not new, but fast afib happening more often

Hello,

I had my first fast afib in October 2015, next one fall 2018, then Sept. 2019 and now Dec. 2019. I have worn a monitor twice (one for a month and one for a week) and it seems I feel it when it happens. These attacks involve high rate (150-190) and sometime slow bp (70 or 90 systolic) and sometimes high (157). I am always short of breath and have chest pain and a weird sensation in my throat. Ambulances (EMT and paramedics) have been involved all 4 times though this last time I tried a partial dose of diltiazem at home and it seemed to work, because the afib stopped while I sat in the ambulance and I went back inside )

I am not on a blood thinner as yet (CHADS 2 since I am over 65 and female but I have been told that the female part doesn't count anymore, essentially). No valve problems or hypertension and weight is low etc.

First episode trigger: flew across the country to help a daughter in health crisis so stress, dehydrated, took Sudafed that am, afib when lay down to sleep, lasted 45 minutes in ER

Second episode trigger: one of my kids staying with me has loud blood sugar alarm and was in the same room , again when I lay down to sleep and was just falling asleep so shocked; this one lasted 4 hours and they admitted me for observation

Third episode trigger: stressful situation between rentals, oil fumes nearby, again in bed but this time asleep and had a dream about heartbeat then realized it was real. Lasted an hour in ER.

Fourth episode trigger: Reclined on couch watching tv and dozing. GERD with burping and feeling of air trapped in esophagus. Having issues with GERD in general. Using zantac sparingly (despite recall) and swallowing inhaled steroid, and TUMS.

I take Magnesium 300 mg at bedtime and drink low sodium V-8 in the morning and do a lot of Tai Chi.

I want to try to address root causes before I am forced on a blood thinner (I have declined for 3 years). I do not take any meds but have bisoprolol and diltiazem in my bag. I cannot feel my arms on beta blockers. The ambulance and hospital use diltiazem for me but it sinks my blood pressure so I am leery of it. This last time I only took 1/4of a 30mg pill, not ER. I do try the Valsalva maneuver, and cold water.

What else should I be doing?

Like everyone, I would love to know when it is safe to try treating at home, since the fast heart beat causes symptoms that are a little scary.

Also, which Kardia device would be best, the one lead or the 6 lead. I cannot wear a SmartWatch because I am sensitive to EMF.

This all started after two things: a serious electric shock in 2013 that resulted in some loss of muscle control, and the inititation of a cancer drug that eliminates all estrogen in my body, back in 2015. The latter is more likely in terms of timing.

Thanks for any advice.

I'm pretty new to all this myself, but it sounds like you have adrenergic afib, meaning it fires up when adrenaline kicks in. Although you were resting in a couple cases, and going into it at rest is more indicative of vagal afib, it was being jolted to an awakened state that set you off. But the GERD is interesting. Stomach acid in the esophagus can piss off the vagal nerve and start afib. So maybe a little of both. It happens. That's my take at least. Controlling the acid is a good call. A beta blocker could help the adrenergic but of course you'll want a doctor to weigh in on all this.

Four episodes in five years isn't much compared to many. I was getting it once a year for eight years but like you, the frequency increased later. Very common with afib. Mine was hitting every few days the month before I had an ablation. I never went to the ER though. You've never converted back to normal rhythm on your own? With a crazy high heart rate like that, I can see that being scary. I've never had that. Just afib with a pretty normal rate.

There are some super knowledgeable people on here. They will hopefully offer insights. The forum is great for helping gain pspective and knowledge, and some peace of mind

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windyshores
I want to try to address root causes before I am forced on a blood thinner (I have declined for 3 years). I do not take any meds but have bisoprolol and diltiazem in my bag. I cannot feel my arms on beta blockers. The ambulance and hospital use diltiazem for me but it sinks my blood pressure so I am leery of it. This last time I only took 1/4of a 30mg pill, not ER. I do try the Valsalva maneuver, and cold water.

What is your objection to an anticoagulant? Stoke is the greatest risk with Afib and the new generation anticoagulants have very few or no side-effects for most. I take Eliquis with no side-effects—not even increased bleeding from cuts. Once you are diagnosed and the patient of an EP, it is good to make a plan with your EP about how to handle an episode. There is rarely the need to go to the ER once you work out a plan. Yes, diltiazem will lower your BP and HR—but that is what you want if you get a high HR and BP. The trick is finding the dose that makes you comfortable without tanking your BP. Since it takes a half hour or so for oral diltiazem to kick in, I was told to keep taking small doses until my systolic BP was got to 120. That would probably make you comfortable but may not convert you. If you don’t want to take an antiarrythmic daily to prevent episodes, have you talked to your doc about the pill-in-the-pocket approach? This is a large dose taken when you have an episode and will often convert you. Then at some point you may want to consider an ablation. We’d all like to get to the root of it, but unless you have something obvious going on like thyroid problems, low electrolytes, sleep apnea, etc. the causes aren’t yet known. Good luck!

