5 PERFECT MONTHS

OK another long "afib free" run......was cardioverted early Nov. 2011, as I was early Sept and Oct 2011 ! (all 3 due to triggers, scotch, tribulis and epineperine) that following a nearly perfect 12 months .......afib almost 7 years now, came very close to ablation twice, once I canceled 2 days prior. This is what I now know as fact (at least for me):

1.) Trigger avoidance is No. 1 (NO - chocolate, MSG, alcohol, epinepherine at dentist and evening meals / indigestion)
2.) maintaining better than 4 / 1 K to Na (I am usually 8 or 12 to 1) I have made sodium the enemy
3.) Supplements - my list is a long one (Ubiquinol, magnesium, ribose, Taurine, Arginol (new one for me) etc etc)

Like most of you I have been told - "your afib will only get worse and more frequent (the opposite has happened), you must take propafanone and cardizeim etc etc.....I take no meds, they are in my cabinet - all out of date

I think it was Gerge that said, post a daily reminder on the bathroom mirror (regarding triggers!), it was Erling that woke me to the Na / K realization! and of course Jacklie with constant support........all I have to do now, is repeat yesterday.......keep it simple and be disciplined

Tom P

Tom - That's a wonderful report. Congratulations! You deserve a lot of credit for sticking with it and finding the combination that works specific for you. Good job.

Best regards,

Jackie

Tom,

Reading your report made my day.

Good job.

Keep it up!!!!

George

Tom,
What about caffeine? Just curious because my last hope to avoid ablation is no more coffee even the 1 or 2 cups I've been having but that never triggered afib or ecotpics. My brother insists it's the buildup of caffeine in the tissues that triggers arrhythmia so it's not an immediate cause and effect.
Some studies have shown coffee drinkers have less arrhythmia

[www.telegraph.co.uk]

Any thoughts?



Edited 1 time(s). Last edit at 04/07/2012 02:21PM by McHale.

Perfect, Tom!! Wonderful for me to read first thing this morning, so thank you very much! You give me encouragement to keep quoting the good scientists of medicine, while the practitioner's minds for the most part remain controlled by the money powers, not by science. The cover picture on Ignore the Awkward! by Uffe Ravnskov MD, PhD says it all: [www.amazon.com]

For your encouragement to continue to full recovery, at 83 I've been free of AF for over 10 years (just a few minor hiccups long ago), preceded by 7+ years of frequent debilitating episodes. Now it seems nothing can 'trigger' my heart into AF. In my case it's certain that a gradual atrial "remodeling" over many years preceded and caused the AF, principally from a deepening cellular deficiency of magnesium bringing about the sort of changes documented by scientist physician K. Shivakumar et al in the following abstracts. To me it's clear that correcting the Mg deficiency allowed magnesium dependent enzyme systems to gradually undo the changes (call it de-remodeling).

Kumar BP, Shivakumar K, Kartha CC. Magnesium deficiency-related changes in lipid peroxidation and collagen metabolism in vivo in rat heart.
Int J Biochem Cell Biol. 1997 Jan; 29(1):129-34.

Magnesium deficiency is known to produce a cardiomyopathy, characterised by myocardial necrosis and fibrosis. As part of the ongoing investigations in this laboratory to establish the biochemical correlates of these histological changes, the present study probed the extent of lipid peroxidation and alterations in collagen metabolism in the heart in rats fed a magnesium-deficient diet for 28, 60 or 80 days. While lipid peroxidation was measured by the thiobarbituric acid reaction, collagen turnover rates and fibroblast proliferation were assessed using [3H]-proline and [3H]-thymidine, respectively. Tissue levels of magnesium and calcium were determined by atomic absorption spectrophotometry. A 39% increase in the cardiac tissue level of thiobarbituric acid reactive substances was observed on day 60 of deficiency (p < 0.001). A marked drop in collagen deposition rate (59%, p < 0.001%) on day 28 but a significant rise in fractional synthesis rate (12%, p < 0.001) and collagen deposition rate (24%, p < 0.001) on day 60 were observed. A fibroproliferative response in the heart was evident on day 80 but not at earlier time-points. Thus, the present study provides evidence of increased lipid peroxidation and net deposition of collagen in the myocardium in response to dietary deficiency of magnesium. These changes were, however, not directly related to alterations in the tissue levels of Mg. It is suggested that the increase in cardiac collagen synthesis and fibroplasia associated with Mg deficiency may represent reparative fibrogenesis, upon oxidative damage to the cardiac muscle, and is mediated by a mechanism independent of changes in cardiac tissue levels of Mg.

