Can correcting a reversible cause cure afib?

Thanks for the add.

I've read lots of information about afib. And very often I see reversible cause is mentioned when diagnosing afib, like hyperthyroidism , electrolyte imbalance, etc. The articles only say something like: correcting the reversible cause often eliminates afib.

So the word 'eliminate' is tricky. Does it mean reversing afib, cure afib, or stopping the current afib episode? Can correcting the cause prevent afib from occurring permanently? Any experience on this?

Thanks!

My first Episode was caused by wearing a Heavy Duty Mask at Work. Not sure if it was from the Anxiety of looking funny, or from restricted air intake, or a combination of both. I stopped wearing it, and never had another Episode for 12 years.

Generally, AFIB is too complex for elimination of a Reversible Cause (Trigger) to Permanently stop it. Multiple things are going on to cause AFIB. However, especially early on, eliminating a Cause can greatly reduce the number of Episodes and what is called AFIB "Burden". Which is the total amount of time spent in AFIB.

As for reversing AFIB effects, staying in NSR for a sustained period of time can reverse the effects of previous AFIB Episodes to a point, but not completely.

Correcting a Reversible Cause helps maintain NSR, but not eliminate it, as multiple factors put us at risk for AFIB and predispose us to it.

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kong2018
I've read lots of information about afib. And very often I see reversible cause is mentioned when diagnosing afib, like hyperthyroidism , electrolyte imbalance, etc. The articles only say something like: correcting the reversible cause often eliminates afib.

There are a small number of things that can cause afib in people who don't actually have the underlying basis for afib. Binge drinking, for example, has long been recognized as such a cause and was given the name "holiday heart syndrome" by ER docs long ago. Major electrolyte disturbances, surgery, and trauma are others. Beyond this very short list, afib is almost never reversible no matter how you define the word. That's not to say that afib can't be stopped. It can. Antiarrhythmic drugs, ablation, and Maze procedures are the recognized ways of stopping it.

Thanks for th reply. I think mine was probably caused by the vegetarian diet I ate prior to afib. Maybe I didn’t eat enough, I felt so tired on the first few days of eating vegetarian and also had diarrhea and heavy sweating. The blood test in ER shows I had low serum potassium level of 3.5, that’s the lowest of the ‘normal’ range. Hoping by correcting the electrolyte can eliminate afib. I don’t have any other risk factors.

Thanks Carey. Is there an end point at which I would know whether by correcting the electrolyte imbalance can eliminate afib? Like if I correct my diet and by taking supplement, is there a general rule or end point like after how much time if I still don't have afib, then I might know it's gone?

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Carey

I've read lots of information about afib. And very often I see reversible cause is mentioned when diagnosing afib, like hyperthyroidism , electrolyte imbalance, etc. The articles only say something like: correcting the reversible cause often eliminates afib.

There are a small number of things that can cause afib in people who don't actually have the underlying basis for afib. Binge drinking, for example, has long been recognized as such a cause and was given the name "holiday heart syndrome" by ER docs long ago. Major electrolyte disturbances, surgery, and trauma are others. Beyond this very short list, afib is almost never reversible no matter how you define the word. That's not to say that afib can't be stopped. It can. Antiarrhythmic drugs, ablation, and Maze procedures are the recognized ways of stopping it.

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kong2018
Thanks Carey. Is there an end point at which I would know whether by correcting the electrolyte imbalance can eliminate afib? Like if I correct my diet and by taking supplement, is there a general rule or end point like after how much time if I still don't have afib, then I might know it's gone?

When I mentioned electrolyte disturbances notice that I said "major disturbances." So I'm talking about severe dehydration, kidney disease, prolonged vomiting/diarrhea, and things like that. Imbalances caused by diet aren't likely to be serious unless your diet is extremely bizarre, and a vegetarian diet shouldn't cause electrolyte disturbances at all. I very seriously doubt that your vegetarian diet had anything to do with your afib. That 3.5 potassium you mentioned is pretty low, and a level that low will make afib more likely, but it's not enough on its own to cause afib. You have to the disease first.

