Case: Permanent AF with bradycardia and other health issues

Hello to all!

I'm Andrea from Romania (EU).
Thank you for sharing your experiences on the forum and website, I've found a lot of useful information I needed.
Please read below the case of my aunt who has been recently diagnosed with permanent AF after she had AF only from time to time...
Any idea, suggestions or warnings in her case are very much appreciated.

Shannon told me about 2 countries in EU where my aunt could find better help. But she can barely travel 2 hours away from her home, let alone between countries... And money is also an issue...

One of her main issues with her AF is that NO ONE TOLD HER WHERE the AF is happening, what is happening inside her heart. The cause is not in her kidneys, nor the adrenals, nor her thyroid. I hope I've written everything you need to know. If you have questions, I will try to answer after calling her (she lives in another town).

On Monday we are going to schedule an appointment to her main electrocardiologist (in another town) and we'll see what that doctor will have to say, but we haven't been satisfied with the communication so far. As you shall see below, the doctor said she can't try cardioversion unless her INR is between 2 and 3 so until then my aunt had to see local doctors to find relief...

Also, her main doctor told her couple of years ago that if she has permanent AF she will need a pacemaker. The last electrocardiologist she saw last week in her town told her that in the current situation she needs a pacemaker. Still, I am wondering, if her main doctor is thinking of cardioversion it means they still want to try something else before putting a pacemaker, right, so this, at least in my opinion, makes me think there maybe in her case there are other ways too...


Nicole, 75 years old, Romania

Current diagnosis:
• Permanent AF since June 27th this year
• Triggers for her AF over time– either sitting in bed and watching TV, other time eating spice, other time stressful and very emotional conversations, maybe very hot weather
• Bradycardia
• Hypertension
• Calcific aortic valve
• Calcium deposits on the walls of all the vessels (due to Calcium supplements taken till years ago without Magnesium)
• Irritable bowel syndrome, diarrhea
• Polycystic disease (polycystic kidney, liver, ovary) – cysts with fluid
• Non-secretory Adrenal gland adenoma – checked every 2 years
• Cataract in both eyes, complete in one, partially in the other
• Depression (no treatment for that, it is also normal taking into account that she has been living alone all her life and she has been suffering a lot for decades)
• Osteoporosis
• Lactose intolerance
• H. Pylori infection
• Stomach acidity (can't remember if she has ulcerus or gastritis)



Current tests results:
• Thyroid hormones are good
• INR is 1.83 (her electro-cardiologist said she needs to have it between 2 and 3 to be able to try cardioversion with her)
• All the blood tests are good
• Triglycerides are good
• B12 is good

Current medication and supplements:
• Betaloc ZOK (50 mg) – containing 47.5 mg Metoprolol Succinate – she is taking 1 pill in the morning and 1 pill in the evening (the latest electrocardiologist said she is taking double the recommended dosage and it is too much. Still, even with this medication, there is no change in her pulse
• Sintrom – Acenocoumarol (3mg/day on 3 days/week, rest of the days in the week she takes 2 mg/day)
• Supplements: Coenzyme q10 in Sea Buckthorn oil, Bilomag for blood flow, Bilomag for memory, Korill (Krill oil) – she could not stand the statins so she tried all the time something else till this Korill really helped her; she took Graviola from time to time.
She has started taking MSM (organic sulfur) for the last couple of days and it seems to decrease the pulse. And after I read the Strategy file on the Afibbers website, shh has recently bought and started using Magnesium (but as the drug store didn’t have Glycinate, she bought something else that is very used in Romania…) and Taurine.

She’s also going to buy K2 MK7 – but this is tricky, right? Because the medication she is taking is blocking vitamin K and she should only take maximum a pill a day to help with her calcification and osteoporosis issue, otherwise her medication will not have effect…? I've found that info here Vitamin K2 Website

NOTE: She is NOT taking Carnitine because at the Romanian TV, years ago, they showed only the study with the bad results on Carnitine and side effects, not the other 13 studies done on the good effects of Carnitine… I told her they are manipulating people on TV here but she doesn’t want to listen

Medical history:

3 years ago she was just watching TV and her blood pressure increased. She was taking Atacand (Candesartan). The higher the blood pressure, the more Atacand she took but the blood pressure became irregular and the AF crises started to come once/month. She also took diuretics.
Arrhythmia resulted as such.

