I tried that two weeks ago come tomorrow. Had a very rare, for me, mid afternoon episode so ventured into the hot garage and moved a bunch of boxes. Boom Gone.

This morning, as soon as I awakened and turned over to head to the restroom, ZOOM off went my heart rate. I tried walking and walking all around the dark house @ 5 a.m. and heart rate dropped significantly and even after 15-20 minutes, the minute I laid/reclined back down right back up it went.

One would think the walking or exercising 2 weeks ago it would go even higher vs dropping so seems almost the opposite of a POTS Tachy rate whatever that might be called by an EP with it improving upon standing & moving around.

A month and a half to go . . . to Ablation and hopefully feeling a lot better. Now 3~ hours later it finally seems to be back down to stay . . . UNTIL next time whenever that might be.

Brisk exercise or walking used to terminate my Afib episodes pre-ablation. The theory is that some episodes arise from too high parasympathetic tone in the ANS and brisk exercise counters that by kicking in the sympathetic system. For many though, the scenario is reversed, so, glad you discovered this.

Concurring with Daisy about the exercise countering high parasympathetic tone (for vagal afibbers).

Very early in my afib "career" I could convert all of my episodes with activity. Then one day it didn't work. Many years later, when I was unknowingly consuming too much calcium (for me), many things became triggers that previously had not been. One of those was the time immediately after orgasm. This is a time where the body gets very parasympathetic. I could feel episodes starting. If I immediately sat up or stood up, it would increase ANS sympathetic tone enough to stop the episode. Once I figured out the issue with calcium and modified my eating pattern to correct it, this was no longer a trigger (thankfully).

I never had any luck converting afib with exercise, but I often could convert my very rapid flutter with it. It took a lot more than a brisk walk, however. I would have to push it to the point where I would have been reaching aerobic levels (if my heart rate hadn't already been 250). Typically, I would do laps up and down a flight of stairs. But in my case, I don't believe this was due to ANS tone; I believe it was due to potassium levels.

I believe that because I later discovered that I could reliably terminate my episodes with a large bolus of potassium chloride. Well, as it turns out, vigorous exercise causes your blood potassium levels to increase, sometimes quite dramatically. I learned this from a fascinating study I read where they looked at a professional football team in Ireland. They would measure their potassium levels before and immediately after practice sessions, and what they found was that intense exercise raises your potassium to levels that would be dangerous or even lethal under any other circumstance. But for reasons I don't understand, this does no harm during exercise. The champion was one player whose K+ level was measured at 8.0, which would kill anyone, but all of them achieved levels between 6.0 and 7.5-ish, which is still in dangerous territory under normal conditions. So taking a big bolus of KCl does the same thing that intense exercise does, so they can both terminate rapid flutter.

Why does it terminate rapid flutter? Because K+ widens the refractory period with the widening being dependent on the K+ level. For me, I had to reach 5.0 or better to terminate. This is both how K+ kills you, by widening it to the point where your heart can't produce the next beat, and how it terminates flutter. Since flutter is a self-sustaining arrhythmia where a single signal keeps going round and round in your atrium, if you can widen the refractory period just enough to cause the signal to circle back around and find the offending cell still refractory, the vicious circle is broken and the flutter terminates instantly.

The trick, of course, is raising your K+ high enough to achieve this without raising it high enough to kill yourself, which is why I do NOT advise anyone to try to use K+ to control their afib or flutter without first going through all the research and investment that I did.

Thanks Daisy, George & Carey

Things are going great and then BOOM they aren’t. Hopefully not much longer and relief will be found.

Not playing with Potassium anymore. Only extra boost via low sodium V8 or cantaloupe or other food sources like sweet potatoes.

I did cut back on Magnesium after doing a “loading dosage” for a couple of months figuring if serum level is middle of the range then actual cellular level isn’t that great. Even requested PCP to do the RBC version and he didn’t. Boo hiss.

And then while everybody, PCP & TCA said go ahead and it is ok to get that 3rd, 6 month intervals, Prolia injection, which I got last Thursday, late afternoon, then BOOM this morning the episode and while it doesn’t contain Calcium it sure does have some very complicated relationship with it. Last time almost 48-72 hours was the Heart Pause. Another rabbit hole visited and still unknown.

Hells bells today I was even looking up any correlation with my CMT, Charcot-Marie-Tooth neuropathy disease, and of course no one knows but the conduction and nerve issue affects mostly hands and feet but others before me have wondered that too with cardiac/afib. Just another rabbit hole in the search for Why and How to fix it or Stop it.

Next stop operating room table for an Ablation.

I have noticed several scenarios where this applies:

The first is when I am in NSR, but having alot of PAC's, that walking tends to smooth them out and diminishes them.

The second scenario is when I am in AFIB. (I was persistent for about 10 years, requiring Cardioversions to convert). Now when trying to covert out of AFIB, I notice that by going for a long hike of 3+ hours, and then using a bolus dose of Flecainide along with implementing breath hold techniques, I can often convert to NSR.

I notice my HR stays elevated for hours after I complete the hike. I am wondering if the strength of the electrical signal itself might actually be enhanced for a time after the long exercise, and that is in part why I can get back into NSR. I asked this question to Google AI last year, and it agreed with this possible scenario, although in another similar search tonight, it downplayed this possibility, and only recommended moderate exercise for indirect cardiac/health benefit.

