pvc's and fish oil

As I have posted in the past, I had an ablation on September 18th and approximately ten days later I started getting a marathon of PVC's. I remember doubling up on the fish oil about ten days later...thinking I need it to heal. I would take two capsules twice a day and then lowered it to two once a day in the evening with my crestor.

My zio patch shows an overall 17.3% PVCs burden....on December 11th, my PVCs were 27.8%.

I stopped fish oil the past four days...my heart is almost calm. I do get a milder marathon of pvcs after taking lisinopril in the evening. I do notice them in the evenings and I do wake up during the night occasionally.... but at least during the day I am not symptomatic to tinkering in my backyard installing low voltage lighting and doing yard work and scrubbing concrete off my pavers that an idiot was messy to leave on...my almost former self. I take a lisinopril in an hour and expect my pvcs to begin again...but the overall daily 24 hour PVCs burden is not like it once was. The evenings are the worst which is ok because I have the full ay to be productive.

I wonder if fish oil is the reason for my pvcs? I'm using pharmo grade fish oil my GP personally investigated and slapped his label on and doubled the price. I also stopped coQ10 as well and will restart in a week.

I know that you saw the following, Susan, when I posted it in your earlier thread re this subject. But re-posting for any others it might be relevant to.

There are at least a couple of recent-ish studies showing a U-shaped curve for doses of Omega-3 vs afib, with an optimum at ~0.6 gms/day.

Here is a para from my most recent update, on my website carrafibdietinfo.com that details my own successful complete elimination of afib and ectopics without ablation or medication :

Regarding omega-3 fats, which health-conscious people often go out of their way to consume, the following is worth noting: the optimum daily intake to minimise afib occurrence has been reported to be approximately 0.6 gms/day of long-chain omega-3 fats ("DHA+EPA", or "n-3 PUFA"), with greater occurrence of afib at both higher and lower daily intakes than this amount. [20, 21] My egg intake and 400gms of Australian range-fed meat are said to provide 0.6 gms (no great surprise really, since consuming them is intended to closely imitate a diet I consider to be the most likely "universal" type of ancestral, "Palaeo" diet that most of us are genetically adapted to), so I take no omega-3 supplement and rarely consume much seafood. The omega-3 contents of eggs and meats will differ in other countries with different animal husbandry practices (feeding practices), such as the USA, so there is a need to review one's own total omega-3 intake accordingly.

I've actually just slightly reduced my egg intake, and replaced the reduction with just 30gms of cooked mussel meat per day (calculated, in fact, to maintain my Omega-3 at the 0.6 gms/day level, plus maintain iodine too), so that para is slightly dated, but the gist is exactly the same.

Here are the references 20 and 21 referred to in that para (these aren't links, but they can easily be found) :

[20] Rix, T.A., Joensen, A.M., Lundbye-Christensen, S., Riahi, S., Schmidt, E.B., Overvad, K. (2013). Moderate consumption of marine n-3 fatty acids is associated with a lower risk of atrial fibrillation—a cohort study (Abstract). Europace 2013; 15 (S2), S84.​

[21] Metcalf, R.G., Skuladottir, G.V., Indridason, O.S., Sullivan, T.R., Bjorgvinsdottir, L., Sanders, P., Arnar, D.O., Gibson, R.A., Heidarsdottir, R., Cleland, L.G., et al. U-shaped relationship between tissue docosahexaenoic acid and atrial fibrillation following cardiac surgery. Metaanal. Eur. J. Clin. Nutr. 2014, 68, 114–118.

Fascinating stuff again thanks Steve. I've always found that fish oil supplements increased ectopics. Just looked at O3 content of various foods and its surprising just how much some foods like canned fish and flaxseed oil for example actually contain. And, notably for me as an avid eater of seafood, a surprisingly large amount in shellfish, so looks like I'll be moderating that from now on too. Before reading your post and then looking on the Internet I'd never have imagined that eggs actually contain way less O3 than mussels!
Cheers,
Mike



Edited 1 time(s). Last edit at 01/07/2020 06:51AM by mwcf.

