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Nocturnal Patterns
Posted by MeganMN
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Nocturnal Patterns April 09, 2024 12:38AM |
Registered: 8 months ago Posts: 186 |
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Re: Nocturnal Patterns April 09, 2024 06:53AM |
Registered: 8 months ago Posts: 186 |
Quote from study:
"Nevertheless, this large-scale multicenter investigation has confirmed the most important clinical implication of Coumel's theory that β-blockers applied in patients with the vagal type of AT/AF may promote arrhythmogenesis and increase the frequency of arrhythmic events."
"the analysis of autonomic nervous system activity, its potential instabilities and short-term surges of vagal activity, which may occur during the night, might be useful in this patient population. Identifying and mitigating these patient-specific promoters of arrhythmias could facilitate arrhythmia management, reduce the number of arrhythmic events and improve the quality of life in this group."
Edited 1 time(s). Last edit at 04/09/2024 06:56AM by MeganMN.
"Nevertheless, this large-scale multicenter investigation has confirmed the most important clinical implication of Coumel's theory that β-blockers applied in patients with the vagal type of AT/AF may promote arrhythmogenesis and increase the frequency of arrhythmic events."
"the analysis of autonomic nervous system activity, its potential instabilities and short-term surges of vagal activity, which may occur during the night, might be useful in this patient population. Identifying and mitigating these patient-specific promoters of arrhythmias could facilitate arrhythmia management, reduce the number of arrhythmic events and improve the quality of life in this group."
Edited 1 time(s). Last edit at 04/09/2024 06:56AM by MeganMN.
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Re: Nocturnal Patterns April 09, 2024 07:47AM |
Registered: 11 years ago Posts: 4,225 |
Interesting.
The first reference I got on afib was "Lone Atrial Fibrillation, Towards a Cure" by the founder of this site, the late Hans Larsen. Below are some quotes from it that I just pulled up on vagal afib & beta blockers from the PDF version I got in 2004 (a 2015 version is available on Amazon, but there is no Kindle version). My AF is almost always (though not 100%) nocturnal. A daytime episode is much more likely to occur when my calcium intake is high (also much more likely to have episodes with no apparent trigger). I'm very vagal. This is why I've never taken a beta blocker (though I would if I had an episode that would not convert and was lasting more than a day) and if I take flecainide on a daily basis (which has been rare through my afib "career"), I only take a dose before bed, not 2x/day which is the normal dosing protocol.
Edited 1 time(s). Last edit at 04/09/2024 08:51PM by GeorgeN.
The first reference I got on afib was "Lone Atrial Fibrillation, Towards a Cure" by the founder of this site, the late Hans Larsen. Below are some quotes from it that I just pulled up on vagal afib & beta blockers from the PDF version I got in 2004 (a 2015 version is available on Amazon, but there is no Kindle version). My AF is almost always (though not 100%) nocturnal. A daytime episode is much more likely to occur when my calcium intake is high (also much more likely to have episodes with no apparent trigger). I'm very vagal. This is why I've never taken a beta blocker (though I would if I had an episode that would not convert and was lasting more than a day) and if I take flecainide on a daily basis (which has been rare through my afib "career"), I only take a dose before bed, not 2x/day which is the normal dosing protocol.
Quote
Hans Larsen
The findings that adrenergic afib is preceded by an increase in sympathetic activity while vagal afib is preceded by an increase in parasympathetic activity explains why adrenergic afibbers can sometimes ward off an episode by quickly chewing and swallowing part of an atenolol (Tenormin) or propranolol (Inderal) tablet. Taking these beta-blockers decreases adrenergic activity and shifts the balance back in favour of the vagal branch. Similarly, vagal afibbers have found that getting up and moving around when an episode seemed imminent can sometimes abort an episode. Physical activity increases adrenergic tone and thus shifts the balance away from vagal predominance. There are, of course, many other approaches to preventing episodes and these will be discussed in future chapters. First though, we will take a look at other atrial (supraventricular) arrhythmias that may accompany AF or be mistaken for AF.
