Need Assistance

Aloha All At the Forum
Needing assisnce. My a. fib episodes are now every week for 2 hrs at night after going to sleep for 1-2 hours. I am now on Flecainide 100mg twice a day which has NOT worked. Last night instead of a rate of 200 my rate was 150 so did NOT go to ER. I did take cardizem 60mg but BP dropped to 80/43. I have low blood pressure as my baseline. I am in perfect health, exercise and eat right. The only thing I did differently yesterday was to buy taurine. I took only one 500mg tablet.

This is my plan. Go have flec serum levels drawn to assess for a therapeutic range. If therapeutic, discontinue flec. If not, increase dose to 150 mg twice a day to a total of 300mg. Once I discontinue flec consider going back to propantheline which kept me out of a. fib at least for 30 days. I take aspirin 81 mg daily. I take baby doses of Magnesium oxide and get potassium from V-8 and bananas and other dietary sources.

I have had 7 hospital visits in the past 4 months, 2 hospitalizations, Monitoring QTc intervals which are no higher than 410. Of course I'm trying to avert torsades de pointe. Should I get a sleep study? What is the relationship of sleep apnea to vagal a. fib?

Any assistance you can provide will be so so appreciated.

Elizabeth,

Sorry to hear about your recent increase in episode frequency. I noted your comment: I take baby doses of Magnesium oxide and get potassium from V-8 and bananas and other dietary sources.

Baby doses of magnesium oxide would have no beneficial effect at all and bananas are not an optimum source of potassium owing to the insulin spike resulting from their consumption. I would suggest that you read Patrick Chambers' article on the importance of magnesium and potassium [afibbers.org] and Jackie's excellent research report The Strategy on the importance of proper supplementation [afibbers.org] Also, I would discontinue the taurine as some afibbers find it detrimental. When you have your flecainide level tested I would suggest that you also have your potassium level checked and finally, you may wish to consider the Exa test for magnesium although there is probably a 90% chance that you will be found deficient.

Hans

Thanks for responding so quickly, Will do on the advice. Please help me with flecainide. It is not working as a regular drug at 100mg twice a day.
SHOULD I go to a PIP approach? Do you think it might work? BP dropped to 80/43 with cardizem. I converted after 2 hours might have anyway without the drugs? I'm tired and discouraged.

Hi Elizabeth,

Sorry about your situation, it is frustrating. I agree with Hans on the Mag and K; also you might get a blood test (which is quicker) although the Exatest will tell you your intracellular levels, which is more important information. Serum level and intracellular level don't always agree with each other.

You were taking Propantheline Bromide, is that correct and you discontinued it when you started the flec? I am not aware of a contraindication between the 2 drugs- discuss with your doctor but if it was working and you had no side effects, I would go back to it.

Regarding the sleep study: if all your episodes are at night, get a sleep study. Sleep apnea can be a trigger-

Let us know how it works out-

EB

EB

My holistic doctor uses Red blood cell test to check magnesium levels, serum levels are not reliable, he said he found Exatest not to be reliable either, even though it is said on here that the exatest is the best.

Liz

Elizabeth P,

I also question the taurine, it is problematic for me. Mag Ox is not a very good source of Magnesium; it's better than nothing, but not much. I feel the number one thing to improve my AF situation is Magnesium Glycinate. It has improved enough that I have been able to reduce my dosage of Rythmol by half. A lot of other small variables, but the Mg is the most important IMO.

Another thing that jumped out at me is your mention of torsades. Do you have a history of long QT? If so, why are you on Flec? I'm not very knowledgeable about this. Maybe some of those in the know will chime in.

lisa
__________________________

So much of medicine is looking solely down the wrong end of the gun barrel, and that is really a pity for all of us---Shannon

"Mag Ox is not a very good source of Magnesium; it's better than nothing, but not much. "
I have to respectfully disagree that MgO is better than nothing. It does an afibber no good at all unless one is in desperate need of a laxative. Money spent on MgO is wasted money, IMHO. Go to iHerb via the links on Hans' nifty site that you are on right now reading this message, get the larger size bottle [240 tablets] and titrate to bowel tolerance, which is different for each person. About the MgO that you still have on hand, either save it for laxative use or try putting it in the pots holding whatever houseplants you may keep, as a plant food supplement. I have done this, one tablet in each pot, and it at least did not seem to harm the plants.

