Zio results.... Huh? What?

I'm puzzled. I got my Zio patch results back and don't understand a lot of it. Could someone please help and explain this to me before I go looking things up and scaring myself?

The EP emailed me and stated "Overall no atrial fibrillation. Looks really good."
I know I have a-fib... it landed me in the hospital last July. Does this mean that it's controlled by metoprolol (and it will be a matter of time b/c A-Fib usually always progresses)? Does "overall" mean that for 13 days and 19 hours, I had no a-fib?

Some of this (below) is really scary to me.... I still don't know what all this means, and that stresses me, and then I get a bit panicky and then I have anxiety and then.... well, it's scary. Thanks in advance for any help and input (and handholding)!
Sue

The details from the Zio results are as follows:
Analysis Time 13 days 19 hours
Heart Rate
Overall Max 190 bpm 07:24pm, 07/14
Min 40 bpm 08:24am, 07/04
Avg 68 bpm

Sinus Max 136 bpm 03:24pm, 07/10
Min 40 bpm 08:24am, 07/04
Avg 68 bpm

Patient Events
Triggered
Events: 10
Findings within ± 45 sec of Triggers:
Sinus Rhythm, Supraventricular
Ectopic beat(s), Ventricular Ectopic beat(s)

Ectopics Rare
<1%

Occasional
1% to <5%

Frequent
5%+

Supraventricular Ectopy (SVE/PACs)
Isolated
Couplet
Triplet
Rare <1.0%
Rare <1.0%
Rare <1.0%

Ventricular Ectopy (VE/PVCs)
Isolated
Couplet
Triplet
Rare <1.0%
0
0
Longest Ventricular Bigeminy Episode 0 s
Longest Ventricular Trigeminy Episode 0 s

Findings
Patient had a min HR of 40 bpm, max HR of 190 bpm, and avg HR of 68 bpm.
Predominant underlying rhythm was Sinus Rhythm.
4 Supraventricular Tachycardia runs occurred, the run with the fastest interval lasting 8 beats with a max rate of 190 bpm (avg 174 bpm); the run with the fastest interval was also the longest.
Isolated SVEs were rare (<1.0%), SVE Couplets were rare (<1.0%), and SVE Triplets were rare
(<1.0%).
Isolated VEs were rare (<1.0%), and no VE Couplets or VE Triplets were present.

Final Interpretation:
Symptoms and patient triggers were mainly sinus rhythm - rare PACs and PVCs
No significant arrhythmia are seen
Very brief atrial runs are seen which were asymptomatic
<end>

Looks pretty good to me for someone with afib. ?

It looks good. A little SVT (which explains the peak at 190bpm - but it was for 8 sec only) and rare ectopics.

But... maybe are you someone like me: when monitored, nothing serious happens. Murphy's Law!

You've had no afib. But for an afibber, two weeks without afib may be pretty usual. This is why many paroxysmal afibbers own and use devices like a Kardia.

Other than no afib, probably the most significant:

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Patient Events
Triggered
Events: 10
Findings within ± 45 sec of Triggers:
Sinus Rhythm, Supraventricular
Ectopic beat(s), Ventricular Ectopic beat(s)

Meaning when you pushed the button because you felt something, it wasn't afib. It was either NSR, PAC's or PVC's.

Thanks for weighing in!

Joe, yeah, where's the a-fib?

Pompon, Murphy's Law indeed! Two days after I mailed in the Zio, I had a couple of weird episodes and sure wished I had that button to push--but it didn't *feel* like a-fib! They actually told me to not push the button for little things like if I felt PVCs.... with only one heart and no spares, anything different is NOT a little thing to me.

George, yup, I did feel something which is why I pushed the button.

Should I be worried about the 40 bpm (I was asleep, I thought 40 was too low even when sleeping!) ?

Seeing the max heart rate of 190 bpm was scary even if it was only for 8 seconds! I was probably sitting and reading a magazine, probably Good Housekeeping or something tame like that, or maybe I was at the grocery store .... it wasn't like I was skydiving or kissing "Jamie" from Outlander!

