RE: Trying to figure out the triggers today

Hello everyone,
Today, I worked on putting up a couple shelves for a pantry. I somewhat had to exert myself may be over half hour by kneeling, bending down and applied force to a few screws. Anyway, later on in the day, I had an irregular heart beat episode that lasted about 3 hours with rate up in 130's and back down to 60's and then back up again. I'm trying to figure out if it's the physical exertion with the pantry or what I ate in the day or last night that triggered the episode (Afib?). I do the regular supplements like I normally do everyday. Frankly, I'm getting tired of trying to figure out and to keep up with what not to eat or to eat and do this and don't do that, take this supplement and take that supplement throughout the entire day. Do you think it's the physical exertion of working on the shelves that triggered my episode? (I read somewhere on this site something about "posture"?)
Also, are we "free" from having to take so much of supplements daily after an ablation from Dr. Natale? Or are we still being limited like before ablation? I'm about 1 year into this condition with a pacemaker, vagal paroxysmal I think, and not taking any meds although I was prescribed to take Flecainide. Am I too early in the ball game to think about Dr. Natale's ablation? Like I said before, I would gladly accept a few episodes PER YEAR like some of you that don't have ablation, but if I'm lucky, I get 2 weeks before the beast comes knocking at my door. I'm really trying hard, but sometimes I just get so frustrated of trying to figure things out. I appreciate any answers or comments. I still have so many more questions, but I have to organize my thoughts to ask later in different posts. Thank you all.

Duke

Duke,

Sorry for your episode. I dont have answers but I can totally relate. I dont think we can ever figure it out totally. I am 8 weeks post ablation and havent had prolonged spells but still having kicks and short runs. The prob is I am active and I fight the thought that putting up a shelf or carrying my garbage out or weed eating causes my problems. I hope not but it drives me crazy. I try to lift weights 3x a week, the other day I did good in my workout and then ten minutes after I was done (putting on my clothes) I start having the dreaded "kickers". was it the workout? was it because I bent over to put on my shoes? This is all crazier than H#@%!! I hope you feel better soon. You may have to take the Flec it does help to reduce some episodes...I think

Hey Duke, for me a definite trigger is bending over whilst working. It seems that the combination of being doubled over and exertion increases pressure in the abdomen and makes me liable to ectopics. If i do it too much it might trigger af.
I now use a kneeling pad and make sure i kneel and keep my back straight rather than stoop over. I am able to do a lot more that way.
As well as magnesium oil for the muscles, i use activated charcoal to minimize gas pressure if i feel bloated.
Sorry for your troubles, i know what it feels like!

What happens is the heart becomes more sensitive to any stimulus, whether from foods, the wrong amount or kinds of supplements, posture, and even exposure to rapid temperature changes. Take a step back and look at what is happening...the heart has foci (cells that can generate heartbeats, rightly or wrongly initiated) that become more irritable to stimuli that would NOT affect normal foci. The vagus nerve generates stimulus, so do many glands, as do some foods and drink. Usually, most of the foci that initiate afib are located in the area of the heart's pulmonary vein group - but other areas of the heart can also trigger afib.

Where do you draw the line? When do you want your life back? The disease is progressive, the foci become more irritable with time, not less. Those very few who have reversed the progression by means of food choice and supplements are NOT representative of the vast majority of afibbers.

Those who have had successful ablations usually do not have to worry about avoiding triggers, however, moderation is always a good thing, as the causes of afib are yet controversial, and clearly vary among us. Whatever process the body took to develop afib may still be in place...removing the "hot" foci with an ablation may cure the current afib, but not prevent more foci failures later on...so moderation of over-stimulating food and drink would be smart, as would a balanced diet/supplements that provide the nutrients the heart needs to function well - especially among older adults such as myself.

As the disease progresses, more triggers appear, and the issue of conductive pathways becoming permanent becomes important to consider. Those permanent pathways can lead to even more episodes and eventually persistent, or permanent afib. Stroke risk increases.

That happened to me. I needed two ablations, the second was a touch-up (very common). I had a tough time with the first one (fluid build up around the heart) but it was still no big deal compared to the daily misery and stress from afib.

I would recommend finding a top EP, there are many besides Natale or the Frenchmen....LOL... I used the folks at Silicon Valley Cardiology in Redwood City, CA - they have a couple of top EP's, Patrawala and Winkle.

Look for a track record when choosing the EP - how many have they done? Success rates? How many complications? If they are worth a darn, they will advertise that information.

