New guy here.

I am new to the forum and so far have found it to be incredibly informative.
Talked to Shannon for over an hour. Great guy with a lot of info and very very helpful. Helped me get logged in to the forum.

Here is my story and I do have questions.
I just turned 60 and a Captain with Delta Airlines. I woke up at 1pm with a fast heart rate and very irregular heartbeat. At 2pm, my wife called the EMT’s and I spent the night in the hospital with afib. I was scheduled for Cardiac inversion, however I converted back to a normal sinus rhythm and it was cancelled. I had no secondary symptoms at all. I was put on Cardium and Eloquis. When I left the hospital, they put me on Cartia XT 180mg (daily) and Eloquis 5mg (twice a day). I am now with an Electocardiologist here in Norfolk, VA. I am med down from flying until I get this worked out.
Now for my back history. I was very athletic and a pilot in the Navy. I was a long distant swimmer and at my peak swimming over 10 miles a day. In the Navy, I swam when I could, once or twice a week, but I ran a minimum of 4 miles a day. I was in great shape. I had occasional PVC’s, but not many at all. Doctor’s said it was because of my conditioning. I was hired by Northwest Airlines in 1997 and I got out of the workout ethic. (Hated tread mills.) I gained weight and now probably 40 lbs overweight. I can still go out and run 6 miles under an hour and feel good. I am a drinker and drank heavily with my buddies and friends. I have cut out the drinking now, maybe 2-3 Miller Lites a week for the past year.
Three years ago, I had a heart incident, where my heart rate got to 180 ppm for three hours. During the day, I played golf (walking and carrying my bag), only drank diet cokes, no water. Got home laid by the pool, still no water, then went drinking with friends from 5 to 10 pm. I drank a lot. Did not eat at all until 10pm and that’s when it started. My wife called the EMT’s and I recovered at home with a vagal maneuver. I still went to the hospital as a precaution. I was med down from flying for three months and it was determined I was severely dehydrated. During my stay at the hospital, they said I did have some afib from my episode.
So, here I am. I find now when I go out and try to work out, I have a feeling of my chest constricting and I have to walk. I never had this feeling before my hospital stay. During the last three months when carrying my bag upstairs, I did feel my heart skip a few beats. I went to the electrocardiologist and did a 24 hour halter and an echo-stress test. I do not have the halter results back yet, and the echo-stress test was not great. I did finish the test, but I had PVC’s. A lot of PVC’s. I had no afib, but I went into bigymane (not sure how to spell it), which means a PVC every other heartbeat. I assume this is what is causing the chest to feel a little constricted when I work out. I went on line that day and found your forum, which has been very helpful. However, I still have a lot of questions. The Electrocardiologist has not called me back yet and my next appointment is a month away. I feel no unusual heart beats and other than not working out, feel great.
Here are my questions. I know we are not doctors, but we are all from the school of hard knocks, so anything will be helpful.
1. Is it normal to take a month to see the cardiologist again? Sounds like he has a busy schedule.
2. I am now on Cartia Xt, a calcium inhibitor, and Eloquis, could this cause my PVC’s? Idid not have them before my afib episode.
3. I do not have afib, other than this one episode; do I need to be on any medication? I will still do what my doctor wants, but I want to arm myself with a lot of facts.
4. In the previous question, can I just have a PIP (Pill in Pocket)?
5. It was recommended to see Dr. Natale in Austin by this forum, does he have a busy schedule and should I see him?
I still have a lot of questions, but these are the most important to me. I will get around asking more later. I am on a tight time line to get back up and flying. I will only fly when fit to do so. Thank you all for listening to my story. I know many of you have stories as well. I do realize you are not doctors. As a Captain, you take everyone’s input and make your best decision on those inputs. I would love everyone’s input, on my situation, so when I go to the electocardiologist, I can make an informed decision on my health.
Thanks again for your help.

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Bileswil
1. Is it normal to take a month to see the cardiologist again? Sounds like he has a busy schedule.

Unfortunately, yes.

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2. I am now on Cartia Xt, a calcium inhibitor, and Eloquis, could this cause my PVC’s? Idid not have them before my afib episode.

No, they're not the cause. The Cartia (generic name diltiazem) is a calcium channel blocker. It will slow your heart rate, and keep the rate lower if you do have another episode. Eliquis is an anticoagulant to prevent strokes. That's absolutely vital and don't even think of stopping it without consulting with your EP first.

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3. I do not have afib, other than this one episode; do I need to be on any medication? I will still do what my doctor wants, but I want to arm myself with a lot of facts.

Maybe you don't have afib and that episode was solely due to the dehydration and alcohol (lookup "holiday heart syndrome"). Time will tell. Afib is often paroxysmal, which means it comes and goes. So it will take a while to find out if paroxysmal afib is what you have. Personally, I wouldn't take the Cartia until/unless I had another episode (PIP).

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4. In the previous question, can I just have a PIP (Pill in Pocket)?

