Is it OK to have a little alcohol now that I no longer have Afib?

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rocketritch


Personally even at 45 I would be hesitant to go off the Eliquis. Or at that point would something like a daily aspirin be recommended? A 3.6 increase, unless maintained for a period of time seems a small amount to make such a decision.

They didn't work in the dementia study, so obviously not stopping mini-clots to the brain.

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mwcf
Stating the obvious maybe, but given the current scientific consensus that fibrosis comprises an at least significant component of atrial myopathy then I’m struggling to see how a Watchman could reverse fibrosis.

It doesn't. It's simply that 90% of all clots that form in the left atrium form in the LAA. So if you close the LAA you eliminate 90% of ischemic strokes. The remaining 10% are going to be clots from other sources, ruptured plaques, etc.

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Carey

Stating the obvious maybe, but given the current scientific consensus that fibrosis comprises an at least significant component of atrial myopathy then I’m struggling to see how a Watchman could reverse fibrosis.

It doesn't. It's simply that 90% of all clots that form in the left atrium form in the LAA. So if you close the LAA you eliminate 90% of ischemic strokes. The remaining 10% are going to be clots from other sources, ruptured plaques, etc.

I wonder how anyone would know the exact percentage of where clots come from. That's supposed to be true for everyone?

If 90% of clots form in the LAA, that doesn't mean you eliminate 90% of ischemic strokes by sealing it off. Clots from other areas are just as likely to get released, and it only takes one.

If you did have a stroke, I guarantee that your doctor would shrug his/her shoulders regarding where it came from.



Edited 2 time(s). Last edit at 10/15/2018 12:10PM by jpeters.

looks like they are talking about CHAD scores?


myopathy underlying AF. Although thromboembolic risk is currently defined by clinical scores, their predictive value is mediocre. Evaluation of stasis via imaging and biomarkers associated with thrombogenesis may provide enhanced approaches to assess risk for stroke in patients with AF. Better delineation of the atrial myopathy that serves as the substrate for AF and thromboembolic complications might improve treatment outcomes. Furthermore, better delineation of the pathophysiologic mechanisms underlying the development of the atrial substrate for AF, particularly in its earlier stages, could help identify blood and imaging biomarkers that could be useful to assess risk for developing new-onset AF and suggest specific pathways that could be targeted for prevention.


[www.ahajournals.org]



Edited 1 time(s). Last edit at 10/15/2018 02:09PM by Elizabeth.

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jpeters
I wonder how anyone would know the exact percentage of where clots come from. That's supposed to be true for everyone?

If 90% of clots form in the LAA, that doesn't mean you eliminate 90% of ischemic strokes by sealing it off. Clots from other areas are just as likely to get released, and it only takes one.

If you did have a stroke, I guarantee that your doctor would shrug his/her shoulders regarding where it came from.

Simple: clots in the atria are easily seen on TEE and 90% of them are found in the LAA.

Of course you'll eliminate 90% of ischemic strokes if you eliminate the source of 90% of clots. Yes, you're still subject to the 10% that come from elsewhere, as I already said.

A cardiac workup with TEE following a stroke is common since a stroke can be caused by a small clot breaking off from a larger one, or there could be a vegetation. In either case they're going to want to know in order to treat to preempt additional strokes.

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rocketritch
Personally even at 45 I would be hesitant to go off the Eliquis. Or at that point would something like a daily aspirin be recommended? A 3.6 increase, unless maintained for a period of time seems a small amount to make such a decision.

I'd also be hesitant. I would want a comfortable margin above the minimum number. I've heard from others that did meet the 45 criteria that Natale said they could stop entirely if they desired but he recommended continuing either a half-dose Eliquis or low-dose aspirin.

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Brian_og
....As with TEE, flow velocities in patients imaged during sinus rhythm were higher than those imaged in AF, but were significantly depressed compared to a similarly aged cohort without a history of AF. Almost by definition, the atrial myopathy underlying AF is likely responsible for the diminished flow observed in patients with AF imaged when in sinus rhythm."

