Hans Larsen

August 20, 2000

From my experience the diagnostic steps are as follows:

1. Clinical experience
2. Ruling out other cardiac causes
3. Muscle testing-low cost but predictive
4. Experienced dentist measuring the current from each tooth and bridge (gold standard)
5. Interrogating your past dentists in detail what were the detail materials used in your crowns and bridges in the past - and whether they left small deposits of amalgam behind them
6. Serum compatibility testing-expensive.

If the above items converge on certain teeth then having a VERY EXPERIENCED dentist replace them with composite materials with conservative detox programs seems to work.

Incidentally I found even very small amounts of alcohol or caffeine i.e. chocolates causes problems.

FM, Ireland

I was hospitalized in April 1999 for a bout of Afib that may have been triggered by flu and pneumonia in January. It is clearly lone atrial fib since I have no hint of structural problems or arterial blockage.

Various medications were tried but didn't work. I was put on Coumadin to prevent strokes. Cardioversion failed as one would expect. I read Hans Larsen's article and began taking CoQ10 with Hawthorn, Mg, L- carnitine and also L-taurine but with less regularity. I also began taking amiodarone. I finally came out of Afib after a few weeks and pushed the dosage of amiodarone down as fast as possible and finally discontinued it on my own.

My cardiologist would have had me on Coumadin forever but my internist wanted me off because of the danger of having a stroke by bleeding instead of a clot. (Obviously there are other hazards such as an intracranial bleed from even minor head injuries and the chance of bleeding out in an auto accident.) I wanted off and simply did so last fall when I quit the amiodarone. The big reason for getting off it was I noticed a big drop in visual acuity in my right eye. Vision problems are listed as a side effect so perhaps I should have expected it.

Since then I have had intermittent trouble with AF. But the episodes are typically mild or moderate. I have stayed on the supplements and believe they are key, at least for me. I have continued to take a amiodarone for an occasional bout of AF that lasts more than a few hours.

I continue to take the supplements I have taken for years which include 400 IU of vitamin E and 3 capsules a day of fish oil (EPA). I feel quite safe not taking the Coumadin because the vitamin E and EPA are both supposed to decrease the tendency to clot.

I am back in AF as I write. I suspect it is because I decreased the amount of Magnesium I was taking from 2000 mg/ day to 500mg. (I thought I was getting 1000mg of Mg in my new multivitamin but it is only half that.)

I would like to get into sinus rhythm and stay there for life. But so far, I keep having episodes. For me, I just get very tired when it happens and my drive and willpower evaporate. I am grateful to all of you who contribute to the forum which I just found today thanks to an email from Hans Larsen. It gives me encouragement to keep looking for other things to try.

I am very interested to check out body levels of mercury and other minerals. However, my impression is that serum levels are grossly misleading and that hair analysis, or "packed-cell" analysis is much better. Anyone know more about this issue?

I believe I have had all the amalgam fillings replaced years ago. But I might still have some toxic metals that are contributing to my problem.

I find Rx drugs frightening and try hard to avoid them as much as I can.

Just for reference here are the current levels of supplements I take:

• 100 mg of CoQ10 with 400 mg of Hawthorn twice a day
• 500 mg. of L-carnitine twice a day
• 1000 to 2000 mg of Mg.

When in AF I take more of each of them at midday when I normally do not take any of these.

Good luck to all of you and thanks for your contributions.

RT, USA

Thank you for your contribution to the LAF forum. I am sure your experiences will be of great interest to all.

I was also advised to take Coumadin (warfarin) for the rest of my life, but decided against it. It really is not that effective in LAF and, as your internist pointed out, has the potential for very serious side effects. I also take fish oils and vitamin E and feel that this will do the job of anticoagulation. Also at the beginning of an attack I take an aspirin.

It is not clear from your message whether your LAF is of the adrenergic type or the vagal type. It would be worth your while to find out by observing the timing and possible causes for your attacks. The optimum treatment could be quite different.

Hans Larsen

July 27, 2000

Update on my LAF: I raised the oral MG intake back up yesterday and came out of AF. I seem to need to keep it at about body tolerance level.

Had an EKG as part of my annual physical today and it showed a few premature beats but was otherwise reasonable.

I think I am quite lucky. My events seem mild. I sometimes have some feeling of pressure in the chest. However, my pulse when I take it just seems to be erratic and I feel more tired than usual. When I am in normal sinus rhythm, my pulse is down in the 60's.