:-) Yes, see above. There is nothing life-saving about Cartia. If an episode happens, take a full dose immediately. That will keep the rate down, which will make the episode less unpleasant. Some doctors think it helps end the episode earlier, but I don't believe that.

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5. It was recommended to see Dr. Natale in Austin by this forum, does he have a busy schedule and should I see him?

Busy as hell. Somebody on another forum I follow (stopafib.org) just made an appointment with him and it's not until May. But at this point I wouldn't fly cross country to see a top-notch EP when you're not even sure if you actually have afib.

Incidentally, there's a guy on stopafib who's also a commercial pilot and he's been grounded for his afib too, but I believe he's back to flying now following a successful ablation.



Edited 2 time(s). Last edit at 02/05/2018 08:59PM by Carey.

If I recall correctly, 6 months of clean rhythm following an ablation is solid gold as far as the FAA goes. I’m not a pilot and haven’t flown anything other than a Cessna 152 lawn dart in years but I do work with a guy who flies gas tanks for the AF reserve and also has a cardiologist (different reason) and we were looking it up just for grins.

Hydration is everything, as you’ve discovered. I get lots of ectopics when I’m low on fluids (I’m a runner) so I can relate. Commercial aircraft cabin pressures are, what, 8000 ft? Dry as a desert, too. Personally, I like low sodium V8 followed by Waller Water (search this forum) as a hydration scheme. Better than Gatorade which has too much sugar and repulsive food dyes.

Bileswil,
Welcome, sorry for your recent incident.
I can relate unfortunately mine started a lot earlier in age. I'll try and help with my thoughts
1. If you get in in a month you are doing great. Go to an EP that has some experience!! And do not do an ablation unless it is a proven EP with bunches of cases!
2. Don't know much about Cartia. Eliquis will not cause Pvcs. I will say that when the heart is slowed too much I've been told by my cardiologist it invites ectopics. My OPINION is that it is possible. It may not be the med for you
3. Man I'm not sure you need to have meds yet. Maybe discuss you want like a flecainide PIP in case it happens again in lieu of meds now.
4. Ref 4
5. Dr. Natale is the best! He is worth the wait. If your case isn't too serious yet a more local experienced EP can prob help meantime.

Tim

I agree with what others have suggested. Would suggest you look at your diet to get down your weight as well as having adequate nutrient intake. No diet coke, alcohol etc. Waller water is and herbal teas might be helpful as well. Still drink Hawthorn/Hawthorn berries tea as well as making sure i get omega 3 fatty acids in my diet (totally avoiding trans-fats)
Anyway, that's what i've done and have been afib free for 2 years and totally off medication for 3 month. Maybe i'm taking a risk but it's my choice.
Best wishes!

The Cartia is also a Blood Pressure Medication, so it would make sense if your BP is high. I'm taking 240-360 mg/day for high BP. I also take it to control my PAC's which have been acting up lately. I exercise normally, with no known side effects. I don't have many PVC's, but the Cartia definately helps reduce my PAC's.

If you make it to your next Appt without another episode, I would definately ask your Dr. about getting off the Meds. I would try to get off of the Eloquis. We can't advise you on Meds because we don't have all of your info, like BP, Echo results, other Heart issues. Generally speaking if a person has just Lone AFIB, and only one short episode, they would not need ongoing medication especially past 1 month.

Bileswil - Glad you found us. Sorry it was necessary.

When you spoke with Shannon, I’m sure he mentioned the importance of recognizing life-style risk factors that can contribute to Afib. You’ve identified the dehydration issue coupled with alcohol consumption, also the diet soda which is neurotoxic. Eliminating those factors is a good start. There are probably more you need to identify as well.

While you are waiting for the various consults and being properly assessed for treatment, you can learn about key nutrients essential to keeping heart cells functional… whether or not you have an ablation procedure.… of which you should be aware as important changes to your ‘life-style risk factors.’ However, chances are, you won’t hear about them from your cardiologist or EP. This has been a major topic since the inception of this forum nearly 20 years ago.

Example: The result of these “insults” is the depletion of essential electrolytes aka minerals needed for proper heart function (along with other systemic functions as well) and includes the #1 heart nutrient, magnesium. Potassium is another key electrolyte and the balance or ratios of magnesium/calcium and potassium/sodium are critical to helping stabilize and maintain a normal heart rhythm. Again … whether or not you have an ablation. We have often commented that developing Atrial Fibrillation is a signal or the “canary in the coal mine” that something is severely out of balance in the body and the Afib is our “signal” to assess what’s out of balance. Replacing and balancing electrolytes is a key factor in managing Afib. If your dietary intake is deficient or is depleted rapidly, many functional problems arise... Afib is just one. Most of us use supplements to help replete and maintain.

While you are waiting for your consult results and as a start, I suggest you begin reading the many topics at this link for background. [www.afibbers.org]

If I can be of help with your dietary/nutritional assessment, send me a PM.

