Lurker, in Chronic afib, Bisoprolol vs. Digoxin or ...

Hello from Buenos Aires, Argentina. So immensely grateful for all the wonderful people and information here. Been lurking since I was diagnosed as in chronic afib (on EKG), mid March by a cardiologist. I consulted because stairs suddenly became an issue. Mid May with lab and echocardiogram results I continued in afib (EKG). Cardiologist prescribed anticoagulants and Bisoprolol (5 mg) to try. She said my heart was OK, my liver enzymes were a wee bit high and, that if this failed, she'd try something "more drastic". I decided to look further.
In 2012 I had already rejected amiodarone and statins for "palpitations", afib wasn't mentioned.
From lurking here I decided to look for an MD to help me follow the Protocol, but for now I've only found a clinician who teaches "Physiological / Nutritional Medicine", and "Natural Recovery from Cardiovascular Diseases" including Arrhythmias. He also has a background in Homeopathy.
After a month on capsules that helped quite a bit, but did not of course affect the chronic afib, this clinician now suggests Digoxin, but based on the pulse reading (under 100) from his blood pressure gadget! He didn't listen when I suggested the gadget merely multiplies a fractional reading to reach a "60 seconds" reading. How could I know, right?
I'm 65, tall and thin, too thin, never could put on weight. I have low blood pressure, and MVP.
I'm taking, twice a day:
1 tsp Primrose oil, 1 tsp Chia oil and 1 tsp soy lecithin.
Capsule 1: G. Biloba / Blueberry / Aloe Vera / Manitol / L5(HO)Triptophane / GABA - Taurine / NAC - L. Arginine / L Glutamine - L. Carnitine / Lysine - Proline / Thea Simensis / Mg Carbonate / Selenium / Vitamin E - D3 / B. Carotene / Shark / Maca / B Complex
Cap 2: Vitamin C / Bromelain / Hawthorn (Crataegus) / ATP / "Heart" / DMEA - PABA / Alpha Lipoic Acid
Cap 3. Curcumin / Ginger / DHEA / Cinnamonium / NADH
I'm stuck because the capsules *have* helped overall and I'm not yet in a position to argue with a clinician about not taking digoxin.
Any suggestions?
ginny

Hi Ginny,

If you've been in afib some time, it is really unlikely a med will convert you to NSR. Electro cardioversion may work, but I'd say it is a long shot. 12 years ago, I was first in afib and having a discussion with an EP about cardioversion. He said he'd do it but he didn't have a good plan to keep me in NSR after. I'd had afib for a few months and this was a couple months in to what turned out to be a 2 1/2 month episode. At that time, he didn't want an ablation for me nor did he think my sub 100 afib heart rate warranted the risks/side effects associated with rhythm meds. I proposed a plan to convert me and I'd keep myself in rhythm with electrolytes. I also proposed he prescribe flecainide (a 200 mg dose for those <70 kg, 300 mg for those over 70 kg) to be used on-demand if/when my electrolyte plan failed. He agreed and I've been doing that ever since. My electrolyte plan is magnesium to bowel tolerance (currently about 3.2 g/day, has been as high as 5 g/day), 4 g of taurine/day and has included a couple of grams of potassium as citrate, but not doing that right now as my serum potassium is fine without it.

The cardio I saw before the EP (same office) wanted to prescribe Digoxin, but I refused. I'd learned it wasn't usually helpful for afib and could be counterproductive.

If a conversion is tried and doesn't "stick," your afib heart rate isn't that high (though I'd like a rate off an ECG), maybe adding in a calcium channel blocker. If you do try conversion, you do need a plan (like my flecainide) to deal with a reversion to afib.

