Afib and Ketogenic Diet

Any insights or experiences with the ketogenic (keto) diet with affibers?

My two cents. I've been keto adapted since Oct 2009. Keto diets can be implemented in quite a few ways. When I adapted, I used a traditional "Atkins" approach of keeping carbs <= 20g/day for several weeks. One of the things that can happen is a large electrolyte shift driven by dramatically lower insulin levels. My understanding from this book is that chronically higher levels of insulin will signal the kidneys to conserve sodium, low levels of insulin will do the inverse - signal the kidneys to excrete sodium. This can be dramatic enough that potassium is excreted also. Some resources suggest this is a cause of "keto flu". In any case, these electrolyte shifts can precipitate arrhythmia in those who are prone to it. A suggestion to keep the electrolytes in balance is to supplement with sodium (table salt), and additionally potassium & magnesium. In my case, I supplemented potassium and magnesium, but not sodium. As time wore on, I had a feeling that an afib episode might come on. Sure enough I did get a 3AM episode. I converted it with flecainide and magnesium. In the 10+ years since, being in ketosis has not caused an afib episode. In 2017, I did nineteen cycles of water fasting 5 consecutive days out of every 14. None of those cycles caused an afib episode. My diet today is relatively high carb for someone who remains in ketosis. I can eat 200 g/day of carbs and still test 0.5-1.0 mmol/L betahydroxybuterate on a morning test after not eating for around 12 hours. I do generally eat in a 2 hour window daily. If I water fast, my serum levels of ketones will be >4.0 mmol/L by day 3 and my glucose will be in the 50's mg/dL (3's mmol/L).

As far as a keto diet "fixing" afib. I have seen a few case reports of people who were not metabolically well go into afib remission when they fixed their metabolism.

Hope this helps.

George



Edited 1 time(s). Last edit at 01/16/2020 09:35PM by GeorgeN.

Thanks George

I started a modified keto diet a year ago when I wanted to shed weight—50g max carbs a day...with a cap of 1200 calories a day, sometimes my carb intake was in the 30s. I was AF free for a long before my weight lost (lost a lot of weight) and I started again to get AF and it put me in the path of at least a dozen cardio conversions. The ER doctor said the keto diet was a shock to my heart and caused my AF. She wasn’t a cardiologist but a seasoned attending doctor. Maybe it was the 3 pounds a week I lost.

However now, after my ablation and PVCs, which I get an average of 17.3% a day, I find if I really cut down on carbs my heart is calmer. I am not on a diet because the PVCs hr is so high I lose weight. Rice chek cereal will give me PVCs (I need the iron and calcium) . The worst is Cassava flour (I’m gluten free) and unsweetened almond milk (unfortunately dairy free too). I find if I avoid these foods and limit my carbs under a 100 my heart is calmer. But that is just me, not based on any medical advise or peer review studies...just trial and error.

I like the Mediterranean diet way of eating, lots of veggies, fruits, beans, eggs, potatoes, fish, meat, seeds, I eat whole grain breads. I don't get pacs, taking magnesium took care of that. I don't eat cereal though, I don't like milk, I have never tried almond milk, it just reminds me of milk and I don't care to try it, I eat eggs for breakfast. Whatever works but I just can't see where the Keto diet is so good.

Liz

{EDIT after Tom's post below to correct inaccuracies}I have a friend who was in persistent afib for ~14 months. The afib was precipitated initially from pneumonia, as I recall. This guy used fasting, keto & exercise and finally they cardioverted him after he reversed his LEVF from 27% to 53%. After ~22 months of NSR, he went back into afib four weeks ago. He underwent a cardioversion today. He sent me this:

"This is why I fast when I’m out of rhythm and I’m in Atrial Fibrillation. The first BNP reading was taken roughly 7 days after my heart went out of rhythm. The second reading was taken 1 day before I started a 103 hour fast. The third reading was taken 24 hours after I ended my fast and is in a normal range. While this low reading is no guarantee of the success of an electro cardioversion, it definitely impacts the likely maintenance of normal sinus rhythm. It also demonstrates that fasting can impact the repair process of the heart."





Edited 1 time(s). Last edit at 01/16/2020 09:12PM by GeorgeN.

Very interesting! Thanks for sharing everyone.

Although I think your friend is being a bit overzealous with his conclusions that "it definitely impacts the likely maintenance of normal sinus rhythm" there is some evidence to support his thinking.

