The AFIB Report

The AFIB Report - www.afibbers.org
Visit our LAFFORUM for information about lone atrial fibrillation. Active, in-depth discussion lounge.


Lone Atrial Fibrillation Forum

A forum for sharing personal experiences regarding lone atrial fibrillation


Welcome to our new Lone Atrial Fibrillation Forum! Our purpose is to serve as a gathering place for people who suffer from LAF or who care for someone who does. Lone atrial fibrillation, although not life-threatening, can have a devastating effect on one's life. Conventional medical science has little to offer when it comes to curing or preventing this condition and what it does have to offer (digoxin, amiodarone, sotalol, warfarin, etc.) often has serious side effects and, in some cases, can actually make things worse.

I battled LAF for over 15 years and have tried most alternative and complementary approaches to preventing LAF attacks. In 1996 I wrote an article on this subject which was based on my exhaustive study of the disorder. You may also find the details of my afib journey to be of interest.

As a result of the publication of my article I received numerous enquiries from fellow sufferers and have tried to answer them all. Many of my correspondents had their own experiences to report, others were looking for ways to ease their symptoms and reduce the frequency and severity of their attacks. This web page is a compilation of the correspondence I received and answered between 1998 and 2000. I hope it will be of interest to you and will ultimately help you to vanquish your LAF.

Please note that all the information contained in this Forum applies to lone atrial fibrillation only. If your fibrillation attacks are associated with any kind of underlying heart disease you do not have LAF and the information may not be applicable. Also the contents of the Forum should in no way be interpreted as medical advice - it is simply a distillation of the experiences of fellow sufferers and you should not apply it to yourself without medical advice.

By September 2000 the Forum had become so popular that it became impossible for me to not only answer messages and enquiries, but also to convert them to html language so as to be able to publish them here. Thus the AFIB Bulletin Board was born. It now contains well over 120,000 postings.

If you have benefitted from our work and feel it is worthwhile please support our research by subscribing to THE AFIB REPORT.

Yours in health,
Hans Larsen









LINKS TO OTHER USEFUL INFORMATION


Books of Interest to Afibbers

Larsen, Hans R Thrombosis and Stroke Prevention Second Edition
ORDER NOW
Larsen, Hans R Lone Atrial Fibrillation: Towards a Cure Volume I
ORDER NOW
Larsen, Hans R Lone Atrial Fibrillation: Towards a Cure Volume II
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Larsen, Hans R Lone Atrial Fibrillation: Towards a Cure Volume III
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Larsen, Hans R Lone Atrial Fibrillation: Towards a Cure Volume IV
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Larsen, Hans R Lone Atrial Fibrillation: Towards a Cure Volume V
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Larsen, Hans R Lone Atrial Fibrillation: Towards a Cure Volume VI
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Falk, RH and Podrid, PJ Atrial Fibrillation: Mechanisms and Management
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Saudi, N, et al. Atrial Flutter and Fibrillation
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Sears, Barry The Age-Free Zone
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Sears, Barry The Zone
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Sears, Barry The Omega Rx Zone
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Graci, Sam The Food Connection
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Graci, Sam The Power of Superfoods
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D'Adamo, Peter J Live Right 4 Your Type
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D'Adamo, Peter J Eat Right 4 Your Type
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Butler, EA Atrial Fibrillation: My Heart, The Doctors and Me
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UPDATED TO AUGUST 24, 2000

July 23, 2000

On your question about antiarrythmic agents for lone atrial fibrillation, I have been reading posts on the "atrial fibrillation page" (you might be interested to review it, although it is somewhat tedious to read through all the posts). There seems to be no doubt that antiarrythmic agents work. Different ones work better for different people, and many have serious side effects. Some, as you noted, can actually make things worse. Usually they are prescribed to be taken continuously, and they either prevent or reduce substantially the number of AF episodes. Flecainide seems to work pretty well for me. My cardiologist gave it to me in the hospital at a high dosage (300 mg) so that he could monitor the reaction, which he said was fine. He then said that I could take 200 mg as a "pulse" dosage to help conversion after an attack (the more normal dosage being 100 mg twice a day). I also found that if a took 100 mg. in the evening I could prevent an attack from coming on, and I did this for about 2 months (going without AF for one month). About 6 weeks ago I stopped taking it altogether. I would rather just take it as needed to convert after an attack. I am also working on the hypothesis that, in my apparently improved condition, a verapamil tablet may be enough to help me convert. The attack that I had 6 weeks ago disappeared about a half hour after taking a verapamil tablet. I intend to try this if I get another attack, since verapamil is safer than flecainide and it also works faster (about 10 minutes rather than 2-1/2 hours to reach the maximum level of flecainide in the bloodstream).

Victor Thuronyi, USA

Thanks for alerting me to the "atrial fibrillation page" (http://members.aol.com/mazern/).

It is interesting that you have found flecainide helpful. Of course, this drug has some rather serious potential side effects so the idea of the "pulse" therapy is probably a good one. I have also tried to take a verapamil tablet at the beginning of an attack, but found it rather scary as it lowered my pulse rate to the low 40s. However, I might try it again.

Hans Larsen


July 24, 2000

Having gone through various cocktails of powerful cardiac drugs I found that the only combination that works, i.e. greater than three months between episodes was 3x150mg of rythmol combined with 50 mg per day of atenolol. The other advantage of this was that episodes had a lower beat rate. What I used to do when I knew an episode was about to happen was to take an additional 50 mg of atenolol immediately and the heart rate slowed to under 90 BPM during fibrillation -almost unnoticeable.

I had a major breakthrough when I found I had 7 Micro amps flowing between my mercury fillings and gold-based bridges. I had the mercury fillings removed under strict protocol-and within six hours I had a dramatic improvement in how I felt. After a month of feeling great -I cold turkied dropped all medication- and got a mild episode of AFIB. Having discussed this with Dr. Huggins I went back on the drugs while I adopt a regimen of mercury detox.

I feel very confident that ultimately I will get off the drugs-but in the meantime I feel great and have largely forgotten my fear of AFIB. Bottom line -if I were you -I would consider taking the drugs I am on -until you got definitely all the mercury out, and ensured low or zero current flow in your mouth. Incidentally the current in the brain central nervous system is in picoamps-so you could anticipate the problems of microamps flowing in such geographic proximity. Needless to say you need to be under a cardiologist before going on rythmol. I would not recommend CORDORONE (amiodarone).

FM, Ireland

July 24, 2000

I would stress the vital importance of measuring the galvanic action in the mouth-by electrically measuring the milliamp flow between the various teeth-before embarking on the mercury removal process. This gives an excellent baseline-to track progress.

I have very high confidence with removing mercury under strict protocol-when the initial currents in the mouth are greater than one milliamp -with excellent results on AFIB episodes.

I am increasingly of the belief that the core issue with AFIB is the Galvanic action in the mouth between some dissimilar dental materials -particularly (but not exclusive) to mercury.