Good luck!

Hi Duke,

TomB's post is right on the money and you are not too 'early' to take that advice to heart. One thing an expert successful ablation process will also bring is that the diet and supplements will at least feel more 'optional' and you wont feel the irritation of be so adherent and yet still having breakthroughs. Like Tom B said its makes perfect sense to continue on with the healthy life style, dietary and supplement protocols that have helped to one degree or another, even if not enough by any means to effectively stop AFIB, after you are free from the arrhythmia. The big difference is that the stress and frustrating disappointment of still having AFIB breakthroughs will be a thing of the past and your feeling of begrudging obligation to continue with the supplement protocols you will likely find will totally change to a greater acceptance, ease and even appreciation for having found good dietary and supplemental aids to healthier living.

It wont feel like you must take this or that supplement everyday, but you might may well find you are voluntarily every bit as dedicated toward keeping your body in the best shape as you can going forward in any event and it usually doesn't seem so tedious, and perhaps as futile, when your heart isn't flipping around inside any longer.

Best wishes,
Shannon

Thank you all for taking the time to respond.

I currently live in southern California, Los Angeles. I think someone mentioned Dr. Natale does ablation in San Diego, correct?
Anyway, Shannon, or anyone, do you know of , besides Natale, any excellent ablationist in the Los Angeles or Orange County?

Does Dr. Natale need to do multiple examinations or different tests on me before the actual ablation or he only needs to examine me one time and know what the ablation plan is? And how often is he here in southern california? Is the "touch up" session part of the package deal or is that entirely separate deal?

Duke

Duke,

I think Natale spends a week or so a month in San Francisco, if that is an option for you to see him. See: <[www.afibbers.org]

George

Duke, I am in OC. Top 2 choices would be Natale at Scripps and Nademanee at Memorial. St Joseph's Mission Viejo hospital has busy AF clinical program but I am just starting to study them.

Hello everyone,

Researcher: I read some bad reviews on Yelp regarding White Memorial Hospital in Los Angeles where Dr. Nademanee ablation center is at.
Also, I'm somewhat leery about Dr. Nademanee medical education from Bangkok, Thailand. Granted, I don't know anything about his successful ablation performance or how many has he done, etc. Do you or anyone else know other excellent ablationists in Los Angeles or Orange county?

Thanks again.

Duke

DUke,

is Scripps really to far for you to travel for a two days and one night maximum? Sure you might be able to get a solid ablation elsewhere in the region, butte question you have to ask yourself is are you really willing to forgo using one of the worlds very best ablationist who comes periodically very close to your backyard? That is a question you want to feel a very positive yes about whatever alternative you might choose, when you could have without too much hassle easily greatly reduced the risks of a bad outcome and increased the odds of a successful ablation process when you begin and end with your that process with the same elite expert. Before bending over backwards to find someone else when Dr N works very near that area as well, just get clear on why you would do so and be happy with your decision if you are going to roll the dice a bit more than you have too, unless there is some other complaining reason you must look elsewhere?v

Best wishes on to whom and where ever you wind up going.
Shannon

Duke, I can't think of anybody else with the breath and depth of experience and skill sets of Natale or Nademanee. It turns out that the Mission internal group that my doctor belongs to has an EP specialty within it and that Aseem Desai does around 400 AF ablations a year and 3/4 of all the AF ablations at St Joseph's Mission hospital (5 miles from me). That's a lot for somebody so young (Stanford fellowship 2005) and he has a good rep. When I look at the highly complex cases that Natale and Nademanee handle, even a busy young gun with good rep like Aseem or the group at UCLA pales in comparison. Nademanee handles really sick patients with VT/VF where average complication and mortality rate is 10X that of AF ablations and only the very elite guys get referred to those cliff hanging cases (Burkhardt handles those cases for Natale). The medical degree that all these guys get doesn't mean a whole lot to me. It is what they do in residency and fellowships and post graduate work that matter. The first medical degree is almost all theory. The real stuff comes later. Both are pioneers. But there are differences to consider. They both do the same lesions but not necessarily in the same order.



Edited 1 time(s). Last edit at 05/11/2014 09:33PM by researcher.

Duke, I remember a poster here that had a Nademanee procedure but search did not bring it up. I just found it and the link is below. I don't know if he still reads the forum. Perhaps you can email him directly and see what his impression was and how well he is doing.

[www.afibbers.org]