Can’t figure out the triggers August 22, 2018 09:55PM |
Registered: 5 years ago Posts: 45 |
Re: Can’t figure out the triggers August 22, 2018 10:32PM |
Registered: 8 years ago Posts: 1,102 |
Re: Can’t figure out the triggers August 22, 2018 11:42PM |
Registered: 5 years ago Posts: 45 |
Re: Can’t figure out the triggers August 23, 2018 12:03AM |
Registered: 6 years ago Posts: 920 |
Re: Can’t figure out the triggers August 23, 2018 12:48AM |
Registered: 5 years ago Posts: 129 |
Quote
wolfpack
It sounds like vagally-mediated AF due to chronic fitness (something I know something about).
Re: Can’t figure out the triggers August 23, 2018 04:21AM |
Registered: 9 years ago Posts: 1,087 |
Re: Can’t figure out the triggers August 23, 2018 06:26AM |
Registered: 7 years ago Posts: 218 |
Quote
The Anti-Fib
Did you ever follow up on an Endocrine/Cortisol check-up, as suggested in in your earlier Post? A Saliva Cortisol 4X/day test would tell what is going on with Adrenal output. The fact that you can sense it coming on several hours prior suggests some sort of intermittent Hormonal or Electrolytic imbalance. I had intermittent periods of Adrenal Suppression which triggered AFIB. I felt wiped out and unsually tired for about a day prior to my episodes.
Re: Can’t figure out the triggers August 23, 2018 07:40AM |
Registered: 9 years ago Posts: 1,087 |
Quote
hwkmn05
Did you ever follow up on an Endocrine/Cortisol check-up, as suggested in in your earlier Post? A Saliva Cortisol 4X/day test would tell what is going on with Adrenal output. The fact that you can sense it coming on several hours prior suggests some sort of intermittent Hormonal or Electrolytic imbalance. I had intermittent periods of Adrenal Suppression which triggered AFIB. I felt wiped out and unsually tired for about a day prior to my episodes.
What is the treatment/med or protocol you use for adrenal fatigue or high cortisol levels at night?
Re: Can’t figure out the triggers August 23, 2018 08:40AM |
Registered: 5 years ago Posts: 45 |
Quote
Pompon
Your doc is right when he wants having you back in NSR as soon as possible. Waiting is usually bad because the longer you're in afib, the more likely afib would worsen.
Re: Can’t figure out the triggers August 23, 2018 08:51AM |
Registered: 5 years ago Posts: 45 |
Quote
The Anti-Fib
Did you ever follow up on an Endocrine/Cortisol check-up, as suggested in in your earlier Post? A Saliva Cortisol 4X/day test would tell what is going on with Adrenal output. The fact that you can sense it coming on several hours prior suggests some sort of intermittent Hormonal or Electrolytic imbalance. I had intermittent periods of Adrenal Suppression which triggered AFIB. I felt wiped out and unsually tired for about a day prior to my episodes.
Re: Can’t figure out the triggers August 23, 2018 10:06AM |
Registered: 8 years ago Posts: 1,102 |
Re: Can’t figure out the triggers August 23, 2018 10:19AM |
Registered: 8 years ago Posts: 1,102 |
Quote
bolimasa
Curious I'm trying to get a handle on "vagally-mediated"
Is there a reason the chronically fit people would have vagally mediated afib? (reference?)
Was there something in his description of his symptoms that would indicate it is vagal? I guess I don't really how people tell vagal from non.
Which gets around to another question I've been having... there are all these things that seem to associate with afib... hypertension, obesity etc.
But of course association and causation are two different things.
I can see that that if longstanding hypertension has damaged (enlarged etc) your heart, that may be causative for afib. But say you are hypertensive and your heart is still normal, is it really the hypertension causing afib? Or is it merely associated, but not causative?
Re: Can’t figure out the triggers August 23, 2018 10:31AM |
Registered: 7 years ago Posts: 218 |
Quote
wolfpack
Beardman,
Your EP is really just following standard procedure for paroxysmal AF patients. It's cardioversion within 48 hours of onset, followed by anticoagulation and AAR/rate control meds. He isn't using you as a "guinea pig" by any means. I can certainly understand not wanting to do that on your part, but do bear in mind that you really want to minimize the time in AF or else it will just get worse. 2 days on, 3 days off is actually a fairly high burden. I know you've said the rate isn't terribly high during an episode, but it will still "wear" on the ventricles after some time.
Re: Can’t figure out the triggers August 23, 2018 10:45AM |
Registered: 7 years ago Posts: 218 |
Quote
The Anti-Fib
Did you ever follow up on an Endocrine/Cortisol check-up, as suggested in in your earlier Post? A Saliva Cortisol 4X/day test would tell what is going on with Adrenal output. The fact that you can sense it coming on several hours prior suggests some sort of intermittent Hormonal or Electrolytic imbalance. I had intermittent periods of Adrenal Suppression which triggered AFIB. I felt wiped out and unsually tired for about a day prior to my episodes.
What is the treatment/med or protocol you use for adrenal fatigue or high cortisol levels at night?
