Heart Remodeling

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katesshadow
But, does having long periods of time between episodes remodel the heart in a good way?

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katesshadow
I guess I misunderstood remodeling. I thought it was similar to Afib begets Afib.

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katesshadow
George, did you try the entire 2.5 month to get out of A Fib and then go to e Flec?

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katesshadow
It's encouraging that you have been able to control yours with lifestyle and supplements, but 24-48 hours without supplements is a relatively short time.

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wolfpack
Remodeling is kind of a years-long thing. If you've had paroxysmal episodes for just a few months, I wouldn't worry too much about it. Your heart is basically the same as it was before AF. You just really need to concentrate on your plan for dealing with the AF, be that medical (AARs, betas, NOACs) or surgical (ablation). Lifestyle and risk-factor management apply equally to both courses of action.

Stress depletes electrolytes, especially magnesium. It plays a huge role in AF. You're not imagining that. Ignore the whitecoats who say it doesn't matter. We all know better.

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MissSunshine
Kate - I hear you. You are hoping the longer you are in NSR, that your heart would prefer to stay there! There may be some that have one Afib episode and then never again. However, as Mike, Carey and George have said, once you have had it, you are more prone to it. However, don’t dispair. Many, many people live long productive and happy lives with Afib. They may control it with meds and supplements, decide to have an ablation or if those fail, live in permanent Afib. I know that it is hard to have a positive outlook when one first starts dealing with arrhythmia. But, today you are in NSR and be grateful for that. Hopefully you are for years to come. However, if the day comes and your heart goes off the rails again, you will not have wasted time worrying about it. My first episode was in 2003 then the next in 2009. Starting in 2013, I was having an episode every 6 to 8 months - all resolving themselves. In November 2017, while hiking in New Zealand, I went into Afib and was there for 3 days. Come home and then January 2018, I went into Afib for a week and had to be shocked back into rhythm. I decided then that my heart was going to keep having longer and more persistent episodes. I had my first ablation in February 2018 and my touch up in June at TCAI in Austin. Other than a 20 minutes episode just a few days outside of my 3 month blanking period from my second ablation, I have been in NSR. I am off of Sotalol and hoping to get off Xarelto soon. But, the psychological part of all of this has been the worst. So, my advice to you as to not worry is advice that I have also had to learn and work on everyday. Working out and living my life to the fullest is the best for the anxiety that goes with this condition. All the best and rock on!

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GeorgeN

I guess I misunderstood remodeling. I thought it was similar to Afib begets Afib.

There is both electrical and physical remodeling.


George, did you try the entire 2.5 month to get out of A Fib and then go to e Flec?

In the two months prior to the 2.5 month episode, I learned I could convert many episodes with exercise. However that did not work for this episode. Initially I had a cardio who told me his favorite afib med was digoxin. I knew I was vagal and that digoxin was contraindicated for vagal afibbers, so we'd have hour long discussions where I refused digoxin and he'd tell me why he didn't believe in vagal/adrenergic triggers. He put me on warfarin, where I needed to be on it for 4? weeks before he'd try to cardiovert me. Ultimately he transferred me to the EP (likely because he got tired of our discussions). The EP suggested I remain out of rhythm as my afib heart rate was low. I proposed a "Plan B" which was him cardioverting me followed by my trying to stay in rhythm with electrolytes with PIP flecainide as a fallback. He agreed to this. I scheduled a cardioversion, but then tried the flec, which worked.


It's encouraging that you have been able to control yours with lifestyle and supplements, but 24-48 hours without supplements is a relatively short time.

Yes it is and I have inadvertently tested this over the years. The biggest cause of my afib episodes is forgetting to take magnesium. It is rare that I do this, but stress can cause me to forget. I have a son with glioblastoma brain cancer and dealing with that has caused me to forget a number of times. I do focus on making it a priority.

Other than doing the things I do to stay on my remission protocol, I focus on optimizing my overall health. In a number of posts in this thread <[www.afibbers.org] I detailed some of this. I'm also very aware of when I'm pushing my limits. For example, I skied Aspen and Aspen Highlands four days last week, lapping the steeps without issue, but by myself. On Saturday I skied with my adult children and their spouses. and some other friends. My daughter is 35 years my junior and an excellent skier. We started lapping the steeps with a couple of my young and excellent skier friends. In this environment, I pushed myself to work harder (i.e. go faster on every turn) than I do by myself. I don't take breaks, so I continue while others eat. About 3:30PM I noticed my heart rate was still a bit elevated while I was on the lift and the beats felt hard. This could be a signal that I was turning the activity into an endurance like activity. So I told everyone I was going to take an easy run down and be done for the day. I went to the car where I had a liter water bottle where the water has 4 g's of potassium as citrate in it. I slowly drank some. When I got home, I took a loading dose of magnesium as hydroxide mixed in organic apple cider vinegar to make magnesium acetate. When I checked my rate in the evening, it was slightly elevated (70) but still fine. My instinct is that had I ignored my warning and continued to push hard, I could have had an episode.

George