It came a time when she went to the emergency room 2-3 days in a row, even though she took medication.
They recommended her Metosuccinate, Amiodarone, Rytmonorm – BUT they didn’t put her on Holter device and they gave her that medication without knowing she was bradycardic!

After those episodes she went to another town, to her current electrocardiologist, highly renowned in Romania, who put a Holter monitor and saw that her pulse was 46-52 and diagnosed her as bradycardic.
The doctor gave her medication to take only when during AF crisis: Metoprolol succinate 25 mg and Sintrom.

This year, with the beginning of the hot summer, on June 27th, with hypertension and bradycardia, blood pressure was 8/140.
She went to see 3 different doctors in her town, being unable to travel to her main doctor, and they prescribed Concor (bisoprolol), that she could not bear to take, and had no effect on her. They changed her medication with Betaloc Zok. But her pulse at noon was 120 ever since, so she has been taking higher dosage for a while.



Edited 2 time(s). Last edit at 12/06/2015 10:19AM by Andrea_S.

Hi Andrea, Sorry to see that your mother is going through such a hard time with AF. You do have a very good EP in Bucharest, Dr. Radu Vatasescu. He has done well over 3000 ablations by now and he does very difficult cases.

Hi! What a surprise, I didn't expect anyone to recommend me someone in Romania, thank you!
My aunt (she's not my mom but she is like one so you are not far from the truth ) is supervised by Dr. Grecu Mihaela from Iasi. (Her CV in Romanian mainly and some words in other languages)

Andrea, I see that Dr. Mihaela had more recent training with Dr. Kuck and Dr. Ernst so she has excellent mentorships. I hope she works out well for your aunt if she can't travel to Bucharest. She completed her fellowship in 2009. Do you know how many ablation procedures she has done?

No, I don't know. And I am not in the position to say anything cause not only I've never met her but the only information I have about my aunt is from my aunt herself and whatever else I was able to read from this website. I still have a lot to read and understand about AF. There are also things we need to discover about her case - maybe we shall find out this time from her doctor.

This is the reason I'm doing some research before accompanying my aunt to her next consultation. I'm an economist, only my aunt has pharmacy and medical degree (dentist).

What makes me think that even doctors don't know much is that no one told her how to treat her calcification, or that she needs to take Magnesium and in what form, or about nettokinase or other supplements that have been mentioned here. It's just an observation, that doctors become too specialized in a field and forget about the whole, maybe. Maybe. I have yet to find out. I don't want to teach lessons to anyone, I just want my aunt to feel better and have the suitable treatment for her body and health issues without side effects that worsen her condition.

I can't offer much help for most of this - but there were a couple of things that lept out at me. Since my afib was originally caused by dehydration, I try and watch out for that. It has continued to be a trigger from time to time when I'm not careful. So among other things, make sure your aunt is drinking enough water during the day.
Nancy

Hi Nancy,

She is drinking mainly tea and a lot of it. She has always had this issue with drinking water. So yeah, it might have been a trigger in her case too if plain water is considered the best needed source of liquid.

Hello Andrea - I have a number of comments about your very detailed report regarding your aunt which I'll be posting soon. Meanwhile, I'd like to comment on your last post regarding her drinking mostly tea. While it may not bother some individuals, depending on the tea, there are several elements worth considering.

The caffeine content of tea may be an issue if large amounts are consumed... caffeine being stimulatory and a potential trigger for AF....and the natural fluoride content of tea. Black tea has the highest content... green next and white tea is negligible as is herbal tea. You can use the search feature here in the General Forum for posts on the detrimental effects of fluoride... which is mostly from treating municipal water (here in the US) but the effects would also apply to large amounts of tea consumption. There are also areas where natural fluoride is found in the ground water so water needs to be treated to remove or avoid using.