I didn't have high levels at night, more on the low side. I was running out of Cortisol especially upon Stressful situations. I have a relatively rare condition of constant Thirst, and I was drinking way too many fluids, and was flushing out the Cortisol in my Urine. As for a treatment, I try to cut down on Water intake, even if I'm thirsty. Also I stopped taking Prednisone and getting Steriod injections for inflammation. I was intermittently taking the potent Drug Prednisone (boosts Cortisol) for Inflammation, and when I stopped taking it, my body did not make enough of its own Cortisol, and I had low Cortisol output for 7-10 days causing the "Adrenal Suppression" which triggered my AFIB. Now if i feel wiped out, I take a low dose of Hydrocortisone (Stress Dosing) to temporarily boost up my Cortisol levels. I have been doing well since I made this change. Almost 10 years into AFIB, never been doing better. No Ablation or Anti-Arrythmics.
Re: Can’t figure out the triggers August 23, 2018 10:54AM |
Registered: 6 years ago Posts: 18,881 |
Re: Can’t figure out the triggers August 23, 2018 12:31PM |
Registered: 5 years ago Posts: 45 |
Quote
Jackie
Joel/Beardman - The Adrenotone may be too stimulating... esp. in combo with L-arginine. The Adrenotone product data sheet has this notation:
Advise patient to discontinue use and consult you if they experience sleeplessness, headache or
heart palpitations when using Adrenotone™.
You should consider cutting back on the arginine as well as that can be too stimulatory for some individuals .... (or just stop completely for a while).
Also - what's your source of magnesium ? Most people can't get enough from food and supplements are needed. Have you assessed your daily intake of potassium from food sources? Those who do endurance athletics and also are plagued by arrhythmia and/or ectopy need to be sure they have the right balance of electrolytes that affect heart cell function.
Jackie
Re: Can’t figure out the triggers August 23, 2018 04:13PM |
Registered: 11 years ago Posts: 4,228 |
Quote
beardman
Your doc is right when he wants having you back in NSR as soon as possible. Waiting is usually bad because the longer you're in afib, the more likely afib would worsen.
I understand this, but with the ability to convert on my own, I just didn't feel it was necessary. I am usually in NSR for 3-4 days at a clip and then out for 1-2 days.
Re: Can’t figure out the triggers August 23, 2018 04:25PM |
Registered: 9 years ago Posts: 1,087 |
Quote
wolfpack
Beardman,
Your EP is really just following standard procedure for paroxysmal AF patients. It's cardioversion within 48 hours of onset, followed by anticoagulation and AAR/rate control meds. He isn't using you as a "guinea pig" by any means. I can certainly understand not wanting to do that on your part, but do bear in mind that you really want to minimize the time in AF or else it will just get worse. 2 days on, 3 days off is actually a fairly high burden. I know you've said the rate isn't terribly high during an episode, but it will still "wear" on the ventricles after some time.
Re: Can’t figure out the triggers August 23, 2018 04:30PM |
Registered: 11 years ago Posts: 4,228 |
Quote
bolimasa
It sounds like vagally-mediated AF due to chronic fitness (something I know something about).
Curious I'm trying to get a handle on "vagally-mediated"
Is there a reason the chronically fit people would have vagally mediated afib? (reference?)
Was there something in his description of his symptoms that would indicate it is vagal? I guess I don't really how people tell vagal from non.
Quote
bolimasa
Which gets around to another question I've been having... there are all these things that seem to associate with afib... hypertension, obesity etc.
But of course association and causation are two different things.
I can see that that if longstanding hypertension has damaged (enlarged etc) your heart, that may be causative for afib. But say you are hypertensive and your heart is still normal, is it really the hypertension causing afib? Or is it merely associated, but not causative?
Re: Can’t figure out the triggers August 23, 2018 04:34PM |
Registered: 5 years ago Posts: 45 |
Quote
GeorgeN
Your doc is right when he wants having you back in NSR as soon as possible. Waiting is usually bad because the longer you're in afib, the more likely afib would worsen.
I understand this, but with the ability to convert on my own, I just didn't feel it was necessary. I am usually in NSR for 3-4 days at a clip and then out for 1-2 days.
I would say that an electro cardioversion would be pointless, it would shorten that event but won't likely prevent the next one. You need a plan to stay in rhythm after you convert.
You don't want meds, but perhaps flecainide on demand might do a quick conversion. Not a forever solution, but at least would minimize the AF burden while you try to figure out triggers.
Even though exercise will convert you, it is also likely part of the problem. It certainly was for me <[www.afibbers.org]
George
Re: Can’t figure out the triggers August 23, 2018 04:41PM |
Registered: 11 years ago Posts: 4,228 |
Quote
beardman
I consume 1,000-1,500 MG of calcium a day, maybe that’s too much and I could try cutting down. I eat a Keto/vegetarian diet though, so I am sourcing most of my fat content from dairy.
Re: Can’t figure out the triggers August 23, 2018 04:53PM |
Registered: 5 years ago Posts: 45 |
Quote
GeorgeN
I consume 1,000-1,500 MG of calcium a day, maybe that’s too much and I could try cutting down. I eat a Keto/vegetarian diet though, so I am sourcing most of my fat content from dairy.
