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Avatar universal

afib in teen

My 17yr son was dx with lone afib last year.  He was converted electrically then went back into afib a week later. He then ended up on propafenone which he stayed on for 8 months. During the first 4 months or so he had many ectopic beats-pacs which he felt.  He stayed on the propafenone during basketball season, then came off.(he had no episodes of afib during this time)...After he came off, he continued to have ectopic beats freq. but no afib until 2 weeks later.  He was put back on propafenoneand converted after 2 doses.  We took him off and he had no afib until 2 weeks later.  Back on prop and converted after 2 doses...At this point he is off the med, has had no afib for 6 weeks, his pacs he hasnt felt at all and his 24hr monitor only showed about 12ectopic beats and no afib. His cardiologist at first wanted him back on the propafenone because of going back into afib twice within 2 weeks of each other butwe discussed leaving him off and seeing what happens.  I'm glad we did because I hate to see him on this drug for a long period of time and seeing that he knows when he's in afib he's able to be treated within the 48hr window if he doesnt convert.
My questions are: (1) If having been on propafenone for 8 months without proarrythmia effects, is it safe to just use it to reconvert as needed outpatient?  My concern arises from the fact that he is going away to college ( only 2 hrs away fom home)
(2)How many times and within what period of time of going back into afib would you think it necessary to be put on propafenone continously? Thank you.
1 Responses
Avatar universal
Dear ozark,
There are many doctors who advocate the "pill-in-the-pocket" approach to treating paroxysmal atrial fibrillation in someone with lone afib. What this means is that the person does not take any regular medications but when they have an afib episode they can take a prearranged drug that they carry with them.  If they fail to convert after a few doses then they can get an early cardioversion.   This approach does work in many, but not all,individuals. It is best in persons with lone afib (no underlying heart disease) and infrequent episodes of afib. Propafenone is usually safe to restart as an outpatient in someone who has already had previous loading without problems.  As to whether this is the best approach for him, his doctor would have to make the final decision.

The number of episodes of afib he has that would warrant continuous medication is really a judgement call.  In my opinion if you are getting 1 or more episodes a month then you need regular medications or consideration for an ablation procedure.
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