Cardioversion/Ablation

If you were me what would you do?

2 failed ablations the last one 6 months ago, stuck on drugs that make me feel worse, have a/fib and a/flutter to contend with.

Have been offered a fourth cardioversion when none of the others lasted more than a few hours or days, EP not keen on another ablation.

So am i destined to spend the rest of my life on medication or should i press for 3rd ablation any suggestions welcomed Thanks janet

Janet - Since you ask, can you review for us what you have done regarding:

-magneisum intake - how much, what form
-potassium-to-sodium dietary intake with the ratio of 4:1
-are you treating for any other medical conditions besides the arrhythmia
-list all the Rx drugs you take
-do you take any other heart support nutrients... such as suggested in The Strategy
-any other supplements? ie, calcium? if so how much?
-do you drink municipal tap water? is it fluoridated?
-do you consume caffeine? sodas? alcohol? anything "diet"?
-describe your dietary intake of foods.. whole fresh? packaged processed?
-age
-weight normal?
-daily amount physical activity

Jackie

Who did your previous ablations, and where? Is s/he one of the best in terms of skill and experience? If not, I would change EP, find one of the best, and try another ablation.

Barry G, who posts here sometimes, was a very difficult case. He had many ablations but persevered, eventually going to Bordeaux three times but the last we heard he was happily in nsr and feeling great.

Gill

Hi Janet -

Specifics to Jackie's list of helpful information:

- serum potassium?
- serum homocysteine?
- fasting serum glucose / fasting serum insulin?
- hypo / hyper thyroid?
- basal temperature?
- blood pressure - systolic / diastolic?
- 'statin' use?

Erling.



Edited 1 time(s). Last edit at 03/01/2012 04:32PM by Erling.

You have the most experienced members with you now and I suggest listening closely and reading profusely.

I am NOT a candidate for ablation as my left atrium has enlarged. I am dealing with the best EP I am able to (one of those on 'the list') and was placed on TIKOSYN and had my Metoprolol reduced to almost nothing. I feel pretty good and am hoping that we will see, as the EP suggests, left atrium shrinking back into the range he can work with. The heart is beating like a Swiss clock.

Regarding electrocardioversions. Read up on them on this forum and I knew I was in trouble when the cardiologist booked an ECV for me without any antiarrhythmia meds in advance. Nor did he comment on my magnesium, potassium, etc. And he used paddles and not the conductive pads and low energy in attempting to convert me to NSR. Never said another word to me and was gone when I awoke. A dismal failure.

Yet dealing with the best, I was put into hospital, put on TIKOSYN and had an ECV when the Tikosyn did not convert me after the sixth dose. My Magnesium, Potassium and other electrolytes were up; they used conductive pads for maximum energy transfer; they used cutting edge gear to decide when to jolt me and the equipment delivered the charge at precisely the right moment. I awoke and remain in NSR and as my heart settled (settles) I find that any episodes of extra or skipped beats has deminished to almost zero.

Participate and share the information that is being requested of you - I can only promise you one thing and that is that you will get the best of advice on this forum from people who genuinely care. And have been down the path and have the T shirt.

I am awaiting my 6 month recall to see if my left atrium is shrinking and will not hesitate to have an ablation by the best in the best facility possible. And I will make sure it is the best that is hands on and not a first year res that is learning with me as guinea pig.

Good luck. Don't give up hope. Think positive thoughts only. You WILL get there. Trust me, if I can get there, anyone can.

Murray

P.S. Drink plenty of that Low Sodium V8 to keep the Potassium up!

Janet, You may be interested in this report from the afibbers.org Resources Section.

Electrical cardioversion [www.afibbers.org]

Hans

I think the problem for Janet is that ablation experience in New Zealand is lacking as evidenced by the following writeup by the one of the most experienced center in the country. The results are not very good and I am being generous in my words. I would follow Gill's suggestion of looking outside NZ. Royal Adelaide is the closest choice.

[www.ncbi.nlm.nih.gov]

Thanks to everyone for your comments.
To Jackie

-magneisum intake - how much, what form -

Doctor's Best, Magnesium, High Absorption x2 a day seems to be the point of tolerance for me

-potassium-to-sodium dietary intake with the ratio of 4:1 yes and potassium level is in normal range of 4.8-5.2

-are you treating for any other medical conditions besides the arrhythmia -Yes statins ,lipitor 10mg for mild ischemia

-list all the Rx drugs you take -Sotalol 120mg x 2 a day,diltiazem 120mg x 1 a day, Lipitor 10mg a day, candersarten 32 mg daily to keep BP normal and Losec for mild hiatus hernia, also warfarin 3 mg a day keeps me in normal range 2.5