On hydration, the experts say that drinking tea or coffee as a water source for hydration doesn't count. It needs to be just pure water. Pure meaning free of purification chemicals including chlorine. Spring water or high-efficiency filtered water is preferred.

According to Alan R. Gaby, MD, "Chlorine in water reacts with organic matter to form a number of organic compounds, some of which are carcinogenic, such as trihalomethanes and chloroform. Consumption of chorinated water has been associated with increased risk of breast cancer [4,5]. Thankfully, chlorine is not hard to remove, either by adding a filter to your tap, by boiling your water or adding a pinch of vitamin C crystals."

Jackie


[4] Koivusalo M, Pukkala E, Vartiainen T, et al. Drinking water chlorination and cancer - a historical cohort study in Finland. Cancer Causes Control 1997;8:192-200.
[5] Flaten TP. Chlorination of drinking water and cancer incidence in Norway. Int J Epidemiol 1992;21:6-15.

[www.doctorgaby.com]

Thank you, Jackie, for pointing it out so detailed. Friends told me about this but I forgot. I don't know if my aunt is going to change something, but the more proof or information I give her the more chances there are that she is going to accept something different than she has been used to.
In Romania we have chlorinated water.

And when you are refering to tea you mean that the plants in general absorb fluoride from the ground, no matter where the plants have been grown, and especially in the areas where waters are highly florinated, right?

Andrea - The fluoride content is something to be addressed eventually. But by all means, it should not be THE most concerning element as your aunt has many other pressing conditions that need to be addressed right now. It's just smart to get rid of any underlying contributors that run interference behind the scenes and watching both the caffeine and fluoride in tea would be a rather simplistic measure.

The fluoride does actually accumulate in the plant from soil sources where the natural content is high or could also come from areas irrigating with fluoridated water as here in the US.

Here's the link to the report on fluoride... if you want to learn more. There is a section describing Dr. Kennedy's work with the Fluoride Action Network when they went to China to observe the cases of osteoporosis caused by high levels of fluoride in the ground. [www.afibbers.org]

I'm compiling a private message to you and will send shortly.

Jackie

She is not drinking either of black, green or white tea due to the nasty reactions she had to them. She is drinking tea from other types of plants.
Unfortunately she does not feel to drink water. I may have some solutions for that but I need to see her, talk to her and see what solution works best in her case.

My belief is that first one needs to change the mindset before changing a lifestyle, diet or treatment... In her case, if you don't get to the psychological level you won't be able to make real changes. I am very aware that not drinking enough and not drinking water is an important factor causing many problems, cause the body can't detox properly, can't hydrate properly and more. I will keep you posted. Next week I am going to see her and I'm already making some documents to print with translations of different information I've found so far to help her understand what is going on and why she should change things and how.

Jackie,

I've read today through more posts about different cases of AF, success stories and threads about magnesium.

My question to you is, in Nicole's case (my aunt), wouldn't it be more wise to fix first the H. Pylori infection and bring her gut bacteria back to normal and then see what type of magnesium really fits her and how much she should take daily?
She is going to take some form of magnesium daily anyway, but I've heard of different types and actually found tablets here in Romania, pretty cheap, with taurine included, it seems they also have magnesium glycinate. The amazing part is the reading for her I actually found out how to take care of myself too

I've found on this forum that Mastic Gum helped some treat H. Pylori infection and this may be an appropriate way for Nicole. She is not keen on using antibiotics (though I've treated myself with antibiotics but I don't have her health issues). We have here Mastic Gum from Secom and I saw that in combination with Jarodophilus Fos from Jarrow it is treated in 2 months.

After all I've seen so far, solving the GI issues actually is the starting point for solving other issues too, cause absorbtion of nutrients improves, the body can clean itself better and the immune system will function better.

Milk of Magnesia or ReMag - two things I am interested in and heard of here (I also read Dr. Dean's book and George's posts here on different types of Magnesium he is taking and how he and others felt with each) are quite expensive for us. But I will give it a shot and see which works at some point. Still, I am wondering when it is the right time to start with those, taking into account she is not drinking water as she should, and also her stomach is sensitive due to H. Pylori infection.