From my experience, I'd stop the Ca++ completely. Now. When I was overeating Ca++ , I had many more triggers. I'm much more robust without it.
How much is too much exercise is too much is likely very individual.
In your shoes, I'd cut the Ca++ and also go to no material exercise and see what happens. If all is good, then I'd gradually add in exercise and see what level is triggering. I'm an "endpoint" guy. I like to start from known "good" and then work from there. Hence I'ld try ditching the Ca and the exercise and see what happens. If it is all good, then you can add back. If that doesn't do it, then you have to think what your next step is.
George
Re: Can’t figure out the triggers August 23, 2018 06:50PM |
Registered: 11 years ago Posts: 4,228 |
Quote
beardman
I’ll try dropping my cheese/dairy intake and see what that does for a week or so.
Re: Can’t figure out the triggers August 24, 2018 05:49AM |
Registered: 5 years ago Posts: 45 |
Re: Can’t figure out the triggers August 24, 2018 09:45AM |
Registered: 6 years ago Posts: 18,881 |
Re: Can’t figure out the triggers August 24, 2018 10:56AM |
Registered: 6 years ago Posts: 444 |
Quote
Jackie
Beardman - your intake of calcium... I consume 1,000-1,500 MG of calcium a day is very high.
You need to cut back to under 500 mg or less... on a permanent basis.
Re: Can’t figure out the triggers August 24, 2018 11:22AM |
Registered: 8 years ago Posts: 1,102 |
Re: Can’t figure out the triggers August 24, 2018 11:36AM |
Registered: 5 years ago Posts: 129 |
Quote
wolfpack
Curious I'm trying to get a handle on "vagally-mediated"
Is there a reason the chronically fit people would have vagally mediated afib? (reference?)
Was there something in his description of his symptoms that would indicate it is vagal? I guess I don't really how people tell vagal from non.
Which gets around to another question I've been having... there are all these things that seem to associate with afib... hypertension, obesity etc.
But of course association and causation are two different things.
I can see that that if longstanding hypertension has damaged (enlarged etc) your heart, that may be causative for afib. But say you are hypertensive and your heart is still normal, is it really the hypertension causing afib? Or is it merely associated, but not causative?
[www.ncbi.nlm.nih.gov]
Vagally-mediated AF is characterized by episodes beginning at rest, often nighttimes, or post-prandially. It is likely an imbalance in autonomic nervous system within the atria in which the parasympathetic (vagal) nerves overwhelm the sympathetic nerves. It is a common side-effect of exercise (AF is something like 5x more prevalent in the athletic community versus the general population).
Think of it like this - when you condition the heart to pump blood very efficiently, my guess is that it needs to retain the ability to "go slow" more than it needs the ability to "go fast" because everyone spends more time at rest than they do at activity. Even if a runner, swimmer, or cyclist spends 1 or 2 hours a day with an elevated pulse due to activity, that still leaves 22-23 hours a day where the heart output needs to meet the lower oxygen demands of being at rest. So to keep the blood pressure low enough, the body will create more parasympathetic tone in the heart to signal the atrial cells to be more refractory (slow down).
In a nutshell, if you're going into AF when you're exerting yourself, you're not vagal. You're adrenergic, or possibly mixed.
Re: Can’t figure out the triggers August 24, 2018 11:40AM |
Registered: 6 years ago Posts: 444 |
Re: Can’t figure out the triggers August 24, 2018 12:55PM |
Registered: 6 years ago Posts: 18,881 |
Re: Can’t figure out the triggers August 24, 2018 01:07PM |
Registered: 9 years ago Posts: 182 |
Quote
Jackie
Beardman - your intake of calcium... I consume 1,000-1,500 MG of calcium a day is very high.
You need to cut back to under 500 mg or less... on a permanent basis. ... because calcium is excitatory to cells... that includes heart cells. And it will dominate over magnesium... (which is calming or relaxing)..... If your magnesium intake is consistently low, then that explains the problems you are experiencing. Most afibbers need to supplement with magnesium continually... especially those who are heavy exercisers.... and it needs to be the form of magnesium that reaches the interior of the cell without interference.
There is a book written by a cardiologist... Thomas E. Levy, MD, JD... titled Death by Calcium.... and he goes into all the details as to why calcium intake is so detrimental to the body on many levels. We need some calcium but not nearly the amount that many people take in daily.
Jackie
Re: Can’t figure out the triggers August 24, 2018 01:37PM |
Registered: 9 years ago Posts: 1,087 |
Re: Can’t figure out the triggers August 24, 2018 01:45PM |
Admin Registered: 6 years ago Posts: 5,357 |
Re: Can’t figure out the triggers August 24, 2018 02:33PM |
Registered: 6 years ago Posts: 444 |
Quote
Jackie
Myth #1 "Calcium supplementation and increased dietary calcium are good for you"
Myth #2 "You cannot get enough calcium in your diet without dairy products."
Myth #3 "Everyone with osteoporosis has a calcium deficiency"
(3 out of 8 elaborations)
Dr. Levy is not alone in presenting the risks of excess calcium in the body. Fortunately, there are many medical professionals giving similar advice and precautions based on the science. The problem is basically, that it's easy to get a lot of calcium from common dietary intake.
