Propafenone/Rhythmol

[redsleek]

So I had been having tons of PVCs and fast beats but no VTs. I got prescribed Propafenone and started taking 1 week ago 2 times a day usually around 8 am/pm along with 12.5mg beta blocker.
Its working fairly great so far. During the day I have no PVCs and able to exercise, run etc..

At night after I take my dose, maybe an hour or so later, I start feeling PVCs. Last couple nights I have been having bad sleep because of PVCs.

Before I was taking the medication, my PVCs would die down at night.

Whats going on?

[is_something_wrong]

The problem with starting two medications at the same time is that you can't know for sure which one is doing what.

Beta blockers usually work well to prevent PVCs/PACs that occur with a rapid heart rate. Those are usually triggered by excess catecholamines and effectively prevented by beta blockers. However, beta blockers may also lower the heart rate and in fact trigger more PVCs / worsen the ones you have with a low heart rate. For example, the selective sinus node inhibitor Ivabradine is infamous for increasing PACs and PVCs, as the heart rate slows but adrenaline effects are the same.

[itdood]

If the PVCs are rate dependent this could be the issue.  In other words, if you get more with a slower or faster rate, that could explain the time of day issue.  

I've been through periods where mine are more active during the day and times where they are more active at night.  The night flares were awful.  

I tried different meds along the way but ended up not taking anything. The results seemed to be similar on meds versus off meds so I could never tell if it was me or the meds, so I gave up on the meds.