Where I think he's being overzealous is in assuming a causal relationship from a correlation. It could be that a third, unknown factor causes both. But it's an interesting theory. I'd like to see it explored more. If I'd seen this study and your friend's results when I had afib, I would have given given it a go.

Actually, I am the "anonymous" friend. I'm just terrible at remembering this resource and so I rarely post in here.

I based my statement on the following studies and articles:

[www.ncbi.nlm.nih.gov]
[www.ncbi.nlm.nih.gov]
[www.ahajournals.org]
[electrophysiology.onlinejacc.org]

Although I don't know that there has been enough study to indicate that it will always be successful, I came across all this back when I was trying to get my cardiologist to agree to cardiovert me after 14 months of constant A-Fib. In that period, I used fasting and the ketogenic diet to reverse remodel from an LVEF of 27% to 53% in 5 months before he cardioverted me. Ultimately, the thing that convinced him were numbers like my BNP, as well as the visual reverse remodelling in my TTE's the first time. I maintained sinus rhythm without rhythm maintenance meds for 22 months (I used Berberine instead of the recommend Amiodarone). But, the 80 hour weeks in that time period along with unnoticed mold in our bedroom finally caught up with me and I went back into A-Fib four weeks ago.

Cardioversion was successful today and I'm hoping for a much longer run this time.

In any case, I remain hopeful.

I had my first Cardioversion today, I don't think I ever had my BNP checked, I thought that was mainly to detect for heart failure. They ran an Echo on me before my Cardioversion, I thought that was good.

Liz

Tom:

Sorry, I didn't know your story, I went back and did some reading. Good luck to you and thanks for posting your story.



Edited 1 time(s). Last edit at 01/16/2020 09:19PM by Elizabeth.

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TomSeest
In any case, I remain hopeful.

Nice to hear from you. Can you check back in, say, in six months and let us know how it turned out? (Sooner if it doesn't turn out well.)

Elizabeth and TomSeest - Wow you had a cardioversion today?! Hope it goes well. Please report back how you all did and the impact it had on you (positive or negative). Also, perhaps in another thread, you can post your experience for those of us who haven't ever done it.

In Tom's post, he linked this paper In it, "Studies have shown that galectin-3 levels are associated with LA fibrosis in AF (24), but whether galectin-3 (or other fibrosis markers) can help predict AF ablation success is unknown." [24] is linked here "Serum galectin-3 value was also found to be a significant predictor of left atrium fibrosis, reduced left atrial volume, or decreased left ventricle ejection fraction in four studies (2 nested case–control, 2 case–control). " Interestingly, one of the many metrics my doc, Steven Gundry tests for is Gallectin 3. In Gundry's world, this is modifiable by the intake of modified citrus pectin. I've seen this in my own results (i.e. taking MCP reduces Galectin 3). My afib burden is so low, I have no idea about associating this with afib, but thought I'd report it just for interest..

{edit} this is the modified citrus pectin I take <[www.swansonvitamins.com] , 1 scoop/day



Edited 1 time(s). Last edit at 01/17/2020 01:30PM by GeorgeN.

Hopefully, George will remind me to post here again. My memory isn't always the best, and I forget I'm a member here.

I spend most of my time working, and I'm hoping to curb that some this year and bet back to bicycle riding.

I remain in NSR this morning and hopeful for another day, as always.

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GeorgeN

{edit} this is the modified citrus pectin I take <[www.swansonvitamins.com]?

Hmm, wonder if drinking one whole lemon every morning would help in a similar way to modified citrus pectin? I've been vitamizing 1 lemon with water every morning for the last 6/8 months and drinking it.

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Joe
Hmm, wonder if drinking one whole lemon every morning would help in a similar way to modified citrus pectin? I've been vitamizing 1 lemon with water every morning for the last 6/8 months and drinking it.

"Some experts caution that citrus pectin and all "modified" citrus pectins may not have the same effects as modified citrus pectin. Citrus pectin does not have the same short polysaccharide chains as modified citrus pectin, and "modified" pectin could indicate that the pectin has been altered in some way, but not necessarily have the shorter polysaccharide chains." <[ww5.komen.org]

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TomSeest
I came across all this back when I was trying to get my cardiologist to agree to cardiovert me after 14 months of constant A-Fib. In that period, I used fasting and the ketogenic diet to reverse remodel from an LVEF of 27% to 53% in 5 months before he cardioverted me.

I think Tom's reverse remodelling of his LVEF from 27% to 53% is truly the remarkable part of this thread.

Thanks George!