Propafenone (Rythmol) and beta-blockers are not recommended for people with vagal LAF
Drugs in vagal LAF
Twenty-six of the 35 vagal afibbers (74%) were taking antiarrhythmics or other drugs to prevent further episodes. There is ample evidence that vagal afibbers should not take digoxin (Lanoxin), beta-blockers or antiarrhythmics with beta-blocking properties as these drugs will markedly worsen their condition[2,3]. Yet of the 26 vagal afibbers on drugs 14 (54%) were on a drug contraindicated for their condition. These people spent an average of 105 hours in fibrillation (over 6 months) as compared to 40 hours for the people on the drugs best suited for vagal LAF flecainide (Tambocor) and disopyramide (Norpace, Rythmodan). Even vagal afibbers taking no drugs at all spent less time (90 hours) in fibrillation than did the people who were on the wrong drugs. Vagal afibbers on flecainide did the best and spent only 23 hours in fibrillation and had an average of 6 episodes (average duration of 3 hours) over the 6 months. This compares to 6 episodes (average duration of 24 hours) for non-drug users and 24 episodes (average duration of 13 hours) for people on contraindicated drugs. There was no significant difference in age or time since diagnosis between the drug and non- drug groups.
For example, beta-blockers (atenolol, propranolol, metoprolol), which work directly to dampen adrenergic response, are definitely contraindicated for vagal origin LAF(3,4,5).
Edited 1 time(s). Last edit at 04/09/2024 08:51PM by GeorgeN.
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Re: Nocturnal Patterns April 09, 2024 12:30PM |
Registered: 8 months ago Posts: 186 |
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Re: Nocturnal Patterns April 09, 2024 01:54PM |
Registered: 3 months ago Posts: 58 |
The article is a bit above my reading comprehension but still interesting. My gut feeling has always been that the Sotolol that I take causes more AF events in the middle of the night. It is super rare that I have AF during the day, always at night and at least 6 nights a week. I am usually to tired to get up and take a Kardia reading at 2.30am so not sure what is actually happening.
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Re: Nocturnal Patterns April 09, 2024 07:27PM |
Admin Registered: 6 years ago Posts: 5,350 |
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Re: Nocturnal Patterns April 09, 2024 08:01PM |
Registered: 8 months ago Posts: 186 |
quote=Carey]
Interesting stuff. I've never heard an EP say they avoid BBs in vagal patients, but both Hans' paper and the NIH paper strongly suggest that perhaps they should.[/quote]
Which then begs the question of what is really left. There aren't many meds on the list. However, I might have preferred to fail the few on the list than all those plus the many beta blockers and others...... More research is definitely needed!!
Interesting stuff. I've never heard an EP say they avoid BBs in vagal patients, but both Hans' paper and the NIH paper strongly suggest that perhaps they should.[/quote]
Which then begs the question of what is really left. There aren't many meds on the list. However, I might have preferred to fail the few on the list than all those plus the many beta blockers and others...... More research is definitely needed!!
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Re: Nocturnal Patterns April 09, 2024 10:54PM |
Registered: 8 months ago Posts: 186 |
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Re: Nocturnal Patterns April 10, 2024 12:06PM |
Registered: 4 months ago Posts: 6 |
Megan, I have been reading here for years and even created an account a while back but haven't time to introduce myself and actually comment. But your problem was one I also have. None of the meds worked for me, especially anything that would bring the heart rate down. I'm not sure which source I got this from because it's been a few years, but L-theanine has been a life saver for me. Not only does it relax it also brings the rate down. I take it with 100 to 200mg magnesium. I also have to make sure I go to bed without a full stomach, and while I get comfortable I do George's breathing routine. And then try to relax, I know that's almost impossible, but it really helps.
My fib was brought on from covid- back before the vaccine- and I am still dealing with the after effects. But I am getting there and hopefully will be well enough to get an ablation in the near future- PFA here I come!
I hope this little tip will help, I have a few more that have helped me and will make some time to post soon. Always know there are people here to listen, even the many who don't comment. We are all in this together!
* I take several doses of l-theanine a day just to keep things on an even mood all day, that seems to work better than waiting for the high rate to happen at night. In fact by bedtime the rate is usually only a hair above normal now and within a half hour or so its down. Be sure to read up on it to make sure it's ok for you.
Edited 1 time(s). Last edit at 04/10/2024 12:15PM by CC.
My fib was brought on from covid- back before the vaccine- and I am still dealing with the after effects. But I am getting there and hopefully will be well enough to get an ablation in the near future- PFA here I come!
I hope this little tip will help, I have a few more that have helped me and will make some time to post soon. Always know there are people here to listen, even the many who don't comment. We are all in this together!
* I take several doses of l-theanine a day just to keep things on an even mood all day, that seems to work better than waiting for the high rate to happen at night. In fact by bedtime the rate is usually only a hair above normal now and within a half hour or so its down. Be sure to read up on it to make sure it's ok for you.
