Afib repeating w/ lower meds

Since mid-October my atenolol has been reduced from 100 mg. to 25 mg. With the reduction I have experienced 6 inciidents of afib (totaling the same amount I previously experienced since diagnosis in November 2002)! My cardiologist suggested putting me on a calcium channel blocker, and I asked to wait. I was hopeful that I would adjust to being off the higher dose of the beta blocker but it appears that I am reacting to everything quickly.--wine, hunger (low blood sugar), pizza, stressful situations. My list of triggers has increased dramatically. (My doctor however, says it could be or it couldn't be the triggers and seems to emphasize that the afib is basically uncontrollable.

It has been distressing to see the increase in incidents, especially since when on 100 mg of atenolol I would go months with no incidents if I was careful with my diet. I asked to go off the atenolol because of the constant feeling of being tired, etc.

I have really been trying to build up my body with good nutrients and it is distressing to feel the heavy impact of what I guess is the adrenalin not being blocked?? I would appreciate if anyone has any suggestions about sticking it out with medication withdrawel and dietary changes or trying a new medication. The amount of afibs has been worrisome and exhausting (especially when at work during a public presentation, etc.) Thank you for your insights.

Terry I read this site most days and contribute rarely .I get information from here and from my work .I am a nurse .
It is too early to say my current regime of medications is a success .
I take the ace inhibitor Avapro 150mg daily .I do not have high blood pressure weigh 160 lbs and height almost 6 feet .
I take Rythmol 300 mg every six hours whenever I have Afib and usually convert to sinus prior to taking my second dose .
I supplement with Rexall magnesium oxide 500mg daily which I get from Walmart .
I take Coumadin to keep my INR between 2-3 .
I eat healthy .
I have had two PV ablations at Shands Hospital Gainsville and have eliminated Atenolol Betapace Amiodarone Zebeta Cardizem and Digoxin .
My PAF was diagnosed in 2000 .
I have been taking Avapro for six weeks after I attended a lecture given by
Dr Morady of Michigan Hospital .It has a similar taste to Rythmol and I find once a day dosing much better .
I am starting to feel more like my pre AFib days and having lots of sinus .
I was born in New Zealand lived in Australia and have worked and lived in Florida for the past eleven years .I am trying to adopt the positive way my
fellow Americans think .
Terry if I was still 'downunder' I would have said try my regime of medication this may work for you but instead I will say Avapro and Rythmol on demand will work for you .Make the change .
And to everyone else that follows sport I will say to the All Black ,Aussie and Bucks supportors there is always next year .

Terry - My first comment is most likely one you don't want to hear....
why are you tempting afib by consuming the known triggers such as wine and pizza... alcohol, starch and high salt?

I can understand your symptoms with the beta blockers. Many of us don't get along with high doses of BB for just the reason you mention fatigue.

Is there a reason you are reluctant to try the ca channel blocker? It could be the answer.

Truly, you can't have it interfere with your job and need to find a solution, but I want to tell you that in the 8 years I had afib, the BB's never totally controlled afib and made me extremely fatigued.

Most likely there is another drug that will be compatible with your system - much as I hate drugs - or unless you refine your diet and lifestyle so that it eliminates all of the imbalances that allow afib to begin. Long process and alot of dedication.

I agree with HenryT - Many posters have said Rhythmol on demand works well. Perhaps your MD would consider that approach.

Good luck. Jackie

Jackie, thank you for your comments. It is certainly what I need to hear. I have not been consuming large amounts of these foods, but since the drop in atenolol I seem to not be able to eat them at all without having an incident. This didn't happen on the 100 mg. of atenolol. It appears my list has grown to refined flour, sugar, msg. aspartame, alcohol. benadryl, coffee, chocolate--are there other standouts that people have? When you experience a trigger food, does the reaction tend to happen fairly quickly--like within the hour? I've told this to my doctor and nurses and they don't seem to believe this, but it seems to be what has been happening. Do the calcium channel blockers not have the same fatigue reaction? What is to consider with their side effects? All input is greatly appreciated. Best regards.