Your low blood pressure/ MVP could indicate low blood volume, see: <[www.afibbers.org]

See Pat Chambers, MD ("PC")'s post on MVP <[www.afibbers.org]

George

Hello Ginny - Here are links to posts here on Digoxin... which should give you plenty of reason to support your decline for using that drug ...starting with the one by Hans Larsen titled, Digoxin: The Medicine from Hell? [afibbers.org]

[www.afibbers.org]
[www.afibbers.org]
[www.afibbers.org]
[www.afibbers.org]
[www.afibbers.org]

If you do a Google search on MVP and arrhythmia, you'll find numerous studies showing the prolapsed can cause arrhythmia.

As George indicates, a focus on electrolytes important to the heart's electrical stability is often very successful in maintaining NSR...especially important to reduce dietary sodium and do not use supplemental calcium. Magnesium is not easy to replete from food sources alone; however, potassium is much easier. As always, be sure you have healthy kidney function.

Jackie

Hello George and Jackie,
Many thanks for your replies helping me as a back up to the questioning of "easy conversion" via meds, and betting on electrolytes. They really help.
I'll be spending even more time reading up on all your suggestions.
Thank you!
ginny

Hello Jackie,
you say "especially important to reduce dietary sodium and do not use supplemental calcium."
The capsules I am taking were reformulated (I was having overly soft and frequent stools) and *unfortunately* this MD included
(each capsule is 1/4 of a dose and I'm to take 2 a day)
Calcium carbonate 300 mg
and
Potassium gluconate 300 mg
Would (I'm supposing) 150 mg calcium a day as supplement be *too* much?
Many thanks,
ginny

Ginny - The the calcium intake at 150mg seems very low... but it could still 'over power' the magnesium you are taking, especially, if the form of magnesium is not adequately bioavailable to access inside the cells. Calcium tends to dominate over magnesium and is considered "excitatory." Generally, afibbers should avoid calcium supplements.

Actually, cardiologist, Thomas E. Levy, MD, JD... in his book Death by Calcium (2013)... makes the case that no one should take supplemental calcium and explains the detrimental effects of supplemental calcium as the focus of the book.

Additionally, I'll just share that when my afib first began many years ago, I became aware that every time I took my calcium supplement at bedtime (for bone health maintenance- as suggested by my MD at the time), I would develop AF during the night. On the nights when I didn't take the supplement, no afib. Could have been coincidence, but I doubted it then and still do, since I learned eventually, I was low in intracellular magnesium.

Does the label on the supplement you are using state the form of magnesium... such as magnesium carbonate, magnesium glycinate, magnesium gluconate, magnesium citrate... etc? How much in milligrams do you take a day?

Jackie

Jackie,
Thanks for your answer.
The second batch of capsules I've started with now include Magnesium carbonate 300 mg, as well as 300 mg of Calcium carbonate and 300 mg Potassium gluconate.
I would hope to supplement with Waller Water, but the issue becomes how to distinguish between soft stools from magnesium (I tried Epsom foot baths before starting these capsules) and soft stools from these capsules. This MD changed a few things on account of the soft stools *and* added the calcium and potassium.
I originally had spoken *against* calcium to him which is why he didn't include it in his first batch.
He, of course, paid no attention to my mentioning magnesium, my intake of calcium from yoghurt and how I thought I had set off this event last February (I drank 5 (five) cups of umeboshi tea - salt! cured Japanese berries).
The first capsules did help with palpitations and allowed me to sleep for 3 or 4 hours at a time and *go back* to sleep. Before these capsules I was sleeping 2 hours, awake another 2 hours, dozing 2 hours, left side, right side, etc.
Any suggestions are very welcome,
Thanks,
ginny

Ginny - Indications are that umeboshi plums are very salty. If true, that would not be a good thing for an afibber to be consuming because of the potassium depletion.

Also if you continue with the capsules with the calcium carbonate, then cut back on your dietary intake of calcium from yogurt and other sources. Best would be just be taking plain magnesium supplements. Refer to the post just previous to your entry... by Flowmaster on Exatest results ... for my comments about magnesium and calcium.

Jackie

Jackie,
Many, many thanks for your reply.
ginny