I would love to find another way of getting my Mg levels up. I am pretty sure that the diarrhea is osmotic in origin. I think that water is drawn into the lower bowel because the Mg levels are higher on that side of the membrane than on the serum side. An IV administration of Mg would raise the levels on the serum side and should lessen any diarrhea triggered by oral intake of Mg. Same is true if I could take Mg sublingually. The problem is that it would be a hassle to get it IV and I know of no sublingual source...

Any thoughts?

RT, USA

Thank you for your update on your LAF. It is interesting that magnesium seems to bring you out of AF. How much do you take? I find that anything much above 200 mg have a definite effect on my bowel. Certainly it is well-established that IV magnesium stops arrhythmias, but I have not heard of it being used sublingually and don't know of any source for sublingual magnesium.

Hans Larsen

August 15, 2000

I find the issue of Mg is complicated by how much Ca I take. I believe that this is partly because they use the same carriers and maybe partly because Ca effects the heart directly.

RT, USA

August 17, 2000

I have not been able to find a sublingual Mg supplement. However, I had an interesting conversation with Suzanne Sutton, who is an advisor to Cardiovascular Research (alias Ecological Formulas). She says that a supplement with Mg and K taurate seems to be more effective against AFIB than other Mg supplements. She seems to think that Mg has a laxative action even when given IV. Is that true? I thought that when cardiologists gave IV Mg to stop fibrillation, that they gave quite a lot -- something like 10 grams and I had never heard of this causing bowel problems.

There is a truly wonderful article by Robert Cathcart about vitamin C that suggested reports that giving vitamin C IV, raises bowel tolerance to oral vitamin C. (It is on his web site at www.orthomed.com and is called The Three Faces of C. (Perhaps you both know it already but if not, I recommend you read it. It suggests a fascinating mechanism to explain why megadoses of vitamin C are so effective against so many things.)

In the article, Dr. C. explains why IV C raises bowel tolerance to oral doses in terms of balancing osmotic pressure on both sides of the intestinal membrane. It strikes me as making very good sense but I am no chemist. If you can find time to read the article, I would very appreciate your opinion on it.

If Cathcart is right about Vitamin C and bowel tolerance AND if the same mechanism applies to Mg and bowel tolerance, AND if Mg does not have some other direct laxative effect not dependent on osmosis pulling water into the lower bowel, THEN I would expect IV Mg to be much better tolerated than oral Mg and the same would be true to a lesser extent for sublingual Mg.

These are not so very helpful to those who have a chronic AFIB problem since it is not convenient to stop by the doctors office for an IV all the time, even if you can find one who will cooperate. Also, it may be that no one is making a sublingual Mg supplement and that it would be hard to persuade someone to do so because the market may be pretty small.

Three other things that came out of my discussion with Suzanne Sutton are:

• It is better to divide one's daily dose of Mg into as many separate doses as one can to maximize heart regulation while minimizing the side effect.
• She says that if one continues to take Mg supplementation, that bowel tolerance will increase with time. IS THIS TRUE?
• She says that doses of vitamin E up to 2000 IU. per day are sometimes very helpful. Presumably because it helps oxygenate the muscle tissues.

My current regimen for Mg supplementation is as follows:

• I take a good multivitamin twice a day which contains 125 mg of Mg and 500 mg of Ca. The Mg is a mixture of oxide, aspartate, and ascorbate. The Ca is a mixture of carbonate, citrate, maleate and ascorbate.
• Also, I take 225 mg of Mg maleate (a whole 150 mg tablet in the morning and 75 mg half- tablet in the evening.) Total Mg is about 475 mg. I have gone a bit higher but have had some problems at a higher level.
• As I believe I mentioned before, I take 500 mg of L-carnitine twice a day and a capsule of 100 mg CoQ10 with 400 mg Hawthorn twice a day. I am getting only 200 IU/day of vitamin E currently but am going to bump that back up to 600 IU (I have been at 400 or higher nearly every day since I first read Dick's (Richard Passwater) book on Supernutrition twenty years ago.

RT, USA

August 17, 2000

From your earlier messages in the Forum, it looked as if you were improving fast. Are you still having LAF episodes?