Have you had a basic physical within the last year? That would include an electrolyte panel and your doctor would have mentioned any serious issues. If you haven't had a physical, get one. That will also either identify or rule out hyperthyroidism, another known cause of afib. Sleep apnea requires a sleep study to diagnose, and it's probably worthwhile for anyone with afib to have one done.

I'm sorry to say that it's extremely unlikely that you can cure your afib by doing anything with diet or electrolytes. There are things you can do to reduce symptoms and/or reduce frequency of episodes, but afib isn't something you can just pop some supplements or change your diet and make go away. I'm afraid that for the vast majority of afibbers, it's a chronic disease that will never go away on its own.

I did have a physical along with blod test about a month before first afib. On that test my potassium was 4.7. The only major change I made before afib was trying out a vegetarian diet. And I felt my first skip beats in my life after three days started vegetarian. Other than that I can’t think about anything that could drive my potassium away.

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kong2018
I did have a physical along with blod test about a month before first afib. On that test my potassium was 4.7. The only major change I made before afib was trying out a vegetarian diet. And I felt my first skip beats in my life after three days started vegetarian. Other than that I can’t think about anything that could drive my potassium away.

Sure, it's possible your new diet led to a low-normal potassium level, but potassium levels fluctuate hour by hour based on many things so there are many things that could have led to your 3.5 reading. The thing is, that alone isn't enough to explain the afib.

Oh, in the ER blood test, I have Free T4 0.08 higher than normal range too, while TSH was within normal range. But the following blood test ordered by my family doctor shows all Free T4, Free T3 and TSH were normal. I just don't know why.

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Carey

I did have a physical along with blod test about a month before first afib. On that test my potassium was 4.7. The only major change I made before afib was trying out a vegetarian diet. And I felt my first skip beats in my life after three days started vegetarian. Other than that I can’t think about anything that could drive my potassium away.

Sure, it's possible your new diet led to a low-normal potassium level, but potassium levels fluctuate hour by hour based on many things so there are many things that could have led to your 3.5 reading. The thing is, that alone isn't enough to explain the afib.

None of those findings are meaningful. Just normal fluctuations.

Kong2018

My first AF episode occurred because I was over medicated on my thyroid meds., in other words I became hyper thyroid. Hyper thyroid or Hypo can cause AF, I am living testimony to that fact.

Liz

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Carey

I've read lots of information about afib. And very often I see reversible cause is mentioned when diagnosing afib, like hyperthyroidism , electrolyte imbalance, etc. The articles only say something like: correcting the reversible cause often eliminates afib.

There are a small number of things that can cause afib in people who don't actually have the underlying basis for afib. Binge drinking, for example, has long been recognized as such a cause and was given the name "holiday heart syndrome" by ER docs long ago. Major electrolyte disturbances, surgery, and trauma are others. Beyond this very short list, afib is almost never reversible no matter how you define the word. That's not to say that afib can't be stopped. It can. Antiarrhythmic drugs, ablation, and Maze procedures are the recognized ways of stopping it.

Is there any test or exam to see if a person has the 'underlying basis for afib. '?

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Elizabeth
Kong2018

My first AF episode occurred because I was over medicated on my thyroid meds., in other words I became hyper thyroid. Hyper thyroid or Hypo can cause AF, I am living testimony to that fact.

Liz

Hi Liz,

So after you corrected the thyroid med to the proper level, can you keep afib away? Because the sounds like a reversible cause to me.

In my case the Thyroid values were way out of normal range. Once brought back to normal by life style changes - i think? My cardio version held - so far (getting towards 2 years). Stopped beta blocker and Eliquis beginning last November.
Nevertheless, i still feel some odd beats occasionally but it doesn't feel like afib. It's more like missing a beat or sometimes a few quick beats.

Thanks Joe for sharing. So from the above, at least it seems afib is not progressive, at least it's not 100% the trend.

