new here - new afibber - thoughts?

My first instance of afib was 2/25/22 and in the ER it took 6 hours to convert. They used Diltiazem. Got an RX for Metoprolol but after a month is was causing more heart rhythem issues. Stopped that and put on Diltiazem 180Xr and was ok until May 19 when ended up in ER again. They upped my Diltiazem to 240mg. Am on Warfarin. Trying to find possible background issues so did bloodwork. Results following. I'm on PPI's since 2002. I find it interesting the B12 is normal but still has dropped a lot.

VIT B12 - normal is >200
April 2010 = >1000
Feb 2016 = 914
May 2022 = 303

Iron - is listed as normal
Value is 75ug/dl
Total Iron Binding 312 ug/dl
Transferrin Sat 24%

Ferritin Serum is listed as normal
65ng/ml

Female - late 60s - walk 1 mile per day with dog when weather permits - which is usually - but have 2nd floor so doing steps 5-10 times per day. GERD has been the biggy over the years, other stuff came was resolved. I did have an instance of AFIB at 26 (lasted 2 hours and self converted) but they said it was mitral valve prolapse and that I should just live with it - if the heart flutters, cough or something to make it stop. That worked til now so maybe had it all along but then it would only last seconds. I don't like all the meds as I am super sensitive to drugs. They are already talking about anti-arhymics but I don't want to follow that as they are pretty dangerous. Next appt followup is 3 months. I was concerned about the B12 because it dropped just over 600 in 6 years. I am planning to start taking supplements - probably Bcomplex even though dr says it is normal. I have read that the NORMAL in UK and Japan has been changed to 550 - not sure if that is true.



Edited 2 time(s). Last edit at 05/28/2022 10:19AM by movourneen.

Your Ferritin is great as 40-60 is the sweet spot....nothing wrong with boosting your B12 over a 1000 through taking a 5k a day supl.

Anyway there are so many causes of this it is virtually impossible to boil it down to 1 or a few for that matter.

So you have had 2 episodes of Afib if i read your post correctly in 3 months + these doctors are drugging you up like this already with stuff that does not work a min. half the time + Gives off rotten side effects.....this is sick IMOP although i have been through this exact medical drug pushing myself so i know what your going through.

This is my 2 cents on what you should do esp. since you are not at all far along with this although it will only get worse not better.

Get off ALL of these drugs slowly or Imed.

Try supl. like esp. Mag. as there are many that have had some/great success with that with many posts onsite showing that even in the last few days.

Try more supl. that might help you as we are all dif. so some work good/somewhat + other people say nothing works...hit + miss.

As you are trying these supl. too many to name but esp. Mag. ask your drug dealer aka doctor for a PIP prescription for either (Flecainide or Propafenone read up on them + decide whats best + your doc will help you decide between the 2) to deal with your currently infreq. episodes so to knock them down down to a few hours or less so to prevent you from going to the ER + give you some much needed peace of mind.

If these supl. fail to give you relief as most likely they will (but worth a try) + your afib gets worse start thinking/preparing to get an Ablation.

We are here to help...i give advice that some here prob. would not but its up to you to decide...we are not here trying to cencor thought...you will get much advice from many dif. angles as that is why you came here Right?

ASK ASK ASK

GL



Edited 2 time(s). Last edit at 05/27/2022 03:48PM by vanlith.

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I'm on PPI's since 2002.

Vagal triggers are common. There are cases of people solving their digestive issues & having a very positive impact on their afib. Tell us more about yourself like do you exercise? a lot? sedentary? Do you have metabolic issues? How old are you? Male or female? Other health issues. And so on.

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GeorgeN
I'm on PPI's since 2002.

Vagal triggers are common. There are cases of people solving their digestive issues & having a very positive impact on their afib. Tell us more about yourself like do you exercise? a lot? sedentary? Do you have metabolic issues? How old are you? Male or female? Other health issues. And so on.

George-- what do you think is the best way to get at digestive issues? I really do think that is part of my issue. I think they were before my first ablation on 2/25. They put me on Prilosec which I am not a huge fan of but wanted to follow dr.s orders. Went off it at the end of the months time. And I got to a point a few weeks ago when it was difficult to swallow an apple (not whole LOL!). and that day my heart which had been mostly sinus went crazy into flutter. I realize this is not completely unusual after an ablation anyway- at the 3 month mark. They are fitting me in for an ablation touch up next week. I begged for help and not to do amioderone. But I want to give it the best shot after I get out. I had found a really nice low acid organic decaf and even gave that up this morning. Cut out all the biggies. Fat seems to kick it off too. I had leaky gut about 10 years ago and maybe that is popping up again. Anyway I am curious your thoughts on the digestive issues- or anyone elses thoughts on how to get rid of those. (I'm on 55 here..I have a cardiac surgery history so I am not saying all my afib is digestive but I want to give the ablation a fighting shot.)