-do you take any other heart support nutrients... such as suggested in The Strategy

Jackie this is what I take and have taken for several years all from I herb and as suggested by Hans
Potassium and Taurine 1000mg a day,Coq10 1capsule a day a day, omega 3 1000mg a day, vitamin C 1000 a day.
serum potassium is always between 4.8 and 5.2 had test recently and it was in this range

-any other supplements? ie, calcium? if so how much? No

-do you drink municipal tap water? is it fluoridated? -we have spring water on our property that is what i drink so no town water

-do you consume caffeine? sodas? alcohol? anything "diet"? No caffeine at all, no soda,might have had the odd diet yoghart, try to eat healthy

foods only but cant do the cave man diet ,sometimes a glass of red wine but not a habit and never been a trigger

-describe your dietary intake of foods.. whole fresh? packaged processed-age , always fresh foods cooked from scratch , never processed, lots of fruit and vegetables. herbs etc grown in own garden where possible, free range meat when available and always free range organic eggs from farm next door.

-weight normal?
normal weight for my height- limited daily amount physical activity due to a/fib


- serum homocysteine not sure what this is.
- fasting serum glucose / fasting serum insulin?
In Normal range i am not diabetic- hypo / hyper thyroid have been tested for this and am ok
- basal temperature Normal yes
- blood pressure - systolic / diastolic generally normal range of 120/75
- 'statin' use yes have taken statins for about 6 years for mild ischemia

that was a lot of questions, what is your opinion
,

Previous ablations done by Martin Stiles in Hamilton New Zealand

Researcher -New Zealand is behind in Ablations but Martin Stiles was trained by some of the best in the world and he is young 39 years but with a lot of experience, he performs ablations on any sports person or well known persons here and spent a lot of time in France learning from the best there, this is why i chose him.

Thanks Janet - your detailed answers are very helpful. Some concerns are:

- 6 year use of Lipitor for ischemia (which I assume means cardiac artery blockage - has this been verified by imaging?).
- treatment for high blood pressure (candesartan)
- the CoQ10 amount is not specified.

There is much to say about why a statin drug, such as Lipitor, should never be prescribed or used for any reason. One of the many downsides of any statin is inhibition of internal Coenzyme Q10 synthesis. Some downstream consequences of such inhibition are reduced synthesis of adenosine tri-phosphate (ATP), the energy / fuel molecule that, for just one example, powers the sodium-potassium pumps in all cells of the body, including of course the heart muscle cells, thus providing the cells' bio-electrochemical power for their myriad functions. A most important function is maintaining a very low level of calcium within the cells, because when the calcium level rises, so does blood pressure, and dysrhythmias, and calcification of arteries and ischemia.

Please read, or at least read about, The Great Cholesterol Con by Malcolm Kendrick, MD at [www.afibbers.org]
- and [www.spacedoc.com] (be sure to watch his brief video on cholesterol vs. CVD death rate).
- and [www.afibbers.org]

The scientifically understood and proven treatment for high blood pressure is to increase the amount of ATP available to the Na/K pumps. This is also the first-line treatment for Afib as explained in CR Session 72 [www.afibbers.org]

If we're not able to convince you to stop the Lipitor - and we've just begun - you must at the very least be sure to take in an amount of Co-Q10 sufficient to compensate for what Lipitor is keeping each of your body's ~70 trillion cells from producing.

Best wishes!.

Erling



Edited 1 time(s). Last edit at 03/02/2012 12:14AM by Erling.

Thanks Erling

I had two semi blocked arteries diagnosed with an angiogram, they were unable to stent them because my arteries were too slender so I was put on Lipitor and candersarten to keep blood pressure down and cholesterol low even though neither were a problem I had they just wanted them lower, in New Zealand we have to have it lower than most places with 4.0 being the target i dont know what that converts to in your part of the world but it is considered the best level here.
I was told that statins would help control the ischemia (cardiac artery blockage) so i took them and take 100mg a day of Co-Q10 to try to combat the problems lipitor can cause, is this enough or not?
how would i know my calcium level and what should it be?
My doctors do test me 6 monthly for liver and kidney function, lipids and sodium, magnesium and potasium levels as well as tests for type 2 diabetes and these have all been within the normal range.
if youd like to tell me what I should be doing im open to trying an alternative way of keeping my arteries unblocked.

My main concern at the moment is the a/fib and a/flutter and why my EP doesnt want to do another ablation but just a cardioversion, I feel like ive been dumped in the too hard basket by all my so called expert cardiologists.
As resercher pointed out we in New Zealand were slower joining the ablation route than others but my own EP is considered one of the best here and has had the Bordeaux EPs over here to watch and assist his work, everything is state of the art where he does the ablations with the latest 3d mapping etc, im trying not to let it get to me but find the whole thing rather hopeless.