I believe I am now 75% "cured" of Afib and I am proceeding on two additional parallel paths:

1) conservative but extensive detox programs;

2) I am following up on those remaining two bridges that are showing some residual currents-even though they were supposed to be gold. I now find there are eight materials in the gold bridges. I sent blood samples under very strict protocols --To Peak Energy Performance---who do 200 hundred combination of tests on various materials to determine which materials have least risk. Their telephone is 719-331-2303----or 800-331-2303.

I will keep you informed on progress.

Thanks for being the initial impetus in getting me started on this.

FM, Ireland

July 25, 2000

Levinson's detox program

  • Coriander blended with virgin olive oil, water and a little sea salt to form a creamy mix. Dose of 1 teaspoon per day - gradually increasing to 3.
  • Seaweed tablets from mercury-free waters (2 tablets per day gradually increasing to 6)
  • Three days of sulphur supplementation (gradually build up to 3 tablets per day) followed by 1 day of zinc supplementation (1 tablet per day)
  • Intravenous vitamin C.

FM, Ireland

It was great talking to you on the phone recently. And wonderful to hear that you have almost overcome your LAF problem and it no longer diminishes the quality of your life! This is indeed encouraging news for us all!

Thank you also for your 2 messages detailing your route to success. I will certainly post them in the LAF forum so that others can benefit from your experiences. Thanks for the detox info.

Hans Larsen

August 5, 2000

I thought I would summarize my experience of lone Atrial fibrillation-as it might benefit some of your readers.

1983-Experienced complete faint after surgery. Hospital initially thought it was a heart attack. Final diagnosis after extensive heart investigation was VASO VAGAL episode. (Footnote V/V episodes often precede subsequent Lone Atrial Fib.(LAF)

1987-Experienced first LAF episode after high intake of caffeine products. After 8 hours went to intensive care-sinus rhythm restored after 12 hours on drugs. Full investigation followed-diagnosis LAF.

1992-Episode immediately after going asleep(Very fatigued with work) Sinus rhythm restored in 12 hours with drugs

1994-LAF episode after going asleep. Sinus rhythm restored in hospital with drugs.

1995-LAF episode-which was restored as usual. Put on minimum full time Beta Blockers.

1997-Major episode of LAF-not initially restored in hospital. After 3 days I was put on cocktail of Beta blockers/digitalis and Rhythmol-full time. Dropped digitalis as data shows it is a mistake to take it on a continuing basis for LAF.

I did reasonably well on this for the next two years. Then I began to experience PVC and PACS- often preceding episodes of LAF. I was constantly aware of spurious electrical currents in the chest cavity areas. Sleeping on my left hand side often triggered PACs. Life was beginning to become unpleasant. What I found helpful at this stage was stress reduction activities like Yoga- I was constantly experimenting. I contacted Hans Larsen on the WEB-and he brought up the question of Amalgam fillings. I followed through on this-finding that I had high currents in my mouth typically 7 microamps. I got all the mercury fillings removed under strict protocol. Within six hours a DRAMATIC difference - stray electric currents and PVC disappeared and energy levels improved. I got overconfident and dropped all drugs-and got a mild form of AFIB in March of this year. Went back on drugs-and I have had ZERO LAF episodes or PVC since.

Next steps. I have still some currents from a gold based bridge (gold contains seven other metals). I had an evaluation blood test-which showed I was allergic to two of the metals. I will be replacing the bridge with composite non-metal materials in October. I am also following a conservative mercury detox programs which I intend to stay on.

Bottom line-I would urge everyone to keep the faith and stay focused-The core cause of LAF is dissimilar metals/toxic metals in the mouth-and it needs a very disciplined process with expert support and your own creativity to solve it.

Good luck to everyone-Please contact me if I can be of help.

FM, Ireland

August 6, 2000

I will be in London next week-and will collect a copy of Levinson's book and send it on to you. It is an outstanding book with references supporting all his theses. Incidentally the original work on the lethal dangers of mercury was done at the University of Calgary.

The Homeopathic remedy I took last year which was helpful was nux vomica.

I am convinced that vitamins etc. are palliatives. The real gain comes from eliminating the galvanic action in the mouth and toxic materials -and conservative follow up detox.

FM, Ireland

August 18, 2000

The book is underway today to you.I think you will find it the definitive reference at this early point of research.

While the current measurement appears to be the gold standard at this point have you had kiniseology (or muscle testing done) for each tooth with a crown? It appears to correlate somewhat with the electrical current tests.

I never heard of alpha lipoic acid for the purpose of mercury detoxification. I will be attending a week long detox program in Brewster, New York in October-carried out by a Doctor of both Western and Ayurveda medicine.

I continue to feel great-now five months completely clear-but keeping my fingers crossed.

FM, Ireland

Thank you so very much for going to the trouble of sending me Levinson's book - I really look forward to receiving it!!

I will definitely try the muscle testing and if this shows up "bad" I'll have something done about my 2 "suspicious" crowns.

I have just started on the alpha-lipoic acid (100 mg 3 times daily). It is supposed to chelate heavy metals and it would make sense that it would bind the mercury with its 2 sulfur atoms. So we will see!

Congratulations on your 5 months free of attacks.

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


July 25, 2000

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


July 28, 2000

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


August 1, 2000

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


August 6, 2000

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


August 23, 2000

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 victortt@aol.com.
  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


August 24, 2000

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



UPDATED TO JULY 22, 2000

March 1998

Throughout early 1997 my palpitations were increasing in frequency and strength, and a 48-hour Holter monitor confirmed atrial fibrillation (AF). My doctor made an appointment for me with a cardiologist. I have been taking 1200 IU of vitamin E for several years, plus vitamin B complex (50 mg) and several other supplements. I learned through reading various health magazines that CoQ10 was good for the heart, but nothing ever mentioned about AF. I started on 30 mg daily of CoQ10 as well as a hawthorn tincture. Together they reduced the severity of AF, but not the frequency.

The cardiologist ordered blood tests preliminary to putting me on a blood thinner and beta- blockers. In the meantime I increased the CoQ10 to 120 mg daily and continued the hawthorn tincture twice a day. July 23, 1997 was my last AF attack and it was mild so I cancelled my appointment with the cardiologist.

It is now March 26, 1998 and I have experienced only two minor episodes. The first was when I gave up calcium/magnesium for several days because of a little diarrhea. The second was when I went off the hawthorn. So it looks like I need a combination of 120 mg CoQ10/day, 3-4 cal/mag (2:1) tablets/day, and 500 mg hawthorn powder capsules 3 times/day. The CoQ10 must be taken with oil to be absorbed. I take mine with a combination of vitamin E, lecithin, vitamin A, and cod liver oil. I am 77 years old and in excellent health.

JN, Canada



July 1999

My symptoms of atrial fibrillation match exactly your article on LAF. My attacks occur after eating and while sleeping. Could you please provide information on diagnosis and treatment of vagal nerve disorder and AF.