[www.amazon.com]

Read this.

On digestive issues ... there are numerous past posts on this topic, since that was an issue in my case.
I found I wasn't producing enough HCl to digest food and that adding that plus other enzymes helped normalize.
Although it didn't reverse my AF, it did seem to help lessen the episodes.

Check this link for some of the reports and replies based on my experience...
[www.afibbers.org]

There is also a report titled: The Gut Connection to Afib - Revisited - A Review of Digestion, GERD, Food Sensitivities, Gut/Adrenal issues… many Influences for AF ... from 2013 - I didn't see it in my first search.

Excerpt...

REVIEW –
DIGESTION, GERD, FOOD SENSITIVITIES, GUT/ADRENAL ISSUES … MANY INFLUENCES FOR AF

1. Adequate chewing
2. Symptoms
3. Dysbiosis
4. Food Sensitivities
5. Lack of stomach acid
6. Leaky Gut Syndrome (Intestinal Hyper-permeability)
7. Candida
8. Stress
9. Stress & Adrenal Dysfunction
10. Stress/Gut Glutamine Utilization – Low Blood Sugar
11. Neurotransmitters and Brain Function
12. Remedies
13. References
14. Reading Resources

Send me a PM if you can't find it in the archives and I'll send you copy by email.

Jackie

I do think mine has to do with GERD also as vagal nerve irritant. If I lay on either side it was triggered into AFIB while on metoprolol. I don't dare side sleep anymore.

When I was having stomach problems - major pain - after eating meals (fat), They found through months of waiting and finally did a DYE test to check my gallbladder. One of the sphincters was not working, rest of organ was fine but that was causing the pain so they removed it. It took me 18 months before I could eat red meat again. That was in 2010. You might ck your gallbladder.

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GeorgeN
[www.amazon.com]

Read this.

So what are your thoughts on not doing the priolosec for the month post ablation? I am going to get that book but I am familiar with the concept. I have done Prilosec in the past but that month after my first ablation I did it 'religiously'. II have another ablation on Thursday... IDK what I might want to do..

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bettylou4488

So what are your thoughts on not doing the priolosec for the month post ablation? I am going to get that book but I am familiar with the concept. I have done Prilosec in the past but that month after my first ablation I did it 'religiously'. II have another ablation on Thursday... IDK what I might want to do..

I don't know enough to have an opinion in your situation. You mentioned seeing a doc in Dr. Brownstein's practice. Those people would know better, in consultation with your EP.

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GeorgeN


So what are your thoughts on not doing the priolosec for the month post ablation? I am going to get that book but I am familiar with the concept. I have done Prilosec in the past but that month after my first ablation I did it 'religiously'. II have another ablation on Thursday... IDK what I might want to do..

I don't know enough to have an opinion in your situation. You mentioned seeing a doc in Dr. Brownstein's practice. Those people would know better, in consultation with your EP.

Thanks. I haven't seen Brownstein's practice in quite a few years. I really need to find a new functional doctor. (I went to another one in between.). The EP.. I love him for that but I mentioned how priolosec could affect Magnesium (my functional cardiologist mentioned this), he looked at me funny LOL.

Do you know what type of afibber you are? Adrenergic vs Vasovagal? This is critical to establish for a starting point in self-care. I myself am adrenergic. For me B vitamins are an absolute trigger. I have tried them all numerous times and next day afib - like clockwork. For anybody new to afib, I would recommend the book, The Afib Cure by Dr. Day and Bunch. Its well done, contemporary and really foundational knowledge for finding your way through this complex and confusing maze of afib.
Good luck,
Jeff

Adrenergic vs Vasovagal -- paroxysmal -- When I brought up to the Dr that it occurred more when laying on either side and suggested it was Vasovagal, it said it doesn't matter because they are treated the same. I am nervous now because I started myself on BComplex - today. I had a B12 reading 12 years ago of over 1000 and then 6 years ago it was just over 900 but now it is just over 300. That is via a blood test so I've read that isn't entirely good because B can be handled different in the body. My first instance was triggered by a 16oz glass of Coke - which I normally don't drink as I am sensitive to caffeine but I was super tired that day and coke always settled my stomach - it lasted about 8 hours in the ER. The second time had no trigger I am aware of as it happened early in the morning before any food/drink/etc. The only thing I could think of is that I had drank some juice before bed the night before and saw that it had stevia in it. don't know if that was part of it or not but it triggered when I rolled over to my right side and boom, off to the races.

