George, Here is a discussion of antihistamines in relation to their toxicity as related to their anticholinergic effects: Please let me know your conclusions as to whether AHs are worth a look for VMAFrs! Regards, Mikeby Mike - AFIBBERS FORUM
I am sure that I have read that antihistamines, antiparkinson drugs, tricyclic antidepressants all have anticholinergic effects - I wonder if it is worth looking at these as part of this discussion too? Mikeby Mike - AFIBBERS FORUM
Long, long, long ago, I was prescribed Donnatal for GI issues. I only took it briefly, as it caused my vision to become blurry. Sorry I can't remember the dose. Louiseby Louise Emerson. - AFIBBERS FORUM
Hans, That looks interesting. For EB, it may have some of the same issues as PB, since blurry vision is a potential effect. As to the other meds mentioned by Dr. Reiffel, urecholine looks like it might act somewhat differently. As to tincture of belladonna, Donnatal is prescribed and comes from belladonna. The prescribing warnings look a lot like PB. There is not a lot of normal prescribby GeorgeN - AFIBBERS FORUM
George, Further to my message about scopolamine I was wondering if Gravol (dimenhydrinate) might work for vagal afibbers. It has anticholinergic effects and, of course is also an antihistamine which may be OK for vagal afibbers. You can read about it here: Hansby Hans Larsen - AFIBBERS FORUM
I am blessed with a GP who actually listens to the patient and I brought in material from this forum on PB. My GP was quite familiar with the drug; he said it was commonly prescribed for GERD back in the days before Nexium and Zantac were available. Since I have a GERD history, he prescribed the PB for GERD. My initial dosage was 7.5mg twice a day; after about a week I noticed my vision changby E. B. - AFIBBERS FORUM
George, I wonder if a transdermal scopolamine patch might work as well as the propantheline bromide? It may be easier to get a prescription for that??? Hansby Hans Larsen - AFIBBERS FORUM
EB - were you taking the PB multiple times a day? As I understand it, you would not need to take PB in the morning if you only had nighttime episodes. Obviously, it would make sense to take the lowest dose that was still effective. Georgeby GeorgeN - AFIBBERS FORUM
EB- What was the dose of Propantheline you were taking? I read about the potential vision side effects and am curious . And how were you able to talk your GP into it?by Jill - AFIBBERS FORUM
Mike, I talked my GP into writing a prescription and tried Prop Bro for 30 days. I had no afib during this 30 day period. I am a mostly vagal affibber, one year post ablation. Prior to my Prop Bro "trial" I was experiencing episodes roughly twice a month. After taking Prop Bro for 30 days I experienced severe blurred vision (both near and far vision). I stopped the drug and my vby E. B. - AFIBBERS FORUM
It's not You v. Me, it's US v. IT.by lisa s - AFIBBERS FORUM
Yes, it's too bad personality got in the way of possibly good info. I am glad to see this subject brought up again in a much more rational way. Kudos to all the rational minds. Lisaby lisa s - AFIBBERS FORUM
Mike, My thought is to develop a fully referenced paper on vagolytic meds generally. Such a paper could be used by people like Jill to educate their physicians who are reluctant to prescribe vagolytic meds. Perhaps Dr. Reiffel would communicate with us or review the paper for accuracy. Unfortunately I have little time to devote to this task at present. So any collaborators would be welcome.by GeorgeN - AFIBBERS FORUM
Mike - these links may help you with your research... be sure to read completely. Jackieby Jackie - AFIBBERS FORUM
mike-- I am also interested in learning about Propantheline Bromide, but am satisfied to research it on my own. I definitely do not care to read the sarcastic, belittling, abrasive posts of **** on this BB. It caused me a great deal of stress to see his postings, and am very relieved that Hans has used his judgement to remove xxxxx from the Forum. At times his posts left me feeling on the verby Louise Emerson. - AFIBBERS FORUM
Thanks for all the responses. Hans, whilst I certainly respect and admire you for providing this excellent forum, it does seem a bit of a shame that my posted link to **** *****'* website was removed since whatever else the man is or isn't the information there is for VMAFrs like me provocative and well-presented. It seems a shame that the man's abrasive nature has effectively kilby Mike - AFIBBERS FORUM
Mike, I have no comments or further references regarding propantheline bromide. Hansby Hans Larsen - AFIBBERS FORUM
Hi George and others interested in PB, I have been researching the use of this drug for my afib. I have exhausted most other means to control my episodes and did ask my GP for a prescription. Although very sympathetic, he would not prescribe it for me. I can respect that, as I am asking for it for an off-label use. That will be a problem for anyone attempting to use PB. He took the literature Iby Jill - AFIBBERS FORUM