So previous AF results in lower LAA velocities. Does this normalise the longer one is clear of AF after a successful ablation and if so after how long? Also, I wonder what total AF burden one needs to have had/have before LAA velocity becomes lowered?

In my own case I’ve had PAF for nearly 20 years but less than 100 hrs AF in total. This might be explained by the fact that according to Prof Jais I have no atrial fibrosis. I think my genetic quirk is way more related to ANS imbalance than anything else. Wishful thinking maybe but maybe my stroke risk is still not much more than folks who’ve never had AF.

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Carey

Personally even at 45 I would be hesitant to go off the Eliquis. Or at that point would something like a daily aspirin be recommended? A 3.6 increase, unless maintained for a period of time seems a small amount to make such a decision.

I'd also be hesitant. I would want a comfortable margin above the minimum number. I've heard from others that did meet the 45 criteria that Natale said they could stop entirely if they desired but he recommended continuing either a half-dose Eliquis or low-dose aspirin.

Full dose (5mg) vs half dose Eliquis confuses me. I know if body weight is >60kg then a full dose is indicated. As stated above, is the person <60kg or is there another reason that a half dose is still efficacious?

Joe:

When my EP wanted me on eliquis, he had tests run for Creatinine and Bun, also for platelets, if you have low platelets (depends on how low) probably can't be on a blood thinner.

L

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mwcf
So previous AF results in lower LAA velocities.

No, LAA velocities only matter if your LAA has been isolated by an ablation, which the majority don't. If that hasn't happened, you can ignore the whole LAA issue.

My thoughts.........as someone mentioned above, um if we are afraid to partake in a mere beverage does that really kind of reflect on our confidence in the success of our procedures?
I think alcohol triggers ectopics for me sometimes and it may be due to dehydration who knows?? I never really drink more than a couple of drinks ever. I've never smoked so I'm under the belief of ........if I want a stupid drink I'm having one, geez life's short.

Life's a game, play it to the fullest because there are no refunds! DLR

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Elizabeth
Joe:

When my EP wanted me on eliquis, he had tests run for Creatinine and Bun, also for platelets, if you have low platelets (depends on how low) probably can't be on a blood thinner.

L

Thanks for that, Liz. Never had any tests, he just prescribed Eliquis and i'm taking it right now. I'll ask him tomorrow.

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tsco
My thoughts.........as someone mentioned above, um if we are afraid to partake in a mere beverage does that really kind of reflect on our confidence in the success of our procedures?
I think alcohol triggers ectopics for me sometimes and it may be due to dehydration who knows?? I never really drink more than a couple of drinks ever. I've never smoked so I'm under the belief of ........if I want a stupid drink I'm having one, geez life's short.

Life's a game, play it to the fullest because there are no refunds! DLR

We're waiting for you to do the experiment. Go drink a bunch and let us know how it goes 😁

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Carey

"So previous AF results in lower LAA velocities.

No, LAA velocities only matter if your LAA has been isolated by an ablation, which the majority don't. If that hasn't happened, you can ignore the whole LAA issue."

They seem to be emphatically stating that cardiomyopathy etc causes low flow which raises the stroke risk. Doesn't mention LAA isolation. What do you think?

"Preliminary findings demonstrate that 4D flow MRI can detect individual physiologic changes in LA flow velocities in patients with AF that are not conveyed by the standard CHA2DS2-VASc clinical risk score.131–133 We have demonstrated an inverse relationship between flow and the CHA2DS2-VASc score. As with TEE, flow velocities in patients imaged during sinus rhythm were higher than those imaged in AF, but were significantly depressed compared to a similarly aged cohort without a history of AF. Almost by definition, the atrial myopathy underlying AF is likely responsible for the diminished flow observed in patients with AF imaged when in sinus rhythm. In addition, there may be a dynamic change in LA flow velocities in sinus rhythm depending on degree of atrial myopathy, frequency and duration of AF episodes, and time from the most recent episode of AF. In addition, other factors such as LA geometry may affect the tendency for areas of stasis and thrombus formation"



Edited 2 time(s). Last edit at 10/16/2018 02:40AM by Brian_og.

