Sleep Apnea and AFib Post Ablation Recurrence

Came across this in my sleep apnea research. Seems like their is a 57% increased risk of AF after ablation for patients with Obstructive Sleep Apnoea (OSA) that are not on CPAP, which is the preferred therapy.

Medscape

Bottomline is that is you think you may have sleep apnea it is worth getting checked out. One initial sign is snoring, another is overall sleepiness during the day.

And, CPAP users had a risk of AF recurrence similar to that of patients without OSA.

I'm currently exploring alternative treatment therapies and wondering if anyone has come across studies that indicate their success at reducing AF recurrence. Top of my list of alt therapies are dental appliances and surgery.

Thanks

Que,

I have a friend who has reduced his afib dramatically with an appliance he bought off the internet. Prior to that, he'd controlled his afib with high dose magnesium. His BMI is not high, but he does have a 17 1/2" neck, which is a risk factor. He is also heterozygous for the ApoE 4 gene. My understanding is this gives people an apnea risk even without traditional risk factors. My friend's magnesium requirement dropped dramatically when he started using the appliance.

I've successfully minimized apnea (I have no traditional risk factors - BMI 22, neck size 15 1/2) by a) taping my mouth shut at night <[www.correctbreathing.com], b) a zzoma device to keep me from sleeping on my back < [www.snoremart.com] and c) Buteyko breathing exercises to increase serum CO2. Overbreathing reduces serum CO2, which contrary to popular belief, is necessary. It is not just a waste gas. If interested I will expand on this. Here is a bit from a prior post <[www.afibbers.org]

{edit} <[snoring.ie]

George



Edited 1 time(s). Last edit at 08/17/2015 02:18PM by GeorgeN.

Thanks George. I'm currently looking into all of this.

One really interesting finding was Vit D levels and sleep healht. Check this out.

Dr. Park

Que,

I run my 25 OHD level at 75 ng/ml. It requires 10,000 IU/day for me.

George

Que,

If you told Dr Natale about the sleep apnea potential prior to your ablation he would had added a few extra lesions in a region known to help reduce later OSA triggering of AFIB by a good degree.

For Vitamin D , I also take 10,000iU a day to keep in the 75ng/ml region of 25(OH)D3 blood testing. You can maximize the efficiency of the dosing on all fat soluble vitamins (A, D, E and K) by taken them with the largest (good) fats containing meal of the day.

Shannon

Shannon: this is the first I've heard of lesions specifically for sleep apnea triggers. What area of the heart would those lesions be performed in? Is it one of the 5 areas we discussed (in another thread), or is it a new, 6th area? (BTW, I did a sleep study and was diagnosed as "borderline". I tried a CPAP machine, hated it, and thus don't use it).

Shannon & George: I too saw the Dr. Stasha Gominak youtube lecture re: Vit D levels, and used 10,000 IU for a few months. I ended up with knee pain caused by excessive calcium deposits in knee cartilege (chondrocalcinosis, aka pseudo gout), detected by X-ray. The MD attributed it to excessive vit D. My 25(OH)D3 levels were 57.8 at the time. Needless to say, I've since stopped the 10,000 IU supplements. Hope you get better results.

I wasn't remembering dreams for years because I wasn't getting REM sleep
and that was my big clue along with AFibbers having a propensity for Sleep
Apnea. I got tested and have mild sleep apnea.
I am now on a sleep CPAP machine and there are different responses to it.
The machine with the small in nose piece with humidifier is what I use.
I found initially that I was more tired and ended up on the depression/anxiety
teeter totter. Not fun. Gratefully I take herbs and was able figure out a regiment
that worked. I found that using St. John's Wort and a number
of other magnesium based herbs would work to finally
balance me out. It took over a month to get balanced, so I had to just continue
using the machine and having faith that I'd figure out which herbs to use.
I also have to talk to the Warfarin Clinic to discuss my herb useage.
I'm using Flecainide and after talking with the pharmacist am concerned, but
it stops my A Fib. My understanding of what the pharmacist said was that flecainide
cuts down on the elasticity of both your heart and lung walls/muscles. That's, at best,
disconcerting.
Glad to be back on this site.
LindaLee
Also I'm interesting in knowing if my Warfarin doseage is low, average or high. I take
5 mg a day.