PMID: 9076947 [PubMed - indexed for MEDLINE] [www.ncbi.nlm.nih.gov]
========================================

Shivakumar K. Model of cardiovascular injury in magnesium deficiency.
Med Hypotheses. 2001 Jan; 56(1):110-3.

Magnesium deficiency is known to produce cardiovascular lesions. It is, however, not clear as to what constitutes magnesium deficiency - reduced serum levels, reduced tissue levels or reduced intracellular levels of the ionic form of the element. This article cites evidence in support of a hypothesis that a fall in serum magnesium levels may trigger a temporal sequence of events involving vasoconstriction, hemodynamic alterations and vascular endothelial injury to produce pro-inflammatory, pro-oxidant and pro-fibrogenic effects, resulting in initial perivascular myocardial fibrosis which, in turn, would cause myocardial damage and replacement fibrosis. Further, angiotensin II may be the prime mover of the pathogenetic cascade in magnesium deficiency. Importantly, such a mechanism of cardiovascular injury would be independent of a reduction in myocardial or vascular tissue levels of magnesium.

PMID: 11133266 [PubMed - indexed for MEDLINE] [www.ncbi.nlm.nih.gov]
========================================

C. Kumaran and K. Shivakumar* Superoxide-mediated activation of cardiac fibroblasts by serum factors in hypomagnesemia
Free Radical Biology and Medicine, Vol. 31(7) (2001) pp. 882-886

Magnesium deficiency is known to produce myocardial fibrosis in different animal models, but the underlying mechanisms are unclear. However, circulating levels of pro-oxidant and mitogenic factors are reported to be elevated in a rodent model of acute magnesium deficiency, suggesting a role for humoral factors in the pathogenesis of the cardiovascular lesions. Probing the mechanism of cardiac fibrogenesis in magnesium deficiency, the present study furnished evidence that serum from magnesium-deficient rats has a more marked effect than serum from magnesium-sufficient rats on mitogenesis, net collagen production, and superoxide generation in cardiac fibroblasts from young adult rats. The enhanced mitogenic response was abolished by superoxide dismutase and N-acetyl cysteine, showing that it is mediated by superoxide anion. Further, a modest inhibitory effect of the neurokinin-1 receptor antagonist, spantide, suggested that factors acting via neurokinin-1 receptors may partly modulate cardiac fibroblast function in magnesium deficiency. The findings are consistent with the postulation that serum factors may activate cardiac fibroblasts via a superoxide-mediated mechanism and contribute to the fibrogenic response in the heart in magnesium deficiency.

PMID: 11585706 [PubMed - indexed for MEDLINE] [www.ncbi.nlm.nih.gov]
========================================

Shivakumar K. Pro-fibrogenic effects of magnesium deficiency in the cardiovascular system.
Magnes Res. 2002 Dec; 15(3-4):307-15.

Magnesium deficiency is known to produce cardiovascular injury. A large body of experimental evidence supports the postulation that an immuno-inflammatory reaction and increased oxidative stress may damage the myocardium and vasculature in magnesium deficiency. Reparative/reactive fibrosis in response to the injury has, however, received little attention. Recent evidence from a rodent model of acute magnesium deficiency suggests that humoral factors may activate cardiac fibroblasts by a free radical-mediated mechanism and contribute to cardiac fibrogenesis. A similar mechanism may also promote cellular hyperplasia and increased matrix synthesis in the vasculature.

PMID: 12635886 [PubMed - indexed for MEDLINE] [www.ncbi.nlm.nih.gov]
========================================

Keep up the good work, Tom!

Erling



Edited 3 time(s). Last edit at 04/08/2012 08:08PM by Erling.

