Dysautonomia [
en.wikipedia.org]
Quotes from CR Session 59 (2007)
Dysautonomia and LAF [
www.afibbers.org]
Hans:The late Dr. Philippe Coumel of the Lariboisiere Hospital in Paris discovered in 1982 that a dysfunction of the autonomic nervous system also plays a major role in lone atrial fibrillation. He concluded that lone atrial fibrillation only develops when three conditions are met:
1. The autonomic nervous system is dysfunctional (dysautonomia)
2. The heart tissue is abnormally sensitive and capable of being triggered into and sustaining an afib episode
3. A trigger or precipitating cause capable of initiating an afib episode is present.
It is clear that dysautonomia plays a major role in lone atrial fibrillation. What is not clear is what causes the majority of cases of LAF. Early surveys have established that it is not viral illness, exposure to chemicals or trauma.
So what is it?
James D: The conundrum I've always had is that, whilst I agree with Coumel's 3 points,
I believe AF can also occur when only points 2 and 3 are true. (i.e. if points 2 and 3 are met you can go into AF with a perfectly normal autonomic system.)
Patrick Chambers, MD: With all due respect to Prof Coumel,
I agree with James in that points 2 and 3 seem sufficient to initiate AF.
====================
The answer is:
None of the above are needed for the development of LAF (unless Coumel's point 2 "abnormally sensitive heart tissue" is interpreted to include foreshortened refractory periods).
In 1982 Dr. Coumel would probably not have had knowledge of the early / developing science of the sodium/potassium pumps in the cardiomyocytes' plasma membrane, or know the implications for cardiology.
In 1986 the fully developed science was published, but was effectively "disappeared" by morally corrupt powers of Salt, Food, Pharma, and Publishing. See
"Why Haven't You Heard of These Developments?" [
www.afibbers.org]
By 2001 the cellular/ Na/K pump science had been republished in books (1993, 2001) and brought out in journals.
In 2003 (CR 2) Jerry explained some highly relevant and important cardiac energy/ voltage/ pH details from published Na/K pump science, unfortunately without attributing the source. The science was obviously from Dr. Moore's 1993 or 2001
The High Blood Pressure Solution See CR 2, pp 20 - 21 [
www.afibbers.org]
From 2003 to 2011 there is not a word about energetics/ voltage in the CRs.
By 2007 (CR 59) Na/K pump/ cardiac energetics/ voltage science per Dr. Moore et al's biophysics research had been published and readily available for 14 years -- clearly it should have been in the dysautonomia/ LAF causation discussion.
In 2011 (CR 72) Na/K pump science was finally applied to cardiac energetics and dysrhythmia, showing that inhibition of Na/K pump activity lowers atrial muscle cells' membrane potential (voltage), shortens their refractory period duration, while increasing intracellular sodium and excitatory calcium, and lowering pH, and by extension accounting for LAF initiation and perpetuation.
Better late than never...
Erling.
Edited 3 time(s). Last edit at 06/20/2012 05:57PM by Erling.