Apache - Re: the calcium deposits... that's why also supplementing with the K2 MK7 is important as an adjunct to higher dosing of Vitamin D3... as free serum calcium can deposit in all soft tissues including arteries, aorta, kidneys etc... as stated.. the major function of the MK7 is to direct the calcium to bones where it belongs. When one takes warfarin, the calcium deposition into soft tissue is even more prevalent. Years ago when warfarin was all we had, most of the allopathic physicians did not also recommend using supplemental K2 MK7 and a lot of people were affected with soft tissue calcium deposits.

On the apnea topic.. .if you do an advanced search just in this session, for the word 'apnea,' there are 348 posts. Probably more in each of the previous sessions over the years.

Jackie

Yes, it was Dr. Stasha Gominak that I was referencing.

Her site is: [drgominak.com]

She more or less lists every medical condition that I have. I also have very low vit D levels.

The Vitamin D Council has a home test kit: [www.vitamindcouncil.org]

Apache,

As Jackie mentions, K2-MK7 is very important. I take 200 mcg of K2-MK7, a therapeutic dose.

Additionally there is an undercarboxylated osteocalcin test is through Metametrix-Genova Diagnostics to be sure. The undercarboxylated osteocalcin being the issue with too much D3 & not enough K2.

George

I got my Vitamin D, 25-HYDROXY blood work back today. 2 months ago it was at 20.2. I thought that I would try getting more sun to correct the problem. Unfortunatley that hasn't worked. I've been in the sun a good 20-30 a day without sunscreen on sunny days. I understand all of the variables (latitude, skin pigmentation, etc.) yet I still am way under. My new Vitamin D, 25-HYDROXY level is 33.5. So, an improvment but still significantly low. So, I guess it's time to supplement.

I'm going to try Vitamin D and Vitamin K.

Found the Vitamin K on Amazon (pretty good price with their Subscribe and Save)

And the Vitamin D there too.

Que - You'll definitely have to supplement aggressively to get your OH D numbers in the 'healthy' range... Those two products by LEF are good ones. Good luck with that project.

Jackie

Thanks Jackie.

Que,
It's called the 3rd Fat Pad Dr Natale ablates. I believe Dr Natale created a circle line ablation around my SVC for my sleep apnea.

"One of the real pioneers in ablation of atrial fibrillation, Dr. Andrea Natale, who is now in Austin, Texas, as part of his catheter ablation procedure for atrial fibrillation would always make a line of ablation, a circle, around the superior vena cava, and he always did it right where the pulmonary artery comes close to the superior vena cava. He’s noticed that by adding that part, it seems to have a little better effect on the patients who have atrial fibrillation associated with obstructive sleep apnea. I think that it may not be that it's circumferentially ablating the superior vena cava, just like the pulmonary vein, but in fact the part that is facing the pulmonary artery, where that third fat pad is, that may be the part of ablation that helps.

We can approach that third fat pad with catheters and actually, more easily, in patients who are undergoing ablation of chronic atrial fibrillation, using a minimally-invasive surgical approach [where] we have direct access to that third fat pad area and can just remove almost all of that tissue.

I think for the folks who are suffering with atrial fibrillation who have obstructive sleep apnea, as we learn more of these things, there may be some improvement coming very, very soon.

McHale



Edited 1 time(s). Last edit at 08/24/2015 12:08AM by McHale.

Thanks McHale. Going back and looking at my Natale Ablation Report it states

2) Successful isolation of all four PVs and SVC for the treatment of atrial
fibrillation.

McHale/Shannon any idea if that means that he worked on the 3rd Fat Pat?

Que

Yes the SVC area takes care of that area, Just be aware that Dr Jackman in assuming the 3rd fat pad being addressed in the SVC isolation is the reason for the improved results with OSA afibbers. I have not heard Dr Natale state that before, and it may over may not be an associated finding with his research as well. Dr Jackman has pioneered addressing Ganglionated plexi ablation and GP are often found embedded within such fat pad locations.

The concept has some merit but is still controversial with not a lot of replication by others using a Ganglionated plexi approach. As another target strategy for non-PV triggers it may have some merit, but Dr Natale has told me it is not just a matter of focusing on GP to get address thoroughly all non-PV sources.

I will try to remember to ask Dr N about his view on this issue, though I do know that he likes to know when a patient has documented OSA prior to an ablation as he does address selected areas around the SVC area that give better results for afibbers with OSA.

Cheers!
Shannon