I'm no scientist at all and mostly ignorant in medicine, but I'm fighting afib and ectopics since Nov 2015. It's not a long time, I've read about people here knowing afib for far longer than me, but it's enough to rot my life, considering I've just had my 300th afib episode two days ago, not counting all the days I've had to bear thousands of ectopics.
I've learnt this illness is highly evolutive. For me, a med or diet never works for a long time, and changing the dose of something which has stopped to work usually leads to an overdose and its highly unwanted effects.

I'm sincerely happy for those having found something that works, but I've still to find such a thing for me.
All this to say I'm doubtful about the fact that a dose of any remedy could be (equally) efficient for any afibber.

SteveCarr: I based my decision on your post as an experiment. Each of my fish oil capsules are 782mg...a tad higher than your .6 maximum. I started taking 4 capsules a day ten days after my ablation and then cut down to 2. I’ll reintroduce one a day soon. Thank you for your post. You maybe on to something. My GP wants a higher amount of fish oil for my plaque particle size tho.

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Pompon
I'm no scientist at all and mostly ignorant in medicine, but I'm fighting afib and ectopics since Nov 2015. It's not a long time, I've read about people here knowing afib for far longer than me, but it's enough to rot my life, considering I've just had my 300th afib episode two days ago, not counting all the days I've had to bear thousands of ectopics.
I've learnt this illness is highly evolutive. For me, a med or diet never works for a long time, and changing the dose of something which has stopped to work usually leads to an overdose and its highly unwanted effects.

I'm sincerely happy for those having found something that works, but I've still to find such a thing for me.
All this to say I'm doubtful about the fact that a dose of any remedy could be (equally) efficient for any afibber.

I agree 100%. I try to understand what’s being said and I feel like a total dummy. I know I went into AFIB and never came out without being ECV. Nothing worked for me except 2 Ablations.
I do not have any degrees in the medical field but I am a retired Electronic Engineer. I do not know what degrees these fine people have who are doing these experiments with supplements etc. but I air on the side of cautious. I admit I have trouble understanding the majority of these trial, techniques etc but I feel I am fairly intelligent.
Anyway I will continue to read and enjoy my NSR by the Ablation technique. I do take 1 gram of magnesium a day

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Pompon
All this to say I'm doubtful about the fact that a dose of any remedy could be (equally) efficient for any afibber.

I think this illness and any solutions are very individual. My standard for trying something is asymmetric risk. In other words, limited downside to trying something with the upside being that it works. 15 years ago here, there was a large cadre of people trying various things to reduce or put their afib in remission. Many were extraordinarily bright, motivated and diligent. Some succeeded and quite a few failed. There is certainly an element of luck in discovering something that works. Also the more progression there is, the more unlikely a solution other than ablation with a top tier EP will be found.

As per the original topic. I consume many grams of fish oil per day without issue. This isn't to say fish oil isn't an issue for some, it just isn't for me. Testing certainly makes sense. I wore a Polar recording heart rate monitor during 7 hours of sleep the other night (I don't commonly wear the monitor). I had a total of 50 ectopic beats, 39 PAC's and 11 PVC's out of a total of 20580 beats (average 49 BPM). This is about a 0.25% rate and de minimis in my opinion, at least for me. Also much less than my first holter worn after my first episode 15.5 years ago. That showed 26 ectopic beats per hour.

I personally think people should try anything that doesn't have a huge downside.

I should have made clear (and I haven't adequately even on my website) that whereas I'm 100% certain that low Ca-intake, and blood-VitD levels close to but below 160 nmol/L (~65ng/mL), have completely eliminated afib attacks and ectopics in two of our family members, and completely eliminated abundant ectopics in a third (see this topic thread) in conjunction with, to a lesser extent, some other dietary changes in my case, I have no real idea whether Omega-3 fats have any effect either way.

