It is getting worse

I am 18 hrs. Into my second episode this week. I've had afib for approx. 6years. In 2012 I hand only 4 episodes. In 2013 I have ramped up to three or four per month. What has changed? Supplements I have stopped include potassium, probably even before last year. In 2012 I diligently drank a large coconut water each day. However, I restarted potassium powder four days ago with v8 so I am wondering how long it takes to get those levels up. I also think I was taking ribose last year too.

From Nov to Dec. I ate a vegan diet and didn't see a reduction in episodes, but had more etopics so I have returned to my paleo ways.

As far as diet I am usually pretty good. The night before this episode I had 4 sq. Of chocolate and a cup of caffeinated tea,but my episode didn't start till noon the following day. I know that I am hypoglycemic and made the mistake of waiting till noon to eat and I would blame it on that, if I hadn't been up at 6a.m. And felt on the verge of an episode.

The strange thing yesterday is that I took my beta blocker (propranolol) when my episode began and my rates stayed in the 100 to 120 range until the beta blocker wore off in the evening when the rates dropped down to the 80s. I know this for sure because I use an Alivecor monitor.

I am starting to consider a pip rhythm control med to terminate my episodes. My doc had given be propronaphone (sp?), with instructions to take it in the E.R. the first time. I just couldn't bring myself to do that, too much risk, but now I am starting to reconsider. Could these longer episodes do some remodeling that would make my episodes more frequent?

My paroxysmal afib episodes got worse, too, and pretty quickly, after about 3 years of monthly episodes.

That is the nature of afib. Hot spots in the heart can proliferate.

So far, I am quite satisfied with my ablation at CPMC by Steven Hao. I wish I had done it sooner.

The sooner they can ablate the hot spots, the better, to catch them when they're fewer and easier to identify.

Please consider consulting a top EP for an ablation ASAP.

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Lone paroxysmal vagal atrial fibrillation. Age 62, female, no risk factors. Autonomic instability since severe Paxil withdrawal in 2004, including extreme sensitivity to neuro-active drugs, supplements, foods. Monthly tachycardia started 1/11, happened only at night, during sleep, or when waking, bouts of 5-15 hours. Changed to afib about a year ago, same pattern. Frequency increased over last 6 months, apparently with sensitivity to more triggers. Ablation 6/27/13 by Steven Hao.

Hi Lynn,

I'm typing this on a plane winging down to Orlando to attend the Boston AFIB 2014 Conference (mercifully moved this year to Orlando considering this Jan weather in Boston!) and will share some updates on the more interesting new findings at the conference soon.

Stopping the potassium probably was t the best decision but be sure you are taking sufficient Magnesium too so that the potassium can work as intended in helping to calm the heart rather than possibly turn pro-arrhythmic if the dose is too high relative to depleted magnesium stores.

Sounds like your metabolic rhythm was about due for an episode and then throwing the gasoline on the fire with the Chocolate squares and/or caffeine tea was likely the proximal trigger. A trigger doesn't have to trigger immediately and can be the next day or easily from the cumulative over use of triggers that build up to an episode.

Absolutely these episodes can and likely will, at least to some degree, encourage further electrical and possible structural remodeling. The fact that you are getting around 4 episodes a month and now are heading toward longer duration episodes and soon will cross the 24hr mark, if you haven't already converted back to NSR, indicates you are a prime candidate for a good ablation by a top tier operator.

I do encourage you to restore the Mag and potassium following The Strategy protocol too in the meantime, but seeing how you might not wish to stick with it and its not a panacea but rather can be a big help, I do very much encourage you to get the ablation sooner rather than later before you risk filling into persistent AFIB. Doing both a solid ablation process of one and perhaps two procedures, if needed, along with dedication to The Strategy protocol is a winning formula overall.

Even though a successful ablation process may prevent any overt episodes of AFIB of Flutter, still paying attention to a good diet and the mineral repletion can really help solidify and stabilize the heart and you will learn to better minimize and control any ectopic activity which is certainly annoying.