Best to you,
Jackie

Awesome input folks. It is truly appreciated. Do not have time now to thank each of you, but I will tonight.

Thanks TSCO. I'm leaning to make sure I have Dr. Natalie.

Thanks Carey. Great info.

Thank you Wolfpack.

Thanks Joe. Just came back from a nutrietionist. I am under her watchful eye. Thanks.

Thanks. Ill talk to my Cardiologist and try and get off the meds and go back to my blood pressure meds. Try to get a PIP in case it happens again. Thanks.

Thanks Jackie. I have been reading those articles and I am now done with caffine free diet coke/diet coke.

Thanks to everyone including The Anti-fib person who i did not mention by name. Everyone's input is awesome. Thanks

I thought there was another forum member who is also a commercial pilot...perhaps he will chime in.

Prior to my ablations you never would have heard me preaching temperance, and I still won't, but I will say that I like NSR a heck of a lot more than I do drinking. Now that Dr. Natale has me ticking away regular, I don't want to change that through excess, despite what William Blake said about it leading to the palace of wisdom. I think Blake got that part wrong. Just ask Jim Morrison....oh wait. I enjoy an occasional glass of wine and that's it.

One thing I haven't seen mentioned is to have a sleep study done, or at the very least grab an oximeter that will record your levels overnight. If you have any degree of sleep apnea it's critical that you get it treated. I strongly believe my sleep machine has helped me maintain NSR, and I feel great every day, all day long.

Thanks AB Page. I do not believe I have sleep apnea. I read studies on the condition. I sleep 6-8 hours a night, never feel tired and never feel like napping during the day. My wife says I do snore, but I have a very restful sleep at night. When I wake, I am in the same position, with my covers on. My breathing does not stop, my wife informed me, and once again I feel rested and energized. I will go for a sleep study if the doctor tells me too. Thanks for the info.

Doesn't sound like you do either Bileswil. FWIW, I didn't think I did either, nor did my wife or my 1st EP. I went ahead and did the study just to be sure, to rule it out. I was diagnosed with mild SA. I'm not saying that's your situation, but for me I was glad I had the study done.

Same here. I don't snore. Sleep very well and yet I tested mild SA.

Jackie

As far as afib and flying, checkout AOPA, they have good summary details.
Basically if you are in afib, stable and stroke risk is addressed, you can get a waiver with several tests. This is a big pain you won’t want to go through every 6 months.
If you have an ablation and are afib free for 3 months, FAA views it as cured.
I heard the military is allowing pilots with afib to fly transport, no fighters though.
Since afib is so common, many people have it with no symptoms. If you are stable while in afib, you will probably function safely.

In your case, IMHO, lifestyle is a big factor that you will need to address and stick with the new better habits.

(Quick answer, sorry.)

One more point, the PVCs and bigamy is your real concern. Those CAN lead to bigger problems than afib. That being said, ablation for those have high success rates.
( I would look into hiring a consultant that will help you navigate your medical records and FAA Oklahoma boys when you’re ready to requalify.)



Edited 2 time(s). Last edit at 02/08/2018 03:54PM by gmperf.

Thanks GMPERF, ABPAGE and Jackie.
I am talking with my Doctor at ALPA. ALPA is our union and they have a medical team to assist us on this journey. He has been quit helpful.
Yesterday the nurse called from my EP's office and said my echo-stress test was normal. Yes, I was shocked, that with so many PVC's, it was normal. I will be talking to my EP on March 9th and ask him about an ablation for those PVC's. I still feel it is the medicine I am on, but I continue taking it until my EP tells me otherwise. Only thing I added to my diet is Magnesium citrate as this web site recommended.
Thanks again and I'll keep everyone informed.

Sounds like you do a lot of flying. You are correct 100%. My doctor at ALPA has been tracking this, right along with me and he has direct contact with the FAA medical. Thanks again and let me know if you find anything else. Once again, thank you very much.
Willis

Ah, Willis, another Bill Murray fan!

I posted this on one of my threads but thought you may not see it. Thanks for your kind words... yes, this forum is a God-Send!
Episodes are still scary, though. I've been having issues with my computer, too, but those are not as scary as this a-fib and pounding heartbeat stuff!
I do have the things I do to try and stay calm. When I'm awakened from a sleep, though, it seems twice as scary because of course I wonder... will this resolve on its own? How long until it resolves or how long do I wait for it to resolve? Goodness gracious! I'm so thankful to know I'm/we're not alone!

Sue

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Bileswil
Only thing I added to my diet is Magnesium citrate as this web site recommended.

If you can tolerate the mag citrate, then that’s great, but many of us find it too laxative on the bowels. Remember if you get “Montezuma‘s Revenge“, then you’ve gone backwards as opposed to forwards on electrolyte supplementation. A better, albeit more expensive, option is the magnesium glycinate. Looks for the Albion TRAACS logo. That’s the good stuff.