PS, USA

I don't know a lot more about LAF of vagal origin than what was in my article. However, here are a couple of relevant quotes from Dr. Philippe Coumel's book:

"The commonest feature is that of weekly episodes, lasting from a few minutes to several hours. The essential feature is the occurrence of attacks at night, often ending in the morning. Rest, digestive periods (particularly after dinner), and alcohol absorption are also predisposing factors. Exercise or emotional stress do not trigger the arrhythmia. On the contrary, on feeling the sensation of an incoming arrhythmia (repeated atrial premature beats), many patients observed that they could prevent it by exercising, but the relaxation period that follows an effort or an emotional stress frequently coincides with the onset of AF."

"Patients with vagal AF not only have the number of their attacks clearly increased by beta- blockers (as well as by digitalis), but they very poorly tolerate these drugs when in sinus rhythm."

Unfortunately, Dr. Coumel does not mention any drugs that do work to control LAF of vagal origin and I have not come across any in my research.

Hans Larsen



September 1999

Your article is the best single source on atrial fibrillation I have seen so far. My atrial fibrillation was diagnosed about 4 months after a severe bout of flu that turned into pneumonia. I never heard of LAF until your article and I think I may have it, but am not sure. I may have had a viral infection of the heart which resulted in pericarditis. So, my first question is whether you think it makes sense to treat it as if it is indeed LAF. Cardioversion failed which is what your article expects for LAF. But I have been on a course of amiodarone since May and converted to sinus rhythm about a month ago. I stayed on the amiodarone and steadily reduced the dose until I had a brief flare-up. I took more of the drug as soon as I noticed it and went back into normal rhythm in a few hours. My dose was raised and I stayed in rhythm until yesterday. This was after another nasty infection which may well have had a viral component, but I have no way to know if the infection was the trigger for the attack. I know you cannot prescribe for me, but what you might be able to do is to tell me what doses the various alternatives were used in the studies you used as sources. Every day I have been taking 800 mg magnesium, 4-10 g vitamin C, 200 mg CoQ10 with 800 mg hawthorn, 500 mg L-carnitine, 800 mg folic acid, 1mg vitamin B-12, and B complex (50-100 mg for each).

If you were me, which of these would you increase? Would you be willing to tell the source(s) of these suggestions?

I find your section "What to do if you have an attack" very interesting. Two minutes ago I tried the Valsalva Maneuver and it did briefly put me back in sinus rhythm.

P.S. Two days ago I doubled the amount of magnesium and came out of an attack in about 12 hours.

RCT, USA

I have a special interest in this subject as I have suffered from LAF myself for the past 10 years. Mine also started out after a severe flu at a time when I was under a great deal of stress in my work place.

It is not quite clear from your message whether you have actually had a medical diagnosis of LAF. If you have not, then I urge you to undergo the necessary tests to ascertain with certainty that your condition really is LAF - that it is atrial fibrillation with no underlying heart disease. The treatment options are quite different depending on whether heart disease is involved to not. For example, amiodarone is generally not recommended for true LAF as it is a very dangerous drug which should be reserved for life- threatening arrhythmias which LAF is not.

Your supplement protocol looks reasonable and quite similar to the one I follow. I take about 600 IU of natural vitamin E and 1500 mg of L-carnitine daily (in 3 divided doses). I also take 3 fish oil capsules (containing 540 mg EPA and 360 mg DHA) daily. Fish oils help prevent serious arrhythmias and strokes which are a potential worry if you have LAF. You have to be careful with fish oils though if you are on Coumadin (warfarin) as they can affect your blood tests. You also need to make sure that they are absolutely fresh and have no rancid smell (cut a capsule open to check). Your increased intake of magnesium to 1600 mg/day may be a little excessive and should be balanced by a corresponding intake of calcium.

The "What to do if you have an attack" section of my article is based on information from two medical textbooks and on personal advice from various doctors. The purpose of all the suggestions is basically to slow down the sympathetic nervous system and enhance the parasympathetic system thus slowing the heart beat.

You may be interested to know that I now seem to be well on the way to conquering my LAF. The answer for me at least seems to be the replacement of all my amalgam (mercury) dental fillings with composites. I have a very high mercury level in my tissues and am currently undergoing a medically- supervised detoxification program. I am getting increasingly confident that this could be the answer for me.

Hans Larsen



October 1999

Do you have any further reference to the statement made in your article that digitalis (digoxin) may upgrade intermittent LAF to chronic LAF?

RC, USA

There are several references in my article (http://vvv.com/healthnews/atrial_fibrillation.html) to the finding that digitalis is no more effective than a placebo in preventing recurrence of AF (references 2, 7, 16, and 17). The main reference to the suggestion that the use of digitalis can convert paroxysmal (intermittent) fibrillation to chronic fibrillation is found in the following reference:

Golzari, Houtan, et al. Atrial fibrillation: restoration and maintenance of sinus rhythm and indications for anticoagulation therapy. Annals of Internal Medicine, Vol. 125, August 15, 1996, pp. 311- 23

Dr. Golzari makes the statement "Digoxin does not prevent paroxysmal atrial fibrillation and can convert such fibrillation to the chronic established form."

Hans Larsen



November 17, 1999

I am taking L-carnitine, L-lysine and hawthorn juice in addition to multivitamins. While it is still in the early days yet I feel greater stability (no pounding sound while trying to sleep - no PACs [premature atrial contractions]). Thanks for the information - it was great talking to you on the telephone.

FM, Ireland

I am so glad to hear that the L-carnitine, hawthorn, etc. seem to be helping. Are you also taking coenzyme Q10 and fish oils? I personally feel that the fish oils are really helping me. I also just reviewed an article which confirms that they have antiarrhythmic properties. I take three one gram capsules per day (providing 540 mg EPA and 360 mg DHA in total), but expect to cut that substantially once I have the problem under control.

I still believe my amalgam removal did the trick for me. I have now had four DMSP injections for detoxification so my mercury level is more or less down to normal - so I am going to give the detox program a rest for awhile and see what happens.

Hans Larsen

November 19, 1999

I'm afraid I spoke too soon - I got PACs yesterday and sure enough I got fibrillations in the night! I will try the fish oils now especially as you say they have antiarrythmic effects. The Dr. Rath vitamins have only 20 units of CoQ10. What do you think is the ideal? I'm prepared for this being a long haul to find a solution and your help I assure you is deeply appreciated.

Does your dentist have any supporting information on the benefits of amalgam removal in avoiding AF? I will definitely go this route even if there only is a 20% chance of it working.

As this condition has as much a mental impact as a physical one, have you come across anyone using hypnosis to put it out of their mind and get on with a normal life?

Yesterday I got into a state of anxiety and shortly after experienced a PAC. It convinced me that there is also a mental component to this if you have a predisposition to AF.

Is there any consensus in the literature as to what gives the best results on LAF? I suspect the answer is no and that your empirical experimenting is the leading edge.