Re: Can’t figure out the triggers August 24, 2018 03:08PM |
Registered: 8 years ago Posts: 1,102 |
Quote
bolimasa
Thanks for the info.
And thanks for the new to me word - "prandially" I'd never heard that one before, and always enjoy an opportunity to learn a new word.
Your description makes me wonder if I am 'mixed'.
Certainly my medical test indicated Afib under exertion, Kinda makes me wonder if this relates to me being a "bad uphill girl" something I've struggled with my whole life. Has my heart always gone a little wacky when I hit that certain exertion point? I wish there was a way to know.
It would be easier to figure all this out if I could really tell when I am in afib... I also wonder about the vagal issue. One odd thing I've been trying to figure out is if there is a link between my pulsitile tinnitus and my afib... I started getting the pulsitile tinnitus ~ 2 years prior to my afib diagnosis. I don't have it all the time, or at least don't notice it all the time, but when I do hear it is when I rest on my couch in the evening and when I go to bed. Now I'm wondering if I am more afibby at this time. I have also noticed that of the few times I could really tell I am in afib, those events happened at night in bed.
Maybe none of this **really** matters... but maybe it would be good for me to understand my patterns (if they exist) so I can best assess my ablation recovery.
Re: Can’t figure out the triggers August 24, 2018 03:49PM |
Registered: 5 years ago Posts: 129 |
Quote
wolfpack
From what you've described - going into AF during the stress echo test - I'd say you're at least adrenergic and possibly "mixed".
It isn't really going to matter much to the EP ablationist. It doesn't change his strategy. My experience post-ablation is that if bad things are going to happen, they're going to happen differently than before anyway. It makes sense to me that if you've altered the electrical substrate of the atria with burns then it's going to behave differently afterwards. If you had an ablation and found yourself as symptomatic as before and with the same trigger patterns, I'd take that as a pretty strong indication that the ablation was a) PVI-only and b) not anwhere near transmural. In other words, a failure probably done by a less experienced operator. (Your EP, Dr. Marrouche, does not fit into this category so no worries there).
Re: Can’t figure out the triggers August 24, 2018 07:44PM |
Registered: 5 years ago Posts: 45 |
Quote
The Anti-Fib
Beardman:
'My EP suggested that I take flecainide, but cautioned me that I absolutely couldn’t take it before the cardioversion as it could put me into NSR which could throw a clot. I know they are going by the book and I don’t want a stroke, but I just wish I could find the balance a little better."
Are you misunderstanding what your EP said? The whole point of taking a AAM like Flecainide is to convert to NSR, and avoid ECV's. Throw a Clot? the chances of that are much higher with an ECV, as the massive jolt from the Shock might dislodge a a Clot attached to the Wall of the Heart. Also, you are already Self-Converting 1-2 times a week anyway, why would your Dr. be extra concerned about Self-Conversion prior to a scheduled ECV? Iv'e had several times where I had an ECV scheduled while taking Flecainide, then in final hours before the ECV was to happen, I Self-Converted back to NSR. My EP and everyone was jubilant that I didn't need to follow through with the ECV. Maybe your Dr. wanted to have an TEE Echo done before the ECV, to check the Atria for Clots, but he could have ordered this without an ECV.
Re: Can’t figure out the triggers August 24, 2018 07:50PM |
Registered: 5 years ago Posts: 45 |
Quote
Carey
I suspect he's being required to take anticoagulants for three weeks prior to the cardioversion to give any existing clots time to dissolve. That's standard procedure. So what his EP is saying is don't take flecainide until that time period has passed. You definitely don't want to convert to NSR by any means when you've got a clot lurking in your left atrium.
Another option would be to do a TEE to see if there is a clot, and if not going ahead with the cardioversion right away. That's what I would ask them to do.
Re: Can’t figure out the triggers August 24, 2018 08:03PM |
Registered: 5 years ago Posts: 45 |
Quote
Jackie
Beardman - your intake of calcium... I consume 1,000-1,500 MG of calcium a day is very high.
You need to cut back to under 500 mg or less... on a permanent basis. ... because calcium is excitatory to cells... that includes heart cells. And it will dominate over magnesium... (which is calming or relaxing)..... If your magnesium intake is consistently low, then that explains the problems you are experiencing. Most afibbers need to supplement with magnesium continually... especially those who are heavy exercisers.... and it needs to be the form of magnesium that reaches the interior of the cell without interference.
There is a book written by a cardiologist... Thomas E. Levy, MD, JD... titled Death by Calcium.... and he goes into all the details as to why calcium intake is so detrimental to the body on many levels. We need some calcium but not nearly the amount that many people take in daily.
Jackie
Re: Can’t figure out the triggers August 24, 2018 09:23PM |
Registered: 8 years ago Posts: 1,102 |
Quote
beardman
The plan was for a TEE and then a ECV, since my chads vasc score is zero it seemed than my stroke chances were actually higher while taking the meds the EP and other cardiologist wanted me on. The stroke chances also appeared to be higher having an ECV done as aposed to just waiting for me to naturally convert. The EP said that my stroke chances where the same no matter how the conversion occurred. He said it didn’t matter if it was an EVC, drug induced or naturally occurring. That statement just didn’t make sense to me and the statistics that I read after the fact didn’t seem to match up either. Again, I am not looking for a stroke, but it just seems like the advice being given is all based on liability.
