There are associations with anticholinergic meds and dementia in older individuals. In this paper they cite the associations but none of the meds were for asthma. To gloaming's point, there was a fellow here, say 10 or more years ago, who was using an an anticholinergic (Propantheline Bromide) med off label to control his afib. The idea was based on a paper (that I've attached) frby GeorgeN - AFIBBERS FORUM
Years ago, there was a fellow from Australia who had good luck with the anti-cholinergic, propantheline bromide (PB ). Dr. James Reiffel was a proponent of this approach. "Although the literature does not contain prospective series contrasting drugs with different autonomic profiles in such patients, my own experience suggests that nocturnal paroxysmal AF can be totally or substantially limiby GeorgeN - AFIBBERS FORUM
Hi Liz, If you are adrenergic, it might be a trigger. If you scroll down to Benadryl on this page: < it says it is acts with a "Cholinergic receptor blockade." You may recall a fellow who used to post here about Propantheline Bromide (PB ) as a treatment for his vagal afib < . Turns out that PB is also an anti-cholinergic. So if it worked to prevent vagal afib, it might havby GeorgeN - AFIBBERS FORUM
Phenergan has anti-cholinergic properties. There was a poster here a number of years ago that used propantheline bromide (an anti-cholinergic) to control his vagal afib. Anti-cholinergic meds inhibit acetylcholine (ACh). I'm assuming if one had adrenergic triggers, an anti-cholinergic might be a trigger. As an aside, chronic anti-cholinergic use in the elderly is also associated witby GeorgeN - AFIBBERS FORUM
Hi Mark, There was a vagal afibber here years ago who used an anticholinergic (which an antimuscarinic med would be) propantheline bromide, for his afib. He left here and set up his own site < . As noted in my link, I subsequently found out I carry the ApoE4 gene which confers a much higher risk for Alz Disease. Anticholinergic's are contraindicated for the elderly and for ApoE4by GeorgeN - AFIBBERS FORUM
This guy took propantheline bromide. < Which is prescription and anticholinergic. At one time, I was able to get a script for it, got it filled, but I never used it. The pharmacy had to get it from the warehouse as it was not widely prescribed. I subsequently found out I'm positive for the ApoE4 genotype. This means a higher risk for dementia. Anticholinergics are contraindicated foby GeorgeN - AFIBBERS FORUM
John Bedson. He also is a strong advocate of propantheline bromide for vagal afib.by GeorgeN - AFIBBERS FORUM
David, In Nov 2012, my afib was very sensitive to vagal stimulation. I started taking powdered organic ginger spice, which did seem to offset the vagal stimulation. I recall, that when I looked into it, it raised the adrenergic side rather than lowering the vagal. Some others have had positive responses to ginger and I recall Hans wrote about it in the Afib Report. Here is a search heby GeorgeN - AFIBBERS FORUM
Hans, A quick summary - as I've posted before < , I had very good afib remission for 7 1/2 years. Then my stress level increased dramatically because of the ending of my long term marriage. My afib became more frequent. I attributed this to the divorce stress. Then it became very frequent - at one point I was getting it every night and terminating with PIP flec. At this point I gotby GeorgeN - AFIBBERS FORUM
Sam, As digestive issue are a trigger for many, if you are sensitive to ginger it makes sense it would not be helpful for your case. Tom, While anything is possible, I very much doubt my positive experience with ginger is due to placebo effect. I look at it as treating a specific risk factor for my afib - an overly large vagal response. My experience this year has been that afib episoby GeorgeN - AFIBBERS FORUM
Hi George, Thank you very much for the good advice here for medicines for vagally-mediated AFib. I am living in Sofia, Bulgaria and for some reason they do not have here neither disopyramide nor Propantheline bromide. There is one drug called Quinidine which is supposed to be close to Disopyramide, however, when I look at literature some authors say it is more risky for pro-arrythmia. The otheby Dobromir - AFIBBERS FORUM
Jackie - Thanks! My new cardio said there is some book I should read about a guy who is always using their body as a chem-lab experiment. He seemed to think it would fit me... I do normally toss a couple of swallows of water down after I throw the ginger in my mouth. I don't think the fresh vs. powder really applies to me. They aren't referring to the electrical kind of heby GeorgeN - AFIBBERS FORUM
Hi Ian, Thanks! I looked up Ginger Jitters and it appears to occur at very high intake levels. This site talks about tolerance levels around 2 g/kg of body weight or about 1g/pound. Hans' 5g is, of course, waaaay under that. I'm guessing I'm in the 5-10g/day range. Your point about acclimation is a good one and argues for minimizing intake to the minimum amount necessary.by GeorgeN - AFIBBERS FORUM
Justine, I'm using ginger from the spice rack that you'd use for cooking. Steve, Thanks! A couple of clarifications. The Phorum software put in the smiley face, I'd intended to say I've not yet used the PB or propantheline bromide. I've noticed that my bowel tolerance level for magnesium has dropped to 1.4-1.6g/day. This is still a lot for most people butby G - AFIBBERS FORUM
There have been several recent threads regarding ginger and vagal afibbers: <; I'm very vagal and am seeing a positive response. I've never had GERD. A quick summary of my afib history. Afib started about 8 1/2 years ago, most like brought on by chronic fitness. It was always a vagal trigger, mostly coming on at 3AM. Initially I had episodes every 10-14 days forby GeorgeN - AFIBBERS FORUM