Kong:

Nope, I got a few episodes a year for a number of years then AF came more often, lately I get it twice or once a month. I am vagal, it lasts anywhere from 5 to 12 hours. I usually do get a few more episodes in the winter months, I get a lot more fruits and veggies in the summer so maybe that has something to do with it.

I have heard that the heart never forgets, there have been a few people over the years that tamed AF but not many. George N. is one, actually he is the only one that I know of, all the other people that claim to have no more AF are not around so who knows.

Liz

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Elizabeth
Kong:

Nope, I got a few episodes a year for a number of years then AF came more often, lately I get it twice or once a month. I am vagal, it lasts anywhere from 5 to 12 hours. I usually do get a few more episodes in the winter months, I get a lot more fruits and veggies in the summer so maybe that has something to do with it.

I have heard that the heart never forgets, there have been a few people over the years that tamed AF but not many. George N. is one, actually he is the only one that I know of, all the other people that claim to have no more AF are not around so who knows.

Liz

Hi Liz,

Thanks. At the very beginning, how many episodes did you get for the first year? I just wanted to see the trend.


K

That was a long time ago, like about 18 years. Probably about 3 or 4 than gradually increased.

Liz

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Elizabeth
That was a long time ago, like about 18 years. Probably about 3 or 4 than gradually increased.

Liz

Have you ever got ablation?

Kong:

No, I never got an ablation, for a number of years I didn't get too many episodes and I was always able to terminate them, I still have been able to terminate them. I do take 150 mg. tab. of Propafenone every night and taking magnesium has helped me a lot. If I was younger, I would consider an ablation, but now, I read so many people have to have more than one ablation, maybe 3 and their ejection factor can be compromised making them take a blood thinner for the rest of their lives or they get a watchman device,

Liz

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Elizabeth
I would consider an ablation, but now, I read so many people have to have more than one ablation, maybe 3 and their ejection factor can be compromised making them take a blood thinner for the rest of their lives or they get a watchman device,

Ablations do not lead to reduced ejection fractions, and unless the left atrial appendage is isolated, which is unusual, they don't lead to the need for lifelong anticoagulants either. It's actually quite the opposite on both counts. Doing nothing and allowing afib to continue with high ventricular rates is what leads to a reduced ejection fraction, aka heart failure, and uncontrolled afib also necessitates continued anticoagulation.

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kong2018
Is there any test or exam to see if a person has the 'underlying basis for afib. '?

No, there's no specific test, but it's not necessary. If you have afib, you have the underlying basis for it.

Carey:

Two people come instantly to mind, Jackie and Shannon, Jackie is around my age and has had 3 ablations with Dr. Natalie and has to take an anticoagulant for life. Shannon had to take a anticoagulant after a problem with the LAA, he has had a watchman device and is now free of anticoagulants. My point is at my age all of those operations that might have to be endured is a little much. Yes, heart failure is a possibility, my ejection factor is quite good. So far, when in AF I am not in it for a long time, don't know about the future but we don't live forever.

Liz

The problem is you take anecdotal experiences of a few people here and make them sound like they apply to everyone. They don't.

Some facts: 1) Ablations do not lead to heart failure. Period. In fact, they prevent it. 2) The majority of Natale's and other top-shelf EPs do not need multiple ablations.

All I ask is that you give people an accurate, realistic view of what they're facing. Your age and medical history aren't relevant to them.

Carey
"All I ask is that you give people an accurate, realistic view of what they're facing. Your age and medical history aren't relevant to them".

Most people that come to this board give their medical history and age, you yourself did as well, Shannon, Hans Larsen George N. just to name a few. If you can't understand that it can be useful to those who are facing similar conditions, I won't bother to enlighten you.

Liz

Liz said:
I would consider an ablation, but now, I read so many people have to have more than one ablation, maybe 3 and their ejection factor can be compromised making them take a blood thinner for the rest of their lives or they get a watchman device,

Carey said:
Ablations do not lead to reduced ejection fractions, and unless the left atrial appendage is isolated, which is unusual, they don't lead to the need for lifelong anticoagulants either. It's actually quite the opposite on both counts. Doing nothing and allowing afib to continue with high ventricular rates is what leads to a reduced ejection fraction, aka heart failure, and uncontrolled afib also necessitates continued anticoagulation.