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Carey

So previous AF results in lower LAA velocities.

No, LAA velocities only matter if your LAA has been isolated by an ablation, which the majority don't. If that hasn't happened, you can ignore the whole LAA issue.

That would have been my presumption too Carey but for that paragraph from the article I referenced in a previous post to this thread that states:

"As with TEE, flow velocities in patients imaged during sinus rhythm were higher than those imaged in AF, but were significantly depressed compared to a similarly aged cohort without a history of AF. Almost by definition, the atrial myopathy underlying AF is likely responsible for the diminished flow observed in patients with AF imaged when in sinus rhythm.""

Which seems to imply that previous AF (and presumably quite a high cumulative burden of it over many years rather than a couple of short episodes) - even when managed back to NSR with a successful ablation results in slower LAA velocities than non-AFrs. I didn't get the impression that the paragraph quoted above relates only to those who as part of their ablation/s have had their LAA ablated but I'm happy to be corrected.

Mike

I am trying to figure out what triggers my episodes. I thought it was alcohol but this morning I work up and an episode had started befor I could eat or drink anything.
Any ideas or has this happened to others. A first for me.episode was very mild.

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Carolyn23
I am trying to figure out what triggers my episodes. I thought it was alcohol but this morning I work up and an episode had started befor I could eat or drink anything.
Any ideas or has this happened to others. A first for me.episode was very mild.

Everyone with afib tries to figure out their triggers, but in the end it's mostly a waste of time. I was rigorous about testing things I thought might be triggers, and one by one when I tested them fairly they all fell by the wayside. At least for myself, the only things I found to reliably be triggers were dehydration and low potassium levels. A few other things made afib more likely, such as high blood pressure, but they weren't triggers exactly. They just made it more likely. I doubt very much there are many things you can do or not do that will consistently cause or prevent afib episodes.

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mwcf
Which seems to imply that previous AF (and presumably quite a high cumulative burden of it over many years rather than a couple of short episodes) - even when managed back to NSR with a successful ablation results in slower LAA velocities than non-AFrs. I didn't get the impression that the paragraph quoted above relates only to those who as part of their ablation/s have had their LAA ablated but I'm happy to be corrected.

Yeah, I see what you're saying and you're probably right that LAA flow velocities do matter even when your LAA hasn't been isolated. That could, in fact, answer the question of why people with afib are more prone to strokes even when they're not in afib any longer.

The only 100% trigger I've ever identified was/is MSG. As I've said many times here before, during 2015 and 2016 I had 3 episodes of AF. Two of those episodes I had an hour and a half after eating Chinese takeway food (and I only had Chinese takeaway food twice in that time period) and the other time was after having greedily consumed 2 large bags of Jalapeno Pretzel pieces that when I read the packet later had 5 different types of MSG (incl. the raw article itself) in them. Needless to say I'm very vigilant about MSG!!

I'm a believer that after the genetic trigger, dehydration plays a big impact. I suspect that when I drank (beer, I was known to binge), it was the dehydration from alcohol that instigated an episode. Now I stay fit, hydrated, exercise, eat mostly well and take the supplemental duo of magnesium & taurine. Regular consumption of low sodium V8, avocados, bananas, and broccoli. I'm eating a 5lb bag a week, most weeks. Good thing I like it.

I had an ECHO done this last Aug. I have had episodes of AF off and on for almost 20 years. The discussion about LA velocity probably only changes when it is isolated. My LA ef is 65%.

Liz



Edited 1 time(s). Last edit at 10/16/2018 02:16PM by Elizabeth.

As I have said before, I never defined a Actual AFIB trigger with the possible exception of anxiety/stress. I ask Dr. Natale years ago about triggers such as laying on your left side. He laughed and basically debunked the triggers with the exception of Holiday AFIB.