I simply put up the info about Omega-3, posted above, because susan.d was specifically asking about the effects of Omega-3, and many (most) people just automatically assume that it is good stuff. My recollection is that there are other scientific papers out there arguing both that it is good for AF and bad for it.

Personally, I tried large doses of Omega-3, and also complete withdrawal of it, in my experimentations, and noticed no effect. But my recollection is that someone with low Omega-3 levels can get it up pretty quickly with supplements, but that to lower it again will take months because it is incorporated into cell walls, so testing withdrawal of Omega-3 is fairly inconclusive.

My attitude is that a U-shaped dose-response curve is highly plausible (like for virtually any other nutrient), and there are a couple of scientific papers claiming to have found such a curve re afib, and that the optimum total daily intake re afib is ~0.6gm, and which could thus explain the other scientific papers claiming both positive effects and negative effects. Also, the optimum level they are proposing is highly plausible for the most likely diets that humans evolved to be adapted for over millions of years. So, in the absence of any better evidence, I err on the side of caution and use their "optimum" as my own dietary guide. But, as I say, I have no direct personal evidence either way.

For those that are interested, Omega-3 contents of foods can be easily found from places like :

USDA FoodData Central

Danish Nutrition Data

Australian food nutrient database

The Australian data downloads as a large Excel file. But if one gropes around in there one can determine that several typical Australian eggs (not even "Omega-3 eggs") and 400 gms of Australian "topside" beef (which is very largely range-fed unlike US lot-fed beef, and probably unlike European too) provides 0.6gms of Omega-3 per day.

From memory, the equivalent UK database is also a large Excel file.

Note also that the terminology used to identify the long chain Omega-3 fats can vary a bit between databases, so one may have to familiarise with this. But it's not too hard. For example EPA = 20:5 n-3 , and DHA = 22:6 n-3 . "n-3 PUFA" is another term.

I like trying supplements or diets, but...
There are so many factors playing their role at the same time, there are so many conditions changing from day to day, that I'm wondering if most of the results I've had to date with supplements are pure coincidences or not.

Let's be realistic : how long have we to try something before deciding it's good, bad or neutral? And during this time, how can we keep other conditions under control to be sure the trial is valid?

Suppose one has to get the basics right first? Eat so blood glucose levels remain fairly constant and optimal. Don't consume/expose to anything that increases heart rate by more than 15 BPM (except for exercise) as George mentioned in another thread (valid once we establish what our normal resting heart rate is). Make sure we aren't burdened by heavy metals and other environmental poisons.

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Joe
Suppose one has to get the basics right first? Eat so blood glucose levels remain fairly constant and optimal. Don't consume/expose to anything that increases heart rate by more than 15 BPM (except for exercise) as George mentioned in another thread (valid once we establish what our normal resting heart rate is). Make sure we aren't burdened by heavy metals and other environmental poisons.

My post was here. To clarify, Dr. Coca's approach is to simply take your pulse before you eat, then 30, 60 and so on minutes after. He suggest if you get more than a 6 BPM elevation, you are sensitive to something in what you ate. To figure out what, you have to eat things one at a time. In my case, I was seeing elevations of 15-25 BPM. When I quit eating those things (which are specific to a person), my overnight average heart rate dropped from 63 to 45. My deep sleep, as interpreted by my Oura ring 2 tracking device, went from 0-4 minutes/night to 30-90 minutes/night. I certainly don't have this dialed in as I keep trying to figure out what will and won't impact my pulse. I claim no impact on my afib, just my sleep. As to dialing this in, I react to most olive oils, but have found one, from Morocco, that I do not react to. So it does take time and persistence. When I eat something that elevates my pulse, it stays elevated for a long time, so I can't test anything else and my sleep is usually not as good that night.

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GeorgeN

Suppose one has to get the basics right first? Eat so blood glucose levels remain fairly constant and optimal. Don't consume/expose to anything that increases heart rate by more than 15 BPM (except for exercise) as George mentioned in another thread (valid once we establish what our normal resting heart rate is). Make sure we aren't burdened by heavy metals and other environmental poisons.