FM, Ireland

It was great talking to you on the telephone again. The fish oil used in the article I just reviewed was called Pikasol and is made by LUBE A/S of Hadsund, Denmark. They used 10 capsules a day providing a total of 3 grams EPA and 2.9 grams DHA or 3 capsules providing 0.9 gram EPA and 0.8 gram DHA. Both worked, but the 10 capsules had a much greater effect.

You mentioned that you have a feeling of dread several hours prior to an attack. This is actually a very characteristic feature of a fairly rare disease called pheochromocytoma which involves a benign tumor on the adrenal gland. The tumor causes the gland to release large amounts of adrenaline (epinephrine) at unpredictable intervals resulting in heart palpitations indistinguishable from LAF. Although this is a longshot you might want to take a test for it - it only involves analysis of a 24-hour urine sample. I have been checked for pheochromocytoma with negative results, but I still get the feeling of dread so it may just be heightened sensitivity that causes it.

There is no consensus in the literature as to what constitutes the best treatment for LAF. Some experts believe in using heart drugs, others believe it is best to leave it alone and give blood thinners to patients at extra risk for stroke. This includes most people over 65 years of age. I personally do not believe medical research is going to come up with a viable treatment until they realize that LAF is a nervous system disorder and not a heart disease.

I have just thought of another expert you may want to consult with. His name is Dr. Mike Godfrey. He is an MD specializing in environmental medicine. He runs a clinic in Tauranga, New Zealand together with a dentist. He is certainly one of the world's foremost experts on the ravages of dental amalgam and may know of a connection between LAF and amalgams. I have met him and he seems like a very knowledgeable and conscientious man - I would recommend you talk to him. He can be reached at the Environmental Health Clinic in Tauranga at (07) 578-5899.

I quite agree with you that there is a very significant mental component to LAF, but have not tried hypnosis.

Hans Larsen

November 19, 1999

A very positive note! After I slowed down the heartbeat with beta-blockers I tried the breath holding technique as outlined in your article. This seems to confirm your hypothesis that it is a nervous system issue and not really a heart one.

FM, Ireland

November 28, 1999

I found an interesting article on the Internet on the Maze procedure. Dr. Cox at Georgetown University Hospital claims a 97% success rate. The bad news is that there is a 1.7% mortality and six months for complete recovery.

I made the mistake of switching overnight to all the complementary stuff at once (i.e. 3x60 mg of CoQ10, 3x500 mg L-carnitine, fish oils, L-lysine, vitamins, minerals, etc.). I woke up in the middle of the night with the most unusual PACs which disappeared with walking around for awhile. So I am now making the changes gradually.

I also saw on the Internet many articles that statin drugs are more effective than angioplasty in moderating heart disease. The reason I mention this is that a young cardiologist indicated that there is a possibility that I could be in the early stages of artery buildup. No other cardiologist has indicated this.

FM, Ireland

As far as Maze surgery goes I don't believe in invasive heart surgery for a problem that originates in the brain! I also don't believe in angioplasty or bypass surgery either. Medical research has shown that these procedures are vastly over promoted and that 50% or more of actually-performed operations were not necessary at all. Also, there are many natural approaches which are equal or superior to statin drugs. If you believe you have a problem with the beginnings of atherosclerosis I would highly recommend that you read "Reversing Heart Disease" by Dr. Julian Whitaker, MD before making any decisions on how to deal with it.

Sorry to hear about your PACs after going full out on your supplementation program. Hope things have settled down by now.

I am just celebrating 60 days of no fibrillation attacks so I am now quite convinced that I have found the solution and that the problem was my dental amalgam fillings particularly the galvanic reaction between them and my gold crown.

Hans Larsen

December 4, 1999

I am visiting a dental clinic in London in two weeks to begin the process of eliminating my amalgam fillings. I shared the information on the Maze procedure for your information only - I would not dream of it at this stage. I don't believe their 97% success rate - as every other researcher says it's 50% at best.

I have a copy of Dr. Whitaker's book.

FM, Ireland

December 5, 1999

I deeply researched bypass surgery and had made up my mind that unless it was the last option in life, I would never go that route. While they say the mortality is 2% the stroke and heart attack rate is much higher. Even worse, over 50% have major personality changes afterwards as a result of the bypass perfusion system. I observed these personality changes firsthand in people who worked with me.

While waiting on the amalgam removal I am experimenting with hypnotherapy with a very well qualified therapist and so far it is encouraging in terms of reducing the fears of an attack.

FM, Ireland

February 22, 2000

Since getting my amalgams removed I have now gone nine weeks without an AF episode OR a single PAC. My life has fundamentally changed for the better! I am now very gradually reducing the medication I was on. My plan is to phase it out over the next three months - hopefully with the same results (I could actually live with some of the medication, if I had to).

A couple of suggestions. Maybe you have a tiny amount of amalgam under one of your gold fillings. To avoid this risk my dentist did a 360 degree X-ray to make sure there was no minute quantity underneath the gold bridges. Another thought is to call the dentist who put in the gold to find out what the materials were they used. While it is controversial a hair analysis might be helpful.

I also met a Naturopathic doctor in Mexico. He recommends the following for detoxification:

  • One spoon of Epsom salts a day (Magnesium)
  • Stopping any calcium intake
  • Vegetarian diet
  • One half glass of pure Aloe Vera after each meal
  • Cod liver oil
  • A spoon of a mixture of one head of garlic, two onions, one complete lemon, olive oil. This should be taken after each meal.
He recommended to stay on the regimen for two months.

Another suggestion might be to go temporarily on a half dose of beta blockers until completely detoxed. The psychological benefit of being AF-free might help accelerate the program.

I notice a big positive increase in energy. I am confident that amalgam is the core issue with LAF.

FM. Ireland

February 26, 2000

I reduced my medication by 30% - so far so good. Within six hours of the amalgam removal I found a dramatic difference in terms of energy and the absence of very subtle electrical signals around my heart that frequently led to PACs and PVCs and then every month or so to AF. Until now I always felt that AF could kick in on the next beat at any time.

Incidentally, the dentist took great precautions when removing the amalgam. He covered my eyes with pads and glasses-my nose was connected to a separate pump for breathing and I had a dental rubber dam in the mouth. He also went to considerable lengths to ensure that minute levels of amalgam were not present under my gold bridges. I also called beforehand to my various dentists to find out exactly the composition of all the bridges. He also measured the currents between the underlying materials beneath each of the bridges and various amalgam fillings before and after. This data and the 360 X-ray gave him confidence that all the amalgam was removed-and he appears to be right.

FM, Ireland



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January 2000

I have been having fibrillation attacks for over three years. I suffer no heart disease and have a borderline blood pressure reading. I have noticed that an onset of fibrillation usually starts after I've eaten lots of sugary things, i.e. chocolate. The last time I had it was when I had just eaten a plate of chips and cheese and some red wine. Your article has been a real eye opener and I am going to start researching some of the things you have mentioned (tyramine and LAF, etc.) And, unfortunately, I'm going to have to get serious about giving up coffee, chocolate, wine and cheese!