Re: Can’t figure out the triggers August 24, 2018 09:35PM |
Admin Registered: 6 years ago Posts: 5,357 |
Quote
beardman
The EP said that my stroke chances where the same no matter how the conversion occurred. He said it didn’t matter if it was an EVC, drug induced or naturally occurring.
Re: Can’t figure out the triggers August 24, 2018 10:08PM |
Registered: 8 years ago Posts: 1,102 |
Re: Can’t figure out the triggers August 25, 2018 12:47AM |
Registered: 6 years ago Posts: 444 |
Quote
beardman
Beardman - your intake of calcium... I consume 1,000-1,500 MG of calcium a day is very high.
You need to cut back to under 500 mg or less... on a permanent basis. ... because calcium is excitatory to cells... that includes heart cells. And it will dominate over magnesium... (which is calming or relaxing)..... If your magnesium intake is consistently low, then that explains the problems you are experiencing. Most afibbers need to supplement with magnesium continually... especially those who are heavy exercisers.... and it needs to be the form of magnesium that reaches the interior of the cell without interference.
There is a book written by a cardiologist... Thomas E. Levy, MD, JD... titled Death by Calcium.... and he goes into all the details as to why calcium intake is so detrimental to the body on many levels. We need some calcium but not nearly the amount that many people take in daily.
Jackie
It just dawned upon me that when I was originally diagnosed I was eating a completely vegan diet so I can only figure that my calcium intake was almost if not zero. I will definitely be trying a drastic reduction in ca since it is an easy test. Thank you for the advice.
Re: Can’t figure out the triggers August 25, 2018 04:14AM |
Registered: 9 years ago Posts: 1,087 |
Quote
beardman
Carey said:
I suspect he's being required to take anticoagulants for three weeks prior to the cardioversion to give any existing clots time to dissolve. That's standard procedure. So what his EP is saying is don't take flecainide until that time period has passed. You definitely don't want to convert to NSR by any means when you've got a clot lurking in your left atrium.
Another option would be to do a TEE to see if there is a clot, and if not going ahead with the cardioversion right away. That's what I would ask them to do.
_______________________________________________________________________________________________
The plan was for a TEE and then a ECV, since my chads vasc score is zero it seemed than my stroke chances were actually higher while taking the meds the EP and other cardiologist wanted me on. The stroke chances also appeared to be higher having an ECV done as aposed to just waiting for me to naturally convert. The EP said that my stroke chances where the same no matter how the conversion occurred. He said it didn’t matter if it was an EVC, drug induced or naturally occurring. That statement just didn’t make sense to me and the statistics that I read after the fact didn’t seem to match up either. Again, I am not looking for a stroke, but it just seems like the advice being given is all based on liability.
Re: Can’t figure out the triggers August 25, 2018 04:35AM |
Registered: 12 years ago Posts: 247 |
Re: Can’t figure out the triggers August 25, 2018 05:03AM |
Registered: 9 years ago Posts: 1,087 |
Quote
beardman
Beardman:
'My EP suggested that I take flecainide, but cautioned me that I absolutely couldn’t take it before the cardioversion as it could put me into NSR which could throw a clot. I know they are going by the book and I don’t want a stroke, but I just wish I could find the balance a little better."
_______________________________________________________________________________________________
Anti-FIB:
Are you misunderstanding what your EP said? The whole point of taking a AAM like Flecainide is to convert to NSR, and avoid ECV's. Throw a Clot? the chances of that are much higher with an ECV, as the massive jolt from the Shock might dislodge a a Clot attached to the Wall of the Heart. Also, you are already Self-Converting 1-2 times a week anyway, why would your Dr. be extra concerned about Self-Conversion prior to a scheduled ECV? Iv'e had several times where I had an ECV scheduled while taking Flecainide, then in final hours before the ECV was to happen, I Self-Converted back to NSR. My EP and everyone was jubilant that I didn't need to follow through with the ECV. Maybe your Dr. wanted to have an TEE Echo done before the ECV, to check the Atria for Clots, but he could have ordered this without an ECV.
______________________________________________________________________________________________
Beardman:
I confirmed with the EP multiple times to make sure I understood. As I understand it though it is a by the book play as I had been out of NSR for longer than 48 hours.
Re: Can’t figure out the triggers August 25, 2018 08:46AM |
Registered: 5 years ago Posts: 45 |
Quote
The Anti-Fib
Beardman:
'My EP suggested that I take flecainide, but cautioned me that I absolutely couldn’t take it before the cardioversion as it could put me into NSR which could throw a clot. I know they are going by the book and I don’t want a stroke, but I just wish I could find the balance a little better."
