Afib log for 8 yrs, including when starting supplements

Hi everyone,

I'm not sure if this is of any interest or benefit to anyone but I am listing my afib log for since it started. As you can see I went 3 months afib free not long after starting the big three so at the time I was sure of their benefits. But now I'm not so sure condensing my afib log to where I can see the big picture better.

After looking at my log I am going to try cutting way back or try stopping the taurine and potassium and see where it goes from there. Also due to my increasing afib I have a doctors appointment this Wednesday to get a prescription for flecainide, I plan on trying it as pip at first and maybe use it full time if that doesn't give me enough relief from the afib.... when is too much, too much?? I'm not sure where to go with taking the atenolol yet, I think I'm more vagal, but not sure? Any opinions on that?

Thanks for any help or suggestions,
James

----------------- afib log ----------------------
Always took multi vim's and magnesium and fish oil and vim C before having afib.

2002
-----
Started BP readings and afib log
*Afib April 8?
*Afib June 15? 1 hr
Quit smoking
*Afib Oct 17 9 hrs

2003
-----
*Afib Jan 20, 15 mins
Started Atenolol 25mgs Jan 23
*Afib Aug 18 10 hrs (bad cold)
*Afib Sep 8 4 hrs (relasp of bad cold)

2004
-----
*Afib Sept, 10 mins
Dec 27, 1 hr

2005
-----
none

2006
-----
*Afib Feb 25, (Riding dirt bike all day, afib started after ride home when unloading dirt bike)
*Afib Nov 9, After eating breakfast

2007
-----
*Afib Sept 13, After eating breakfast

2008
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*Afib Feb 5, After eating breakfast
*Afib Feb 12, (No notes)
*Afib Apr 9, 11 hrs (After riding dirt bike)
*Afib July 8, 4 hrs (Startled awake middle of night camping on a motorcycle trip)
*Afib Oct 11, 10 hrs (about 1 hr after going to bed) First real night time afib.
*Afib Nov 3, 11 hrs (Went home at first break at work, didn't eat anything before afib this time)
----->>>> Started Potassium and Taurine - always took magnesium even before having afib.
*Afib Nov 12, 4 hrs (Day off work, didnt eat anything before having afib in the evening)
*Afib Nov 26, 10 mins (at car warsh after second day in a row riding dirt bike)
*Afib Dec 7 (After eating lunch)
*Afib Dec 25, 3 hrs (Just starting to eat at 7pm)
*Afib Dec 28, 4 hrs (After eating at 8pm)

2009
-----
*Afib April 7, 9 hrs (no notes)
*Afib April 21, 2.5 hrs (Bad cold, flu, fever)
*Afib ??, 13 hrs (Vacation- Abib started after supper, ended when I got up)
*Afib May 27, 6 hrs (Started at night, quit when I got up)
*Afib July 27, 4 hrs (Started when I got up off couch to eat supper)
*Afib Aug 12, 7 hrs (started before work)
*Afib Aug 29, ?? hrs, (lots of ecpotics after lunch, went into afib after work, didn't eat before afib this time)
*Afib Sept 16, 16 hrs (Started when I got up in the morning)
*Afib Sept 27, 6 hrs (Started about 2 hrs after I went to bed)
*Afib Oct 17, 6 hrs (had lots of ecptoics at work, came home and went into afib 2 hrs later)
*Afib Nov 3, ?? hrs (Started about 2 hrs after I went to bed)
*Afib Dec 3, 8 hrs (had lots of ecptoics after lunch at work and went home, alost went into afib a few times then went into afib getting up in the middle of the night)
*Afib Dec 14, 1 hr (after cutting a load of firewood)
*Afib Dec 16, 8 hrs (on way home after cutting another load of firewood, eating a apple on the way home) I cut about 8 loads of wood and only had problems 2 times.