WP, USA

February 2000

I have been suffering from either atrial fibrillation or flutter for the past two years. Right now my cardiologist and I are attempting to determine which arrhythmia I have. I was wondering how recent the information posted on your website about lone atrial fibrillation is. I would like to ask my cardiologist about this information.

PU, USA

The report was first published in the "International Journal of Alternative and Complementary Medicine" in November 1996. I believe it is still quite current, but have a few later observations to add. Please note that all my research and observations apply to LONE atrial fibrillation only and may or may not be applicable to AF with underlying heart disease.

From the number of enquiries I receive regarding lone atrial fibrillation it certainly would appear that it is a near epidemic. This is perhaps not too surprising as I am now convinced that its main cause is stress. LAF, by definition, is not a heart problem, but rather, in my opinion, a dysfunction of the central nervous system with a heavy involvement of adrenal hormones.

I have suffered from LAF myself for over 10 years and during this time I have tried pretty well every therapy you can think of to get rid of it. I have not found cardiologists particularly helpful and would not consider taking heart drugs myself and least of all not Lanoxin (Digoxin).

As you know, LAF is annoying, scary, exhausting and depressing, but it is not life-threatening. I do take an aspirin when I am having an attack, but otherwise I rely on fish oils and vitamins E and C to prevent strokes. I have found fish oils particularly helpful as they not only prevent blood clotting, but also help prevent arrhythimas and to fight depression. Besides fish oils (3 grams/day) I take coenzyme Q10 (180 mg/day) and L-carnitine (500 mg three times/day) plus a very powerful multivitamin with lots of vitamins B, C and E (50 mg of Bs - except just 1 mg of B12 and folic acid), 1500 mg of vitamin C/day and 400 IU of natural vitamin E/day. I also take calcium and magnesium in a 1:1 ratio.

I believe these supplements and avoidance of trigger factors and excessive stress are very important, but have found that, in my case, the most important step in preventing LAF attacks has been to have my amalgam (mercury) fillings in my teeth replaced and my mercury toxicity burden reduced by a medically- supervised detoxification program. So far, this has reduced the frequency of my attacks from two per week to about one every six weeks and eventually I expect to be rid of them altogether. I have also found that taking a warm shower followed by 30-45 seconds of the coldest water you can stand is quite effective in stopping an attack.

Hans Larsen

February 2000

I am a track and field athlete - I do the decathlon. Since it is my last year in college, I would like to figure out a way past this atrial fibrillation so I do not have to cut my season short. I go into my arrhythmia after a full day of classes leading up to practice and then I have the problem during my running workouts. I guess you could say they seem to be stress induced. I was wondering if you have anything else you might be able to help me with in the area of exercise (high intensity). With what you have told me already I feel I have a good start if it is LAF. I plan to discuss your recommendations with my cardiologist before I take any action. I hope to be taken off Norpace so I can lead a drug-free life.

PU, USA

The adrenergic form of LAF is often preceded by exercise or emotional stress. A characteristic feature of this is frequent urination. I would suggest that you take it easy and avoid high intensity exercise for awhile to see if this will help. You definitely want to nip LAF (if this is indeed what you have) in the bud as it tends to remodel the heart's electrical system so that attacks become more frequent with time.

Hans Larsen



March 2000

I recently read your article on lone atrial fibrillation and found it most interesting. I have had LAF for several years now and have been under the care of a cardiologist who has prescribed digoxin for me. I now understand that this may not be appropriate for LAF. I also read an article about magnesium deficiency causing the problem, but my blood test was normal. Do you have any suggestions in addition to those presented in your article?

JM, NY, USA

Digoxin (Lanoxin) is not recommended for this condition as its long-term use can lead to a worsening of the attacks. As far as magnesium is concerned over 99 per cent of the body's magnesium stores are found in tissues (especially the heart) and bones. A blood sample is a notoriously poor indicator of magnesium status so you could well be deficient even though the blood test is normal.

Fish oils are useful in preventing serious arrhythmias and coenzyme Q10 and L-carnitine have also been found to have a beneficial effect. My very latest finding is that replacement of amalgam dental fillings with inert composite fillings may totally eliminate the problem. This makes sense when one realizes that mercury is a very powerful central nervous system toxin. Medically-supervised detoxification is a must if replacing mercury fillings. Amalgam replacement may be particularly beneficial in cases where other metals (bridges and gold crowns) are also present in the mouth.

Hans Larsen



March 2000

I enjoyed speaking to you on the phone a few days ago on the subject of lone atrial fibrillation. I am having a difficult time with it and from your article I can see that all my triggers are of the adrenergic variety. This is hard on me as I love hiking, swimming, and dancing. Since starting fish oil and magnesium, and giving up calcium supplements my episodes have been much shorter - 20-30 minutes rather than 2 hours. I have a date with my dentist to remove my 6 small amalgam fillings, but she can't do it for the next 3 weeks, and I am thinking of finding another dentist who can see me more quickly, as the AF is happening every few days and is not fun, and leaves me weak and shaky. What kind of medically supervised detoxification are you referring to after amalgam removal? Any ideas would be appreciated.

SG, USA

I am glad to hear that your attacks have been much shorter, but I know from experience that even a short attack can be exhausting. I used to have attacks (12 hours duration and more) once to twice a week. After replacement of my amalgam fillings I go now for 2 or 3 months without an attack.

Detoxification in North America usually involves oral DMSA or intravenous DMSP. I went the DMSP route; it certainly worked, but I have a feeling that it could be a bit rough on the body. Anyway, there are two really good web sites that explain it all and will even help you find a suitably trained physician and dentist in your area. They are as follows:

You can order DMSA yourself from Thorne Research.

Hans Larsen

April 2000

Thanks to your help I have found a dentist who specializes in removing amalgam fillings and will go to him April 10th unless he has a cancellation before that. In your monograph you mention homeopathic aconite for sublingual use during an attack - I was able to find aconitum napellus, and wonder if that is the same? I am trying to strengthen my heart with hiking and going to a gym - so far two weeks without an attack, but I am constantly vigilant and frequently on the verge. I really hope that mercury may be a causal factor. My cardiologist raised her eyebrows, but asked me to tell her how it worked! She keeps mumbling about Coumadin and amiodarone, which I decline to take. After the Bill Bradley revelations, I wonder if lone atrial fibrillation is often found in tall people - everyone I know who has it is over 5'9". We do present more of a challenge for the heart, which is why giraffes have the largest hearts of all mammals, or so I have heard. Has your situation continued to be good after the fillings were removed, and how long ago did you have them out?