Titrating to bowel tolerance is done by first taking one lonesome tablet just before you go to bed at night. Do that each night for a few nights, then add another tablet with your supper some night so that you are taking 2 tablets evey 24 hrs. Do that for a few days, then add one tablet with your lunch for a total of 3 tabs each day. A few days later, add another one with breakfast. Once you can take 4 tablets a day without any liquid diarrhea, try taking 2 tablets at bedtime. If no trouble with that, increase slowly to 2 tablets 4 times a day, then to 3. At some point, you will find a dose level that gives you diarrhea. Stop there and begin reducing the dose slowly the same way you increased it, one tablet at a time. Reduce the dose of Mg glycinate until you find a dose level that produces 2 or 3 soft bowel movements a day, but no diarrhea. That dosage level, whatever it may be, is the bowel tolerance level of Mg glycinate for your unique system.

Finding out how much potassium gluconate to supplement involves finding out how much potassium is supplied by the foods you normally eat each day. This is best done, i think, with the aid of a free online nutrient calculator like the one at
www.fitday.com
One records here everything one eats and drinks each day for a few days to a few weeks. Fitday tells you how much of each nutrient is supplied by your normal food intake. Once you know how much potassium in particular your regular diet provides, you can either eat more potassium containing foods or you can supplement to make it come up to our government's recommendation of 4700 mg each day.

Here is a useful info site about potassium:

[www.whfoods.com]

And here is the best potassium info site i have ever seen, originally called to our attention by our sorely missed friend Howie:

[lpi.oregonstate.edu]

All the best to you in this and everything.

PeggyM

Liz, if 100 mg. of Flec. 2X is not working,(assuming you just started taking it because it has a tendancy to become less effective over a few years) I don,t think that any diet or supplements in the world are going to help at this point, I would seriously consider an ablation by the best EP you can find, then take the supplements and watch the diet to make the ablation last. Just do it and save yourself alot of grief and money.

Tom

I am not sure who you are responding to, I am Elizabeth H., Elizabeth Perez is the person who started this thread---I sign my name as Liz, you addressed Liz, I am not having the problems that Elizabeth Perez is having.

Liz

Hi Elizabeth Perex -

Since you mentioned that afib begins after going to bed, have you ruled out acid reflux/GERD as a possible trigger/cause?

Although the connection is rarely made by cardiologists or gastroenterologists, this has been reported by a number of afibbers.

Carol

Elizabeth - I cured, and that means I completely stopped my night time episodes by correcting my diet. I did this by getting a food sensitivity test from Alcat.

It took me a long time to figure this out. I went to a number of doctors and said "I think my afib is tied to indigestion". And they looked at me like I was an idiot.

I finally figured out that indeed the heart and stomach are very much linked together. They in a small space and if your stomach is doing back flips it will press on your heart. But more than this I learned that your heart and stomach are affected, or controlled by the Vagus nerve, and if your stomach is in revolt, your Vagus nerve will be stimulated and will have an affect on your heart.

My indigestion / night time afib events were hideous. I tried sleeping upright, not eating in the evening, a food combing diet, etc etc etc. All trial and error things that did not work. I honestly think it would have killed me eventually.

Most doctors do not have a clue about this test. I believe it is something that the pharmaceutical industry does not want as it threatens their multi gazillion dollar anti acid business.

It is expensive at about $1100, but it is cold hard science and it will tell you what things you are putting in your body to cause the stomach problems.

You have to search around to find a practioner that can provide the test as most doctors don't have a clue about it.