4 months running

Well I'll be entering month five here soon of constant dis rhythm. My Kardia mostly is unreadable and when it does read normal the chart looks crazy anyway. My pulse feels kinda normal with some quicker hits and some slower hits. But a general feeling of dis rhythm. Am lightheaded frequently. My thought is I'm in some kind of Junctional rythym. Pulse varies 60s, 70s, slower at night dropping in 50s some. I am having no afib which I suppose is a great thing. I'm thinking my SA node is giving up the ghost. Not sure why all of a sudden and this is my speculation. I'm flying from KY to Austin next Tuesday for an apt with Natale. I really want his opinion as to what I should do. My EP here just seems to not give me definitive guidance. I also just want a masters opinion also. Again how telling is it that I can get an appointment with someone as busy as Natale in Austin, TX quicker and easier than getting in with my local??? For my local care it makes me feel insignificant. Wondering if anyone has any thoughts. My fear is am I hurting my heart by staying in this if it is Junctional AV ? For some reason if I take large doses of potassium it seems the rhythm isn't as noticeable.

All I can say is you are doing the correct thing to go see Dr. N!

What George says.

If there's time, please ask for the maestro's 10 second verdict on this example of accelerated junctional rhythm!

Cheeky as hell yes. But a bloke's gotta try! Anyway totally understand if you just think b*gger off mate!!

Anyway, hope you get things sorted out for yourself ASAP and seeing Natale has to be the very best place to start.

[drive.google.com]



Edited 4 time(s). Last edit at 04/27/2018 01:16PM by mwcf.

George, thank you I have to get his opinion no doubt

Mwcf, is that your accelerated junct? I have a feeling that's what I'm in (as a guess).

Yes tsco - that's my Acc Junt. But that said, my EPs thus far have always been a bit uncertain about it - hence why I am always looking for further opinions - particularly from the very top EPs!

You're unlikely to get new opinions from any EP on that ECG. The opinion you already got is pretty much what anyone is going to say.

Mwcf, so do you stay in Junctional most of the time? What does your EP suggest you do?




And I get the opinion question.........it is what it is but the treatment amongst docs may vary. That's what it after



Edited 2 time(s). Last edit at 04/28/2018 10:42PM by tsco.

tsco,

No, that AJR (assuming that's what it is) only occurs in tandem with AF. As in, I can get AF lying down (usually in bed - either 1am or 5 am typically) and then the AF switches to the AJR when I stand up (go the loo, for a drink, whatever); then when I lie down again it will - after a few minutes - slowly drift back into AF (and so on) until I convert from either or the other (usually from AF) back into NSR. My AF/AJR episodes usually last for 2 to 3 hours these days. I take Flecainide 100mg BID + an extra 150-200mg (I am 220lbs and 6' 4") to aid conversion to NSR. I do think that in addition to being posture-related the AJR association with AF is linked to some degree or other with the Flecainide (I never had the AJR prior to taking Flecainide this last 10 years). I should add that before taking the extra Flecainide when an episode strikes as aforementioned I take 20-30mg or propranolol 10 minutes beforehand. I've never had the AJR just kick off on its own. I typically get (these days) 2 to 4 episodes of AF per year. I've had paroxysmal AF for nearly 20 years. My mother had it from age 30 reaching 70 before it went from paroxysmal to persistent and then permanent. She died aged 80 from another non-heart-associated condition (following a very bad fall).

As for what to do; no EP has ever suggested that I need to do anything other than as I already do.

My only absolutely guaranteed trigger is a good wallop of MSG (think Chinese meal or over-greedy consumption of heavily flavoured crisps (last occasion was s2 x 125g bags of Snyders Jalapeno Pretzel Pieces...) Hence why I'm currently on something a mission diet-wise eliminating all forms of MSG as well as trying to cut down free glutamate, gluten and nightshade family foods. Yes it might be grasping at straws and/or not last long if it IS of any benefit AF-wise, but it'll certainly stand me in better stead healthwise in general going forward.

Another interesting thing - well; to me at any rate - is that on my birthday I had an episode whilst in Majorca where for the 2 days prior I had exclusively eaten cured meats (MSG), pickles and strong cheese plus a lot of red wine. So no surprise/stupidly brought it on myself etc. But the thing is, that in the mid afternoon I had a distinct arm-pit aroma like pickled onion crisps that I was amazed by as it wasn't hot (68F) and I never normally have any untoward aromas from my arm-pits. My partner and I both noted and commented upon this. I genuinely think that my body chemistry was out of whack that led to this aroma and then soon thereafter by a visit from AF. Not that I've ever noticed such a correlation before mind, but even so. The thing this time - and the only time for me - was that the episode occurred late afternoon rather than nocturnally.

Cheers,

Mike



Edited 1 time(s). Last edit at 04/29/2018 06:37AM by mwcf.