Another thing I am curious about and only time will tell, is the impact of MSM on her condition and calcification. I don't have calcification but other issues and I've experienced with it for the last 8 months.

From the online research and translations I am doing regarding the Cellular Matrix Study conducted by Patric McGean it is something to look into. Their report says that over 50 patients with cardiac disease didn't need heart surgery anymore. Now this is a very small number out of 100,000 or over members of the study all over the world, but still it is a thing that got me interested. It is not a panacea and nowhere no one states that, but it can be a foundation for health improvement from head to toe. (I'm testing it for the brain injury for my oldest son, along with other supplements/nutrients for the brain and body).
Being a blood thinner, alcalizer, anti-inflamatory and analgesic, tool for heavy metal detox inside the brain and any other part of the body, protector of stomach and intestinal tract lining and much more, in my opinion it should be beneficial.

One of the members on this forum said that MSM may not be as beneficial for all afibbers, refering to vagal ones. This idea is the first one I see online. I haven't seen much info on MSM and AF. It does have a good point, cause MSM brings you energy and wakes up your brain, your mind is much clear, your vision is much clear. [My guess is that this is why it is advised to start with very small doses and increase gradually and monitor your state closely. In some cases they needed 3 years to get out all the toxins in their body - in a healthy and balanced manner, not accelerating and blocking your system - and bring the body back to normal (I have a friend who may be such a case, intoxicated with bromide, glyphosate and who knows what other stuff in her life, including fluoride, and having a lot of health issues due to all that).]

Andrea - That was going to be my response to you..in the private message, but I'll post here.... Address the H. pylori immediately. Any underlying factor such as that will definitely influence overall health and can also be related to Afib. One of our former posters, Sharon Glass, found that H.pylori was behind her Afib and once she was free of that pathogen, the AF also resolved. She details her story in Conference Room 65 at this link: [www.afibbers.org] She did use Mastic Gum.

The fact that, fundamentally, afibbers are typically found to be low in magnesium gives that a priority for repletion. Starting should be with low doses and slowly increased since she has other health issues. Those core nutrients in The Strategy typically serve the average afibber very well, but varies obviously by individual, age, depletion status, interfering factors of metabolism, etc.

However, on the magnesium .... since she has the H.pylori - there will be stomach distress issues and bowel issues so you'll have to be very cautious in dosing with magnesium to avoid diarrhea.

Because she is using Sintrom – Acenocoumarol, you should not overload with nattokinase and risk blood over-thinning. Same for Krill or any other supplement that helps reduce platelet aggregation.

The calcifications are not uncommon in cases where magnesium is low and calcium supplements are used. With time, supplementing with K2 MK7, reductions in soft tissue calcifications do occur... slowly. A typical dose is 200 micrograms daily. It will also help with osteoporosis.
[www.menaq7.com]
[www.lifeextension.com]

This brings up the need to be conscious of tissue pH. If a diet metabolizes to acid ash, this causes the pulling of minerals from bone to alkalize the acid to prevent organ damage and this process results in bone thinning. The importance of alkalinity is detailed in this report, Alkalinity, pH, Healing and Voltage - The Inside Story... [www.afibbers.org] and a segment on this will be included in the upcoming revised version of The Strategy. Tissue alkalinity is critical to maintain health. One of the first books I read on this topic was Alkalize or Die by Theodore Baroody, DC, ND, Ph.D., Dipl. Acu [www.alkaway.com.au] I'm emphasizing this because it's one of the easiest things to do for the road back to health and the beneficial effects are far-reaching. Once tissues are alkaline, they respond far more easily to other treatments modalities.

You mention of MSM - which can be a very useful addition for some biochemistries. Those with sensitivities to sulfur may have less than satisfactory responses. However, this sulfur form works well for detoxification and lowering inflammation, making joints more comfortable and most importantly, helps in the production of the body's "master antioxidant" - glutathione - which is the topic of my next Healthy Aging Tips post... coming soon. As a note of interest, I can't take sulfur-containing drugs, but I use MSM very successfully and find it helps keep my aging body 'comfortable.'