The sinus max of 136 bpm at 3:24 pm--I have no idea what I was doing at that time -- I have a big learning curve.

Thanks again for your input!!!
Sue

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SueChef
Thanks for weighing in!

Joe, yeah, where's the a-fib?

Pompon, Murphy's Law indeed! Two days after I mailed in the Zio, I had a couple of weird episodes and sure wished I had that button to push--but it didn't *feel* like a-fib! They actually told me to not push the button for little things like if I felt PVCs.... with only one heart and no spares, anything different is NOT a little thing to me.

George, yup, I did feel something which is why I pushed the button.

Should I be worried about the 40 bpm (I was asleep, I thought 40 was too low even when sleeping!) ?

Seeing the max heart rate of 190 bpm was scary even if it was only for 8 seconds! I was probably sitting and reading a magazine, probably Good Housekeeping or something tame like that, or maybe I was at the grocery store .... it wasn't like I was skydiving or kissing "Jamie" from Outlander!

The sinus max of 136 bpm at 3:24 pm--I have no idea what I was doing at that time -- I have a big learning curve.

Thanks again for your input!!!
Sue

Is this the trigger?


[www.tapatalk.com]

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SueChef

Should I be worried about the 40 bpm (I was asleep, I thought 40 was too low even when sleeping!) ?

Nope, not to worry. I've been there or even a few BPM lower, though since I don't train endurance cardio for the last 12 years, its come up a bit to like 48

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SueChef
Seeing the max heart rate of 190 bpm was scary even if it was only for 8 seconds! I was probably sitting and reading a magazine, probably Good Housekeeping or something tame like that, or maybe I was at the grocery store .... it wasn't like I was skydiving or kissing "Jamie" from Outlander!

On ectopics or a short run, it isn't related to how much effort you were doing at the time. It just is what it is.

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The sinus max of 136 bpm at 3:24 pm--I have no idea what I was doing at that time -- I have a big learning curve.

Could have been walking up stairs, who knows.

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jpeters
Sue
Is this the trigger?
[www.tapatalk.com]

Nice!

The 190 was probably just noise. I just spent a night wearing a monitor and I fooled it into detecting v-tach at 220 just by flopping around in bed trying to rearrange the covers. The 136 might have also been noise. You really need to believe the doc when he says it looks good.



Edited 1 time(s). Last edit at 08/05/2018 12:50AM by Carey.

I just got back results from a 30 day monitor...
I would agree the results are confusing.
So things like high heart rates... if your heart rate is only high for a couple of beats, does it really matter?
I was surprised that my monitor didn't report anything about PACs.... I'm pretty sure I'm having tons of them. The 48 hour holter monitor I had after my ER visit said I had PACS 16% of the time... I'm mostly out of rhythm according to my Emay when I check.. I' always confused that nobody seems to care that even when I'm not in afib I'm most often out of rhythm.

My 30 day results said I was in Afib 5% of the time... and that I had 1 critical, 8 serious and a couple dozen other events. I think it also said my longest afib was 45 minutes, but in the listed events it didn't mention a 45 minute afib event... so yeah I'm confused. I'd love to know how long my average Afib last

I'm also disappointed in my Emay monitor, as it tells me I'm in arrhythmia, but not whether it's afib... I've been trying to read my traces... but get the impression that even though I'm out of rhythm my Afib may only last for a few beats in a 30 second read. But maybe I'm wrong there too. It's confusing!

Depressing though to get confirmation that I really am totally screwed up, Can't really argue with 30 days of being clearly messed up.
Guess I really should consider the ablation.

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Is this the trigger?
[www.tapatalk.com]

You got the right idea!

Thanks, George for more info... and Carey, for adding your input... and bolimasa, I don't know enough about things to say anything more than it can be confusing!



Edited 1 time(s). Last edit at 08/05/2018 02:58AM by SueChef.