For me, I was a persistent AFIBBER from the day I was diagnosed with AFIB in late 2011. Only the paddles would bring me back to NSR except one time after my 1st Ablation.
I think it could be in the water and I am serious. The water we drink this day and time has so many byproducts made from the chlorine used to disenfect the water such as THM’s(Trihalomethanes). These is BAD. Read about it sometime. It can be in your bottled water etc. Years ago, when we were raised on Well water there was no THM’s because no chlorine was used.
Just food for thought,

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Elizabeth
I had an ECHO done this last Aug. I have had episodes of AF off and on for almost 20 years. The discussion about LA velocity probably only changes when it is isolated. My LA ef is 65%.

You're mixing up the left atrium (LA) and the left atrial appendage (LAA). An external echo can't see the LAA. Only a TEE can see it and measure LAA flow velocity. That 65% number you mention sounds like your ejection fraction, which is the amount of blood pumped out of your left ventricle on every beat.

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smackman
The water we drink this day and time has so many byproducts made from the chlorine used to disenfect the water such as THM’s(Trihalomethanes). These is BAD.

Drink?

"In fact, while showering, your body absorbs 6 times the contaminants it does when you drink 8 glasses of water."



Edited 1 time(s). Last edit at 10/16/2018 07:57PM by jpeters.

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jpeters
Drink?

"In fact, while showering, your body absorbs 6 times the contaminants it does when you drink 8 glasses of water."

Who or what are you quoting?

Carey:

You are right, thanks for the correction.

Liz

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Carey

Drink?

"In fact, while showering, your body absorbs 6 times the contaminants it does when you drink 8 glasses of water."

Who or what are you quoting?

Aquaoxfilters (Removes TTHMs (Trihalomethanes)

[www.aquaoxfilters.com]

Disclaimer...I have no idea whether they work, and have no intent to try them.



Edited 2 time(s). Last edit at 10/16/2018 11:19PM by jpeters.

The US has some of the safest public water supply in the world. It's usually safer than bottled water. I'm really tired of reading alarmist crap about it aimed at drumming up sales of useless crap.

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Carey
The US has some of the safest public water supply in the world. It's usually safer than bottled water. I'm really tired of reading alarmist crap about it aimed at drumming up sales of useless crap.

"Bottom line: A good water filter can turn ordinary tap water into a healthy and cost-effective source of pure hydration for your dog and the entire family."

[www.dogster.com]



Checked out test results for my area from the EWG database:


East Bay Municipal Utility District

Contaminents ABOVE Health Guidelines
Chromium (hexavalent)
cancer✕
Radiological contaminants
cancer✕
Total trihalomethanes (TTHMs)
cancer✕

Other Contaminents:
Aluminum
Bromide
Chlorate
Fluoride
Haloacetic acids (HAA5)
Molybdenum
Nitrate
Strontium
Vanadium

Source: Industry

Aluminum
Bromide
Chlorate
Strontium
Molybdenum
Vanadium
Radium, combined (-226 & -228)
Radium-226
Uranium



Edited 1 time(s). Last edit at 10/17/2018 01:12AM by jpeters.

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Carey
The US has some of the safest public water supply in the world. It's usually safer than bottled water. I'm really tired of reading alarmist crap about it aimed at drumming up sales of useless crap.

A friend of mine had a water treatment sales guy come to his house. He has well water and the guy was trying to convince him he needed a system. So my buddy went to the fridge and brought back a unopened bottled water. He told the salesman that if the water in the bottle was better quality than his well water he would purchase whatever the guy wanted him to buy. The salesman left dejected.

I do have a whole house charcoal filter on my home and a drinking water system as well. I purchased it when we lived in our former home as there was so much chlorine in the water i could not take showers without coughing up a lung.



Edited 1 time(s). Last edit at 10/17/2018 04:55AM by rocketritch.