Thanks for you input knowledge is everything

Hi Janet,

Thanks for your details as well. In addtion to all the good advice fron Erling and Jackie, a through steroid hormone profile on 24 hour urine could be very useful making sure it includes all the adrenal metabolites including Aldosterone. Either a two low or two high cortisol and/or aldosterone will make one prone to arrhythmia. Directly in the case of too high aldosterone and indirectly when it is too low. Like in all things hormonal you want to be in the nice safe optimal range and neither too low or too high which very often can trigger the same problems like AFIB .... Hypo and Hyper thyroid being another example.

And this highlights another major reason to avoid statins entirely, unless perhaps you are one of those relatively rare people with true familial hyper-cholesterolemia with super high lipids uncontrollable by any other means. That reason being that cholesterol is the grandfather of all steroid hormones and is the first element in the chain of hormone synthesis and metabolic break down. Once you cholesterol drop below 180 you are definitely impairing global hormone production. Yes some of those down stream hormones from Cholesterol may still register in the overly broad 'normal' reference range, but will be significantly lower than for the same person with a higher more healthy cholesterol level.

With regard to hormones, the problem with these age-based so-called 'normal' blood ranges is that they are derived from taking thetested levels of the bottom 2.5% and upper 2.5% of those people who get tested at each lab during a years time and those two values are then used to establish the upper and lower range of 'normal'!! The problem is, as people age a far larger percentage of those people getting tested to begin with include a much higher number of sick people with major deficiencies in the very substance/hormone being tested and thus those so-called 'normal ranges' wind up getting skewed far toward the deficient range by including so many sick deficient people in the pool used to derive a 'normal range' and do NOT reflect optimal healthy ranges at all!

For most normal-sized people and for most hormones tested, you are far better off using the 'upper quintile'of the 'normal reference range' as a more useful healthy optimal range than settling for institutionalized deficiency being accepted and condoned due to gross negligence/ignorance of basic physiology.

The artificially low levels of total cholesterol accepted in New Zealand are strictly Drug company/medical boards induced nonsense geared to insuring a larger percentage of the population has to take an larger dose of their product for life. For Ubguinol 100mg is good minimum but 200mg would likely be better for someone taking statins.

Shannon

Janet,. I see that he was trained at Royal Adelaide which is the probably the top center in that region. It is good that he is visiting other top centers in other countries to maintain an edge. I think it takes confidence from the EP for him to tackle a difficult case that requires multiple procedures. You noted that he seem reluctant to do a 3rd procedure and I presume that he is smart and knows the limitations of his skills and the risks involved. I am sure he would not mind discussing his concerns with you and perhaps even refer you to someone else (likely outside of the region) that is more experienced.

Thanks Shannon - well said!
Drug company/medical boards induced nonsense geared to insuring a larger percentage of the population has to take a larger dose of their product for life.

Hi Linda - thanks for your reply.

Your (total) cholesterol 4 = 155 mg/dl, which is dangerously low. (1 mmol/l = 38.66976 mg/dl)

Please read this brief randomly picked article:

Low Cholesterol Can Be Dangerous Too
- By Nancy Hirsch, Certified Nutritionist [www.visivite.com]

Quote:

At the 24th American Heart Association Conference on Stroke and Cerebral Circulation, researchers found that as an individual's cholesterol level rose above 230 mg/dl, their risk of ischemic stroke increased. But the researchers also found that as cholesterol dropped, the risk of stroke increased significantly. A person with a cholesterol level below 180 mg/dl [4.7] had twice the risk of stroke compared with someone with a level of 230 mg/dl.[5.9] Another study found that men with cholesterol levels below 150 mg/dl had four times the risk of cerebral hemorrhage compared with men who had cholesterol levels about 190 mg/dl [4.9]

Also, please read this article by brilliant scientist / physician / cholesterol researcher Uffe Ravnskov, MD, PhD - one of my many medical science heroes:devoted to truth and healing:

The Benefits of High Cholesterol [www.afibbers.org]

It begins: People with high cholesterol live the longest. This statement seems so incredible that it takes a long time to clear one's brainwashed mind to fully understand its importance. Yet the fact that people with high cholesterol live the longest emerges clearly from many scientific papers.

... and ends with: To the public and the scientific community I say, "Wake up!"
===============

> "...100mg a day of Co-Q10 to try to combat the problems lipitor can cause, is this enough or not?"