_______________________________________________________________________________________________
Anti-FIB:
Are you misunderstanding what your EP said? The whole point of taking a AAM like Flecainide is to convert to NSR, and avoid ECV's. Throw a Clot? the chances of that are much higher with an ECV, as the massive jolt from the Shock might dislodge a a Clot attached to the Wall of the Heart. Also, you are already Self-Converting 1-2 times a week anyway, why would your Dr. be extra concerned about Self-Conversion prior to a scheduled ECV? Iv'e had several times where I had an ECV scheduled while taking Flecainide, then in final hours before the ECV was to happen, I Self-Converted back to NSR. My EP and everyone was jubilant that I didn't need to follow through with the ECV. Maybe your Dr. wanted to have an TEE Echo done before the ECV, to check the Atria for Clots, but he could have ordered this without an ECV.
______________________________________________________________________________________________
Beardman:
I confirmed with the EP multiple times to make sure I understood. As I understand it though it is a by the book play as I had been out of NSR for longer than 48 hours.
So your EP is saying that if a patient has been in AFIB>48 hours, that they must discontinue Anti-Arrthmics, as it it might convert them back to NSR, thus causing Stroke. An then the Patient undergoes TEE/ECV to get back to NSR.
If such a treatment protocol exists, someone please direct me to it. I've been in these scenarios many times, having 30 ECV's. Sure getting out of AFIB<48 hours is the Goal, but to suggest that we should avoid spontaneous self-conversions by withholding AAM's is new to me. At some point you have to try and get out of AFIB, it's not risk free.
In your case, it sounds like you've Already had 50+ self-conversions over the last year. This is why minimizing Stroke risk is important, and Dr's emphasize anti-coagulation especially for someone in out out of AFIB as much as you are.
Re: Can’t figure out the triggers August 25, 2018 12:15PM |
Registered: 6 years ago Posts: 18,881 |
Re: Can’t figure out the triggers August 25, 2018 12:30PM |
Registered: 6 years ago Posts: 18,881 |
Re: Can’t figure out the triggers August 25, 2018 12:31PM |
Registered: 6 years ago Posts: 706 |
Re: Can’t figure out the triggers August 25, 2018 12:37PM |
Registered: 6 years ago Posts: 444 |
Quote
Jackie
However, some forward-thinking doctors have asked...if you block the calcium, where does the excess calcium go? It gets deposited into arteries ... according to a paper presented at European Cardiology Society in Amsterdam noting CCBs caused 85,000 avoidable heart attacks and cases of heart failure each year.
Re: Can’t figure out the triggers August 25, 2018 12:49PM |
Registered: 6 years ago Posts: 444 |
Quote
Jackie
For those on vegan diets, there is more than abundant calcium content in the vegan foods to satisfy the body’s requirements so avoiding dairy isn't really a penalty that requires supplementation with extra calcium. The risks of too much calcium and especially in afibbers is real and correct from a basic, biochemistry standpoint.
Re: Can’t figure out the triggers August 25, 2018 01:54PM |
Registered: 6 years ago Posts: 920 |
Re: Can’t figure out the triggers August 25, 2018 02:27PM |
Admin Registered: 6 years ago Posts: 5,357 |
Quote
jpeters
Scary article on calcium channel blockers:
Quote
CONCLUSION:
Our study demonstrates that CCBs reduce the risk of all-cause mortality compared with active therapy and prevent heart failure compared with placebo. Furthermore, with the inclusion of recent trials, we confirm that they reduce the risk of stroke, also in comparison to angiotensin-converting enzyme inhibitors and do not increase the risk of cardiovascular death, myocardial infarction and major cardiovascular events.
Quote
Conclusions This large population-based study provides strong evidence that CCB use is not associated with an increased risk of cancer. The analyses yielded robust results across all types of cancer and different durations of exposure to CCBs.
Re: Can’t figure out the triggers August 25, 2018 02:43PM |
Registered: 6 years ago Posts: 444 |
Quote
Carey
Scary article on calcium channel blockers:
Until you notice that the newest research they relied on to arrive at the scary article is 18 years old and contradicted by larger, more recent studies. For example:
Re: Can’t figure out the triggers August 25, 2018 04:51PM |
Registered: 11 years ago Posts: 4,228 |
Re: Can’t figure out the triggers August 25, 2018 05:18PM |
Registered: 6 years ago Posts: 444 |
Re: Can’t figure out the triggers August 25, 2018 08:25PM |
Registered: 5 years ago Posts: 45 |
Quote
The Anti-Fib
Did you ever follow up on an Endocrine/Cortisol check-up, as suggested in in your earlier Post? A Saliva Cortisol 4X/day test would tell what is going on with Adrenal output. The fact that you can sense it coming on several hours prior suggests some sort of intermittent Hormonal or Electrolytic imbalance. I had intermittent periods of Adrenal Suppression which triggered AFIB. I felt wiped out and unsually tired for about a day prior to my episodes.
Re: Can’t figure out the triggers August 26, 2018 12:22AM |
Registered: 9 years ago Posts: 1,087 |
Re: Can’t figure out the triggers August 26, 2018 08:48AM |
Registered: 5 years ago Posts: 45 |
Quote
The Anti-Fib
Beardman:
I think every Dr. will want you on Blood Thinners. If it was only an episode every 2 months, then they would be more inclined to accept no Anti-Coagulation. Keep in mind when you are doing your research, that Paroximal AFIB could mean bi-monthly episodes, or 1-2 a week like yours.
