at night vagal, ), I would take 1 tab. and go to bed, the one didn't bother me, why the extra 1/2 did I don't know, but in the last six months I took Propafenone only when I got AF.

Liz

Carey:

Yes, they are checking the Creatinine and Bun--and I also have low platelets.

Liz

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Elizabeth
Yes, they are checking the Creatinine and Bun--and I also have low platelets.

They're checking your kidney function before prescribing an anticoagulant. Sounds like you've got good doctors.

Liz, since you are vagal (and the BB properties of Propafenone), wondering if flec might be a better med to try chronically once you get the anti-coagulant situation sorted.

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GeorgeN
Liz, since you are vagal (and the BB properties of Propafenone), wondering if flec might be a better med to try chronically once you get the anti-coagulant situation sorted.

BB properties of Propafenone do exist, but they are low. About 1/20th of metoprolol. Flec is almost always RX’ed with a beta because of the flutter risk,

I took Propafenone (Rhythmol) for months without a beta and suffered no ill side effects - other than AF which “broke through” the Propafenone annoyingly often.