Congratulations Tom, that's great news. I think you are right on track. I really changed my diet last Oct. also following the K to Na ratio. I also lost fifteen pounds and had no problems until travelling to Mexico for the month of March. We stayed in a little fishing village one hour north of Puerto Vallarta, and I had two, two hour bouts of afib. I put it down to diet change and possible excess Na. We ate out about every second or third day, and who knows what ingredients they use. I also had a couple of bouts with stomach issues which I'm sure contributed. Back home for almost two weeks and no problems.
All the best,
Lou

McHale, strange but caffiene not an issue with me as I drink dark heavy coffee every morning, 1/2 to 3/4 cup though I don't push it.......and that "is" the only caffiene I get every day.......

Hey Tom,
Great news... I hope to be following in your footsteps soon.

Tom

Tom,
I don't think caffeine is an issue for me either but I'm at the end of my rope it's been three years now and I'm trying anything. This week was the worse I've ever had with all kinds of irregularities which never lasted for more than 2 days. I'm in sweet NSR since yesterday after 7 days. Just had a hard workout too let's see if anything is triggered the next few days. Stress echo on Tuesday and would like to be in NSR unlike last years test.

5 months sounds pretty good to me, Tom. Welcome to The List.

In case anybody is curious about it, The List is an informal method for marking posts from people who have figured out how to stop having afib episodes without surgery or heart meds. To see posts in The List, use the search function here on this site.Type in "The List" as a search term. The post or posts you will want to see is the one GeorgeN or me is answering, just like here with Tom Poppino's post.

PeggyM

Peggy,

I'm glad The List lives! Haven't seen a List post in a long time.

Thanks for keeping it alive!!!

George

Thanks, George, have not been so lively myself. Getting better but youth and its attendant vigor have left and will not be returning. c'est la vie, i guess.

PeggyM

Great job Tom!

Are you a vagal AFr??

Tom,

GREAT that all is going well for you! I, like you, are most appreciative of the many hours spent and insights provided by the many knowledgeable forum regulars.
A grateful thank you to all. Not just for the practical medical type info, but also for the support. Like you Tom, I am at the moment pretty much afib free (and in good health at age 66), but as all suggest on this forum, having an afib "condition" is a day to to day experiment of one....... I offer my updated wordy journey below in the hope it might help some one else.


Like Erling suggests above, in retrospect, I believe the conditions that brought on my afib were going on for awhile before the afib actually came on.
My first officially recorded episode was in the fall of 2007.

But again, now in retrospect, I think a series of stressful events/times in certain years of the 2000's and a lot of other little things (like maybe not being more aware of getting enough sleep, maybe too much exercise, a lot of dental work, weekends with few drinks, short breathing patterns, years of trying to keep my marginally high BP under control (At various points in time I was on Lisinopril, and/or Lopressor and/or diuretic).................. etc. all contributed.

As best I can recall/figure a few times in 2005 and 2006 I noticed sort of a racing heart when I went to bed. Usually on a weekend after I might have had say 2 or 3 draft beers after dinner (like at a college parent's weekend deal). Also, it was around this time in 2006 say that I mentioned to my GP that I thought I was occasionally having a dream (nightmare) where I would wake up and my heart would be beating fast.
The in the summer of 2007 I noticed a few times that my heart beat seemed not just fast but irregular.
My GP gave me an event monitor and in November it captured an afib event which probably was an hour or so in length. This event was 2 days after I had had major dental surgery during which 2 fifteen year old implants were pried out of my jaw bone so 2 new ones could go in.
I was put on Atenolol in November because of the "event".

After going on the atenolol, I still would experience shortish bouts of afib (in Nov/Dec), but I also at the same while on Atenolol developed bouts of vertigo, anxiety, short term memory loss, and hearing loss in my right ear during November and December 2007. ( Also, my blood pressure was more subject to bouncing around going low say55/95 to say 85/155 ----Typically, all my life before, I was always at the upper range of pre-hypentension and taking a beta blocker and diuretic. Somewhere in the 2000's Lisinopril was added for BP and because it worked well the beta blocker Lopressor was dropped). Side note: Somewhere in middle 2000's I started to get BPH and with Lisinopril working well for BP, the diuretic was dropped.