Edited 1 time(s). Last edit at 04/10/2024 12:15PM by CC.
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Re: Nocturnal Patterns April 10, 2024 11:32PM |
Registered: 8 months ago Posts: 186 |
CC, thank you SO much for this advice!! I took Theanine for years to help me sleep/relax and have just been taking GABA, but will definitely add the Theanine back in! Unfortunately, the formulation that I currently have are horse pills, but I will try to find a way to swallow them down without choking!! I will try it tonight. Thanks so much!!
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Re: Nocturnal Patterns April 11, 2024 08:06AM |
Registered: 11 years ago Posts: 4,225 |
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Re: Nocturnal Patterns April 11, 2024 10:48AM |
Registered: 3 months ago Posts: 4 |
Megan: Have you tried liquid Theanine drops? MIght be easier for you?
There are many options available at reasonable prices:
[www.amazon.com]
Personally, I like the SBR brand of liquids. Both my wife and I have taken their D3 + Mk7 since the start of the pandemic
[www.amazon.com]
Gordon
There are many options available at reasonable prices:
[www.amazon.com]
Personally, I like the SBR brand of liquids. Both my wife and I have taken their D3 + Mk7 since the start of the pandemic
[www.amazon.com]
Gordon
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Re: Nocturnal Patterns April 11, 2024 12:40PM |
Registered: 8 months ago Posts: 186 |
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Re: Nocturnal Patterns April 11, 2024 08:25PM |
Registered: 4 months ago Posts: 6 |
George, the one I use for evening relaxing is the Wim Hof. (no shoveling snow in shorts for me though!) As a a swimmer I've used many different breathing techniques for endurance and underwater breath holding. But for relaxing I found this works great for me. I had lung problems post covid (now clear as of 6 mo ago yay) so it wasn't easy at first. I still use some of the others depending on what I need, relaxing or physical activity. I'm so glad I you posted about it, and in great detail. Actually many of your posts have helped me immensely.
Megan, I'm sorry about your horse pills ugh! Every theanine brand I've used is a tiny slippery capsule and I've had no problems. Just be sure to use a good reputable brand, with any supplements. Right now I'm using Jarrow. Also, laying flat always brings on afib for me so besides the mag and theanine I also sleep very inclined. It took a while to get used to but with a lot of good comfy pillows it really isn't too bad at all. Good luck!
Megan, I'm sorry about your horse pills ugh! Every theanine brand I've used is a tiny slippery capsule and I've had no problems. Just be sure to use a good reputable brand, with any supplements. Right now I'm using Jarrow. Also, laying flat always brings on afib for me so besides the mag and theanine I also sleep very inclined. It took a while to get used to but with a lot of good comfy pillows it really isn't too bad at all. Good luck!
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Re: Nocturnal Patterns April 12, 2024 02:02AM |
Registered: 9 years ago Posts: 1,087 |
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Re: Nocturnal Patterns April 12, 2024 03:11AM |
Registered: 1 year ago Posts: 781 |
That's great advice. None of us likes to take medicine, but sometimes it's the least of the evils ahead of us. I take melatonin or a portion of a Zopiclone about every fourth or fifth day, and it really helps. By taking them so seldom, their effect on me is more potent...I don't get used to them at all. So, they mostly work...not absolutely every time, but often enough that they're my go-to.
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Re: Nocturnal Patterns April 12, 2024 12:15PM |
Registered: 8 months ago Posts: 186 |
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Re: Nocturnal Patterns April 13, 2024 11:57AM |
Registered: 4 months ago Posts: 6 |
Quote
GeorgeN
... while I get comfortable I do George's breathing routine.
As I've mentioned more than one breathing routine, I'm curious which one you are referring to?
This got me thinking and I went back to look for info. This link [www.afibbers.org] has the post that started my playing around with breathing. When I still had covid 3 years ago I found myself sitting hunched over trying to breath.At this point fib was fast and furious all day and night. I would push my shoulders forward and I noticed the afib slowed or weakened .Not really on purpose I stopped breathing, now doing it I notice it's on the inhale. It would stop for just a few seconds. As time went on it would last longer and longer. Now I have integrated it into a relaxed breathing routine- a bit of my own and a bit of what I've read. I had assumed what you'd posted was the Wim Hof routine. Now reading it with a clearer - slightly- head I see its a mix of techniques?
Hopefully my brain fog will clear soon as well!
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