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bolimasa

I'm also disappointed in my Emay monitor, as it tells me I'm in arrhythmia, but not whether it's afib... I've been trying to read my traces... but get the impression that even though I'm out of rhythm my Afib may only last for a few beats in a 30 second read. But maybe I'm wrong there too. It's confusing!

Don't be disappointed with your Emay. This device (I never used one) probably does what it's intended for: telling you if there's something wrong with your HR. I don't think any other single lead portable ECG device on the market would tell you "you're in afib" (mine says "suspected a little fast beat", "suspected slow beat" , "irregular beat interval" and things like this). They all recommend seeing your doc and showing him/her the recordings where something wrong has been detected. It's wise.
Even a professional 12-lead ECG isn't reliable enough to tell you "you have afib" with its automatised interpretation. The cardiologist's eyes and experience are needed.



Edited 1 time(s). Last edit at 08/05/2018 06:33AM by Pompon.

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bolimasa
So things like high heart rates... if your heart rate is only high for a couple of beats, does it really matter?

No, not in the least. Everyone, including people who don't have afib, will experience brief runs of tachycardia, PVCs, etc. These are meaningless, harmless and perfectly normal.

I think you're reading too much into this. Trying to analyze these reports in detail without being an electrophysiologist is mainly just a good way to create stress in your life. Your EP's interpretation of the results is what you should be paying attention to.

40 bpm is no big deal, especially when you’re in bed.

Short bursts of tachycardia are also no big deal if they are < 30 seconds.

Basically, if you haven’t fallen over or passed out due to an arrhythmia then there really isn’t a need to panic. It’s treatable and you’re going to be OK.

Thanks for ringing in, wolfpak.

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It’s treatable and you’re going to be OK.

I guess I need to keep hearing that, along with some serious hand-holding!

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Carey

So things like high heart rates... if your heart rate is only high for a couple of beats, does it really matter?

No, not in the least. Everyone, including people who don't have afib, will experience brief runs of tachycardia, PVCs, etc. These are meaningless, harmless and perfectly normal.

I think you're reading too much into this. Trying to analyze these reports in detail without being an electrophysiologist is mainly just a good way to create stress in your life. Your EP's interpretation of the results is what you should be paying attention to.

You are right... it is a bit crazy making reading these... but... well, you know... The cardiologist office hasn't said too much really... mostly that I'm out of rhythm a lot, and being an ablationist that's their recommendation. Of course what worries me is if any of these things are going to make me suddenly drop dead... My kids wouldn't like that!

I'm also a bit confused about the things they report... I had the 1 'critical', 8 'serious' and a few dozen 'stable' reported events. What is the difference between the 3 classes and how big a deal are they? Critical sounds scary, right? Plus I know the monitoring company did call my doc after one of these.. The 'Critical' one has me really curious... as it looks no worse than the others. I'm also confused how elsewhere in the report it says my longest run of afib was 45min, yet that wasn't an event (but 1 minute was?)

Of course I do suppose the bottom line is that I'm screwed up, should get the ablation and hope for the best... but my science mind would like to be able to self interpret n bit as I think it would be helpful for me to self monitor... especially because I want to give up the anticoagulants if I have a successful ablation.


A few examples from my report
Critical: Atrial Fibrillation Sustained (1 min) w/PVCs (1 in 1 min)/Artifact
Serious: Atrial Fibrillation RVR Sustained w/Artifact
Serious: Atrial Fibrillation RVR Sustained w/Couplet PVCs/PVSs (4 in 1 min) Artifact
Serious: Atrial Fibrillation RVR Sustained w/Run of V-Tach (3-7 Beats)/Couplet PVCs (5 in 1 Min)

Stable: Atrial Fibrillation RVR Sustained w/Run of V-Tach (3-5 Beats)/Couplet PVCs/PVC (8 in 1 Min)
Stable: Atrial Flutter with Variable Conduction
Stable: Atrial Fibrillation RVR Sustained
Stable: Atrial Fibrillation Sustained

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bolimasa

Of course I do suppose the bottom line is that I'm screwed up, should get the ablation and hope for the best... but my science mind would like to be able to self interpret n bit as I think it would be helpful for me to self monitor... especially because I want to give up the anticoagulants if I have a successful ablation.

