Could The Beast Be Back ?

Hi all ! I was a user of this great site back in 2002 and 2003 when I had afib. As a result of what I had learned here I decided to go the ablation route in the summer of 03' and have been afib free since then with no meds and no symptoms...so,
About 5 months ago I began having what I would describe as an involuntary muscle twitch slightly below and to the right of the heart area. It would come and go with no rhyme or reason but would be distracting enough to sometimes make it harder to fall asleep.

This twitching can not be felt in the pulse the way I was able to feel every one of my afib symptoms back in the day...so I'm assuming that it probably isn't afib...

I did visit my Internist Dr. last July and she didnt really seem to be that concerned so I've just let it go...

So my question to the group is, are afib palpitations or other irregular heartbeat issues ALWAYS felt in the pulse ?
Are there heart rhythm situations where one part of the heat can feel normal and another can go a bit haywire ?

The symptoms persist, no pain,no shortness of breath,no trouble when working out etc...And it never has done anything more than just be an annoyance...

So, could the beast be back, only in another weird shape shifted form, or am I just experiencing a strange reoccurring muscle twitch which just happens to be in my heart area?
All comments and ideas appreciated...

Sam

Hi Sam,

First of all congrats on a great experience after a single ablation, where did you get it done? How frequent is this twitch and how long does it last?

An EKG would tell you what it is but if its not persistent as it sounds like its not, then it could be hard to catch without an event monitor worn for a month or just buying an AliveCor.com IPhone or Android based case that acts as a real single lead EKG that you can test whenever you feel this 'twitch' .. You can now even get the strip you capture interpreted by a cardiologist or cardiac tech for a small nominal fee without having to go to your own doc, and can be a useful tool and training help until you learn how to recognize AFIB on the EKG reading from the V1 lead read out.

All in all, though, sounds like you've done great. Even if it is back, a basic touch up is likely all that is needed to put it back to sleep for good and you also might be able to make it quiet again with the magnesium and potassium protocol as described in 'The a Strategy' article found above in this page via the 'AFIB Resources' link above. It is certainly worth a dedicated trial for 6 months or more as you continue sorting out this new issue and determine whether or not an follow up ankation might be in the cards.

Best wishes,
Shannon



Edited 1 time(s). Last edit at 01/02/2014 11:25PM by Shannon.

Sam - Muscle twitches are a common symptom of magnesium deficiency. Certainly check out by ECG or wear a monitor to capture what is happening and also... as Shannon mentions, refer to The Strategy report which I wrote as a result of my experiences with breakthrough AF that occurred in the years 4, 5 and 6 after my ablation.

If you aren't supplementing with the core essential heart nutrients, especially magnesium and potassium, then you should begin with a determined focus. The Strategy is being revised to include several other key points that I neglected to include mostly because they became such a part of my daily routine, I mostly forgot that they were working behind the scenes in a fundamental way. The revision is a work in progress... hopefully, finalized in a month or two but the information in the original will serve you well as a start.

Magnesium is at the very "heart" of the arrhythmia problem and it's very easy to become deficient and not always quick or easy to replete to an optimal level. An ablation does nothing to add magnesium to your diet nor does it help you maintain the proper potassium levels needed to maintain NSR.

If you need more specifics than is in The Strategy report... send me a PM.

Jackie

The Strategy - What Metabolic Cardiology Means to Afibbers
[www.afibbers.org]

Conference Room Session 72
Potassium/Sodium Ratio in Atrial Fibrillation (February 7 - June 11, 2011)
[www.afibbers.org]

Magnesium Absorption
[www.afibbers.org]

If its frequent like most all the time Sam, I'm thinking odds are less that its just a muscle twitch, though but could be. And the nature of any arrhythmia you may had had originally before an ablation of ten years ago could certainly manifest with a different sensation and rhythms for sure post ablation and particularly after so long a period of heart stability in which positive reverse remodeling would have taken place to a large degree which, indeed, could change the nature of how this feels now, if indeed it is an atrial tachycardia of one brand or another?