SG, USA

I am glad you found a suitable dentist and hope all goes well with the removal. If my experience is anything to go by, you can expect the attacks to get more frequent just after the removal, but then the frequency should decrease dramatically. I am now down to one every two months. Have you decided what to do for detoxification? Hal Huggins apparently recommends 50 mg of DMSA 5 days a week for a year. Even though I went the route using DMSP injections I honestly don't think I could recommend it; I think they are quite hard on your system. I had my fillings replaced in early July of last year.

I applaud your decision not to take Coumadin or amiodarone. Coumadin is really not that effective when you look at the actual trial data and one large Canadian study found that what was gained in lowering the rate of ischemic stroke was completely counterbalanced by the increase in intracranial bleeding. I take fish oil instead; it not only helps prevent blood clotting, but also helps prevent arrhythmias (ventricular at least) and helps fight depression. As I mentioned before, I believe LAF is a problem of the autonomous nervous system not a heart problem, so taking a powerful, dangerous heart drug like amiodarone would not make much sense. I have never come across any studies which show that it works for LAF. One of my subscribers reports that 300 mg/day of Rythmol (propafenone) may be somewhat helpful in keeping things on an even keel.

As far as the aconite is concerned. Yes, Aconitum Napellus (7 or 15 c) is what was recommended. I have also found that Lycopus (15 or 30 c) taken just when you feel you are on the verge of an attack may help abort it.

I have never seen anything to support the "tall people" theory, but it sounds plausible. I have read somewhere that the same type of people who get panic attacks (intelligent, perfectionist, orderly, etc.) also tend to get LAF. Don't know if there is anything to that. I tried Paxil for awhile. It definitely helped, but I had to discontinue it because the attacks I did have were longer and longer (4 days or more) and eventually turned into bradycardia.

Hans Larsen

May 6, 2000

I have enjoyed your web site, and your latest newsletter. I can't seem to get to the atrial fibrillation forum from the html you gave or the homepage. Please advise. I am still at the amalgam removal business, and have started the DMSA from Thorne. Thanks so much for your help.

SG, USA

Sorry you had a problem getting to the LAF forum. Anyway, there are a couple of ways you can get to it. You can go to the article on atrial fibrillation (www.pinc.com/healthnews/atrial_fibrillation.html) and then click on the bar saying "please visit our new LAF forum" about halfway through the article.

You can go to our home page and click on "Research Reports" on the top panel and then on "Lone atrial fibrillation" and then proceed as above.

You can go to our home page and then to "Members Entrance" and then use your access code to get into the members section. There you'll find a direct link to the LAF Forum.

You said in your message that you "are still in the amalgam removal business, and have started the DMSA from Thorne". I don't know if it applies to DMSA but I know that you should not have DMSP injections until every last bit of amalgam has been removed. Apparently the DMSP gets into the saliva and starts to "eat away" at any mercury remaining in the mouth which sort of defeats the purpose of detoxification. You may want to check on this assuming you still have some amalgam left in your mouth.

Please let me know what you think of the forum and whether your attacks have diminished in frequency and or severity.

Hans Larsen

May 7, 2000

Thanks so much - I found the forum easily and really enjoyed it. It is extremely helpful to read other people's experience, and the reading gives me courage and hope that I can manage this thing myself. I have had all visible amalgam removed, but now am going to have my two gold crowns removed to see what might be underneath - old dental records not available. When that is done I will start the DMSA again - thanks for the advice. For the umpteenth time in my life I am starting to meditate morning and night - only 5 minutes each time so it won't seem too hard - and I think this will calm my CNS and have a good effect. When I have persevered with meditation it has been very helpful in smoothing out my jangled, self-deprecating thoughts - I have noticed that fish oil does the same thing.

SG, USA

May 27, 2000

It has taken me an extremely long time to have all my amalgam fillings removed - three dentists, etc. Finally done yesterday. Amalgam was found under 2 out of 3 gold crowns. And, as you suggested, I have gotten worse during the process. Not in the way of more attacks, only 2 of those, two weeks apart, but more 'on the verge' feelings, which I can usually treat by taking a small bite out of a 10 milligram propranolol tablet (a beta blocker which slows the heart rate). I am especially vulnerable when I get up in the morning, and currently have to eat a banana (hypoglycemia is a trigger for me) and take a little propranolol before I get out of bed. Now I am starting on a detox program in earnest (thanks for your suggestion not to start before all the mercury fillings were gone). I have DMSA from Thorne, and an article from them about how it works. There are several suggested protocols about how much to take, for how long. Also they suggested hydrolyzed whey protein. I emailed the author of the article with questions a few weeks ago, but he did not reply. I will call them next week and see what they have to say. How long did it take you to start feeling better after your removal? I would like to call you on the phone, but do not want to take advantage of your good nature and your time. Please let me know if you prefer not to be called, and to use email to answer questions.

SG, USA

It was good to hear from you and I am glad to hear that you have finally got rid of all your amalgams! Yes, my attacks certainly got a lot more frequent immediately after my amalgam removal was completed. I would say it took about a month before I noticed a vast improvement. Interesting with the propranolol. Do you actually keep the "bite" in the mouth for awhile or do you swallow it?

I took hydrolyzed whey protein during my detoxification, but really can't say if it helped.

My friend in Ireland found a doctor/dentist (not sure which) in the US who was very helpful and knowledgeable about detoxification. His name is Dr. Jacobsen and he can be reached at (850) 936-1729.

Please feel free to give me a call anytime - I will be delighted to share experiences with you. My phone no. is (250) 384-2524.

Hans Larsen

June 5, 2000

I have a tall friend with lone a fib who found that the valsalva maneuver, performed with vigor and for as long as possible, enabled him to convert to normal sinus rhythm. I am going to get hold of that paper in the Am J of Cardiology. I was a little premature in telling you that I had gotten rid of all my amalgam fillings - had a final small gold filling removed today with an amalgam filling under it! Tomorrow morning I am going to have a phone interview with Dr. Jacobsen, the retired dentist in Florida whose number you gave me. For some reason I am now starting to have hope that I can get better. Although I have not had more frequent attacks since starting the amalgam journey two months ago, I have had many more symptoms, feelings of impending attacks, intense cardiac awareness, and a need to eat every few hours to ward off those feelings. I note that you wrote that hypoglycemia is a trigger for some people, and it certainly has been so for me in the last two months. As I mentioned, I carry 10 mg propranolol tablets in my pocket, and dissolve a little bite of them under my tongue several times a day. They help, which stands to reason if the problem is caused by sympathetic nervous system dominance. I think that meditation is helping me also in that regard.

SG, USA

Thought I would pass along some info after talking to my friend in Ireland. He had his amalgams removed in January and has now gone for 4 months without a LAF attack. So there is hope for us all!!

How are things going with your progress? By the way, he highly recommended a book by a Dr. Jack Levinson entitled "The Menace in Your Mouth". Have you read it?

You may also be interested in knowing that I have found lavender oil quite beneficial. Whenever I feel the kind of anxiety building which I know can lead to an attack I rub a few drops of pure, natural lavender oil onto my left wrist. This calms me down almost immediately. Let me know if you try it.