Our Chinese friends to the rescue, through eBay <[www.ebay.com]

Ten or so years ago, several posters here got their own holters, they were much more expensive then. I borrowed one for a bit, but it was overkill for what I needed, so I never got one. I can do longer term monitoring with a Polar H10 strap and an app, uploading the data to analyze on my computer. It only gives me a tachogram (beat to beat HR vs time), but that was/is (though I rarely use it these days) sufficient for monitoring for 30 minutes or 8 hours for me. Depends on how much effort you want to put in.

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bolimasa
A few examples from my report
Critical: Atrial Fibrillation Sustained (1 min) w/PVCs (1 in 1 min)/Artifact
Serious: Atrial Fibrillation RVR Sustained w/Artifact
Serious: Atrial Fibrillation RVR Sustained w/Couplet PVCs/PVSs (4 in 1 min) Artifact
Serious: Atrial Fibrillation RVR Sustained w/Run of V-Tach (3-7 Beats)/Couplet PVCs (5 in 1 Min)

Stable: Atrial Fibrillation RVR Sustained w/Run of V-Tach (3-5 Beats)/Couplet PVCs/PVC (8 in 1 Min)
Stable: Atrial Flutter with Variable Conduction
Stable: Atrial Fibrillation RVR Sustained
Stable: Atrial Fibrillation Sustained

There is nothing there that any cardiologist would call "critical," and nothing that's going to make you fall over dead. You just have afib.

If afib made anyone suddenly drop dead, then this forum would be a lot less active!

It won’t.

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wolfpack
If afib made anyone suddenly drop dead, then this forum would be a lot less active!

It won’t.

It won't if you take care of it.

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GeorgeN


Of course I do suppose the bottom line is that I'm screwed up, should get the ablation and hope for the best... but my science mind would like to be able to self interpret n bit as I think it would be helpful for me to self monitor... especially because I want to give up the anticoagulants if I have a successful ablation.


Our Chinese friends to the rescue, through eBay <[www.ebay.com]

Ten or so years ago, several posters here got their own holters, they were much more expensive then. I borrowed one for a bit, but it was overkill for what I needed, so I never got one. I can do longer term monitoring with a Polar H10 strap and an app, uploading the data to analyze on my computer. It only gives me a tachogram (beat to beat HR vs time), but that was/is (though I rarely use it these days) sufficient for monitoring for 30 minutes or 8 hours for me. Depends on how much effort you want to put in.

I'm not doing well at interpreting my hand held monitor. No sure I'd know what to do with 12 leads!

12-lead is too much. You'd have difficulty placing the pads if you haven't been trained how to do it properly. And even then it's kind of difficult to do on ones' own self. I wouldn't recommend anyone purchase such a technical monitor unless you're really, really motivated to learn how to use it and can justify the expense.

Kardia is the best, in my opinion. The subscription stuff to store EKGs is certainly a downside for those of use who weren't "grandfathered in" as early adopters. I'd still recommend it, though, with the caveat that you just have to remember to email yourself a copy of each trace that you want to keep or otherwise print it out right away.

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wolfpack
12-lead is too much. You'd have difficulty placing the pads if you haven't been trained how to do it properly. And even then it's kind of difficult to do on ones' own self. I wouldn't recommend anyone purchase such a technical monitor unless you're really, really motivated to learn how to use it and can justify the expense.

Kardia is the best, in my opinion. The subscription stuff to store EKGs is certainly a downside for those of use who weren't "grandfathered in" as early adopters. I'd still recommend it, though, with the caveat that you just have to remember to email yourself a copy of each trace that you want to keep or otherwise print it out right away.

