PACS

I have been having PACS for 4 or 5 days now. Also, my heart is not beating at a normal rhythm. It is too fast when I am doing very little and then it'll go slower when I am in motion. It is very disconcerting. Any suggestions? I have been careful about low sodium, taking magnesium, potassium and drinking lots of water. Yesterday I took 12 MG of metropolol to see if that helped. But I was reading that a vagal afibbers shouldn't take metropolol. I feel so anxious when this happens which doesn't help things. I just want to get back to feeling good again.

Try Gatorade as opposed to water for hydration. Keep up with the electrolytes.

Speaking as a vagal AFer, yes, beta blockers (such as metoprolol) are not helpful. They aggravate.

And, anxiety = AF = anxiety = AF... You get the picture. Break the cycle. Tough as it is, try to relax. The mind can control the heart just as much as the opposite, sometimes.

I think I am vagal by the description . However, I have only had afib 1 time in the night in bed. I don't get it when I am active. It is so random that it is hard to figure out what the trigger is. Do PACS map your heart like afib does? They stop when I am sleeping and then start up again upon awakening. This has been going on for almost a week. It is starting to wear on me. I have tried everything to try to coach my heart back into normal rhythm.

PACs are normally inconsequential on their own but in us a-fibbers they can be the precursor to an episode. Sort of like the first few popcorn kernels in the popper before it really gets going. They won't remodel your atria just on their own, though.

What is your heart rate? You can take low doses of metoprolol to help slow the HR. I was very vagal and was able to use small amounts of metoprolol (12 mg - 25 mg) during the day to help when the PACs were overly annoying. Of course, we are all different in responses to drugs.

Remember that the PACs... reflect the time between beats... or a shortening of the refractory period and typically, PACs indicate not enough magnesium primarily and then you need optimal potassium to slow the time between beats... once you are optimized in magnesium. That can take some time.

Don't over-do the water intake... about 8 eight-ounce glasses should be more than adequate unless you are perspiring significantly. A bit of sodium is okay as the body needs some; just not the typical high amounts in most packaged, prepared foods.

Consider using a low-sodium V8 type veggie drink as another source of potassium. Organic, if you can find it,

Also avoid Gatorade as it has lots of sugar from bad sources.... and sugar depletes magnesium quickly. Also, it contains way too much sodium and only a minor amount of potassium (65 mg versus 250 sodium)...plus colorings and other unhealthy stuff.

Jackie

Thank you for reminding me about the V8 juice! I was drinking it regularly until recently. I just happened to buy some the other day. I take 10 meq ex r potassium every morning. A 200 mg bisglicinate magnesium and then 150 MG magnesium malate in the evening. Plus 1000 MG of vit d, 100 MG ubiquinol, and coenzyme b-complex with methylfolate . I take these every day. Do you think I am taking enough magnesium? It's hard know when to take it to bowel tolerance as I have IBS anyway.
How do I know if I am vagal or mixed? I read the description in the book, but I can't figure out what my triggers are. The only thing I know is that I usually get afib every 6 months or so for the past 3 years. It takes me about 12 hrs to go back to nsr.
As far as my heart rate with PACs it is hard to get a good read when I am having them. It's more like my heart is hesitating with beats rather than premature beats, as my heart rate will read lower when I am having them.

I have had these PACS daily for 3 weeks now. I have taken magnesium, potassium, drank water, V8 juice, watched my diet. But they are continuing. Nothing I do is helping.

How many per day would you estimate?

You can certainly ask for a low dose anti-arrhythmic if they are particularly bothersome, but that is swinging a large hammer so to speak.

Amy - it can take several months or more to optimize the intracellular magnesium stores that are the foundation that allows potassium to function in helping to normalize the time between heart beats and eliminate the PACs. While everyone is different in the amount of supplemental magnesium that's tolerated, your dose of 350 mg daily is still probably too low. Try increasing more of the bisglycinate as that form carries the least risk of causing bowel issues with higher doses. Space them out throughout the day and always take one dose at bedtime. It's common to tolerate 3 doses of 200 mg. each... but as we've noted, everyone responds differently. Remember that Rx drugs and other chemicals deplete magnesium so that means you need to push the dosage higher. Or, if you have a lot of stress, then you use up the Mg quickly and need more Mg.

Jackie

I have been having PACs every day, all day for over 3 weeks. I would estimate an average of 5 "skipped" beats a minute. But once I go to sleep, they stop and my heart goes into a normal rhythm until I get up.
I had a difficult night trying to get to sleep last night. My heart was beating around 100 bpm and very irregular until about 1 am. I took a magnessium and another potassium, but my heart kept waking me up. I got up and took 1/2 low dose Xanax, which I have for afib attacks. About once every 6 months I have taken it to help me sleep. I was able to get to sleep very quickly after that and slept well for the rest of the night. I have not had any PACS ALL day, for the 1st time in 3 weeks! Maybe it is my nervous system that is out of wack. I am very reluctant to try anti arrhythmic drugs. I would rather go the natural route if I can. I believe that this is something that is a result of a nutritional deficiency or hormonal problems. I am grateful to find this board because it has helped me find the answers I am looking for. I respect Jackie's very informed help, and am taking your advice!