[www.google.com]

Has anyone else ever thought about the relation of electrical signal strength, not just HR, to AFIB conversion?

It just dawned on me after thinking about Carey's post, is that another hypothesis is that I am able to convert by lengthening the ERP, from 3 different angles.

1) Flecainide
2) Breathholds
3) Exercise

According the GeorgeN's research, Breath Holds can increase the ERP
We know this is one of the main mechanism's by which Flecainide is effective. [www.google.com]
And finally, Carey's work involving K+ also indicates an increased ERP as a mechanism for conversion.

I need to find out how to measure my K+ right after a hike, and then find out how to measure what is going on with my ERP during attempted conversion sessions. Years ago, I used to a have a K+ meter, but sold it because I and others on this site deemed the wide fluctuations of K+ as not useful and confusing. Measuring the ERP might not be feasible
for me as AI indicates that a formal Electrophysiology Study is required.

You would have to buy a meter to measure K+ but I don't know of any way to measure the refractory period directly. If you get a meter, you'll find it very interesting to use after exercise. I did that once after a 4-hr bike ride and retested myself every hour after that. Exercise definitely increases serum K+ significantly, and then it falls off relatively quickly. It took about 4 hours for my levels to return to baseline and then they dropped a bit below normal before stabilizing. That explains why I almost never experienced flutter during a bike ride or immediately after, but I often did hours later.

Thanks for your comments Anit-Fib & Carey!

For those who don't know, ERP is atrial effective refractory period. It was discussed in our Conference Room years ago: [www.google.com]

I did some AI queries on lengthening ERP. I've thought about it for years, primarily in the area of electrolytes. Turns out my lifestyle includes many of the suggestions, even though I wasn't specifically targeting ERP when I started many of these practices. I will prepare a proper post on it when I have some time.

Quote
GeorgeN
Thanks for your comments Anit-Fib & Carey!

For those who don't know, ERP is atrial effective refractory period. It was discussed in our Conference Room years ago: [www.google.com]

I did some AI queries on lengthening ERP. I've thought about it for years, primarily in the area of electrolytes. Turns out my lifestyle includes many of the suggestions, even though I wasn't specifically targeting ERP when I started many of these practices. I will prepare a proper post on it when I have some time.

George, I'm working on reading this Conference Room discussion. I had previously found and read and reading yet again.

So I'm now wondering . . . Is the pre-procedure infusion of a magnesium solution SOP before ablations? Or
just a trial that did or didn't become an accepted new protocol or something.

From the Conference Room:

There is increasing evidence that magnesium plays a crucial role in preventing and
terminating cardiac arrhythmias. A group of cardiologists and pharmacologists at the
Hartford Hospital reasoned that a pre-procedure infusion of magnesium might help prevent
the acute development of atrial fibrillation following a radiofrequency ablation for this
disorder. As a first step in proving or disproving this hypothesis, they decided to do a trial
in which half the participants would have saline solution (0.9% sodium chloride) with 4
grams of magnesium sulfate (800 mg elemental magnesium) infused over a 15-minute
period just prior to accessing the left atrium in a standard PVI procedure, while the other
half would just have a saline solution infusion

Quote
Qwackertoo
Is the pre-procedure infusion of a magnesium solution SOP before ablations?

No idea. I know that some ER docs used MgSO4 infusions to convert afib. I have an ER doc friend that I talked to about this years ago. I always found it interesting that the ER docs were using it, but cardios commonly did not. However my EP was receptive to my plan that included Mg in 2004. A concierge cardio I chatted with in 2012 was also receptive.



Edited 1 time(s). Last edit at 07/05/2025 08:22PM by GeorgeN.

Interesting.

And yet as of late 2022 some EP’s are still prescribing the oxide version of Mg or at least that is what mine did. From what I’ve read, there are much better choices . Hit or Miss on this rocky AF Road!!!

The citrate formula is the most easily taken up by the body, but it's also the one responsible for 'leaky' nether orifice if you ingest too much of it.

I think I'm a pretty good example of someone who was able to stop Afib episodes, which I did hundreds of times. I got my first bout of Afib drinking a strong cup of coffee from Starbucks. I then spent the next 10 years in and out of Afib. The last year or two that I had Afib, I was getting it every single day.....but I could also stop it every single time. (a couple of times it took a 2nd or 3rd brisk walk to stop it). A brisk walk stopped it more times than I can count, which is why I put up with it for as long as I did.

I learned about Dr Natale on this forum and had my first ablation with him when he was up in New York. It was a LAA and i remember him saying that a couple of my pulmonary veins had self ablated (I'm assuming because I had Afib so often and for years at that point). All was great, until I had acupuncture about 7 months later, and when my acupuncturist put a needle in my left shoulder area, I immediately went into flutter. First and only time I needed to be cardioverted - which only lasted 2 weeks. Scheduled a "touch up" ablation with Dr Natale then and have been in NSR ever since (11 years). Dr. Natale put in the Watchman for me 2 1/2 years ago ON my birthday (haha....they sang to me in the operating room) - and I've been good since.

I thank God for Dr. Natale, as I really think I might still be wrestling with Afib today.l