Your research should also focus on the critical function of the mitochondria - especially in cardiac cells - and the production of cellular energy. Using CoQ10 in large doses is typically what's needed to enhance cardiac function along with d-ribose and carnitine and of course magnesium, potassium and taurine. I'll look up some of the links on previous posts for you. (be sure that sodium intake is low by comparison to potassium.... see this post on the importance of the Sodium/Potassium ratio for dietary intake as it relates to Atrial Fibrillation [www.afibbers.org]

These points are just a few of the useful things you can do behind the scenes to help support Nicole's health while she undergoes whatever measures her doctors take to manage the other conditions. Be aware that unless the doctors are also 'holistic' practitioners, it may fall on deaf ears to discuss these with them.

Hope this helps. There's a lot to bring up on this topic but this is a good start

Best wishes to both of you,
Jackie

Jackie,

Thank you for such a great answer, I will translate it and also study the links you gave me. I have few more questions and please bare with me and also no need to rush answering, I appreciate the time you are giving to give appropriate information.

MenaQ7 is what she started taking.
One important note is that for a day she has started taking Digoxin too, as she had both high blood pressure and pulse and went to ER where they recommened to increase her medication (but that didn';t help and she knew it would be worse), while on Digoxin she really feels much better.
Regarding MenaQ7 and her medication, can you tell me whether reacing 200mcg/day is safe in her case related to her anti-clotting medication? Yes, we do go gradually from 45mcg/day (1 cps) to 4 / day but how to do you when to increase the dosage and if it safe (meaning not interfering with your medication)?

One other things is related to electrolytes and sea salt/Himalayan salt. Dr. Dean wrote in her book about taking sea salt in water as one of the things to bring balance to electrolytes in body if I recall. What is your opinion so far on that? Is it safe to take? Or do you recommend adding trace minerals or drops in water instead of using sea salt?

I don't know if her doctor would be open to supplements intake but Nicole and I have to do what feels best for her and what really helps her. She prefers to use less drugs and find natural ways to cope so she is not going to stop taking what is useful, but also she is aware that no matter the side effects, the medication does help her. And though she is not keen on accepting surgeries, if she has to, I will be there for her and she will have the strength to do it as long as her body can stand the procedure.

Best wishes to you and all here on forum! All of you here stirr up great thinking and interest for those who want to improve their health

Andrea

Andrea - Yes, you can use the higher dosing with blood thinners but as always, it's best to start with a low dose to observe compatibility with whatever compound is being introduced.

Long ago, when K2 MK7 was being introduced, the standard dosing was 45 mcg...for prevention and double that for cases of soft tissue calcifications. Since then, the researchers at the University of Maastricht - specifically Professors Shurgers and Vermeer - have recommended increasing to 200 mcg as preventive for soft tissue calcifications...such as arteries, aorta, etc.

Keep in mind that this Vitamin K2 or menaquinone form (the MK7) does not function in the vitamin K clotting pathway or clotting mechanism. It targets circulating calcium and directs it to bone cells where it belongs and thus helps prevent it from depositing in soft tissue such as the arteries, aorta I referenced earlier. Here's a good report by cardiologist, William Davis, on K2 MK7 in Life Extension that helps clarify the use and action of K2 MK7. [www.lifeextension.com]

On the sea salt... The Celtic sea salt is preferred to Himalayan as much of that 'name brand salt' comes from mines that also have a high fluoride count; whereas, the Celtic does not. Unrefined Celtic salt is beneficial.... but one with afib or hypertension should be sure not to consume a lot of salt... In that Conference Room link on the sodium and potassium ratio (#72), you'll read that ideally the dietary intake of K:Na ratio is at least 4:1. Read at least the Introduction. The whole 70 pages is a really good resource to learn more about these critical electrolytes and why it's important to maintain the ratios... whether or not you are an afibber, but especially so for afibbers.

My personal preference is using Celtic salt and using powdered potassium gluconate in a shaker formerly used to salt and I also add that to food for taste and potassium repletion.

