Afib for 4 days

I’ve had paroxysmal Afib for 8 years, typically it lasts for no longer than 24 hours. In the last month I’ve had one episode that lasted 3 days, and am current having an episode that has been going on for 4 days. The on call dr. has told me as long as long as my hr is under 100 bpm, I should ride it out at home. I’ve never had an episode this long am wondering if you have any advice/tips?
I’m on metoprolol and Eliquis.

Thank you!

I'm no expert, but, AFAIK, your Dr is right... if you're OK while in afib. Taking a blood thinner and a betablocker puts you in the "rate control" strategy, which is not necessarily bad. Many afibbers are fine like that and live a long life.
Nevertheless, there are other conditions you don't mention : global health state, age, other problems, how you are while in afib, and so on... All this may one say it's better or not trying to keep you in NSR.

If you do not have structural heart disease, perhaps talking to a doc about a prescription for flecainide or propafenone on demand to convert. [pubmed.ncbi.nlm.nih.gov]

Thank you so much for the information!

George is 100%....and i say it is NEVER OK being in AFIB for any longer then it can be stopped + Flec or Propafenone can usually KO Afib in less then 3 hours from the start although in your case i am not sure being ongoing for so long but hopefully if you get 1 of those drugs it will stop it soon because with me the longer i let AFIB run on the harder it was to stop it...i called it my runaway train so i had to stop it before it got too much MO. Chewing a 150mg pill of Propafenone did it for me...80 out of 80 times before my suc. Ablation in 2018...it was my miracle drug CHEWED that is not swallowed as that gave me mixed results....on ave. a 1 hour conversion chewed + never more then 1:45 min. which happened about 3 times in 80 chewed events.

What is your HR as you read this by the way aprox. by taking you pulse for about 15 -30 seconds?

GL



Edited 3 time(s). Last edit at 07/25/2022 02:37PM by vanlith.

AFAIK AFIB begets AFIB. It only gets worse as time goes on.

Quote
PavanPharter
AFAIK AFIB begets AFIB. It only gets worse as time goes on.

Yeah. Usually.
It seems it's what's happening in the OP's case.
Taking rhythm meds may be efficient... for some time.
The rhythm drugs often have bad side effects.
Then comes the ablation way...
IMO, the most crucial thing is to know "how is the patient while in afib", before taking other potentially dangerous drugs.

My hr fluctuates from the 70’s to low 110. It’s been almost 6 days. Dr said if I don’t convert, I will have to go in for a TEE and then cardio version.
I have never been offered flecanaide as pill in the pocket, only offered it for daily usage.
I have many sensitivities and flecanide was very harsh.
Has anyone had a TEE?

Dini....Try the Propafenone if you don't want to try the Flec.
Try something to get back to NSR so you don't need a TEE then CV.
As stated earlier Propafenone was my Can't miss miracle drug...i cannot say enough good about it...CHEWED that is...try it as it may turn out to be yours also until you get your much needed Ablation before you become persistent or perm. possibly.
I will tell quickly how i got introduced to Propafenone as it is similar to your current situation....i went to the hosp. in 2015 because i was in AFIB for just under 48 hours at that point but i told them i was only 36 hours cause i did not want to be sent home + take Blood thinners for a month then come back + CV if i was still in AFIB because that episode was my worst ever..... so they tried Cardioverting me 2 times in around 10 hours or so with no other drugs involved other then fentinol to put me just barely under + both failed other then converting me for 2 minutes they said as i was out then i went back in so they gave up + were ready to send me home + just before i was going home they offered me a drug called Propafenone so i said hell YA i will try it....so i got 2x150mg pills swallowed at that point + in EXACTLY 1 hour of the most stubborn AFIB attack i had ever had that was around 60 hours long at that point I could feel my heart kind of in a tug of war for about a minute of my HR increasing + the AFIB intensity got worse + seconds of NSR also back + forth then BOOM nothing but NSR....smooth sailing as i left the hosp. about 15 min. later on top of the world + that Drug not only helped me incred. well until i finally became whole with an ABLATION 3 years later but from the neck up i cannot tell how much peace of mind i got also knowing i have (for me) a better then hosp. treatment sitting in my med. cab.

Ask your doc. for Propafenone 150mg.

GL

Quote
Dini
Has anyone had a TEE?

Many of us have. I've had 4 or 5, maybe 6 TEEs (lost count) and 15-20 cardioversions. If they put you under temporarily using propofol, it's really a nothing procedure. Most of your time will be spent being bored waiting for doctors to show up. Then when they do they'll knock you out for a few minutes, do the TEE then the cardioversion, and you'll wake up and be clear-headed minutes later. There should be no pain, no nausea, no side effects of any sort other than maybe a mild sore throat from the TEE, and maybe some skin irritation from the cardioversion pads. There are never guarantees, of course, but that's how it usually happens.

But you should ask them in advance how they're going to do it. If they plan to just have you gargle a numbing agent and do the TEE or the cardioversion while you're awake, I would refuse if I were you. It will change from a nothing procedure to a decidedly unpleasant procedure. I've never had one done that way, but I've heard enough from others who have that I would simply refuse that procedure. There's just no good reason for doing it awake other than saving (them) money.

I just had my tee today for my 6 month watchman check. It was quick. Same anesthesiologist as my ablations. They had me bite onto a plastic donut for the camera and I quickly went down with only 10mg propofol within seconds and awoken minutes later clear mind waiting the hour to go home. No sore throat, it was easy peezy. Plus I was hydrated because I asked for a liter of saline because it was a hot day and I was running around afterwards all morning. You can’t drive for 24 hours. That was my only restriction.

Propafenone is the same class of rhythm drug as flecainide, with some slight bb properties.
If flecainide does not work or has unbearable side effects, it'll likely be the same with propafenone.

Quote
Pompon
Propafenone is the same class of rhythm drug as flecainide, with some slight bb properties.
If flecainide does not work or has unbearable side effects, it'll likely be the same with propafenone.

Yep, I agree with this.

Could be guys about Propafenone but it is worth a try for him...i never had any side effects mainly because i never took very much of it to get the desired effects....that's the beauty of chewing 150mg pill or even swallowing 2x150mg every 3 days or so to KO an episode as it comes along.
Everyone is different so i would try it if i was him + if he did not like it he can stop....without trying he will never know.

Thank you for all the information. I converted 30 mins after taking diltiazem on day 5 of afib. I will definitely talk to my dr about
Propafenone.