2010
-----
*Afib Jan 10, 3 hrs (started before I had supper, lots of ecptoics earlier working on a craft project)
*Afib Jan 23, 5 hrs (Woke up sleeping on left side, turned over and went into afib)
*Afib Feb 3, 6 hrs (woke up at night with fast heart beat, then afib)
*Afib Feb 19, 3 hrs (started just before supper, no reason)
*Afib March 3, 3.5 hrs (started at night while sleeping,turned to left side then started)
*Afib March 17, 6 hrs (almost went into afib watching a movie then later in the evening on the computer went into afib)
*Afib April 6, 9 hrs (started about 1 hr after going to sleep)
*Afib April 19, 8 hrs (started about 1 hr after going to sleep, had a lot of ecptoics the last 2 days)
*Afib April 21, 5 hrs (started at night, no reason, had a good day)
----->> Started Paleo diet April 22
*Afib April 30, 4.5 hrs (started after shower before breakfast, no reason) out of afib for 1 hr, then back into afib for 3.5 hrs
*Afib May 2, 6.5 hrs (Driving back from Diamond Lake in evening)
----->> Stopped Paleo diet
----->> Started cutting back on the atenolol
*Afib May 26, ?? (2 hrs after I went to sleep, woke up with fast heartbeats then afib)
*Afib June 22, 7 hrs (started at night about 2 hrs after going to sleep)
*Afib July 8, 10 hrs (had heart skips when I got up at night then afib started when I got up in the morning)
*Afib July 25, 6 hrs (started in evening, woke up at night in nsr)
----->> down to 1/3 pill atenolol - took my time weening off
*Afib Aug 13, 8 hrs (started about 1 hr after going to sleep)
*Afib Aug 29 13 hrs (woke up about 1 hr after going to sleep with a lot of heart skips, afib started went I got up to go to the bathroom)
----->> less then 1/4 pill atenolol every other day to none.
*Afib sept 11 (had a few skips when taking morning shower, ate breakfast and worked out 30 mins on bike, then went golfing and was fine. Afib started while eating after I got home, middle of the meal)

Hi James,
Thanks for posting your log - very interesting. Like you, I have experienced an increasing AF burden over the last 6 years and have been taking atenolol and various supplements (including magnesium) for a couple of years. I recently purchased a polar heart monitor and I was surprised just how many ectopic beats I was experiencing including possible bigeminy and trigeminy. It also shows the AF episodes quite clearly. I too have been contemplating flecanide and actually took a tablet this morning and felt very anxious about it. As you can imagine, my anxiety levels created a significant increase in the level of ectopcs (mainly PACs) and occassional bursts of AF. Not sure if the flecanide had any part to play. Again, this was clear to see on the polar monitor. I'm wondering how your stress levels have been in recent years. I mention this because I know that my stress levels have a significant impact on the level of ectopics I experience and hence possible triggering of AF. With the use of the Polar monitor, it is also evident that I can reduce the number of ectopics considerably with anti anxiety medication (benzodiazapines) and also meditation/relaxation. The atenolo also helps in this regard. I'm sure that others will comment on your post and probably advise a rate control medication with your flecanide. I would be most interested to hear how you progress with the flecanide.
Kind regards.

Hi,
have you by any chance writen your log using Excel? If so and if you are interested, I could convert the data so you could get all the graphics available in my system. It would be interesting to compare our experiences with AF. See my webpage at [hem.bredband.net]

Ideally, I would like to get startdate and time stopdate and time.

James - Thanks for taking the time to abbreviate and list your log. There is always merit in stopping supplements... taking a pause... and noting what happens... then re-introducing one at a time and noting chanes.

Keep in mind that very often the forms of the supplements determine efficacy. Multivitamins are notorious for being the wrong form depending on the brand. Keep in mind also, that just because an individual takes various supplements, it doesn't mean they reach the target tissue and are of benefit. Many interferences occur along the way that include absorption and assimilation issues. I'm in the final lap of a post on this very topic... so stay tuned.

I've probably asked you previously, but what is the brand and form of the magnesium you take? How many milligrams in a day?

Jackie

Thanks everyone for the input,

Sujo, keep us posted on how you do with the flecanide, ok and thanks.

Gunner, Wow... I still havn't figured that all out, lol. I just have a few scribbles in a note book for my log. If I'm reading your logs right you had a pretty heavy afib burden that you improved a lot using two different drugs? Can you simplify that and I take it you havn't had an ablation? Thanks.