The other thing is that you are relatively early in your discovery of your AFIB. You have done well and better than most in understanding this complex condition you have. Patience is warranted here. I still think you should medicate during episodes, and I stand by my post regarding this in your initial Thread several months ago.
Re: Can’t figure out the triggers August 26, 2018 10:16AM |
Registered: 8 years ago Posts: 1,102 |
Re: Can’t figure out the triggers August 26, 2018 11:16AM |
Registered: 5 years ago Posts: 45 |
Quote
wolfpack
Completely understand the frustration. Bear in mind, though, that we are all biologics and not machines. The same set of inputs does not always have to produce the same set of outputs. AF is a progressive disease. It will change over time. As things are today, there are really 3 choices for AF: don’t treat, medicate, ablate.
Eliquis has a reversal agent that was recently approved. It is called Andexxa. Your physician may not be aware of it yet. I’m not sure if there’s a big cost difference with respect to Pradaxa, though. It would be worth asking.
Re: Can’t figure out the triggers August 26, 2018 01:55PM |
Admin Registered: 6 years ago Posts: 5,357 |
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beardman
With the three different cardiologists and the EP that I saw, not one of them even asked about my diet. I was very clear with all of them that I kept very good records of everything and even asked if changes in my diet might help. I always received the blanket statement that eating better is always good for you . . . What is,”better” when you don’t know what I’m eating! Sorry for the vent.
Re: Can’t figure out the triggers August 26, 2018 03:45PM |
Registered: 10 years ago Posts: 1,748 |
Re: Can’t figure out the triggers August 26, 2018 04:09PM |
Registered: 6 years ago Posts: 444 |
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Elizabeth
Most doctors don't want to listen about diet as that isn't their business, they are in the business of handing out pills or (slash and burn) not trying to find out what is causing your problems.
Liz
Re: Can’t figure out the triggers August 26, 2018 08:43PM |
Registered: 9 years ago Posts: 1,087 |
Quote
beardman
Beardman:
I think every Dr. will want you on Blood Thinners. If it was only an episode every 2 months, then they would be more inclined to accept no Anti-Coagulation. Keep in mind when you are doing your research, that Paroximal AFIB could mean bi-monthly episodes, or 1-2 a week like yours.
The other thing is that you are relatively early in your discovery of your AFIB. You have done well and better than most in understanding this complex condition you have. Patience is warranted here. I still think you should medicate during episodes, and I stand by my post regarding this in your initial Thread several months ago.
I understand am trying to be patient with this, but as you all know it is tough. It is especially difficult for me when I appear to be doing to same thing and am receiving different results. I keep a journal of everything that I can think relates to this. My new things to make note of will be the calcium intake also any association with bradycardia and perhaps Hawthorne berry (Iv’e been doing a fair amount of reading on that as well).
From an outside point of view I don’t disagree with the medication. They would have just such a huge impact on my life being that they want me to stop any martial arts at all while on the blood thinners. On top of this, it seems that the pharmaceuticals are only a temporary solution for most people, especially when their younger. Oh, and then their is the huge cost as well. I requested a blood thinner that had a reversal agent, apparently that is only Pradaxa. It would cost around $600/month just for that. I think the flecainide was another $150 or so and I am supposed to take that twice daily everyday.
Re: Can’t figure out the triggers August 30, 2018 09:45AM |
Registered: 5 years ago Posts: 38 |
Re: Can’t figure out the triggers September 01, 2018 06:35AM |
Registered: 5 years ago Posts: 45 |
Quote
Dinodog
Hi Beardman-
I'm sorry you have to deal with this and understand it all too well. I just turned 45 so now how it is to get this diagnosis and feel like your life is in flux to say the least. Take the time to do some more reading, and I think you will likely conclude that an ablation is the way to go. You are young with a structurally sound heart so your success rate with a top EP will be very high. This is the best method of trying to get off these meds, at least temporarily. I've seen lots of people in your age group with years of med free NSR after a successful ablation. You will of course need to continue not to over-exercise and watch all of the other lifestyle factors- but that doesn't seem to be an issue for you. I don't see why you can't do martial arts on a blood thinner. If it's high contact then yes you might be banged up with bruises. The biggest risk would be hits to the head which hopefully isn't part of the protocol. I am snowboarding on a blood thinner. I don't go out on icy days, wear my helmet, and have a medical ID on me. My top EP advised me that the biggest risk is a bad head injury, and if you have one you'd be in trouble even if not on a blood thinner. I'm choosing to live my life with this diagnosis and try to accept it and move on. You are new to this and all of that will take time. But know that you can still do the things you love and will get through this.
Tracy
Re: Can’t figure out the triggers September 01, 2018 08:19AM |
Registered: 8 years ago Posts: 1,102 |
Re: Can’t figure out the triggers September 01, 2018 08:51AM |
Registered: 6 years ago Posts: 18,881 |
Re: Can’t figure out the triggers September 01, 2018 08:57AM |
Registered: 5 years ago Posts: 45 |
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Jackie
Beardman - The support factor is definitely an important part of the forum. Always has been. I'm pleased to see your cutting back on the Ca and arginine helped and as time goes on, you'll probably see continued stability but you also may need further reductions. What are the numbers of the herniated discs?