Hans Larsen

July 3, 2000

Thank you for the update on your Irish friend and yourself. I really appreciate it, as this whole thing is quite isolating, in the sense that no one who hasn't had the problem can quite understand the feelings. Ever since I started on my amalgam odyssey I have felt more unstable, although I have only had 2-3 attacks in 3 months. I have a little more expertise in warding them off these days, but the anxiety of getting one is always with me. I will try the lavender oil at once - in fact I will start tonight with some lavender blossoms growing in my yard. I remember an article in the Lancet a few years ago on the efficacy of lavender oil for insomnia in the elderly.

Having had all my amalgams removed, I am taking DMSA for 3 days every two weeks as recommended by Alan Miller at Thorne research. I am starting to feel slightly better, and I am not sure if it is due to that or to a walking program I am on. A new symptom for me has been extreme hunger - a hypoglycemic type of feeling that comes on between meals, especially if I eat alot of carbohydrates - for example oatmeal, raisins and whole rye toast for breakfast. I feel better after an egg white omelet. Anyway, I have been eating all day long recently to ward off the bad feeling, which leaves me quite vulnerable to an attack of a fib. I never craved meat before, and was a vegetarian for over 20 years. No longer possible. Did you have any such symptoms? It's quite new for me.

SG, USA

Good to hear from you. It sounds like you have hypoglycemia. Does the blood sugar test show this to be a possibility? Have you looked into changing your diet to alleviate it? Cutting out sugar and white flour products and increasing your intake of foods with a low glycemic index may help as may more frequent meals. I was also almost totally vegetarian for many years, but find that I need meat or fish at least twice a week now to feel OK. I think it is a fairly common "age" thing and probably has nothing to do with the amalgam removal.

Hans Larsen



June 8, 2000

I'm pleased to have found this forum. I have every reason to believe that the approach of AF sufferers sharing their findings provides more benefit than the over-zealous use of drugs that seems to be the normal treatment through the medical establishment. I have just in time, after taking lanoxin for nearly a year, come to the conclusion that it was exacerbating the problem it was supposed to cure. The attacks had gotten to 12 per month, lasting from 2 to 6 hours, although there had been earlier ones over 12 hours. Now, three weeks after dropping the lanoxin in favor of 800 mg. of Magnesium daily, 175 of Calcium, a 1/2 teaspoon of Salt substitute (Potassium Chloride, along with Vitamin E, C, A, I have now gone 12 days without an attack, and the abdominal pain that had been getting worse and worse, whether in the midst of an AF episode or not, has gradually abated. Thank God for people who don't just lie down and take the nasty drugs!

DR, Canada

Thank you for sharing your experiences with digoxin. I really don't know why physicians keep prescribing it for lone atrial fibrillation!! There is ample evidence that it makes things worse. Glad to hear that your supplement regimen is helping. Please stay in touch - your findings will help others.

Hans Larsen



June 30, 2000

I have had LAF for about 18 months now, and have found your site most interesting. How did you find out that you had high levels of mercury in your body?

Thanks for site.

JB, USA

I am glad you found my site useful. I hope you also had a look at the LAF Forum (http://www.pinc.com/healthnews/lafforum.html).

I only found out that I had a high mercury level once I started the detoxification process after having my amalgam fillings removed. But I do know of some LAF patients who have discovered that their mercury levels were high through a hair analysis.

I reasoned that since mercury is a potent neurotoxin it might cause an imbalance in the autonomous nervous system that could lead to the start of an atrial fibrillation attack. So far it seems that removing the mercury from ones mouth significantly lengthens the time interval between attacks and may eventually stop them altogether.

Hans Larsen



July 5, 2000

First, I would like to thank you for posting on the web your article on Lone Atrial Fibrillation. I went into the emergency room on Dec. 27, 1999, because there was something strange going on with my heart and I felt a tightness in my chest -- I had no idea what was going on and ended up hospitalized for a few days after cardioversion so that they could adjust my coumadin level. While in the hospital I fortunately had my laptop with me (being a workaholic I had brought it home during vacation), and was able to surf the web and found your article among others. This gave me some starting info and I was able to ask my doctors some informed questions -- for example, whether they thought I had lone AF (they said apparently so). Subsequently I used the citations in your article to do some reading in the NIH library, primarily tracking down the writings of Dr. Coumel, and by observing my pattern of AF determined that I had a classic case of vagally mediated AF. I have written the attached two articles, one about vagally mediated AF in general and the other about nutritional approaches. As you can see I also have had quite high levels of mercury. At this point, I don't know whether the problem is with my dental amalgams. I intend to have another blood test done in September and if my mercury levels have not come down sufficiently due to the detoxification agents I took I will think about doing something about my teeth. I do not intend to rush into that, though, because the dental work involved would have complications of its own and it is not an emergency situation. Fortunately, for the moment the AF seems to be at bay. If you would like to post the articles I have written on your website, feel free to do so.

Victor Thuronyi

Thank you so very much for your message and the attached article (vmpiaf.doc) which I found extremely interesting and very thoroughly researched. I would be delighted to post both your e-mail message and the article in my LAF Forum (http://vvv.com/healthnews/lafforum.html)!

I normally just use the initials and country in the signature, but as you will be listed as the author of the article perhaps I can use your full name in this case. Please let me know if this is OK with you.

Hans Larsen

July 7, 2000

Thank you very much. You can use either my full name or initials as you like. Attached are both articles, slightly revised. The one on nutrition answers your question about what I did for mercury detoxification. I decided to put off dental work pending further test results, but will consider removing my amalgams if that proves necessary (i.e. if I still have elevated mercury levels despite the detoxification).

Victor Thuronyi

Nutritional Treatment for Atrial Fibrillation

Vagally Mediated Paroxysmal Atrial Fibrillation: A Patient's View



July 14, 2000

You talked about mercury fillings as a cause for you AF. I tried searching Pub Med for correlation between AF and mercury with no luck, even though there were plenty of references for each of them separate. Do you have any references that tie these together?

RJW, USA

Thank you for your message with the attached information on your AF episodes and supplementation program. It is fascinating that humming and taking a shower seem to stop the attack. Is it a cold shower? I have found that a cold shower sometimes helps convert. Do you feel that the Tenorman helps? Do you take it only during attacks? What about the Norpace? Have you noticed any effects of this?

I take 180 mg/day of coenzyme Q10 and also take fish oil daily (Coromega). I believe this helps too.

I have not found any medical references that link lone atrial fibrillation as such and mercury. However, I did find an article in the "Journal of Orthomolecular Medicine" (Vol. 5, No. 3, 1990, pp. 138-42) that linked palpitations/tachycardia to amalgam fillings. Twelve out of 13 patients with this problem apparently improved after removal of their amalgam fillings.