Jackie, thanks for the input and I'm looking forward to reading your next post. I started on one ounce of magnesium citrate a day on a empty stomach as recommended by our friend Dr Carrow on the radio. He always said that was about 375mgs of elemental magnesium. I took that for probabaly 2 or 3 years or maybe even more before I ever had my first afib. I switched to the Drs Best magnesium gulconate when I first ordered the potassium and tuarine (Nov 1908) I started with 400mgs and have over time worked up to as high as 600mgs. I have added extra magnesium a few different times up to 800mgs but after a few days of that it was way too much. I would say at 600 mgs I'm on the borderline of being too much. I'm thinking about going back to 400 mgs a day now (2 in the morning, one at lunch and one at supper). Also cutting my taurine back from 3 grams a day to 1 gram in the morning, and cutting my potassium back to 1 scoop in the morning about 500mgs. At times I have experimented using fitday raising my potassium as high as 7 to 8 grams a day total. I have tried a lot of the other supplements that has helped others also. My last experments was with digestive enzymes, then now with probiotics. As you can see from my log its always afib as usual.... one of my last posts was "I'm running out of things to try" lol. But, I'm not one to give up!

Thanks again everyone,
James

Hi James ex hard core motocross rider here (raced int the 70's 80's and 90's (Finally won a championship in 1996). Quit motocross in 1998 then stepped up the running hard core. The beast came in 2001. Not exercised or rode my crosser since.
KX125 1998 six race meeting only still unwashed an in garage (shame on me).
A.fib pretty well under control till Aug 2006 then absolutely went insanse probably well in excess of 100 episode in a few months. Started flecainide late Dec 2006. Been pretty good since. A few break throughs but clear again since Dec 2009.
Taking 250mg flecainide per day and diltiazem Adizem XL 120 1 per day. Still have greatly modified lifestyle, no exercise, no alcohol and take magnesium.

Regards
Mark

PS do your disagree that Ricky Carmichael is the greatest ever sportman of all time. Won every outdoor championsip he ever competed in. 10 years straight and two perfect seasons. What a man.

All the best.

James,

Two things:

1. The frequency of afib episodes tend to increase the longer you have the condition. Your progression from 3 episodes in 2002 to 14 in 2009 is probably not unusual.

2. It seems that most of your episodes are vagally mediated. Atenolol is completely the wrong drug to take if you are vagal. You may well note a sharp decline in episode frequency once the atenolol (a beta-blocker) gets out of your system.

Hans

Hans,
According to James log it appears that he started atenolol in Jan 2003. If this was going to adversely impact his AF, wouldn't this have happened long before now?
Regards

sujo,

That is a good question! Unfortunately James did not have notes about the timing and trigger of his episodes for the first two years. So if they were adrenergically mediated atenol would likely have helped. The "variety" of lone afib can change over time. I started out being heavily adrenergic, then went vagal and ended up being mixed (random). It seems that about 70% of James' episodes so far in 2010 have been vagally mediated which is why I would expect his situation to improve once he gets the beta-blocker out of his system.

Hans

Is there a comprehensive list, meaning one place, of which triggers are vagal and which are adrenergic?

Hi everyone,

I think your right Hans, maybe started going more vagal last year.

There is a mistake in my log, my last afib was sept 9th. I have only had one taurine and one potassium serving the last two days. Today and yesterday I didn't do anything physical. Had a few heart skips earlier today and when I started to eat my lunch I went into afib again. I took one atenolol to get my heart rate down and hopefully I can convert soon. Also this is the second time that I have tried cutting back on taurine and potassium. The first time I started back on the supplements after lots of ecptoics for 3 days. Now afib after cutting back for two days, so I'm going back on the supplements again.

Thanks everyone, kinda bummed right now,
James
p.s. Mark, the G.O A.T is the greatest of all times!

Thanks Hans - I can see your rationale. I am still trying to work this out for myself.

Lisa - I also would find such a list most helpful and have asked same before on this forum but no clear response to date. I am still trying to determine the category of my triggers towards refining treatment approaches, including medication.

Regards

James - your history looks a little line mine. I started off my afib "career' with intermittent episodes, which gradually increased to daily episodes over 5 years times. I could always stop my episodes with exercise - primarily brisk walks - but got tired of feeling like a hamster on a wheel. Finally went on Atenolol and Flecainide together, and have been SO much better since!

I believe I am mostly a vagal afibber, but I feel the Flecainide makes me a non-afibber, so the added atenolol shouldn't matter at that point - in terms of avoiding if one is vagal. I am afraid to take the Flec without the atenolol, but have lowered the dose to about 20 mgs./day (I shave off a little of the 25 mg. tablet). It's been 2 years now, and I have had maybe 2 minor, short episodes. Compare that to DAILY episodes, and you can see why I'm enthouisastic about this protocol - at least for me.