Best of luck to you.
Shannon

I should add that I take 600 mg. 2 x day of chelated magnesium, plus add about 1 t. of Calm each day. So I think mag. levels should be up there which leaves me puzzled about the RVR.

Lynn:

I take propafenone (150mg.) at night before bed, I am vagal. My EP never said I needed to start the med in the hospital, so I never did, I also do not take a beta blocker with it, Propafenone has some beta blocker in it. Taking the propafenone every night plus magnesium has helped me a lot, I also eat quite well as I grow my own veggies/fruits. Why not try the propafenone either as a PIP or everyday, see if it helps.

Liz

Shannon,
Tell Andrea "The Greek from New York" wishes him a Blessed New Year!!
Heart beating like a Swiss Watch!!!

God Bless the Maestro,

McHale

Elizabeth,

That is interesting that it did not require you to take it in the E.R. the first time. Maybe he thought this would give me more assurance. The whole rhythm control spectrum of drugs scares the heck out of me. How long have you used it? Have you ever had an ablation?

Does getting out of an episode more quickly help prevent remodeling or other changes that lead to additional episodes?

Lynn:

I also just take the Propafenone only once/day (night), I am vagal and get my episodes in the late evening or during the night. Most docs say to take one tab. every 8 hrs. to keep a steady supply in your system. My EP felt that the tab. at bedtime would work the best for me. I have used this protocol for at least 7 years, no I have never had an ablation. I don't as a rule get a lot of episodes, usually every 3 months, more or less and they are tolerable, they generally last anywhere from 11 to 20 hours, perhaps if I took a larger dose of propafenone during my episode they would stop quicker.

I would suppose that if one had an episode quite frequently that could lead to remodeling. I had a ultra sound of my heart about a month ago and there weren't any changes from my last ultra sound, that was a period of about 5 years.

I will say that just the mag. and supplements alone didn't do it, the addition of Propafenone and mag. is what has helped me. My mag. does test at the low end of the lab scale, but I cannot take a lot of Mag., no matter which brand I try.

There appears to be a cavalier attitude about ablations lately, thankfully most have been successful, but there have been some that have not, we had a lady posting about the terrible aftermath of her ablation, her husband wrote a book about it. I know of a doctor that got his ablation at the U.of M Michigan hospital from a doctor that had studied with Natale but the doctor died, so, there are great outcomes and some bad, it isn't all wonderful for everybody.

Liz

Lynn,

For a time, I successfully used Flec once a day, before bed for a while a year ago. Just as Liz does with Propafenone. I'm vagal and all my episodes were at night, too. It worked well. Then I titrated the Flec down to zero, taking ginger as organic powdered spice before bed, too. Ultimately I figured out I'd added too much calcium in my diet through food and once I corrected that, my control went back to its normal stellar ways. I then did not need either flec or ginger. We are all experiments of one, but my goal has always to do anything within reason to minimize the time out of NSR, and was willing to use flec for that purpose.

George

Lynn,

As others have said, it is not unusual for this disease to get progressively worse. Have you thought about what your next step will be?

TP

Contemporary ablations done by top doctors are quite safe, probably as safe or safer than taking the drugs, given the side effects, etc.

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Lone paroxysmal vagal atrial fibrillation. Age 62, female, no risk factors. Autonomic instability since severe Paxil withdrawal in 2004, including extreme sensitivity to neuro-active drugs, supplements, foods. Monthly tachycardia started 1/11, happened only at night, during sleep, or when waking, bouts of 5-15 hours. Changed to afib about a year ago, same pattern. Frequency increased over last 6 months, apparently with sensitivity to more triggers. Ablation 6/27/13 by Steven Hao.

I guess I am hoping to sort it out and get back to where I was like George. Dr. Is retesting my thyroid. There may be an issue with my compounded thyroid meds. I'm toying with the idea of a pip for rhythm.