That is why I chose the Emay... it stores all the traces in a database on my computer.
Now if I could only parse out the useful information... like when I'm actually in afib vs not afib arhythmia. That is where I'm having a hard time,

You could always get the Kardia, too, and compare them. I know it's expensive but so is everything else when it comes to AF. I probably eat over a Kardia's worth of supplements every other month!

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bolimasa
Now if I could only parse out the useful information... like when I'm actually in afib vs not afib arhythmia. That is where I'm having a hard time,

Just look at the R waves and measure the distance between them (count the small boxes on the grid). If the distance between them varies a significant amount from beat to beat, odds are it's afib.

But otherwise, diagnosing most arrhythmias with a single-lead device like the Kardia is somewhere between difficult and impossible. A single lead just doesn't show the views you need to make most diagnoses. And anyone contemplating buying a 12-lead needs to take an ECG course first. It's not something you can learn in 20 minutes on a forum.

To expand, the R waves are the “tops” of the QRS complexes (the “big spikes”). Each little box on the EKG trace in the X (horizontal) direction is 40 ms (milliseconds). There are 5 “little” boxes in one “big” box, making the “big” box 200 ms, or 0.2 seconds. Just remember that and it’s pretty easy to count them up.

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bolimasa
Now if I could only parse out the useful information... like when I'm actually in afib vs not afib arhythmia. That is where I'm having a hard time,

I'm in the same boat. I'm slowly learning the basics of the ECG. It's not that sophisticated when the goal is just to track arrhythmias, but some tracings may be confusing when we are not used to look at what we should (as explained here above by Carey and Wolfpack). I've posted some tracings here to get some help and, thanks, I got it.

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wolfpack
To expand, the R waves are the “tops” of the QRS complexes (the “big spikes”). Each little box on the EKG trace in the X (horizontal) direction is 40 ms (milliseconds). There are 5 “little” boxes in one “big” box, making the “big” box 200 ms, or 0.2 seconds. Just remember that and it’s pretty easy to count them up.

I get the basic waves... but what I don't get is telling arrhythmia from Afib...

My monitor says arrhythmia most of the time... A trace often looks like this, where I'm partially in rhythm (evenly spaced with P waves)for 3 or more beats, then I get some little runs of 2-5 closely spaced beats where I don't see the P wave, but don't really see fibrillations either. Are those regions a few quicker beats afib or some other arrhythmia like PACs? Sometimes I see things that are I think, clearly afib, but most of traces are similarish to this one:

You're probably over analyzing this. I think what you posted above is bursts of PACs and maybe very short runs of afib, but what does it matter in the end? PACs cause symptoms too, so whether it's PACs or brief runs of afib isn't really a useful distinction. I think most EPs would look at that, shrug, and ask you if you felt symptoms.

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Carey
You're probably over analyzing this. I think what you posted above is bursts of PACs and maybe very short runs of afib, but what does it matter in the end? PACs cause symptoms too, so whether it's PACs or brief runs of afib isn't really a useful distinction. I think most EPs would look at that, shrug, and ask you if you felt symptoms.

Yeah, I do like yo over analyze everything.

I mostly I don't really notice any symptoms.
I guess I thought it matters because if AFib is the thing that matters, I would like to be able to figure out when I'm doing it.

If it doesn't often bother me, and PACs don't matter, and if I only AFib for a couple beats at time, do I really need blood thinners? Do I really need to be considering an ablation?

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bolimasa
If it doesn't often bother me, and PACs don't matter, and if I only AFib for a couple beats at time, do I really need blood thinners? Do I really need to be considering an ablation?

You can't answer those questions by looking at ECGs. People with afib tend to have strokes more often than people without afib even when their afib is well controlled. The question of an ablation is whole 'nother bag of worms and it also doesn't depend on some ECGs you recorded.

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bolimasa

To expand, the R waves are the “tops” of the QRS complexes (the “big spikes”). Each little box on the EKG trace in the X (horizontal) direction is 40 ms (milliseconds). There are 5 “little” boxes in one “big” box, making the “big” box 200 ms, or 0.2 seconds. Just remember that and it’s pretty easy to count them up.