Sujo - I know how you feel - when I first took Flecainide, I ended up driving myself to the cardiologist office two days in a row, as I was experiencing great anxiety and ectopics, I believe (although it sure felt like afib). I was reassured that it wasn't and all was OK, so I continued. I did have to ramp up the amount of Flecainide before getting a totally calm heart - I take 300 mgs/day, which is alot, but that's what I needed to get to this place. While I would love to get off the drugs, I love being in NSR too much right now...

I hope this info helps a bit...best to you ~ Barb

Thanks Barb for relaying your experience with flecanide. Did you ramp up slowly and do you take the flec in divided doses?

I you or anyone else mail me the startdate/time and stopdate/time for their attacks in an Excel-file. I can convert the data to suit my system and produce graphics of the type shown in picture 2, 13 and 15 at my webpage.

Trends calculated with regression analyzes will show the development of your AF in graphics that is way easier to take in than a tables. I will make a limited amounts of such conversions for free under the condition that I can publish them on my webpage so that other afibbers also can study them.

I haven't looked at your results for several months. It is really impressive how you have managed your and reduced your AF burden with the spreadsheet. How does the logistics with the medication work? Do you self medicate with pharmacy providing different dosages with remote monitoring by doctor? What does the doctor's prescription read like if you self medicate?

Lisa and Sujo,

The most common triggers mentioned in LAF Survey 14 (2007) involving 224 lone afibbers were:

Monosodium glutamate MSG 34%
Aspartame 38%
Alcohol 56%
Caffeine 67%
Tyramine-containing foods 7%
High glycemic index foods 22%
Cold drinks 24%
Heavy evening meals 42%
Dehydration 40%
Stress 34%
Physical overexertion 38%
Sleeping on left side 44%

The following excerpt from my first book, "Lone Atrial Fibrillation: Towards a Cure", may also be of interest:

"Triggers
Most survey participants had a vivid memory of their first LAF episode. The most common trigger of that first one was emotional or work-related stress (26%) closely followed by physical overexertion at 24%. Caffeine, alcohol, and ice-cold drinks were next at 10%, 6% and 8% respectively. Other less common triggers were severe illness or a viral infection (experienced by 6% of respondents), dehydration (4%), and rest (4%). Digestive periods, coughing and burping, pharmaceutical drugs, surgery, electromagnetic radiation, and toxic chemicals round off the list of initial triggers with 2% (1 respondent) each.

The triggers of subsequent episodes follow in the footsteps of the first one. The overwhelming favorite for the title of most important trigger is emotional or work-related stress. A full 50% of all respondents listed stress as a trigger. Physical overexertion was next at 24% closely followed by alcohol (including wine) and rest at 22% each. The digestive period following a heavy meal was a trigger for 18%, caffeine was mentioned by 16%, and an ice-cold drink by 12%. Ten per cent reported that MSG (monosodium glutamate) was a trigger for them and 6% said that lying on the left side would set off an episode. Aspartame (NutraSweet) was mentioned as a trigger by two respondents (4%) as was chocolate, coughing and burping, and flying (at high altitudes). Three men over 30 years of age (6%) felt that their episodes were cyclical in nature and not related to any specific trigger. Other triggers mentioned were aged cheese, sugar, food additives, acid indigestion, a hot bath, Nyquil (a cold remedy), electromagnetic radiation, toxic chemicals, hypoglycemia, high blood pressure, and changes in weather patterns. Please note that the percentages do not add up to 100 because many respondents listed more than one trigger.

The triggers uncovered in the LAF survey are similar to those found by James Driscoll in his on-line survey (http:www.dialsolutions.com/af/database/stats.html). In James’ survey based on 105 entries stress again was the clear “winner” followed by alcohol, caffeine, exercises, fatigue, and rest and resting after exercise. Cold drinks, MSG, chocolate, bending over or lying on the left side were other important triggers.

It is clear that the triggers for LAF are many and varied and highly specific to each individual except for excessive emotional and physical stress, which is pretty well universal. "

Hans

Hans,

Thanks for the reply, but I guess I wasn't clear enough about what I was asking.
What I really meant was there a list where the triggers point to a vagal response or an adrenergic response? For example lying on one's left side is a vagal trigger, and being scared or startled by a snake at your front door would be adrenergic.

