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%) noctuby GeorgeN - AFIBBERS FORUM
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
Before I had my ablation 6 years ago, my Cardiologist had me on Disopyramide, which I was told was an older drug. I've been told subsequently that it was an unusual choice. It did an excellent job for me for several years before the afib overpowered it. I had no side effects on it whatsoever.by Howenow - 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
Thanks Carey. I've read in multiple articles online that beta-blockers should be avoided with vagal AF. For example... Article 1: Drugs which block the sympathetic nervous system commonly used in the management of AF such as beta blockers and digoxin should be avoided. Alternative drugs such as those which reduce vagal tone should theoretically be effective. These drugs include flecainby cirenepurzalot - AFIBBERS FORUM
Susan, Tenormin is a beta blocker. Beta blockers can be used to one's advantage for those with a sympathetic or adrenergic trigger. BB's are normally contraindicated for those with vagal triggers. I'm not a doc, see what Natale says. These quotes are from Hans Larsen's (the founder of this site) book: < The findings that adrenergic afib is preceded by an increasby GeorgeN - AFIBBERS FORUM
Regarding the Norpace Anti-Arrythmic Drug, I looked at the article which has the "Black Box" warning. Here is a relevant exerpt: "Considering the known proarrhythmic properties of disopyramide and the lack of evidence of improved survival for antiarrhythmic drugs in patients without life-threatening arrhythmias, the use of disopyramide should be reserved for patients with lifby The Anti-Fib - AFIBBERS FORUM
Carey, George, wolfpack & Shannon, Many many thanks for the really helpful responses - much appreciated and most reassuring. I saw an EP in Leeds UK this week who did greatly impress me in all respects (and I'm not easily impressed). My partner is a top surgeon and is adamant that if she needed an ablation that this guy is who she would be getting to do it. This guy has been doingby mwcf - AFIBBERS FORUM
QuotePrevention of vagal type LAF Flecainide and disopyramide can be quite effective in preventing vagal LAF episodes. They are both powerful drugs and can have very serious adverse effects so they should only be used by afibbers with structurally sound hearts. Beta-blockers and sotalol have strong beta-blocking properties and are contra-indicated for vagal afibbers as they are likely to worsenby GeorgeN - AFIBBERS FORUM
I've ordered various meds. internationally. Here is a search with some options, like Canada. < Here is one option < Or generic < I have no knowledge of this vendor - just came up in the search. Georgeby GeorgeN - AFIBBERS FORUM
Thanks, George, for the references and future reading for me. By the way, I just converted to normal sinus rhythm after being on disopyramide for five days! Now, let's see if it keeps me there! Tomby leondas - AFIBBERS FORUM
Tom, Back in the day, PC (an MD and prolific poster) used it. Here is a search and you can go to the old pages for PC's posts < Georgeby GeorgeN - AFIBBERS FORUM
I recently started taking this "old drug" for rhythm control, but then again I'm an "old guy" at 75 :-) Flecainide worked wonders for me during a long period but became less and less effective in recent months. I am a vagal afibber, with episodes coming on only during my sleeping hours. I do plan to get tested for sleep apnea in the near future as that may be a factor. Iby leondas - AFIBBERS FORUM
Enrique, Pat Chambers, MD, who posted here as PC used it. He is now a Bordeaux ablatee and has not posted in a while, but here is a search on his posts on disopyramide < PC was vagal. Georgeby GeorgeN - AFIBBERS FORUM
Hello Can anyone tell me her/his experience with the antiarrhythmic disopyramide indicated for vagally- mediated AF and its possible side-effects? Thank youby Enrique - AFIBBERS FORUM
George, et al. If you go to a page for sotalol, and then find the "Interactions" tab and click it, you will be brought to the page On that page you will see "A total of 903 drugs (5533 brand and generic names) are known to interact with sotalol." under that you will see a red stop sign for which there are "202 major drug interactions (754 brand and generic namesby Morpheus - AFIBBERS FORUM
Randy, now that you mention it, I realise that those sudden postural shifts have been triggering a run of PACs - I'd just forgotten about them. Yes, dominant vagal tone seems to be at the heart of it. Did you find a way to reduce vagal tone? I've also been researching alternative medications for Paroxysmal LAF of the vagal kind. The flecainide hasn't really worked for quite a feby DavidPrice - 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
Colindo, Some afibbers have found disopyramide (Norpace) to be an acceptable alternative to flecainide. You may wish to give that a try. You can get empty gelatin capsules in the afibbers.org vitamin shop . Just search for gelatin capsules. You may also wish to try the organic ginger extract from New Chapter. You can find it here . Hansby Hans Larsen - AFIBBERS FORUM
I thought Flecainide was also good for vagally-mediated AFib (I even read it somewhere on this site). It's been working well for me, and my AFib is definitely vagally mediated. Isn't flecainide somewhat vagolytic?by Diane98683 - 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
fwiw this has been linked to elsewhere and it made a lot of sense to me..by afhound99 - AFIBBERS FORUM
Hans, that is interesting. It only happened to me 'on demand' that one day right after ablation. Before that AF would mostly (but not always) be vagially-mediated and would certainly not stop if I stood up (or start if I lay down).by afhound99 - AFIBBERS FORUM
Thank you everyone for the advice. I need to have a more serious conversation with my EP and if necessary perhaps find a new EP.by dnrec - AFIBBERS FORUM
afhound, You may be interested in this quote from Professor Coumel's foreword to my first book: Lone Atrial Fibrillation: Towards a Cure: For instance, the first patient who led me to describe vagally-mediated PAF was alternately in sinus rythm or AF depending on whether he was standing up or lying down. Hansby Hans Larsen - AFIBBERS FORUM
I agree about getting an ablation before it becomes persistent. Not that it always will, but this forum helped me to decide to go for a ablation (well I already had an appointment but was wavering a bit) and I did almost a month ago. Apart from the day after the procedure when I had what I liked to call 'on demand AF' (only when lying down, stopped when I stood up) I've been bliby afhound99 - AFIBBERS FORUM
dnrec, I was much like you, the afib was an annoyance and didn't keep me from living a normal life including a lot of exercise and physical activities. The one thing that tipped the scale was that my wife and I enjoyed extended hiking trips in Europe and I didn't want to get stuck on a long climb with afib, so I wasn't planning any trips. Once I had the ablation, then the tripby Ken - AFIBBERS FORUM
I'd get an ablation if I were you. If you wait, your afib will become persistent and then an ablation is less likely to work. I'd get an ablation ASAP.by Diane98683 - AFIBBERS FORUM
dnrec, I was much like you, the afib was an annoyance and didn't keep me from living a normal life including a lot of exercise and physical activities. The one thing that tipped the scale was that my wife and I enjoyed extended hiking trips in Europe and I didn't want to get stuck on a long climb with afib, so I wasn't planning any trips. Once I had the ablation, then the tripby Ken - AFIBBERS FORUM
I would like to have an ablation however my EP says since I have no debilitating symptoms such as fainting or pain or shortness of breath, he would not recommend it. My afib is more of an annoyance than anything. It does not affect my daily routine and after several hours it does stop. However it has been lasting longer. I am convinced it has to do with my stomach. Thanks for your help.by dnrec - AFIBBERS FORUM