Jackie
Re: Can’t figure out the triggers September 01, 2018 02:56PM |
Registered: 6 years ago Posts: 18,881 |
Re: Can’t figure out the triggers September 01, 2018 03:05PM |
Registered: 5 years ago Posts: 45 |
Quote
Jackie
Beardman - oh - yeah ...well, too low in the spine.... I was curious to know if the disc issues were higher up and had some impingement in areas of the vagus nerve, but not down there. I certainly wish you every success with the procedure.
There are some specialists in this area that are injecting special forms of what I'll call "collagen" for lack of a better term...into areas to help regenerate discs which are the 'cushions' between the bones of the spine. The results are said to be amazing. I have no personal experience... just hearing from others. You definitely want to get those repaired as minimally invasive as possible...so you can get back to a normal, active life. Keep us posted.
Best to you,
Jackie
Re: Can’t figure out the triggers September 06, 2018 09:57AM |
Registered: 5 years ago Posts: 45 |
Re: Can’t figure out the triggers September 06, 2018 11:19AM |
Registered: 6 years ago Posts: 444 |
Re: Can’t figure out the triggers September 06, 2018 11:48AM |
Registered: 5 years ago Posts: 45 |
Quote
jpeters
"Calcium is especially important for athletes because they are more likely to lose calcium, as well as other minerals, through perspiration."
[www.uofmhealth.org]
Re: Can’t figure out the triggers September 06, 2018 01:09PM |
Registered: 6 years ago Posts: 18,881 |
Re: Can’t figure out the triggers September 06, 2018 01:43PM |
Registered: 5 years ago Posts: 45 |
Quote
Jackie
Beardman - Good you are getting rid of the excess calcium since anytime there is too much intracellular calcium... which is almost always the case with afibbers, there is also the finding that intracellular magnesium is low. The ratios of calcium-to-magnesium and potassium-to-sodium are established by fundamental biophysics... along with the calcium-to- sodium ratio that is often out of balance in those with hypertension.
Low magnesium causes many more health issues than arrhythmia... but like low magnesium causing muscle cramps, it definitely is attention getting.
Keep up the good work.
Jackie
Re: Can’t figure out the triggers September 06, 2018 02:19PM |
Registered: 6 years ago Posts: 444 |
Re: Can’t figure out the triggers September 06, 2018 02:50PM |
Registered: 5 years ago Posts: 45 |
Quote
jpeters
I have noticed a fair amount of muscle cramps lately, but I attributed that to my increase in biking at the gym. I swapped out running because of my back/leg issues for biking.
"Without enough calcium you may experience muscle cramps."
Re: Can’t figure out the triggers September 06, 2018 03:57PM |
Registered: 10 years ago Posts: 1,748 |
Re: Can’t figure out the triggers September 06, 2018 04:10PM |
Registered: 6 years ago Posts: 444 |
Re: Can’t figure out the triggers September 06, 2018 08:56PM |
Registered: 8 years ago Posts: 1,102 |
Quote
beardman
I have noticed a fair amount of muscle cramps lately, but I attributed that to my increase in biking at the gym. I swapped out running because of my back/leg issues for biking.
I do take a magnesium supplement and I also cut way back on my supplements, so maybe something there is off too. I am now taking
Nattokinase (2,000 FU 1x day)
Taurine (1,000mg 3x day)
Hawthorne Extract (300mg 3x day)
Chelated Magnesium Bisglycinate (200mg 2x day)
Re: Can’t figure out the triggers September 06, 2018 09:21PM |
Registered: 5 years ago Posts: 45 |
Quote
wolfpack
I have noticed a fair amount of muscle cramps lately, but I attributed that to my increase in biking at the gym. I swapped out running because of my back/leg issues for biking.
I do take a magnesium supplement and I also cut way back on my supplements, so maybe something there is off too. I am now taking
Nattokinase (2,000 FU 1x day)
Taurine (1,000mg 3x day)
Hawthorne Extract (300mg 3x day)
Chelated Magnesium Bisglycinate (200mg 2x day)
How about potassium? I had a hypokalemic paralysis event about 7 years ago and, in hindsight, it was preceded by several weeks of severe muscle pains.
Re: Can’t figure out the triggers September 09, 2018 09:16AM |
Registered: 6 years ago Posts: 18,881 |
Re: Can’t figure out the triggers September 19, 2018 06:25PM |
Registered: 5 years ago Posts: 45 |
Re: Can’t figure out the triggers September 06, 2019 03:21PM |
Registered: 7 years ago Posts: 218 |
Re: Can’t figure out the triggers September 07, 2019 09:05AM |
Registered: 5 years ago Posts: 45 |
Quote
hwkmn05
Cardiologist, Thomas E. Levy, MD, JD, in his book, Death by Calcium
Another great read by Dr. Thomas Levy is "Hidden Epidemic". A personal story of his own root canal teeth he believed to be the direct cause for his heart attack and other health issues until removal.