Mike, The whole concept of vagolytic meds seems to be an underexplored area. PC used disopyramide, however it has the same risk as some other anti-arrhythmic drugs (AAD)- namely torsades de pointes. I posted about Propantheline Bromide to Jill here: <; and in the same thread here: <; In my post to Jill, I reference the AERP relationship. We are obviously trying to lengthen it withby GeorgeN - AFIBBERS FORUM
It's a shame that ******* has caused so much turmoil on this site. I wish he could be a bit less abrasive, but I guess we cant all be diplomats. I too would like to see more discussion on this topic. I find it very interesting, as all other approaches have failed me. My main concern is that, if I understand it correctly, PB lengthens your QT interval. I'm not sure I like the sound ofby curt r - AFIBBERS FORUM
OK; so we all know that this is the illustrious ***********'s personal pet project, but despite the fact that he has obviously got peoples' backs up here on this forum for other reasons, isn't the option of trying to reduce STRONGLY-VAGALLY-mediated LAF episodes with PB not worthy of more detailed discussion here on this forum?? My own AF episodes are DEFINITELY vagal and, as such,by Mike - AFIBBERS FORUM
Jill, Unfortunately clicking on your name does not give an address. Mine will show. Cyndie & Louise, your emails came through. I plan to do a much longer post on the vagolytic med approach to dealing with vagal afib. It will take me a while to accomplish this because I have my business, family and a demented mother as other demands on my time. In the interest of giving you somethingby GeorgeN - AFIBBERS FORUM
Hi Joyce, The specific anticholinergic mentioned for afib is propantheline bromide. I saw reference to the same study you mentioned and did some follow up. From the below reference, "Central nervous system adverse effects should be minimal at usual clinical dosages, as propantheline does not cross the blood-brain barrier." If one chooses to use propantheline bromide, the brain issby GeorgeN - AFIBBERS FORUM
Subsequent to the above post regarding anticholinergic meds, I came across this post: "Researchers ... conducted a six-year observational study, evaluating 1,652 Indianapolis area African-Americans over the age of 70 who had normal cognitive function when the study began ... 'aking one anticholinergic significantly increased an individual's risk of developing mild cognitive impaiby GeorgeN - AFIBBERS FORUM
Dirk, For what it is worth, here are my thoughts. (1) I experienced lots of episodes when I came to rest in bed after a strenous day. That is, I lay down in bed for sleep and while calming down I turn into LAF. Vagal (2) Same question as above regarding LAF after coughing. Is coughing a vagal or a sympathetic stimulus? Vagal <> "VNS may also be achieved by one of the vagal maneuvers: hby GeorgeN - AFIBBERS FORUM
Hi Mike On the topic of propantheline bromide - I felt really dumb when Arthur was posting, because I could not find any info about it. I was interested, but could find no studies...nothing. I know I'm missing something here....do you know what this stuff is? Trade name? I remember vaguely it suppressed stomach acid, which I don't think is a good thing. But Arthur was touting it asby Lynn Robinson - AFIBBERS FORUM
Hi Lynn, Yes indeed. I do these days really notice my heart trying to crank up from vagal dominance in the night to sympathetic when I arise around 6-30 to 7-00am! Lots of ectopy and seeming reluctance to pick up some rate increase that goes on for an hour or two! Maybe ironically the only practical thing we can do to get our sympathetic NS in better fettle is to take more exercise?? Or maybe soby Mike - AFIBBERS FORUM
Sean, I presume that exercise does not bring on the afib - perhaps only in the aftermath of exercise - therefore you are vagal. Just a guess given your level of activity. See <; See this post regarding: ERP shortening due to (P cells + low potassium + ANS tone) => AF Risk <; The shortening can occur with both directions of ANS tone - vagal or adrenergic. Most "active"by GeorgeN - AFIBBERS FORUM
Tom, An inexpensive ECG finger monitor might give useful info here discriminating between afib & flutter. An example I know nothing about beyond what you see here is Here is an iPhone product As to being vagal, see this post: <; with regard to Propantheline Bromide. Other vagolytic agents other than propantheline bromide include urecholine, tincture of belladonna. Also the anti-arrby GeorgeN - AFIBBERS FORUM
Curt, In this post, <;, the ERP relationship is detailed- ERP shortening due to (P cells + low potassium + ANS tone) => AF Risk I've dealt mostly with the electrolyte part of this equation. As noted in my referenced post, Arthur Gibson deals with the ANS tone part with a novel (to me) approach of Propantheline Bromide. Looking through this search for his posts on the topic may beby GeorgeN - AFIBBERS FORUM