Aloha Pat, My experience agrees with your electrolyte imbalance/autonomic tone analysis. If electrolytes are good, then ANS doesn't matter. If electrolytes are imbalanced, then ANS matters alot. I've always felt that to be successful with a non-medical approach to afib, the arrhythmogenic substrate level must be low and generally the non-medical approach started very early in thby GeorgeN - AFIBBERS FORUM
Sam, My take on your post is that you are vagal. Something that is a vagolytic may help. This might include powdered or tincture of ginger, or tincture of licorish. These should have the same effect as standing up or exercise. See recent posts by Hans and others on ginger. The med propantheline bromide is a vagolytic. If you are elderly and have any memory issues, I would not recommeby GeorgeN - AFIBBERS FORUM
As I've previously posted here, I had seven+ years of afib quiescence with my Mg++, K+, taurine program, using PIP flec about 10 times. This last year I've had the stress of my wife separating and ultimately divorcing. Interestingly, I had some episodes when the issue first arose and the stress was at its peak. However, the episodes increased in frequency even as my perceived stressby GeorgeN - AFIBBERS FORUM
A brief history - My first afib episode was about 8 1/2 years ago. Initially they occurred every 10-14 days, lasting 6-9 hours and self-terminating or with exercise. They were clearly vagal, coming on around 3 AM. After 2 months, I had an episode that would not terminate. It ultimately lasted 2 1/2 months and was terminated with 300 mg of flecainide. I had an EP who suggested I remain out ofby GeorgeN - AFIBBERS FORUM
I recently engaged a concierge cardiologist to support me in playing with propantheline bromide as a vagolytic med. I gave him my supplement protocol (heavy on the mag) and he commented that when he was a fellow, they did a study with injected mag. and afib. The results were promising, but because the sample size wasn't large enough, there wasn't enough statistical power. Georgeby GeorgeN - AFIBBERS FORUM
dnrec, Disopyramide has strong anticholinergic properties, which means it is vagolytic and a good choice for vagal afib. There are some other vagolytic choices such as Propantheline Bromide that are not class 1A rhythm meds and don't have the potential for issues such as torsade de pointes that you may wish to investigate. If you send me an email I will get you more info. I'm tby GeorgeN - AFIBBERS FORUM
I got to thinking about other vagolytic agents. The following may be a source of novel agents for this purpose. Michael Tierra's review of Botanical Medicine: by Dan Kenner, L.Ac. and Yves Requena, MD (there are probably many other practitioners using similar approaches too). There is much in there of the neuroendocrine approach common in Europe with four nervous system types: sympby GeorgeN - AFIBBERS FORUM
Namor, Great work! I certainly agree. In my case, my ANS is very much not static. The interesting question is modulating it in a favorable direction. The electrolyte balance is part of the equation. If my electrolytes are out of balance, a strongly vagal status will result in afib. If they are in balance, I am much more likely to stay in rhythm. Presently I have more tools to plby GeorgeN - AFIBBERS FORUM
Hi Elizabeth, Sorry about your situation, it is frustrating. I agree with Hans on the Mag and K; also you might get a blood test (which is quicker) although the Exatest will tell you your intracellular levels, which is more important information. Serum level and intracellular level don't always agree with each other. You were taking Propantheline Bromide, is that correct and you discby Anonymous User - AFIBBERS FORUM
Jill, As I recall it you are, or at least were, taking propafenone and propantheline bromide for the prevention of what you believe to be vagal afib. As you are no doubt aware propantheline strongly suppresses the parasympathetic (vagal) arm of the autonomic nervous system (ANS) resulting in an increase in heart rate at times when the vagal arm tends to be dominant (during rest and after mealby Hans Larsen - AFIBBERS FORUM
Welll well Tom I dont know about my triggers like yours HOWEVER I was discharged today after a 6th visit to the hospital for a fib with rapid rapid rates of 200. This time the docs said although you converted in ER after IV cardizem the time is now to start Flec. I have resisted since April 30. For safety reasons they kept me for 4 days and started a baby dose of Flec. The only trigger I can seeby Elizabeth - AFIBBERS FORUM
(Circulation. 1995;91:2834-2843.) Anticholinergic Effects of Class III Antiarrhythmic Drugs in Guinea Pig Atrial Cells, Different Molecular Mechanisms Katsumi Mori, MD; Yukio Hara, PhD; Toshihiro Saito, MD, PhD; Yoshiaki Masuda, MD, PhD; Haruaki Nakaya, MD, PhD Department of Pharmacology and the Third Department of Internal Medicine, School of Medicine, Chiba University, Japan. Hi Elizabeby Anonymous User - AFIBBERS FORUM
p4: "Sharifov et al. showed that catecholamine can induce AF (about 20% of the time) in open chest dogs, and atropine completely prevents catecholamine-mediated AF, indicating an important role of cholinergic tone in these AF episodes. " p6: "The patient was treated successfully with disopyramide, which has anticholinergic properties." The paper is shot through with rby GeorgeN - AFIBBERS FORUM
Hi Jackie, The main concern with fluoride as regards AF is its direct inhibition of Na/K pump activity, also of other pumps such as Ca-ATPase, probably all P-type ATPases . See for example: Inhibition of the Na,K-ATPase by Fluoride Parallels with its Inhibition of the Sarcoplasmic Reticulum Ca-ATPase. Alexander J. Murphy and J. Craig Hoover Department of Biochemistry, School of Dentistry,by Anonymous User - AFIBBERS FORUM
Erling - in your response to Randy, you mentioned avoiding anything containing fluoride. I presume this is because of the iodine competition. Then would propantheline bromide be acceptable/beneficial as bromide also inhibits iodine? Wikipedia says one side effect (adverse effect) of PB is tachycardia. Jackie .by Jackie - AFIBBERS FORUM