I get the basic waves... but what I don't get is telling arrhythmia from Afib...

My monitor says arrhythmia most of the time... A trace often looks like this, where I'm partially in rhythm (evenly spaced with P waves)for 3 or more beats, then I get some little runs of 2-5 closely spaced beats where I don't see the P wave, but don't really see fibrillations either. Are those regions a few quicker beats afib or some other arrhythmia like PACs? Sometimes I see things that are I think, clearly afib, but most of traces are similarish to this one:

[s15.postimg.cc]

You are getting PAC “storms” and are on the cusp of a-fib. Unless Murphy’s Law doesn’t apply to you, it’ll only progress. The good news is you have time to contemplate a decision.

I over-analyze everything, too. Tenacity is an asset when it comes to AF (and health in general). Don’t apologize for that!

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wolfpack


To expand, the R waves are the “tops” of the QRS complexes (the “big spikes”). Each little box on the EKG trace in the X (horizontal) direction is 40 ms (milliseconds). There are 5 “little” boxes in one “big” box, making the “big” box 200 ms, or 0.2 seconds. Just remember that and it’s pretty easy to count them up.

I get the basic waves... but what I don't get is telling arrhythmia from Afib...

My monitor says arrhythmia most of the time... A trace often looks like this, where I'm partially in rhythm (evenly spaced with P waves)for 3 or more beats, then I get some little runs of 2-5 closely spaced beats where I don't see the P wave, but don't really see fibrillations either. Are those regions a few quicker beats afib or some other arrhythmia like PACs? Sometimes I see things that are I think, clearly afib, but most of traces are similarish to this one:

[s15.postimg.cc]

You are getting PAC “storms” and are on the cusp of a-fib. Unless Murphy’s Law doesn’t apply to you, it’ll only progress. The good news is you have time to contemplate a decision.

I over-analyze everything, too. Tenacity is an asset when it comes to AF (and health in general). Don’t apologize for that!

So is that how it works? Lots of PACs proceed Afib?
That they are a harbinger of bigger problems in the future?

Does cardiac stress increase Afib? I know when I had my stress echo it said I was in Afib when under stress. I **think** I have more actual Afib when I do things that get my heart rate up (like at stair #112 at work)..... though that is one reason I'd like to figure out how to better discern PACs from Afib... so I can figure out what brings it on... and to figure out how to keep it from coming back if I get it fixed.

I do suppose Carey makes a valid point, that I have Afib and the monitoring results don't really matter... that my choices are drugs I don't want to take or an ablation... but I find I still want to over analyse and figure things out.

At this point I'm thinking I'm going to do the ablation.
It seems foolish not to do it while my heart is still otherwise healthy, my insurance is good and I have a (I think, I hope) an excellent EP.

Yes, PACs almost invariably precede an AF episode. They are happening because the conduction in the atria is changing and other foci, likely in and around the pulmonary veins, are beginning to depolarize at a frequency very near the sinoatrial (SA) node - the heart's natural pacemaker. Thus the re-entrant rhythm we call atrial fibrillation.

If it happens when you are under exertion then that signifies an adrenerigic trigger. Your heart is regulated by pressure, just like any other pump. It doesn't matter if a mechanical engineer designs it or Mother Nature. Pumps are in pressure servo loops. The laws of physics aren't different for biologics versus machines. In our case, there are baroreceptors in the carotid arteries that sense blood pressure. When it falls, for example, due to physical exertion then the hypothalamus (neuroendocrine system, or the brain/gland connection) signals the adrenal glands to release norepinephrine into the blood. When that reaches the heart (literally in a second) it shortens the atrial refractory period. The refractory period is the time during which atrial cells are not electriclally stimulatable. A long refractory period means a lower heart rate. A short refractory period means a higher heart rate. In your case, it's quite plausible that this norepinephrine "rocket fuel" shortens the refractory period of some "rouge" cells in your left atrium such that they compete with the SA node in your right atrium. That's AF.