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Carey
The US has some of the safest public water supply in the world. It's usually safer than bottled water. I'm really tired of reading alarmist crap about it aimed at drumming up sales of useless crap.

As someone who lives in a area where THM’s levels are 3x above the limit, what you are saying is not true. I also have served on this water commission board for years until a few months ago. In many areas, It is not a conspiracy theory; It’s a reality and a costly nightmare to remove from the household water.
You might be a medical expert but I know this from personal experience and knowledge. I am no leftie in politics; In life, I am a down the middle individual. The Aquafier in Many Parish’s in Louisiana especially Norhern area have very bad water.
Also, It does soak through the skin and buying a filter for your entire house is out of range for the average household.

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jpeters
"Bottom line: A good water filter can turn ordinary tap water into a healthy and cost-effective source of pure hydration for your dog and the entire family."

"A source of pure hydration" -- what the hell does that even mean? (Answer: Nothing whatsoever.)

Not paying for water filters is even more cost effective.

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Carey

"Bottom line: A good water filter can turn ordinary tap water into a healthy and cost-effective source of pure hydration for your dog and the entire family."

"A source of pure hydration" -- what the hell does that even mean? (Answer: Nothing whatsoever.)

Not paying for water filters is even more cost effective.

My Youngest Daughter(35) lives in Frisco, Texas. Their water at the tap is Excellent. There quarterly water report I dream of having. We both have the same Humidifiers with the same filter. They use one filter from November to March; I have to change my filter at least every month due to dirt and calcium buildup.
Water is needed for survival. I really believe and fight for clean drinking water for all families. I do believe it is a much bigger issue than 50 years ago because most of the cancer byproducts in the water are formed when chlorine is introduced into the system.A very informed man said from Louisiana Dept of Health last month said if we could sell these byproducts made by using chlorine, Louisiana would be a very Wealthy State.
It is a tremendous Health Issue. I do use a .5 micron carbon filter for my drinking water but to install a filter for the entire house that would eliminate these cancer causing byproducts cost approximately $6000.

Wow, all this talk about water makes me wonder if I should filter my beer!

Back on topic, I'm not one of the ones for whom alcohol was ever really a "trigger". My suspicion is that arrhythmia may be secondary to consumption due to the loss of potassium, magnesium and overall dehydration. Perhaps if one were concerned about it, one could add a little bit more of the supplementation before and after having a few drinks. Not a whole lot more, mind you, to the point of bowel issues but perhaps 10-20% more than what one normally takes on a daily basis. Drinks are going to make you pee - that's a certainty - so I don't think its at all risky to bump up the electrolytes in the short term. Most importantly, have water as well. Ever since I got my supplementation figured out I can report almost no problems at all with alcohol consumption. At worst if I really overdo it I can expect some PACs the next day but who knows if they weren't in the mix anyway? It's tough to say. There have been other times where nothing happens at all. Football season usually sees me popping open "a few" (ahem) on a Sunday. I hit the track or treadmill Monday morning and everything's smooth as glass.

Of course, if alcohol has proven time and time again to give you problems, then certainly don't do it. But I wouldn't avoid it based on fear alone just because we have AF histories. We all know what the doctors say, but realize they are ethically bound to give the soundest advice possible and that's what they do. In reality a beer or cocktail is no Sword of Damocles.

Hello Smackman... good for you to be so diligent about the quality of water. Certainly very important.
You may be interested in this report by Ty Bollinger (he's the researcher who does The Truth About Cancer series and blogs)

Is Tap Water Safe to Drink? Minimizing Your Risk of Carcinogens in Drinking Water
[thetruthaboutcancer.com]

Jackie

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Carey
The US has some of the safest public water supply in the world. It's usually safer than bottled water. I'm really tired of reading alarmist crap about it aimed at drumming up sales of useless crap.

Oh really, tell that to the residents of Flint, Michigan, they can't drink their water, many of the young are sick from it.