Terry,

I had a period not too long ago when I was as sensitive to triggers as you are. Based on my experience I would add to your list chili peppers and ginger, in fact anything that could be considered a stimulant.

John S.

HenryT,

Can you give us a little more info on Avapro? I see that it is for high blood pressure but don't find much more about it. What does Morady like about it?

Thanks, Don R.

Don .In a randomized study Irbesartan/avapro was used in conjunction with Amiodarone to maintain sinus rhythm after cardioversion .Patients taking this combination remained in sinus for a longer time than those just taking Amiodarone .
ACE inhibitors blunt acute remodeling so other ACE inhibitors may work as well .Dr Fred Morady gave out the drug Avapro and I ran with it .I did not ask him why he mentioned Irbesartan instead of Captopril .
This is where I'm at .I use Propafenone to convert my heart back to Sinus and use Avapro to maintain Sinus .
On my plan Avapro is expensive but with samples from my GP and less Propafenone to take I will stay with Avapro .
I read this site often so will be interested in what the experts say about ACE inihitors .
At first I believed beta blockers were necessary and although Propafenone has beta blocker properties .The amount I take now is minimal .I will find out if Avapro is a better substitute .I do feel much better .

Don,

Irbesartan (Avapro) belongs to the class of medicines called angiotensin II inhibitor antihypertensives

Angiotensin II receptor antagonists, as their name suggests, block the binding of angiotensin II to the AT1 receptor. These drugs to not inhibit kinin metabolism (e.g., bradykinin). Aspirin may reduce the beneficial CHF effects of ACE inhibitors, but apparently does not alter the efficacy of angiotensin II inhibitors in treating CHF.

Angiotensin II receptor blockers and ACE inhibitors have roughly equivalent beneficial effects on symptoms and hemodynamics of patients with CHF.

To Break it down further...

This drugs blocks angiotensin II, a chemical that causes the arteries and veins to narrow, from attaching to the arteries and veins and causing them to narrow. As a result, the arteries and veins dilate (become larger), and blood pressure is reduced. When the blood pressure is reduced, the heart doesn't have to work as hard to pump blood.

Some doctors believe that Atrial Fibrillation can be a side effect of hypertension.

Joe

Terry, about how long it takes to react to trigger foods or drinks, i think people are real different, but personally it has varied from instantly on one occasion [that was my last cup of coffee] to more usually several hours or the next day. Hope that is at least a little helpful.
Peggy

Terry - to answer the time frame - it is reported that some reactions can happen as quickly as within 20 minutes of consumption. One method of testing is to check your pulse before eating and then check it at intervals 20 minutes 30 minutes etc. after eating. Any significant increase in heart rate indicates a food sensitivity....often originating from leaky gut syndrome and the antibody reaction that causes.

In other people and situations, food allergies which could be triggers may occur as much as 4 days later - making tracing the culprit virtually impossible.

Regarding the Ca channel blockers, I have never taken them so I can't give you my personal experience.

Terry, I urge you to pay attention to possible triggers and work at cleaning up your diet/lifestyle. The benefits you will receive far outweigh the foods you will miss. Soon they will not be missed but looked upon as culprits and easily avoided.

Best of luck. Keep us posted on your progress. Jackie

Greetings
Terry alcohol can effect me up to 30hrs later. Late night eating is normally followed at approx 3am in the morning i.e much sooner.
Chris H

Terry,
After having difficulty with several beta blockers (and a calcium channel blocker) I finally found betaxolol, a beta blocker without so many debilitating effects.
Initially I used 20mg once a day; then I went down to 10 mg/day. It worked well for a year or so, but then my afib progressed and I needed to add flecainide as well. The combination worked well. You might also consider magnesium glycinate; several people on this board have found it very effective.
I cut out wine completely; it is a trigger for me no matter what meds I may be taking.
Buster