Then New year's day in 2008 early in the morning my BP was especially low after having Afib in the night,, and I stood up and fainted. A week later almost same thing happened, so I took myself to Mass Gen. Hospital. After a couple of visits and an overnight., the cardiologist said I had intermittent afib and they had captured an episode or two and that they had observed a tendency for a heartbeat "pause" when I coming out of afib and back into regular sinus rhythm...... The hospital stay also showed showed what my yearly exams showed: a slow heart beat (around 46-52).
I was given stress test, echo, chest X-ray. I checked out OK.
Heart Dr's said I needed pacemaker to (A) prevent a pause going in and out of afib (and feinting)
( keep a record of my afib
(C) Have a way to keep heart going fast enough should the Dr's need down the road to give me medicine that slows heart down


In retrospect, I was scared -- the vertigo (I did not that was what it was at the time), the anxiety (I did not know that was what it was), the hearing, etc. in retrospect were bothering more than the afib (and I am a very symptomatic afibber). At the time I was getting afib for a couple hours once a week or so. On feb 15 I went in for pacemaker.

For the pacemaker operation, I went off the Atenolol. The morning after my EP said he wanted me back on the Atenolol. For some reason, at 6AM in my hospital bed and a little groggy, I said no ....no more of that Atenolol.. He said OK then ....he would give me a different beta blocker ----Metoprolol, but said that they (beta blockers) were all similar. I said OK to changing to Metropol.

Some other "side bar" points: At about this time I now realize in retrospect, I was was starting to get digestive issues (going to bed only sleeping on your back at night hoping no bout of afib will kick in was a worry as was having a dream where you wake up with your heart doing weird stuff). Having never heard of IBS, I did not know what to make of it....................... I think I am both vagal and regular afib as I got it both day and night. (My heart Drs never talk about these terms/words).

When I saw my GP after Feb 2008 pacemaker put in, (he had been on vacation in January) in late February, he said my blood tests and electrolytes C protein were relatively OK. I did not know about Exatest at the time. When I mentioned the vertigo, etc, he really did not respond..... I have switched GP...I have same heart Drs. They are much less pompous than the GP.

By early March 2008, while I was still getting afib about once a week (the pacemaker was recording this, but I KNEW without a recording chip later revealing it, the minute I was having an afib attack)......but the vertigo, anxiety attacks (which sometimes were a sister to the afib bouts) etc were subsiding....I think because I had stopped taking the Atenolol!!!! My short term memory got better too, but not my hearing. My GP (now my ex GP) thought I was/am a nut case on this matter.

At any rate for the rest of the year (2008) I tried diet, supplements, etc,.... while my cardio and EP mentioned arrhythmia drugs and/or ablation. I was getting afib once a week and worried about remodeling, permanent afib, and getting enlarged heart, etc......And I was probably being worried about a night attack of afib or one at work, etc. and was not, not getting enough good sleep.

Finally I agreed to try taking flecainide. I have taken it daily and it is a big reason things are better...., but also less exercise, more sleep. more hydration, less stress, tai chi, diet, supplements, little or no alcohol, together with the Flec, have caused me only get one or two 2 minute afib bouts in the last 2 years. (Also, the IBS has settled down....and even BPH seems less...no more crazy dreams too). I have reduced the flec to 50mg in morning. 100mg at night.....I am on 25 mg of Metoprolol. I am on 40mg of Lisinopril for BP. Got off Warafin 2 years ago, I know take a regular aspirin per day.
Blood pressure is usually 70/130.

At the moment...debilitating Afib at bay...thanks a lot to this forum.....



Edited 2 time(s). Last edit at 04/10/2012 12:52PM by tibbar.

I just tried trace minerals to the point I had dirreah then backed off a little. I'm amazed! I climbed
to the top of Angels Landing at Zion NP, which is a steep hike, and no afib. I'm hoping this is the cure
for me. I buy a liquid trace mineral called ConcenTrace and drink it in my water all day. I also try not to
miss a meal which seems to be a trigger.