RT, USA

I am afraid that I'm not out of the woods yet! I still experience attacks every 4 to 6 weeks, but generally feel much better since I had my amalgams replaced. I have a suspicion that there may still be some mercury lurking under 2 of my crowns. I am going to look into this in the Fall. I have started taking alpha- lipoic acid (100 mg 3 times daily). It is supposed to remove heavy metals so may keep my mercury level down and hopefully gradually reduce it.

Thank you for all the interesting information contained in your message on magnesium and vitamin C. I think you would be better off sticking to the citrate or maleate forms of both calcium and magnesium. Calcium carbonate and magnesium oxide are often poorly absorbed. Otherwise your program looks good. Have you considered supplementing with fish oils. I feel this really helps me. See our new website oilofpisces.com for more details.

Hans Larsen

Congratulations on the excellence of your Webpage. I am specially interested in your AF forum . Would you kindly respond to these questions:

1. How frequently do you update the AF forum ?
2. Are you aware of any documented evidence that those people who present with Parox AF have below normal red cell ( intracellular ) magnesium ?
3. Are you aware of any documented evidence that below normal levels of red cell ( intracellular ) magnesium can be restored to normal levels with oral intake of say magnesium glycinate or is it the case that normal levels can only be restored by intake of intravenous magnesium sulfate ?
4. Is there any documented evidence that harmful levels of mercury prevent magnesium supplements from getting into the red cells ?
5. What is the DMSO that one can take orally to rid the body of harmful levels of mercury ?
6. Does one get DMSO on a doctor's prescription from a pharmacy?
7. On a scale of one to ten how certain are you that PAF is caused by harmful levels of mercury in the body ?
8. What is the maximum harmless amount of mercury that the body can handle?

Congratulations again on the great work you are doing .

TB, Australia

Thank you for your message regarding the LAF forum. I will attempt to answer your questions.

1. There is no set schedule for updating the forum. We do it whenever we can find the time.
2. I have not seen any published medical reports concluding that people with LAF have low magnesium levels. However, there is evidence that people with mitral valve prolapse and panic attacks do.
3. There is some evidence that oral magnesium supplementation (magnesium gluconate) can halt muscle cramps and inhibit the toxic effects of an excessive release of catecholamines - which may be involved in LAF of the adrenergic variety. Certainly there is ample evidence that magnesium infusions can stop arrhythmias.
4. I have not heard of this.
5. I believe you are thinking of DMSA. You can read more about this at http://www.drcranton.com.
6. In North America you need a prescription - and an understanding physician!
7. I would say that I am about 80% certain that many, if not most, cases of LAF are caused by amalgam fillings or by galvanic currents between dissimilar metals in the mouth.
8. It probably varies widely among people and undoubtedly is highly dependent on what other stresses the body has to handle (mental or physical).

Hope this answers your questions. You may want to check out http://www.sbakermd.com/magnesium.html for more information about magnesium deficiencies.

Hans Larsen

August 11, 2000

I have been troubled by Paroxysmal Atrial Fibrillation for twelve years . Currently I have episodes of PAF about every ten days and on average they last about eighteen hours . I am aged seventy one and have had twelve amalgam fillings in my mouth for over fifty years . They are still there and I have no immediate plans to have them replaced .

I would greatly appreciate your opinion on the effectiveness of beginning a mercury detoxification program using either alpha-lipoic acid ( see Victor's testimony on your AF forum ) OR DMSO while I retain my amalgams . Do you think it is a total waste of time and effort to begin a course of detoxification while my amalgam fillings are intact ? You may wonder why I would contemplate this course of action . Well I have so many fillings that to remove them all would precipitate a whole new set of problems . !! I want to find out whether I can significantly reduce my mercury levels while my amalgams are intact and whether if such can be done whether the frequency of my Parox AF can be diminished and maybe reduced to nil !!! Is it stupid on my part to even consider such a course of action?

I would also greatly value your comment on whether you believe that alpha-lipoic acid is as effective as is DMSO in reducing the harmful levels of mercury in the body . Is alpha-lipoic acid a well known dietary supplement and well known as an effective way to reduce harmful levels of mercury in the body ?

TB, Australia

I don't believe a mercury detox program would be of any value until you have had all your amalgam fillings replaced. As a matter of fact, depending on the detox regimen used, it may make matters worse. Intravenously injected DMPS, for example, gets into the saliva and actually starts extracting mercury directly from any remaining fillings.