Famous cardiologist Stephen Sinatra in his 2008 book on Metabolic Cardiology recommends 180 to 360 mg Co-Q10 per day for "Intermittent Atrial Fibrillation", but that's not considering statin use. In your case it would seem that at least 400 mg Co-Q10 per day would be appropriate. Life and health is all about non-stop energy (ATP) production and utilization in which Co-Q10 plays an important role, but many other equally important substances are involved, e.g. carnitine, ribose, magnesium, fish oil (omega 3 fats), etc.

> "... how would i know my calcium level and what should it be?"

Intracellular (IC) calcium level is the important measure --it can indicate cellular ATP energy utilization. In the US, ExaTest by Intracellular Diagnostics, Inc. is often recommended to determine all IC electrolyte levels. Perhaps ExaTest, or equivalent, is available in New Zealand? MIke F. in the UK has used ExaTest verifying High IC calcium and low magnesium, currently being treated with magnesium injections. See [exatest.com] and [www.afibbers.org]

Be well!

Erling. (more later).



Edited 1 time(s). Last edit at 03/02/2012 07:21PM by Erling.

Janet - thanks for taking the time to respond..

As for the 2 capsules of magnesium daily is a comfortable tolerance level, it may still fall short of your total body needs not to mention heart cells. I'd push for topical applications of magnesium oil and foot baths if you can't take in more orally. Magnesium is the key and most everyone with arrhythmia is deficient especially if they can't absorb it well.

I'd also like to see what the actual number are for your thyroid lab tests you mention are "normal" same for the glucose and insulin.

Did any of your monitoring tests give your Ejection Fraction?

Do you avoid starchy grains, carbs and sugar?

The most concern is obviously the statin intake and you can use supplemental antioxidants to discourage oxidized lipids from aggravating the coronary artery blockage.... Coenzyme Q10 is definitely a powerful antioxidant as is Resveratrol.

I didn't see your age, but you need to know that statin adverse effects can be especially damaging in older individuals which should give you incentive to consider not using or at the very least, adding a large amount of CoQ10. It's known that CoQ10 production peaks at age 21 and is on the decline from then so by age 65 most people are 45-50% low (according to William V Judy, PhD, CoQ researcher)

The Ubiquinol form of CoQ10 supplements may be better suited for older people having impaired ubiquinone-to-ubiquinol conversion and for people having an abnormal genetic make up (NQO1 or NAD[P]H:quinone oxyreductase that inhibits the conversion of ubiquinone to ubiquinol.
(Back to the Coenzyme Q-10 Basics: Part 1 An interview with Drs. Fred Crane, Gian Paolo Littarru and Stephen Sinatra By Richard A. Passwater, Ph.D.)

Jackie

As for what's 'older' or 'elderly'.... I recently heard a speaker evaluating the results of several clinical studies on "older" individuals and the question was asked.. "what is the age typically considered to be 'elderly' for these studies. The response was... For studies - typically, 50 and older.

Janet -

> "serum homocysteine - not sure what this is."

Homocysteine is the actual villain in cardiac artery blockage, not cholesterol. It is a routine blood test. Homocysteine (Hcy) is toxic and damaging to all cells, including the cells lining the arteries -- the damage 'sets the stage' for arterial calcification and cholesterol. Kilmer McCully, MD, another medical science hero, has a 2 part article on homocysteine at spacedoc.com, the website of astronaut / physician Duane Graveline, MD, MPH who was severely damaged by Lipitor. Dr. Graveline consequently wrote several books including The Statin Damage Crisis [www.amazon.com] There are many articles by noted researchers and much information at [www.spacedoc.com]. Dr. Kilmer McCully's article on homocysteine: [www.spacedoc.com]

Erling.

PS - Why don't we hear much about the true villain, homocysteine? There's no money it - high Hcy is inexpensively reduced with non-patentable B vitamins 6 and 12 plus folic acid -- even better, add non-patentable inexpensive choline and tri-methyl glycine -- whereas The Great Cholesterol Con and Statins are a mega-billion money machine that keeps giving, and giving, and giving . . . .



Edited 3 time(s). Last edit at 03/03/2012 12:20AM by Erling.

Researcher-
My EP has decided that he will cardiovert me this coming Wednesday at an attempt to restore NSR, if that fails or only lasts a while he will do a 3rd ablation, he explained that he wasnt reluctent to do another one, just thought it sensible to try cardioversion first.

I dont think there is a better EP than he is in New Zealand, all the others are old school where as martin stiles is young at 39 yrs and open to all the new technology ,he returned to New Zealand a couple of years ago to make a difference to those of us with a/fib.
I know i may never be totaly cured but would like to try one more time.

Janet, Thanks for the explanation. I misunderstood your earlier comment that "EP is not keen on another ablation" as him giving up on your case. In the link below, there are links to presentations by world class clinicians on repeat procedures.

[www.afibbers.org]