My post was here. To clarify, Dr. Coca's approach is to simply take your pulse before you eat, then 30, 60 and so on minutes after. He suggest if you get more than a 6 BPM elevation, you are sensitive to something in what you ate. To figure out what, you have to eat things one at a time. In my case, I was seeing elevations of 15-25 BPM. When I quit eating those things (which are specific to a person), my overnight average heart rate dropped from 63 to 45. My deep sleep, as interpreted by my Oura ring 2 tracking device, went from 0-4 minutes/night to 30-90 minutes/night. I certainly don't have this dialed in as I keep trying to figure out what will and won't impact my pulse. I claim no impact on my afib, just my sleep. As to dialing this in, I react to most olive oils, but have found one, from Morocco, that I do not react to. So it does take time and persistence. When I eat something that elevates my pulse, it stays elevated for a long time, so I can't test anything else and my sleep is usually not as good that night. As previously noted, I've had autoimmune issues since birth. I have no ideas if others will react similarly.

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Pompon
"Let's be realistic : how long have we to try something before deciding it's good, bad or neutral? And during this time, how can we keep other conditions under control to be sure the trial is valid?"

In my experience of completely eliminating my afib and ectopics, and that of my two other family members, the reduction in ectopic beats from significantly reducing Ca intake begins to show up decisively around three days after the Ca reduction, and is roughly complete after about six days. I have tested and observed this many times. There are two provisos : firstly I am referring to a situation in which blood vitamin D levels are already "high" (actually historically normal for all our millions of ancestors), and secondly I easily detect every ectopic beat in waking hours (proven by 24 Holter-monitoring), but some may need a monitoring device to observe the reduction.

So I would say that it is very easy to maintain "other conditions under control to be sure the trial is valid" over just that sort of time span.

But you certainly have a point when it comes to varying one's blood VitD levels. Even dosing with 5,000 iu per day will take weeks if not months to raise most people's blood levels close to the standard historical "solar saturation" level of 160 nmol/L (64 ng/mL). That is why I outlined the sort of "loading dose" required to get one's blood VitD levels up to that level in, say, 10 to 14 days, in this topic thread.

Then one can pretty easily do a full test of both Ca-intake reduction and while being at higher blood-VitD levels, while keeping everything else constant for just a fortnight, which is manageable.

Back on the subject of Omega-3 fats : I have now amended the para that I quoted, above, from my website carrafibdietinfo.com so that it now (more appropriately) reads :

"Regarding omega-3 fats, which health-conscious people often go out of their way to consume, the following is worth noting: the optimum daily intake to minimise afib occurrence has been reported to be approximately 0.6 gms/day of long-chain omega-3 fats ("DHA+EPA", or "n-3 PUFA"), with greater occurrence of afib at both higher and lower daily intakes than this amount. [20, 21] Four large eggs, 400gms of Australian range-fed meat and 30gms of cooked mussel meat are said to provide around 0.6 gms/day (no great surprise really, since consuming such amounts of these foods should closely imitate a diet likely to be the most "universal" type of ancestral, "Palaeo" diet that most of us are genetically adapted to), so I take no omega-3 supplements and aim to average the sort of seafood consumption just indicated. The omega-3 contents of eggs and meats will differ in other countries with different animal feeding practices, such as the USA, so there is a need to review one's own total omega-3 intake accordingly. Despite experimenting with omega-3 supplements and their withdrawal, I have no personal evidence that they affect afib or ectopic frequency, but choose caution as outlined."

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GeorgeN


Suppose one has to get the basics right first? Eat so blood glucose levels remain fairly constant and optimal. Don't consume/expose to anything that increases heart rate by more than 15 BPM (except for exercise) as George mentioned in another thread (valid once we establish what our normal resting heart rate is). Make sure we aren't burdened by heavy metals and other environmental poisons.