Thanks all!

I have seen three cardiologists. I had a CHADS score of 1 until I turned 65. None of the docs at this point are pushing blood thinners, though this episode in the past week is MUCH closer to the last one. Until now, my episodes were every 3 years, then once a year.

My blood pressure runs low normally. So I don't take daily meds. I tried some diltiazem this last time, but only 1/4 of a 30mg pill without knowing my bp. When the paramedics did a push in the IV in September, my bp tanked. I just ordered a blood pressure cuff so I can tell if it is safe to take a diltiazem when this happens.

The problem is the tachycardia in terms of calling an ambulance. My symptoms are kind of dramatic. My EKG was "very ugly" according to ER doc. I actually, twice, have driven to the police station which isn't too smart. My daughter was visiting this week and made me call 911.

I am calm about all this, but trying to problem solve. I know I will need a blood thinner at some point. I do not have afib outside of these discrete events, 4 in 5 years, most lasting 45 minutes but one lasting 4 hours. And My afib is always like a big fish leaping around, with very fast heart beat.

My GERD is bad. I have no idea why. This evening I had the full feeling after eating, and made sure to sit upright. As soon as I lay down I felt palpitations.

If I were to buy a Kardia, would any of you suggest the Kardia 6 or is the Kardia 1 the best option still?

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windyshores
Thanks all!

I have seen three cardiologists. I had a CHADS score of 1 until I turned 65. None of the docs at this point are pushing blood thinners, though this episode in the past week is MUCH closer to the last one. Until now, my episodes were every 3 years, then once a year.

My blood pressure runs low normally. So I don't take daily meds. I tried some diltiazem this last time, but only 1/4 of a 30mg pill without knowing my bp. When the paramedics did a push in the IV in September, my bp tanked. I just ordered a blood pressure cuff so I can tell if it is safe to take a diltiazem when this happens.

The problem is the tachycardia in terms of calling an ambulance. My symptoms are kind of dramatic. My EKG was "very ugly" according to ER doc. I actually, twice, have driven to the police station which isn't too smart. My daughter was visiting this week and made me call 911.

I am calm about all this, but trying to problem solve. I know I will need a blood thinner at some point. I do not have afib outside of these discrete events, 4 in 5 years, most lasting 45 minutes but one lasting 4 hours. And My afib is always like a big fish leaping around, with very fast heart beat.

My GERD is bad. I have no idea why. This evening I had the full feeling after eating, and made sure to sit upright. As soon as I lay down I felt palpitations.

If I were to buy a Kardia, would any of you suggest the Kardia 6 or is the Kardia 1 the best option still?

Gastroparesis??? If so, you can find a way to mitigate or solve the problem.

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windyshores
My GERD is bad. I have no idea why. This evening I had the full feeling after eating, and made sure to sit upright. As soon as I lay down I felt palpitations.

My doc is Steven Gundry. In his book, "Longevity Paradox" he says, "Okay, okay, enough, you’re saying. What am I supposed to do about my heartburn, Doc? I get it. I (Gundry) used to have horrible heartburn, or gastroesophageal reflux disease (GERD). I refused to use PPIs, but there was an ever-present supply of Tums and Rolaids on my nightstand and in my suitcase. It’s now been more than seventeen years since I’ve had heartburn, because I don’t eat the lectins that were the cause of the heartburn in the first place. Rest assured that the foods you’ll eat on the Longevity Paradox program will not cause heartburn. Many hundreds of my patients have been able to throw out their PPIs to protect their gut buddies (and their homes) without suffering any negative consequences. Indeed, several of my patients with the precancerous condition Barrett’s esophagus were completely cured by stopping their PPIs and removing lectins from their diet.

Gundry, Steven R.. The Longevity Paradox (The Plant Paradox) (p. 45). Harper Wave. Kindle Edition. "

Gundry notes in the section before this quote that PPI's are bad news:

"Another class of drugs that is disastrous for your gut is proton pump inhibitors (PPIs) and other stomach acid reducers such as Zantac, Prilosec, Nexium, and Protonix. Stomach acid is important and necessary. It kills off most of the bad bugs you swallow before they make it to your gut. Without enough of it, bad bugs—including those that can cause infectious diseases—can take over. This is why people who regularly use acid blockers are three times more likely to get pneumonia than those who don’t use them; stomach acid is one of the best defenses against bad bugs getting into you, as one of its main purposes is to kill bacteria. Also, remember that lectins are plant proteins; stomach acid is designed to digest proteins. So by using stomach acid blockers, you inadvertently wipe out one of your major defense mechanisms against lectins! But back to our gut buddies: most of them hate acid. And some of our most important microbes live in the colon, where there is no oxygen and no acid. What keeps them there is referred to in medicine as “the acid gradient.” Stomach acid gradually reduces as food moves along the intestines, where the liver and pancreas add other alkaline digestive enzymes. This transition to a low-acid environment happens where your small bowel meets your colon. But with no stomach acid to keep them in their place, bacteria can easily crawl from their home in the colon into your small intestine, where they don’t belong. There they disrupt the gut barrier, causing leaky gut and laying the groundwork for a condition called small intestinal bacterial overgrowth (SIBO). Here these bacteria really wreck havoc by living in a place without much defense against them, thereby laying waste to the absorptive surface of your gut and producing the protein wasting and muscle loss so often seen in the elderly. What’s worse, SIBO and irritable bowel syndrome (IBS) are associated with an increased risk of dementia, as shown in a recent Taiwanese study. Stomach acid is so important to protect your gut barrier that my colleagues at the Medical College of Georgia (where I went to medical school) are starting to use baking soda as a treatment for autoimmune diseases such as rheumatoid arthritis. When patients drink a baking soda solution, it stimulates the production of more stomach acid. Among other things, this additional acid helps to keep the gut bacteria where they belong and prevents inflammation—and therefore helps to reverse autoimmune disease. Moreover, their research shows that baking soda actually sends a signal to the immune cells lining your gut to “chill out” when confronted by foreign proteins. Proton pump inhibitors do more than neutralize acid and generate inflammation. These medications are aptly named: they paralyze proton pumps, which your mitochondria (hello again, sisters!) need to generate energy. When PPIs were introduced years ago, we were naive enough to think that they worked by paralyzing only certain proton pumps in the stomach lining that make acid and not the proton pumps throughout the rest of the body. Unfortunately, that is not the case. So, every time you swallow that Prilosec OTC to enjoy your corn dog heartburn free, it doesn’t stop at the stomach but actually poisons your brain’s mitochondria (and the mitochondria throughout the rest of your body as well), making it impossible for them to produce energy. Sure enough, a long-range study published in 2017 that looked at nearly 16,000 healthy people aged 40 and older found a significant association between cumulative PPI use and the risk of dementia. Meanwhile, a German study from 2016 showed a 44 percent increased risk of dementia among 74,000 people aged 75 and older who used these drugs, compared to those who did not. Other studies have linked the use of PPIs to chronic kidney disease. Not surprisingly, these diseases can all stem from mitochondrial dysfunction. No wonder the FDA issued warnings on their use and package inserts advise not to take these drugs for longer than two weeks. How long have you been on them? Because you need stomach acid to break down dietary protein into amino acids before they can be absorbed in your gut, people who take these drugs are also likely to be protein malnourished. This is not because they aren’t eating enough protein. Rather, it is because they have no stomach acid to digest it into amino acids! Couple that with a leaky gut from SIBO and lectins, and it’s no wonder that you hear doctors telling their older patients that they need to eat more protein. But when protein isn’t broken down and absorbed, it leads to muscle wasting, called sarcopenia, a health crisis among the aging population. I mean, why live to 100 if you don’t have the strength to walk to the kitchen (or worse, the bathroom!)?

Gundry, Steven R.. The Longevity Paradox (The Plant Paradox) (pp. 43-45). Harper Wave. Kindle Edition. "

You might wish to read his books, The Plant Paradox and The Longevity Paradox He's also got cookbooks, but read these two first.

I know quite a few folks that have been helped by his plan (also know he has a supplement business & I'm not suggesting any of that).

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If I were to buy a Kardia, would any of you suggest the Kardia 6 or is the Kardia 1 the best option still?

I think a Kardia 1 works fine for most purposes.As Carey notes here. Otherwise, a full 12 lead ECG is indicated.

George

I have never used PPI"s because I was aware of the downside. In an urgent situation I might take a zantac but never more than twice in a row. I do not eat dairy, gluten, citrus, nuts, salmon, avocado, chocolate. I have given up seltzer and eat before 6pm. I swallow an inhaled steroid meant for asthma, a treatment for eosinophilic esophagitis. I do take Tums if needed. This issue comes and goes, not sure why.

Burping actually protects my heart! I take simethicome (Gas X) to help get the air out.

This has been relevant for only one out of my 4 episodes but trying to calm things down. Today I tried a little baking soda in water.

There may be something structurally wrong, some kind of inflammation no doubt. I am too tired to pursue with GI and by the time I get in, it will be better.

Thanks for the advice on the Kardia.

I am dealing with breast cancer meds, which affected my bones, but cannot take the bone meds (Tymlos) because they trigger tachycardia. It's complicated!

Just back from ER with my elderly demented mother and sometimes feel she is healthier than me!!!!!


ps Joe thanks for the gastroparesis idea...it's possible....I have some reglan prescribed. Food tends to get stuck, especially bread, but not all the time so I feel like something might be swollen.



Edited 1 time(s). Last edit at 12/22/2019 04:11PM by windyshores.