The biochemistry behind how norepinephrine acts on atrial tissue is that it alters the preference for voltage-gated ion channels in each and every cell membrane to leak out potassium (K+) and absorb sodium (Na+). To a much smaller extent, also calcium (Ca2+). That lowers what's called the action potential and makes beats more frequent. This is why many of us find it beneficial to supplement magnesium (necessary for the K+ pump), potassium (raises the action potential), and to avoid sodium (lowers the action potential) and calcium (helps the Na+ pump). It won't "solve" AF but it will at least set up a more favorable electrolyte balance so there's not as much "fuel for the fire" when things go wrong.

Grab a (salt-free) snack and watch this: Cardiac Action Potentials



Edited 1 time(s). Last edit at 08/09/2018 11:05AM by wolfpack.

Thanks, Wolfpack, for those explanations.
(I'll not die stupid).

I agree about the magnesium: it helps, even if it does not prevent afib. It's the supplement I'm sure I've better carry on taking. It gives me better sleep and eases my bowels.
I've just received betaine HCl. It's something I've not yet tried. I hope it'll help my stomach. My afib episodes are always coupled with stomach uneasiness.

No problem, but fact check me. I probably got some stuff wrong there! Typed it pretty fast. The Khan videos are really well done, though. If you have an hour or two, watch them all. Maybe take a break in between so your brain doesn't swell, but you'll come out in the end with a really good basic intro to cardiac electrophysiology. I find that some doctors will open up a bit more and spend more time with you once you cross their idiot threshold. Knowledge is power.

Thanks Wolfpack, for the information.....
Hopefully this weekend I'll find some time to further look at the information.

(Can I say how much I'm tired of thinking about this? I just want put my head in the sand and pretend I'm a healthy person again)

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wolfpack
No problem, but fact check me. I probably got some stuff wrong there! Typed it pretty fast. The Khan videos are really well done, though. If you have an hour or two, watch them all. Maybe take a break in between so your brain doesn't swell, but you'll come out in the end with a really good basic intro to cardiac electrophysiology. I find that some doctors will open up a bit more and spend more time with you once you cross their idiot threshold. Knowledge is power.

I'm sure it'll take me some time (and head scratching) to understand all that, but I like learning, so why not?
I've noticed the same thing with doctors: once they realize you've learnt some basics, they are more prone to explain what happens in your heart. Knowledge is really crucial with afib, because there's no indisputable remedy. Choices and decisions belong to the patient.

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Pompon
Thanks, Wolfpack, for those explanations.
(I'll not die stupid).

I agree about the magnesium: it helps, even if it does not prevent afib. It's the supplement I'm sure I've better carry on taking. It gives me better sleep and eases my bowels.
I've just received betaine HCl. It's something I've not yet tried. I hope it'll help my stomach. My afib episodes are always coupled with stomach uneasiness.

What does the betaine do?
I only know of it as PCR additive in the lab.

Betaine HCl is hydrochloride acid, like the one we have in our stomach. When getting older, acid and pepsine production tend to decrease. When so, digestion is too slow, the food produces gas and discomfort. Bloated stomach and afib are related. That's why I'm trying this supplement...

Pompon - ultimately, the problem may be that there are not enough essential nutrients to make the stomach acid.
This is typically a specific B vitamin and zinc deficiency. Definitely, keep taking the betaine HCl and try to be tested for the essential nutrients that support stomach acid production so you can target repletion.

Jackie

Thanks, Jackie. It's too soon to say my acid production was definitely unsufficient, but the fact is I've now much less ectopics after meal. At least, betaine HCl was worth the try...

Pompon - yes definitely... taking the additional HCl is easy, inexpensive and if effective; definitely worth it because then your food can be broken down properly so you can benefit from the nutritional components. Many people have had relief from Afib by managing digestive complaints.

Jackie