L

A single city with a huge problem caused by political corruption hardly makes a case for US drinking water being unsafe. Regardless of Detroit, it's generally considered the safest in the world.

Its Flint not Detroit, they were OK when using Detroit water when they started using Flint water (which was contaminated by factories dumping) they got in trouble. Sure, it was political, but if you think that a lot of the big cities don't have any problems with their water, think again.

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Elizabeth
Its Flint not Detroit, they were OK when using Detroit water when they started using Flint water (which was contaminated by factories dumping) they got in trouble. Sure, it was political, but if you think that a lot of the big cities don't have any problems with their water, think again.

You can just click on the link in the article I posted and type in your zipcode.

You can just click on the link in the article I posted and type in your zipcode.

What link in what article?

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Elizabeth
You can just click on the link in the article I posted and type in your zipcode.

What link in what article?

[www.ewg.org]

I have my own well, the water is high in minerals, tasty too.

L

Wells can have plenty of problems, just ask the folks a few miles west of me who were all condemned due to TCE (trichloroethylene) contamination from an old factory. Turns out another old factory did the same thing a few miles east and also contaminated the groundwater. There hasn't been a single new neighborhood built around me with individual wells in the last decade. All community wells. Coincidence? Probably not.

I just paid my county $350 to do a VOC (volatile organic compound) and Rads package (uranium, radon) assay on my well water. I'm still in the queue waiting for it to get done because about half the county has drawn the same permits it seems.

We should probably branch off this discussion into General Health. The OP wanted to know about having a cocktail and here we are debating drinking water! Oops.

I have been known on occasion to have a beer with dinner when out with the family without any issues. And have shared a pitcher with friends after a long day on the bike with friends without issue following my ablation back in 2009 but as a rule don't drink at all. However, to indulge has always been my ruin so far as the heart goes.

Summer 2016, I was installing new gutters on the house.What I though was going to be a morning project was slowly turning into an all day event.My wife sensing my frustration opened a bottle of wine. She took a glass, I took the bottle. This happened twice that afternoon and my heart was a mess as was I. But as others have mentioned here, I'm not so sure it wasn't dehydration that caused my issues that particular day and not the alcohol.

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rocketritch


Summer 2016, I was installing new gutters on the house.What I though was going to be a morning project was slowly turning into an all day event.My wife sensing my frustration opened a bottle of wine. She took a glass, I took the bottle. This happened twice that afternoon and my heart was a mess as was I. But as others have mentioned here, I'm not so sure it wasn't dehydration that caused my issues that particular day and not the alcohol.

A far more prevalent event is falling off the roof syndrome which, like many other self inflicted injuries, is highly correlated with alcohol consumption.

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jpeters
A far more prevalent event is falling off the roof syndrome which, like many other self inflicted injuries, is highly correlated with alcohol consumption.

I have 2 friends that have fallen off of ladders several times,stone sober, breaking multiple body parts. I've been pretty fortunate on the not falling from high places front. Mostly as I fear heights, which is odd for a guy that hunts from tree stands and is on the rope rescue team at work.

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rocketritch



I have 2 friends that have fallen off of ladders several times,stone sober, breaking multiple body parts. I've been pretty fortunate on the not falling from high places front. Mostly as I fear heights, which is odd for a guy that hunts from tree stands and is on the rope rescue team at work.

A construction guy I know with afib claims that his fear of heights is a major trigger.

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jpeters

A construction guy I know with afib claims that his fear of heights is a major trigger.

Fortunately I have never had an issue in either situation. I suppose the confidence in my rescue team members nulifies any stressers I might normally have.

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rocketritch
I have 2 friends that have fallen off of ladders several times,stone sober, breaking multiple body parts.

My time as an EMT taught me there are some things people fear that they shouldn't, and other things they don't fear that they should. Ladders are very high on the should list.

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Carey
My time as an EMT taught me there are some things people fear that they shouldn't, and other things they don't fear that they should. Ladders are very high on the should list.

If memory serves me right death from falling from lladder statistics are pretty high.