Good points Carey, but I would like to point out that Ablations, particularly repeated ones, have at times led to decreased Atrial Contractibility, thus necessitating Anti-Coagulation, although this not as much as an issue as it was years ago.
Also Many of Dr. Natale's Patients although not a majority of them have had to have multiple procedures and have to take Anti-Coagualtion for life, it has to do with his Ablatement of the LAA. They have posted here, and Shannon has quoted the Stats.
I agree that uncontrolled AFIB can lead to HF, but that presumes that effective rate control was not employed. I doubt it's a precise Benchmark, but the EP's say that the Ventricular rate has to be over 100 for a duration of more than 24 hours to cause Cardio-Myothapy.



Edited 4 time(s). Last edit at 03/04/2018 02:51AM by The Anti-Fib.

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I doubt it's a precise Benchmark, but the EP's say that the Ventricular rate has to be over 100 for a duration of more than 24 hours to cause Cardio-Myothapy.

When i had the 24 hr monitor my average HR was 120, peaking at >170. My total afib time was about 4 months. My cardiologist told me that my heart is back to normal size (left atria still slightly enlarged) and my heart function is fine - was i just lucky???

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The Anti-Fib
Good points Carey, but I would like to point out that Ablations, particularly repeated ones, have at times led to decreased Atrial Contractibility, thus necessitating Anti-Coagulation, although this not as much as an issue as it was years ago.
Also Many of Dr. Natale's Patients although not a majority of them have had to have multiple procedures and have to take Anti-Coagualtion for life, it has to do with his Ablatement of the LAA. They have posted here, and Shannon has quoted the Stats.
I agree that uncontrolled AFIB can lead to HF, but that presumes that effective rate control was not employed. I doubt it's a precise Benchmark, but the EP's say that the Ventricular rate has to be over 100 for a duration of more than 24 hours to cause Cardio-Myothapy.

I don't dispute any of that and I have an isolated LAA myself so it's not like I'm unaware. What I object to are blanket negative statements with no context that give the impression that everyone needs multiple ablations, everyone ends up on lifelong anticoagulants, and that ablations lead to heart failure. The first two are a minority of cases and the last statement is true only if you add the words "when performed by an incompetent EP." When discussing treatment outcomes, it's very important to give at least a general sense of probabilities so people get a realistic idea of what they're facing. Fear mongering is not helpful to anyone.

I wasn't going to respond, however it appears that I am being singled out so I must:

"This was said by a poster about me"
I don't dispute any of that and I have an isolated LAA myself so it's not like I'm unaware. What I object to are blanket negative statements with no context that give the impression that everyone needs multiple ablations, everyone ends up on lifelong anticoagulants, and that ablations lead to heart failure.

This is what I said:

Liz said:
I would consider an ablation, but now, I read so many people have to have more than one ablation, maybe 3 and their ejection factor can be compromised making them take a blood thinner for the rest of their lives or they get a watchman device,

I then gave a couple of names that had more than one ablation and someone who had a Watchman device, (this is a blanket negative statement with no context?) I also was answering a person who asked if I had an ablation, I explained I didn't and why, this was in regards to me not others. I have been told on this board about a stroke, heart failure if I don't take an anti-coagulant or have an ablation which I understand, I am not asking for conformation as to the amount of time one is in AF and the likelihood of having a stroke or heart failure plus give me stats. Many people have strokes and heart failure and are not in AF, oh, I must have stats, they will be forthcoming.

By the way, at the top of the AF forum is this message:

A forum for sharing experiences regarding atrial fibrillation and other atrial tachy-arrhythmias


Good health to all
Liz



Edited 1 time(s). Last edit at 03/04/2018 09:09PM by Elizabeth.