Lisa

Thanks Lisa for seeking clarification of your original question. Hans, this is something I am interested in as well.
Regards.

Lisa and Sujo,

Please see: [www.afibbers.org] 89.pdf

Hans

Hello again Lisa, the best explanation i know of is in Hans' FAQ. Find it like this:
1] click on the yellow bar at the top right, the one marked Questions About Afib.
2] scroll down to see the list of questions, and click on the 3rd from the top, "Are there different kinds of LAF?"
3]scroll down to the 5th paragraph, the one that begins:"Adrenergic LAF..." and read the next 2 paragraphs also.

PeggyM

My physician is aware of what I am doing. I have shown him the software and also supplied him with a written report of what I am doing and also the results and a discussion why I think it is working. I actully gave him a written report last week. He was a bit surprised as he in a letter sent to me in January 2010 wrote taht my AF would go cronic in a near future. Half a year ago I asked if he thought I should continue and the answer was yes. The local health service has provided me with an EKG when I have been in doubt about my QTc intervall.

The program is a lot more than a spreadsheet. The data is stored in a relational database and my software is remotly controlling Excel to draw graphics which is embedded in my software or the Excel sheet can be saved for futher calculations by the end user. aLL graphics can be copied and pasted into other programs that support that function, e.g. Word, Frontpage, mail programs, etc.

Hans and Peggy,

Thanks for your replies. That was getting much closer to what I was asking. I guess an actual list doesn't exist in the form I was seeking.

You and many others work so hard so that AFers like me can try and make sense of all this and can try and come up with a game plan for ourselves. I, for one, certainly appreciate it.

Lisa

Please also comment on your medication. I wasn't sure from the tables whether you are keeping the dosage the same and varying the time that you take the meds or whether you vary the dosage also. Thanks.

Hi Gunnar,

When I described my anti-afib protocol to an MD friend (magnesium to bowel tolerance, supplemental potassium as the difference between 4700 mg and what is in the diet, 4 grams taurine/day, then monitoring PAC/PVC frequency on recording heart rate monitor and a fall-back position of PIP flecainide if all fails), he said, "sounds like a great program for a high-IQ, highly motivated patient - however those are in short supply in the average medical practice."

I would put you and your program in the same category - perhaps even more so.

George

I take 40 mg of Sotalol each day. In August 2010 that has varied a little: 20 mg or 40 mg each day.

When I have an attack I use the computerprogram to get a list on how I should take the pills. Before I used the program I made a calulation in the head around the half lifes of the drugs and in practice that meant that there was some variation. I have been particularly qworried about getting to much sotalol because of the consequences. I have used my BP and HR and also EKP printouts as my guidlins. Bp not under 100/60 HR around 100-120. QT under 500ms.

From the records of my "manual" medications I used the software to count backwards to see at which level of each drug i converted, See picture 10. I also had one experience when I fainted at convesion. See picture 6. I also had 3 instances of taking to little Bisoprolol, where the heart tried to convert but then flipped back to AF, See picture 11. In picture 12 the left graph you can see 2 rather long attacks of AF, here the heart tried to convert but went back to AF. In the 3 long attacks mentioned I stopped to take more druga at about 24 hour and resumed to take more Bisoprolol after I had checked the QT interval at the local health care centre or the ER at the regional hospital.

When I had a conversion to sinus I stopped taking any more drugs for 24 hours. You can see in picture 8 that I stopped taking more drugs after 15.22 when I converted. The computer also stop to printout drugs in the list at about 24 hours.

The last 10 or so attacks I used the same "levels" 100 for Sotalol and 10 for Bisoprolol and reduce the Sotalol a little towards my last attacks to 80, as I realized that it was the Bisprolol level that was really important for conversion.

I would like to emphasize that you cannot translate my drug usage to another patient, It depends a lot on for how long you have taken a beta-blocker as the body adjust itself. I do not plan to stop taking sotalol for several months but will gradually reduce the dose.

sujo - sorry for the delayed response... Yes, I ramped up to the higher dose over the course of about 2 months. I take 150mg/ in the morning, and repeat that about 12 hours later. I do feel that the added Taurine makes a noticeable difference in keeping me in NSR too.

Good luck ~ Barb