Alpha-lipoic acid is a known chelator of heavy metals, but I have not seen any specific literature that would indicate it is effective in removing mercury. It is quite likely that it would. Alpha-lipoic acid is also a powerful antioxidant and is considered a safe supplement. You can read more about it in my research report "Alpha-lipoic Acid: The Universal Antioxidant" which is available to our subscribers.

Hans Larsen

August 18, 2000

Thank you so much for your information regarding mercury. I can now see, thanks to you, that the sequence of events must begin with removal of my amalgams.

I really appreciate your kindness.

TB, Australia

I am a 58 year old male. I have been diagnosed with Lone Atrial Fibrillation about 4 years ago, after extensive Cardiac Testing. However, I believe I did have Lone AF for many years before because I have similar chest tightening feeling on several occasions. Unfortunately, each time I was admitted to the hospital the heart rhythm checked fine. These effect happened during high tension associated with work pressure. However, during a routine check 7 years ago after severe diarrhea, the EKG recorded arrhythmia.

I had Lone AF on & off, until it became Chronic....4 years ago.

I have tried external cardioversion. It did not work.

Presently, I am on Coumadin, digoxin and diltiazem and I am constantly tired. I am also taking a daily dose of vitamins C, E, and B. Also, some time I take magnesium.

I am looking for a permanent solution. The only proven method is the Maze surgery. I do not like going through it because it is considered a major heart surgery.

Does anyone know of a surgeon who has a high rate of success in the catheter ablation or Maze Minimal Invasive Procedures?

ON, Saudi Arabia

I am sorry to hear that your LAF is now chronic. You could well be correct in your assumption that being on digoxin has played a major role in this happening. Digoxin is not recommended for LAF as it can worsen the condition and eventually convert it to the chronic form. It is also likely to cause fatigue. Coumadin (warfarin) is generally not required in LAF patients below the age of 65 years unless they have other risk factors such as diabetes, angina or hypertension.

I don't know why you are taking diltiazem - it is usually prescribed for angina or hypertension. Diltiazem interacts with digoxin and makes its adverse effects even worse. So, as you can gather, I don't think much of your current drug regimen! I would suggest that you find a physician or cardiologist in Houston who can take you off these drugs (it must be done under close medical supervision) and put you on something that might work. Tenormin (atenolol) may be worth trying with the adrenergic form of LAF. It is well-established that cardioversion does not work for LAF.

I don't know much about the maze procedure as I have never considered it myself. You can find more information and comments about it at http://members.aol.com/mazern/

I would strongly suggest that you read all the letters in the LAF Forum (http://www.pinc.com/healthnews/lafforum.html) and see if there is anything there that might help you. Certainly if you have amalgam fillings or dissimilar metals in your mouth you should seriously consider replacing them and embarking on a detoxification program.

Unfortunately, LAF is not considered curable by the medical profession so it is very much a "do-it- yourself" project to get rid of it. Good luck!

Hans Larsen

I am 35 years old and have had intermittent lone AF for several years. My attacks (3,4 per year) are SOLELY triggered by drinking cold drinks too quickly. It is usually the day after drinking more alcohol than usual or being worn out. Have you heard of this? You might say stop drinking cold drinks, but I get lulled into a false sense of security because it happens only sometimes when I drink cold drinks. Also my bouts seem to be progressively lasting longer, 28 hrs the last time. Is this cause for concern?

MW, USA

It is quite common that LAF attacks are triggered by binge drinking. I have not heard of cold drinks acting as a trigger. It is possible that they could, but I would be more inclined to blame the alcohol and the excessive stress it puts on the body.

If you think you know how to avoid getting an LAF attack I would strongly urge you to apply this knowledge. In the natural progression of LAF attacks tend to become more frequent and longer lasting with time. Some researchers believe this is because the heart's electrical system remodels itself so as to amplify the pathways which produce the fibrillation - somewhat like the needle in a vinyl LP making the scratch deeper each time its played. So it is very important that you do everything you can to stop your attacks now. If you are lucky you might save yourself another 35 or 40 years of increasingly frequent and debilitating attacks.

Hans Larsen

Thank you for organizing this forum.