Perhaps too you are getting frequent runs of atrial or ventricular ectopics like PACs and/or PVCs which can certainly feel annoying as hell and very much can seem like AFIB if its consistent enough, but if it is just ectopics its not necessarily an issue to be overly concerned with.

Nevertheless, be sure and either get an EKG while this is happening or get an Alivecor.com monitor for your smart phone and capture several runs of whatever it is for a proper diagnosis.

If its just runs of ectopics then really jump on a The Strategy AND read Hans 'PAC-tamer' protocol in the AFIB Resources too and follow the recommendations religiouly to really help quiet that kind of nuisance activity down most of the time.

Shannon



Edited 1 time(s). Last edit at 01/08/2014 03:23AM by Shannon.

Whatever you do, it is time for a call and a visit to see your cardiologist/EP ASAP. The best you can be doing is guessing at what these symptoms represent. Could be anything; probably nothing. Do you want to take a chance? Modern portable ECG monitors are tiny and are worn on your belt with pads on your chest, etc. They can mark your chest with a china marker and you can shower in the morning and put fresh pads on for the monitor noooooo problem. I wore one for a month!! And what it showed was that I was skipping beats, nothing more nor less. No PACS, No PVCs, No aFib, just skipped beats that were quite symptomatic but showed up on the monitor while nothing else did. These new monitors are so intelligent they can detect an "event" automatically but also have an EVENT button that you press whenever you feel pressure, flip flops, etc. It then takes a strip of the prior minute and the following minute. If after a minute you continue to experience whatever, you press the button again and it records likewise the prior minute and the next minute of ECG. Marvellous device and I am especially pleased to be able to shower and shave each morning.... my prior cardiologist had an old fashioned holter monitor that simply recorded for 24 hours or 48 hours and could not be removed. No showers.

As of late I seem to be having more frequent periods of 'chest pressure' or flip flops and can feel my pulse skipping beats with my finger; or can see it on my pulse oximeter. Nontheless, I am calling tomorrow to make an appointment to see my EP to discuss the issue and to see how soon I can have ablation; the side effects of the TIKOSYN (I believe) are becoming intolerable.

Bottom line? I would find out what is going on in my chest. Easy to do. Don't wait.

Murray L

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Tikosyn uptake Dec 2011 500ug b.i.d. NSR since!
Herein lies opinion, not professional advice, which all are well advised to seek.

Thanks for the responses.

@ Shannon and Jackie, as soon as these symptoms began I started supplementing with magnesium and that didnt seem to help.
I checked out the alivecor monitor but I use an ipad and their product only works with the smaller smartphones.

After doing a whole bunch of researching today I'm beginning to believe what I have is a flutter, much as my afib began. There are cases of those like me who even 10 years after ablation begin to show symptoms. I read something about the abated vein can eventually grow back or re-attach which causes the beginnings of afib or even just flutter.

It has been so long that I forgot what the original flutter symptoms felt like...I guess once you experience the joy of full blown afib, an annoying flutter is a mere distraction.

Anyway, you're all correct. I should and will see an electro cardio person soon. I guess I was still feeling invincible from the success of Dr. Chinitz's ablation all those years ago...August 3rd, 2003. Maybe it's time to deal with whatever it might be...

Until then, I have a sh*tload of snow to remove in a few hours so .......the snowblower is ready to rock ....

Thanks again for the ideas and help.i really thought I wouldn't need this forum again, but life is strange.

Hi Sammy,

You are on the right track, just first confirm exactly what is going on with an EKG. You can always get an older model Iphone 4.5 with unused models costing very little and then add the AliveCor case/monitor that fits that model phone and use it exclusively for checking arrhythmia, but if you can catch this for sure on a standard twelve lead EKG too that is the good standard for confirming AFIB/Flutter.

Atypical left atrial Flutter which is the most common kind to develop at some point after an ablation can be highly symptomatic and often harder to endure than full blown AFIB, especially when fast.

