Slower (cyclical) heart beat leading to vagal episodes

I'm a vagal periodic afibber who has posted many times in the past. Hans wrote an article in 2003 about the cyclical nature of afib for some of us - speculating it was hormone related (focusing in part on Aldosterone and Cortisol). I can't make sense of how to work with his musings (I don't think Hans did either), but my afib clearly follows a cyclical pattern (most recently about every 25 days - better than it use to be). His article is called Aldosteron:Villain of the Peace?, and his follow up on this website is here [www.afibbers.org] I wonder about trying Eplerenone.

Hans didn't mention slower heart rate triggering the episodes, but that is true for me. As I get closer to day 25 or so, my resting heart rate drops from about 58 to about 48. It is at the lowest points that the afib is triggered (I understand how a longer refractory period gives more opportunity for an errant electrical signal to jump in). Any scientific explanations/hyposthesis for why someone's resting heart rate cycles in this manner??? And ideas for how to avoid it dropping? Any follow up on Hans article? Thanks

Ralph,

Perhaps ginger (as in powdered spice) might be useful <[afibbers.org] After I wrote this, I learned that, for me, calcium was a bad actor and when I reduced its intake, I no longer needed the ginger.

In the first few months of my afib journey, in 2004, I also experienced cyclical afib. This did not continue after my 2 1/2 month episode and I added in lots of mag & taurine.

George

thanks George. I've tried Ginger capsules and Ginger - they don't move the needle when I'm in this part of the cycle, and don't keep me from getting to it. As far as Mag goes, I cut it out about 6 months ago as an experiment (I wrote about it at the time - I'd had some questionable associations with Mag) and it's removal has made zero difference thus far. I never noticed any improvement or downside of Taurine, but when I used it I was at 1 or 2 capsules (I think 500's).

I suspect there is a solution to this, but the one size fits all thing doesn't work for me. I've stopped alcohol and caffeine altogether for months at a time - no difference. I've taken various doses of all the things recommended on this site and in Jackie's strategy with no measurable success. The only thing that definitively worked a few years ago was reducing my internal experience of stress (I no longer have PVC's as a result, and afib cycles became longer).

I am about 6 years into this process - the frequency of the episode cycles is somewhat better than it has ever been, but the length of the episodes is reliably longer (which obviously concerns me). If that longer trend continues, I will find myself on Dr. Natale's table.

I hear you, Ralph. One size doesn't fit all. It is a journey.

I know that I tried many things when I had higher calcium intake and didn't realize it was my problem.

Ralph - Early in my afib saga, I had the problem of low heart rate and then when I would lie down for the night, that was a typical trigger.... although not cyclical, as you mention. When I joined this forum, I was about 7 years into afib and I mentioned it in a post that Patrick Chambers, MD, (also an afibber) answered. He suggested that each evening before bed to do arm exercises to increase my heart rate. I used free weights every night and it seemed to work for those events, but definitely not during the day. About the same time, I was tested for low adrenal function and was diagnosed as having adrenal burnout; so, began following the adrenal support protocols set forth by my integrative/functional medicine MD which continued for about two years. The Strategy doesn't cover the protocols for adrenal fatigue.

I can't testify that it made a difference in the Afib because the following year, I did have ablation #1 with Dr. Natale, but after the blanking period, I was mostly afib free for 11 years.... (until I wasn't). On the occasions I had breakthroughs, I was found to be low in magnesium and potassium, but initially before ablation #1, my low adrenal function and hypoglycemia in the middle of the night were my well known triggers and my HR was always low.

Check the description at this link to see if anything relates to your observations.... (not that you have Addison's but regarding the comments on the relationship to adrenal function/aldosterone/coritsol production.)

[www.niddk.nih.gov]

Jackie

I had the same exact problem. Whenever my heart rate dropped (and it did, less cyclically than yours), the PACs, and the AF, would start. Episodes would self-convert in 2-3 hours.

I tried to chase this down over about 2 years, including having my cortisol levels checked, supplementing with DHEA to counter the aldosterone, extending out to encompass pregnenelone and progesterone supplementation, and a host of other things, from "The Strategy" to chelation. I'm working on a longer writeup of all the stuff I tried (cutting to the chase, The Strategy and berberine are the only two things that really seemed to have much impact--and berberine interacts with MANY drugs, so if you're taking anything, it may be a no-go. And it stopped working after 6 months in any case.)

My episodes increased in frequency until I went to see Dr. Natale in March. No AF since then, though I will be going back for a PAC ablation to clear up some lingering and very persistent trigeminy.

None of this is easy, and I wish you luck in finding a solution, ablation or otherwise.

Thanks Jackie and George. I take corticosteroids for asthma (pulmicort) and rhinitis (flonase). My afib started about 5 years after starting to take them. I've been reading how these can suppress normal cortisol production [www.ncbi.nlm.nih.gov] which surprised me because I was told they only had local effect. I wonder if they have effect on aldosterone production as well since apparently aldosterone is also a corticosteroid. And how it may relate to afib. Any thoughts? Thanks