My post was here. To clarify, Dr. Coca's approach is to simply take your pulse before you eat, then 30, 60 and so on minutes after. He suggest if you get more than a 6 BPM elevation, you are sensitive to something in what you ate. To figure out what, you have to eat things one at a time. In my case, I was seeing elevations of 15-25 BPM. When I quit eating those things (which are specific to a person), my overnight average heart rate dropped from 63 to 45. My deep sleep, as interpreted by my Oura ring 2 tracking device, went from 0-4 minutes/night to 30-90 minutes/night. I certainly don't have this dialed in as I keep trying to figure out what will and won't impact my pulse. I claim no impact on my afib, just my sleep. As to dialing this in, I react to most olive oils, but have found one, from Morocco, that I do not react to. So it does take time and persistence. When I eat something that elevates my pulse, it stays elevated for a long time, so I can't test anything else and my sleep is usually not as good that night. As previously noted, I've had autoimmune issues since birth. I have no ideas if others will react similarly.

Sorry George! I was quoting from my memory reading this book a few decades ago - obviously my recollection is wrong .Will read the link to his book you provided soon. He's the guy who discovered his allergy to eggs when he was a med student???
Seem to recall that establishing a true resting heart rate was one of the rules? E.g. it could be a problem should one be allergic to house dust and consequently have a higher pulse rate to begin with?

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Joe
Sorry George! I was quoting from my memory reading this book a few decades ago - obviously my recollection is wrong .Will read the link to his book you provided soon. He's the guy who discovered his allergy to eggs when he was a med student???
Seem to recall that establishing a true resting heart rate was one of the rules? E.g. it could be a problem should one be allergic to house dust and consequently have a higher pulse rate to begin with?

I don't remember eggs & med. school. Yes, he says house dust could be an issue, but I think he mentions you'll still see an elevation above a higher baseline to foods you are sensitive to. My own experience with respiratory allergies is that as I minimize the intake of foods I'm sensitive to, my respiratory issues have declined dramatically as I mentioned in the mouth breathing thread.

[i[ I wore a Polar recording heart rate monitor during 7 hours of sleep the other night (I don't commonly wear the monitor). I had a total of 50 ectopic beats, 39 PAC's and 11 PVC's out of a total of 20580 beats (average 49 BPM). This is about a 0.25% rate and de minimis in my opinion, at least for me[/u].[/i]

George, How can you tell PVCs from PACs using a Polar heart monitor? I use one but only reads heart rate---beats.

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Anton
George, How can you tell PVCs from PACs using a Polar heart monitor? I use one but only reads heart rate---beats.

Anton, this is looking at an "r to r" (RR) or beat to beat recorded file. Most heart rate monitors (HRM) average the heart rate over 5 or more seconds. Additionally, some software will filter out artefact in the data. What I'm looking for are the individual beat lengths (without any averaging or filtering), or heart rate - same thing after conversion: 60,000/(beat length in milliseconds)= heart rate in beats per minute. For example an RR time of 1000ms = 60 BPM. In the equation 60,000/1,000 = 60 BPM. 950 ms RR time would be 60,000/950 = 63 BPM. Likewise 1050 ms RR time would be 60,000/1,050= 57 BPM.

What I discovered ~15 years ago, is the Polar straps do not "see" the malformed QRS waveform of a PVC. Here is an example of two PVC's in a row on an ECG:

I actually ran an ECG in parallel with a Polar strap and recording watch to verify this. Because of this, a PVC appears as a beat that is half as fast (or the RR time in ms is twice as long).

I started out using a now ancient Polar S810 recording watch with strap. Today, I use a Polar H10 strap in tandem with the Heart Rate Variability Logger app on an iPhone (available on Android also). The app will send data files to Dropbox, where I put them into an .HRM file that can be read by old Polar software linked here. The "RR_Kubios.txt" file just has RR times in milliseconds. I copy and paste these times into a .HRM file after the [HRData] tag. I explained in detail here.

Examples and more discussion (from 2007) are here, here and a lot of images here (the last file is courtesy of Mark Robinson, a former prolific poster from the UK).



Edited 2 time(s). Last edit at 01/12/2020 01:22PM by GeorgeN.