As far as the repletion of Magnesium and potassium, so many people just 'give it a try' by taking some oral magnesium for a while and it doesn't help as much as they had hoped so they drop it.

Afibbers as a species are almost endemically fast wasters of these cardiac critical electrolytes and the vast majority have to really work diligently for at least 6 months and often a year or more taking in significant amounts of Magnesium and then adding in the key Potassium as laid out in the Strategy mentioned above and that Jackie gave you a link too.

It's not easy to get Magnesium levels restored to an effective Intracellular range and often it can take a combination of Mag forms including topical Mag applied to the skin to bypass any digestive issues the limit absorption if oral only forms and some need IV Magnesium Sulfate weekly fir a few months to get a quicker restoration of IC Mag levels.

If you have a new open a Flutter circuit now the minerals might not be enough to fully put the genie back in the bottle, but it can still really help give your heart and an further touch up ablation needed a solid edge in supporting that ablation and helping to maintain as quiet of an atrial substrate as possible going forward, not to mention help improve many other aspects of health for those deficient in these most important minerals.

If you do need a touch up carefully choose the ASAP to do it since while a touch up following a really good ablation by an experienced ablationist usually is a shorter process or tracking down one or a few reconnections of old ablated spots or new trigger sources, it can be tricky to discover all the areas of mischief and fully track down all the culprits.

Some EPs don't even venture much into certain non-PV sources like the coronary sinus (CS) or left atrial appendage (LAA) which is increasingly found to be the key area for later trouble after a prior ablation of the usual suspects that still remains solid without reconnections.

You want the most experienced possible EP who is skilled at addressing these areas of the LAA as well, if need be.

Your original EP has a solid experience e base but the word is that you are not always assured the he himself will be actually performing all the critical parts of your ablation as he sometimes is training newbies and has them take over much of ablation work done under his name.

Sat least that is what I have heard directly from several of his patients from recent years, so just confirm with him or with any EP you might choose, that the person you want and expect to be doing the whole procedure will for sure make a promise to you before hand that only them will do your work and not farm it out to a trainee.

Back in 2003 wit the still relative early years of AFIB ablations it was no doubt more common for the top EPs to do their own work for the most part as they built up their own experience base. The point being that especially with a follow up ablation to address atypical left atrial flutter in particular, your best odds are not with a trainee welding the catheter regardless if who might be in the room checking in from time to time or who it is that is just signing off on the procedure after the ablation.

If you can't get a firm commitment from your original ASAP that only he will do any needed work, then don't hesitate to walk and go to an equally or even more experienced ablationist who will do your whole procedure themselves.

Best of Luck sorting this all out. I'm sure you will do fine.

Shannon

Hello Sammy, good to hear from you again even though you are having some trouble. Good to know you are still in the world and doing comparatively well.All the best to you.

PeggyM

Good to hear from you Peggy. Hope you're good as well..

Seeing an EP next Monday...symptoms have strangely disappeared...but that's the nature of the beast...I guess I've gone at least 8 years without seeing a cardio person, so either way it's time for a fresh look...

See u all after I figure out whatever the situation is.

Just to follow up, I saw a great EP and he couldn't find any heart issues at all. What he and now I believe I have is benign fasciculation syndrome

It's basically an involuntary muscle twitch or spasm. Mine has been going on and off for 9 months and strangely right below my heart area.Probably a benign situation but it was close enough to my heart to be potentially a flutter and he agreed that it could have been mistaken for that.
At this point I'll try and ignore it.

Anyway, hope everyone has an NSR 2014 !

Sammy - Good news on your heart report!

Consider using the topical or transdermal magnesium oil (gel) right on that area as often as needed for the fasculations. It works well for muscle spasms and sore muscles, plus delivers a dose of magnesium as well. You should be able to find it locally as it's popular in Europe.

Check this info from Dr. Mark Sircus on the Zechstein minerals [www.ancient-minerals.com]

Jackie