Very often, a combination of both the drugs and good dietary control plus targeted supplements offer the best approach with the fewest side effects. The idea is to learn what is the core cause of the particular ailment and then target what can be done to restore function through nutritional support and then, hopefully, the drugs intake can be minimized or eventually discontinued. That takes time.

Hope this helps.

Jackie

Andrea,

First - I didn't read all of your back and forth with Jackie - so if you already covered what I commented on, forgive me.

As to K2 & INR, yes it is an issue, but can be accounted for with increased warfarin dosage if the doctor is agreeable. Issue is since the warfarin acts by destroying vitamin K (K1 - clotting, K2- "telling calcium where to go"), there is a long term issue with more calcification because of the warfarin. There is a tradeoff - long term calcification vs. short term stroke risk. Not a great choice, but that's what it is.

It is standard to want someone anticoagulated for 3-4 weeks before cardioversion is attempted. The issue in your aunt's case how to maintain NSR if the cardioversion is successful. Because of the calcification, high BP and a significant time in permanent afib, this maintenance of NSR will be difficult.

If a water fast for a few days will drop her blood pressure (being mindful to reduce BP meds if it does), then a very low carb diet might be indicated for the BP. This is because low insulin (from fasting) signals the kidney to excrete sodium and it can be the sodium/potassium balance at the cause of the high BP. If so, then a low carb, modest protein diet could be used to maintain the low insulin and lower BP. This would at least remove one of the possible pathologies leading to afib. The caclification is hard to reverse in any case and especially in a short period of time.

George

Update about Nicole:

She went to ER last night. She had 160 pulse and entered flutter. At the hospital she met Dr. Ciocan, resident MD specialized in EP. She can do cardioversion too and told us to ask permission from Dr. Grecu (Nicole's main EP etc.). And I did, I called Dr. Grecu this morning and by January the 5th when Nicole is schedules for consulation at Dr. Grecu (she's booked this month), the other Dr. can do her best and try cardioversion.

Current diagnosis:
Sinus Node Disease and Bradytachycardia (this second diagnosis was not legible on paper but as it seems related to SND I think Nicole guessed right)
(I don't know what all these mean, of course, I will have to study...)

So till tomorrow afternoon (before the next consultation in town) Nicole's medication is this:
Ryrtmonorm (propafenone) 3 x / day
Sintrom - according to INR
For high blood pressure - Atacand (1 in the evening) and Leridip (1 in the morning)

This morning Nicole confessed that she may have a stress response issue. She may be very sensitive to stress. And she remember the endocrinologist saw in tests that her cortisol levels were high (815 - but I don't know the unit of measurement). And that doctor suspected that it was not organic but her sensitiveness and she got really scared - which she did and she is in general a person who becomes scared easily...
There is a test she is going to do to see if indeed it is organic or not.

NOTE: Her IBS started when she found out my mom died, in 1992.


Jackie,
I will continue to study what you recommended me. As always, you're a treasure of information!

George,
Thank you for posting, you and anyone else is always welcome to comment, I am taking notes and reading everything carefully and I always pass on to her everything new that comes up.
She told me she has been taking anti-clotting medication for the last 3 years.
I am aware of the things you mentioned in her case. Now she is hoping and in a better mood because she really likes the resident MD approach and attitude and trusts her too. So she is going to do what it takes to get her ready to try. Meanwhile, she is also taking supplements.


I will keep you all posted. Wish everyone here the best!

Andrea

Hi!

Update:
Natalie had electro-cardioversion yesterday (Wednesday, Dec 16th). From you I learnt that it may or may not be successful. In her case at the beginning seemed fine but things turned around:

Everything was fine till one moment this afternoon when suddenly her BP was 180. Both she and the nurse got scared (I wasn't there, I found out a bit later). They gave her Nitroglycerine IV and the BP lowered on to rise again. Then they gave her Enalapril and Betalok and something else. Still BP was high. Only after she took Atacand and Leridip her BP was 126.
She has also started taking Eliquis for blood clotting.

Natalie says she feels something is not ok at the heart.

I don't know if it matters but she didn't drink much after the cardioversion. Only today she started drinking more tea and during the night she'll drink water.

Andrea