I have had 3 episodes of LAF in 2 years. I am a 53 year old MD. I am an elite Triathlete, having won World Championships and 2nd and 3rd places in the Hawaii Ironman. I am competing in Hawaii this year 14 October also. The first episode Sept 98 was treated with I/V Flecainide which failed and then by successful Cardioversion. I felt this attack was precipitated by an extremely cold milkshake at work! I was in AF for 5 days, my resting pulse rate only rises to 60-70 bpm during AF and does not worry me a lot although it does affect my performance. My normal resting pulse is about 38.

My second LAF was in March 99. It occurred in the morning in bed the day after a short triathlon. This time I was in AF that day and had a successful Cardioversion that night. Apart from Aspirin I took no medication. After this I trained and raced extremely well until last Sat evening when another AF episode took over. I had been on an extremely long ride that morning-6.5 hours at a low pulse rate and felt tired but well. I had 2x cardioversions the next day but only stayed in sinus rhythm for 2 hours. I was given anti coagulants and amiodarone and successfully reverted 2 days later(Tuesday 22 Aug). I went for an easy 40 minute run this am and feel OK. In the past I have taken mainly for normal good health Selenium, CoQ10, l-Carnitine, Vit E, Vit C, Ca and Mg, Ginseng, Ginkgo Biloba but not always compliant and not in your dosages.

I had my Amalgams removed about 10 years ago.

1. I have the feeling when I have LAF that it won't revert by itself, possibly because I have never been allowed to wait long enough-how long is long enough?
2. Victor describes LAF in endurance runners -are there any studies or papers on this or is it just anecdotal?
3. I was interested in the intracellular blood test described by Victor, please explain test method.
4. Please explain I/v Magnesium dosage and is it given as a bolus or in a drip?
5. My cardiologist advised me that if left longer than 3 days AF is harder to revert by any method; do you agree?
6. My episodes seem to have been vagal and adrenergic etiology-have you heard of this before?

BB, Australia

Thanks for your message - I will try to answer your questions:

1. I have had episodes as long as 96 hours. They always convert by themselves and the one time I had cardioversion it was unsuccessful. So I would think that LAF episodes generally (eventually!) convert by themselves.
2. Researchers at the University of Helsinki have found that men who engage in long term vigorous exercise have a five times greater risk of developing lone atrial fibrillation than do less active men.
   Karjalainen, Jouko, et al. Lone atrial fibrillation in vigorously exercising middle-aged men: case control study. British Medical Journal, Vol. 316, June 13, 1998, pp. 1784-85
3. You can contact Victor directly about the intracellular blood test at [email protected].
4. A study at the Brooke Army Medical Center found that magnesium sulfate is useful in decreasing the ventricular rate in atrial fibrillation. An initial bolus of 2 grams of magnesium sulfate over 1 minute followed by a continuous infusion of 1 gram/hour for 4 hours was used.
   Hayes, Janet V., et al. Effect of magnesium sulfate on ventricular rate control in atrial fibrillation. Annals of Emergency Medicine, July 1994, pp. 61-64

   Magnesium injections/infusions have also been found to reduce the number of ventricular arrhythmias in patients with heart failure. The trial involved an injection of 0.3 mEq/kg magnesium chloride in 5% dextrose in water followed by continuous infusions of dextrose/water/magnesium chloride solution (0.08 mEq/kg per hour) over 24 hours.
   Sueta, Carla A., et al. Effect of acute magnesium administration on the frequency of ventricular arrhythmias in patients with heart failure. Circulation, Vol. 89, No. 2, February 1994, pp. 660- 66

5. See my answer to question 1.
6. It is quite common to have adrenergic and vagal episodes intermixed. It seems to me that the adrenergic type attacks may be easier to prevent either by avoiding trigger situations (exercise and stress) or by taking beta-blockers (atenolol or propranolol).

Hans Larsen

Just an update of things - I haven't had any attacks in the month since my leg surgery, but I know they could occur if I do the wrong thing - that is to say exercise without warming up or get too excited. However, I am improving every day - can now get up from sleep like a normal person and do hill walking without problems. From your description, I decided all my attacks were adrenergic (except for one from wine sauce in food, and one from ice water or carbonated water). I carry propranolol 10mg tablets in my pocket at all times, and if I feel too adrenalinized I take a small bite out of one, letting it dissolve under my tongue. This gives instant relief from the stressed feeling. I take a bigger bite, or a whole tablet, if I have an attack.

SG, USA