Hans Larsen

July 19, 2000

I take a warm shower because one time when my heart was missing a lot of beats, which usually precedes an A.F. episode, I was feeling shaky and cold. The warm shower calmed things down that time. It seemed to help during the A.F. episodes also.

I took the Tenorman because my heart specialist said to take it as a precaution to prevent the A.F. from spilling over into the ventricles. However, when I come out of the episode my heart rate is down to about 48 and it takes a few days to get it out of my system. My heart doesn't respond very well to things like stairways with Tenorman.

I was taking only Tenorman regularly as indicated by my sheet, but it didn't prevent the AF episodes. My heart specialist said it wasn't usually effective for the vagal form of A.F. that he said I have.

I still had a full AF episode after starting the Norpace at 400mg/day, but since have been taking 600 mg/day. The two episodes at this dose were only 15min. Some of the effects of Norpace are: I still get skipped beats. Sometimes, I get a "sinking feeling " in my chest , with my pulse light and slightly faster, even during periods when I am just sitting. My heart seems to respond more slowly to stairways with that sinking feeling, but after I get walking for a while it is fine.

I haven't tried to push myself hard, like mountain biking up a long hill, windsurfing in high winds, or singles tennis, since the A.F. started. These are all activities I normally do. However my heart specialist told my to go ahead with any of these activities.

Thanks for the reference on mercury. I have ordered the book "Uninformed Consent:..." and intend to ask my "non-amalgam type" dentist about it.

RJW, USA



July 17, 2000

I'm writing to you after downloading your valuable and informative article on Lone Atrial Fibrillation. My wife has had intermittent AF for about 6 months, and the frequency of episodes has been increasing to several times a week. An episode leaves her feeling very fatigued. After reading your article she contacted a medical herbalist who prescribed hawthorn. She feels that an episode is triggered by emotional and physical stresses which she is learning to identify, and when she senses that one threatens she has been breathing deeply, doing the "blowing up a balloon" maneuver, and meditating deeply on what is happening with her heart and emotions. All this has made a considerable difference.

However, she is 74 and her practitioner adopts the view that your article on LAF does not apply to her because she is too old. She wants her to take aspirin and sotalol. My wife does not mind the aspirin but is extremely reluctant to go down the path of beta-blockers.

I am obviously not asking for your advice on what she should or should not do. But I would be grateful for your comments about the applicability to her of the discussion in your article.

LC, UK

I am sorry to hear about your wife's LAF - but don't give up yet! Although LAF is scary and exhausting it is not life-threatening. I urge you to carefully read all the information posted in the International Health News LAF Forum (http://www.pinc.com/healthnews/lafforum.html) before you decide on the sotalol. Depending on what type of LAF she has (adrenergic or vagal) sotalol could worsen the situation and it is by no means a safe drug. The LAF Forum contains several examples of what fellow LAF sufferers are doing to improve their condition. Some of them may work for your wife.

As you so rightly point out, I cannot give you medical advice and what she ultimately decides to do is a matter between her and her doctor. However, have a look at the Forum and please stay in touch.

Hans Larsen



July 18, 2000

My AF experiences are now over 14 years old and still counting. To be honest with you I didn't even think I would make it this long. I am now 41 years old and a veteran of AF episodes. AF has been very hard on me, especially mentally. My having, or fear of having an AF attack in a social situation has had a dramatic effect on the life of both me and my wife. My AF episodes are so dramatic to me that I can specifically remember many of them that are now many years old. My first occurrence was when I was 27 years old and vomiting from a drinking binge. I felt a thumping inside my chest and went to the hospital, I was there two days and the drug they gave me snapped the heart back into rhythm. From that moment on I have never been the same. My heart beat has been very pronounced and I get AF episodes that can last a few seconds to several minutes for all these years. At age 31 I put myself in the hospital again when I went AF over several hours and again the drugs snapped it back after two days. Over the years I have used the Holter monitor many times and taken stress tests which have shown nothing or very little. I have not been hospitalized since but that does not mean I'm better. Far from it, actually the only thing that has gotten better is my mental tolerance of withstanding a considerable AF episode. I have been on Lanoxin for 14 years and the addition of Quinidine for the past ten years. My doctor has suggested on my getting off the drugs and I tried it once for a few months last year but the AF episodes without drugs scared me more and I wanted back on the drugs.

While reading over the Fibrillation article and Forum many things struck a chord with me. In the beginning I believed I had a heart disorder but now I believe I have a nervous system disorder. I have other symptoms, under a great deal of stress not only do I get increased AF episodes but my little and ring fingers in both hands become tingly or prickly and can even go numb. I have had prickly sensations on my legs and back as well. As an example, once during a blood test (stressful for me) and without even moving a muscle, both the fingers in my hand went completely numb, I almost fainted and I went into complete AF and it lasted for a full day. The next day the AF kick back to a regular rhythm when I was hauling the garbage out to the road.

That brings up another thing that seems very odd. Even with all these problems I am still quite active, I consider myself to be in good shape, I play a lot of hockey, run and lift weights. I am 6'3" and weigh 220 lbs. Not every time, but many times physical activity can help me gain a proper rhythm. I have had many horrible days with AF at the office and then during and after a hockey game it has clear up, go figure! Actually being completely at rest or quietly reading can be very nerve racking when AF is on the prowl.

I have read yours and many other articles and I think it is time I try something different. Do you have any suggestions on where I should start?

BM, USA

Thank you for your message and your very thorough description of your LAF condition. It is probably as good a description as any of vagal origin I have ever read! I assume that your tests have shown your heart to be sound and that you do indeed suffer from LONE atrial fibrillation.

It seems to me that you have already taken the first and most important step in getting rid of your AF attacks. You have realized that you yourself are responsible for doing this. The next step you need to take is to follow your doctor's advice and stop the Lanoxin (digoxin) and quinidine as soon as possible. You will probably have to gradually withdraw over a period of 3 weeks or so under your doctor's supervision. It is a well-established medical fact that digoxin and beta-adrenergic blocking drugs may increase the frequency of AF of vagal origin(1). So having taken Lanoxin for 14 years may well be at least partially responsible for your condition today. I would strongly recommend that you stay away from heart drugs - with your doctor's agreement, of course. They are more likely to cause harm than good in your case.

We all get scared when the heart beat goes awry, but LAF is not life-threatening and there are many natural ways of avoiding or dealing with an attack. The beginning of an attack involves very subtle changes in the central nervous system so it stands to reason that very subtle remedies may have a great effect. For example, I have found that rubbing a drop of pure lavender oil on my left wrist has an immediate calming effect. The homepathic remedies lycopus (6 or 30 c) and arsenicum album (30 c) may also be effective in your case.

Please read about the experiences of your fellow LAF sufferers in the LAF Forum (http://www.afibbers.org/lafforum.htm). I think you will find Victor Thuronyi's 2 articles of particular interest.

Good luck and please stay in touch. We all need to share our experiences if we are to beat LAF!

Hans Larsen





The AFIB Report