This "trigger" thing makes me crazy. While there are some things that can contribute to a new afib episode, I would guess that well over half the episodes we all have are triggered by NOTHING. It just happens. We all want to fix the problem, and if there is something we can do or take that will minimize or eliminate afib, our nature is to search for the answer. Other than maintaining good hydration as well as ample levels of magnesium and potassium, you are likely "spinning your wheels". An ablation from an expert is the best solution, but even that is temporary. I have been dealing with it for 27 years and once again am afib free since my second ablation two years ago. It will be back, it's just a question of when.

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Ken
This "trigger" thing makes me crazy. While there are some things that can contribute to a new afib episode, I would guess that well over half the episodes we all have are triggered by NOTHING. It just happens.

I wholeheartedly agree.

After ablation, knowing it can return and probably will, do you stay on a blood thinner?

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bettylou4488

[www.amazon.com]

Read this.

So what are your thoughts on not doing the priolosec for the month post ablation? I am going to get that book but I am familiar with the concept. I have done Prilosec in the past but that month after my first ablation I did it 'religiously'. II have another ablation on Thursday... IDK what I might want to do..

EPs prescribe PPIs after ablation to prevent any esophageal injury that might have occurred during ablation. The stomach acid would retard any healing process.

Is that what you’re referring to?

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movourneen
After ablation, knowing it can return and probably will, do you stay on a blood thinner?

After a successful ablation, there will be no afib for some period of time. After my first, I went for 13 years with no afib and I am now at 2 years since my second. There is no reason to take a blood thinner if you do not have afib. However, you may have other issues and a CHADS VASC score high enough to warrant taking a blood thinner, but not because of past afib.

When afib returns, then you go back to the normal management, blood thinner, rate control and Anti-arrhythmics



Edited 1 time(s). Last edit at 06/01/2022 09:40AM by Ken.

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Ken
This "trigger" thing makes me crazy. While there are some things that can contribute to a new afib episode, I would guess that well over half the episodes we all have are triggered by NOTHING. It just happens.

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Carey
I wholeheartedly agree.

During my 18 year afib "career" I have had times when there were no consistent triggers & as Ken and Carey say anything or nothing can trigger an episode. Initially, it was excess endurance exercise, then I had a 2 1/2 month episode. After implementing my remission plan after that episode, more often than not, I've had a pretty good idea what my triggers are and if I avoid them, I stay in NSR. The difference, as far as I can tell, is the state of my overall system. During 14 months of 2012-2013, anything or nothing could be a trigger. It turns out that I had increased calcium in my diet and when I eliminated the increase, I went back to a state where triggers were generally either excess long duration higher intensity exercise or missing dose of magnesium. 2021 was also a year where anything or nothing could be a trigger. I had 15 episodes during 40 weeks. Since Oct 27, I've now gone 31 weeks without an episode and everything is very stable. PAC's during sleep (per my monitor setup) average 1 or 2/hour. From my historical data, this is minimal. At these levels, I'm unlikely to have an episode. What changed? Well initially I decided to start taking 50 mg of flec a day. I did this for 2 months, then dropped it to 25/day for maybe 3 1/2 months, then 12 mg, then 6,mg then 0 now for a few weeks. In a prior post, I noted an association with episodes and my 4 COVID vaccines (2 Pfizer, 1 J&J, 1 Moderna booster). Others have told me they've also seen this association. However, a couple of the episodes occurred prior to vaccine #1. On my doc's advice, prior to the vaccines, I changed my diet somewhat due to food sensitivities (lab tested). I may have inadvertently added more calcium in. So I don't really know what the root cause of last year's episodes are. My last vaccine was taken while I was taking the 50 mg flec/day. I also looked hard at my food intake and did an analysis with a food scale and entering the data into an analysis app to look for and remove excess calcium. It could be both, since it has now been a long time since I've had a vax and I did remove excess calcium. In any case, I'm now back to where I'm stable. These things are hard to figure out and are frustrating, to be sure. I continue to take my magnesium, potassium & taurine supplements, I limit long duration exercise to a Zone 2 level and pay attention to the rest of my lifestyle (one friend said I have a "six sigma lifestyle.")

In summary, I look beyond triggers, to see what in my lifestyle could create an environment conducive to afib, not only looking at triggers.

My GERD has never been this worst since starting Sotalol. Recently I was vomiting acid from 6pm to 4am and needed to go to the urgent care for IV to hydrate so I wouldn’t get AF.

But Sotalol has kept me out of tachycardia ER for 143 days so I’m staying on it. I just drink unsweetened almond milk to coat my esophagus and remember to eat, chew and sip liquids.