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Joe
I doubt it's a precise Benchmark, but the EP's say that the Ventricular rate has to be over 100 for a duration of more than 24 hours to cause Cardio-Myothapy.

When i had the 24 hr monitor my average HR was 120, peaking at >170. My total afib time was about 4 months. My cardiologist told me that my heart is back to normal size (left atria still slightly enlarged) and my heart function is fine - was i just lucky???

From what I can tell you might be Lucky. I had Tachy-Cardia induced Dilated Cardio-Myopathy. My Ejection Fraction went down to 20%. I went undiagnosed for 3 years, then after finally diagnosed, and I implemented rate/rhythm-control, I slowly recovered up to 70% EF, and my, but it took like 18 months. The Doctors were shocked at my recovery.

As for the "rate over 100 for over 24 hours rule," that was stated as a minimum requirement to get HF from uncontrolled AFIB. So if someone had HF, and wasn't over a HR of 100 for > 24 hours than they could rule out Tachy-Cardia as the cause of the HF.

I don't know how hard you or your Dr. tried to get your rate down while you were in AFIB, but long-term, that AFIB/HR is too high. Some people just can't lower their rates down even with Medication. If AFIB returns I suggest redoubling your efforts at Rate-Control. Their are different Medications and combinations of Medications to help.

Thanks for that heads up!
My HR was only marginally lowered with beta blockers. While in hospital they gave me (luckily only once) digitalis because of my very low response to BB.
My heart was quite enlarged but some months after the CV it reduced in size the cardiologist called normal.
BTW, what is a good ejection fraction? Mine was 56% measured about 5 months ago.

Oh, just googled and it is borderline to normal, depending on opinion.



Edited 1 time(s). Last edit at 03/05/2018 03:43PM by Joe.

Joe:

I also read that a high ejection fraction has problems also:

"EF higher than 75% may indicate a heart condition like hypertrophic cardiomyopathy."

Liz

Liz - You referenced my three ablations.... yes, true... and that was over a span of 20 years.

I had the first Natale ablation in 2003 after the initial onset eight years prior. I nearly cancelled that date because I had actually managed to be AF free with no meds and just using the core nutrients. But I did go ahead and have it because of the potential for a major insurance change. Eleven years later, I began to have episodes of a-flutter.

In hindsight, I'm quite sure that because I had begun aggressive treatment for Lyme markers ...indicating I had a previous exposure but not active Lyme... and as a result, I began experiencing the flutter. I stopped the treatment, but the flutter persisted and those sessions were incapacating. Thankfully, with Shannon's help, I was able to see Dr. Natale in Texas (August 2014) very quickly. This time, he isolated the LAA so that requires staying on Eliquis until the clearance velocity of the appendage is checked 6 mos. later and all was fine. However, not quite 6 mos after that, I started with some flutter again and flew immediately to Texas for the touch up. Eventually, I was able to take half dose Eliquis because the clearance velocity was still good... but I'm sure because of my age ... (you and I are about the same age)... Dr. Natale said it would be "best to continue" on the half dose.

I can appreciate your comment and apprehension about going for an ablation but from what Shannon has shared with us about Dr. Natale often treating patients in their 80's.... I would not lose much sleep if I had to go back again... although, I'd definitely prefer to visit Austin just for fun time with my son who lives in a suburb.

Not everyone will need three or more procedures, but my experience is that I had virtually no down-time other than following the post-procedure instructions for all three. Of course, I attribute that to Dr. Natale's exquisite expertise and I will forever be extremely grateful to have been his patient.

Jackie

Jackie:

The problem that I could face is that I might have to have more than one ablation or isolating the LAA which would necessitate being on a blood thinner. I have had problems with a blood thinner and can't take it---of course there is always the Watchman device. I am being realistic as to how much time I have left and to contemplate spending it having all of the above is a little too much.

You started on your journey 20 years ago, that is different. I do get episodes of AF a little more often now but they don't last as long as they used too, so I just keep on.

Liz