PAC's and PVC's

In the most recent issue of the AFIB Report, you say "PACs and PVCs can pretty well be eliminated by ensuring adequate magnesium and potassium status." I had catheter ablation for AFIB in 2009, and am now developing PVC's with increasing frequency. My electrophysiologist wants to do ablation surgery to eliminate the PVC's. I am already supplementing with rather large doses of magnesioum and potassium.

Can you provide me with a reference supporting your statement? Any comment on the use of ablation surgery for PVC's? And also, how much magnesium and potassium should I be taking?

Many thanks for your help.

Hello Jay,

There is substantial evidence that the occurrence of PVCs is associated with low levels of magnesium and potassium [www.ncbi.nlm.nih.gov] [afibbers.org] . There is also recent evidence that oral administration of magnesium reduces the frequency of both PVCs and PACs [www.ncbi.nlm.nih.gov]. I have personal experience regarding the swift elimination of PVCs with potassium infusion. However, the most compelling evidence that an adequate magnesium and potassium status is essential in avoiding ectopics is based on the experience of dozens of afibbers who have found that supplementation with magnesium and potassium prevents PACs and PVCs and, in many cases, even atrial fibrillation episodes. For details about supplementation please see The Strategy [www.afibbers.org].

I would suggest that you consider having your intracellular level of magnesium determined [exatest.com] and if it is low arrange to have magnesium infusions or injections (assuming your kidney function is normal) to bring your magnesium level into the normal range. Serum potassium level is a reasonably good indicator of potassium status and should preferably be at least 4.5 mEq/L. Please keep in mind that it may be difficult to achieve this level if magnesium status is inadequate.

Catheter ablation for PVC elimination is an established procedure [www.ncbi.nlm.nih.gov] and [www.ncbi.nlm.nih.gov] with a success rate of 80-90%. However, as with any catheter ablation it is essential to pick a top notch EP to perform the procedure.

Hans

Hi Jay,

Just echoing what Hans recommends above. And to make sure you verify that you are actually assimilating the magnesium you are ingesting and that it has raised your Intracellular Magnesium (use the Exatest as Hans noted) into the upper quarter of the IC reference range. You want your IC Mag to be from a low of 38 to 41 to 42 if you can get it up there. Anything below 25 is getting suspect and below 34 is a problem.

Weekly IV magnesium infusions are often necessary to restore a significantly depleted magnesium store house. particularly is there is any latent on-going digestive issues which are also so common these days and in particular in people over 45 to 50.

A lot of people who just give the nutrient repletion an honest but not thorough enough try, will wind up thinking it was a waste of time, when in fact they never came close to getting their IC levels of these vital ions within an effective optimal range. And as such, they make a shortsighted and incorrect assumption simply because they feel they 'took enough pills'. ..

In this case you must confirm where your IC levels really are with both Mag, Potassium and Sodium.

Shannon

PS Jay,

I meant to say in regard to the Exatest IC magnesium levels that anything from 35 and below (not 25 as I type mistakenly above) is suspect and below 34 is a reflective of too low an IC mag ... Especially for people prone to AFIB....

Shannon

Eight years ago, my Exatest mag was at 34, as I recall. I've never had a retest, nor have I done injections. However, ingesting mag at levels close to bowel tolerance has kept my afib well controlled during this time. I do take a lot, currently around 3 grams of elemental mag/day.

George