I got the pharmacogenetic testing as well, Daisy. It was fascinating! I discovered I am a rapid metabolizer of caffeine and the beta blockers (propranolol, etc). Super interesting.by MeganMN - AFIBBERS FORUM
ButTaurine doesn’t inhibit not all aspects of P450, only P450 3A4. You can look up different medications to see how they are metabolized and while 3A4 is any important one, many drugs are metabolized by 2D6. QuoteThe cytochrome P450 2D6 (CYP2D6) is an enzyme of great historical importance for pharmacogenetics and is now thought to be involved in the metabolism of up to 25% of the drugs that arby Daisy - AFIBBERS FORUM
The minute I saw your description of the article I knew I was going to see Natale's name on it. He's been preaching this for years. If all you do is isolate the pulmonary veins, you're going to have a lot of unsuccessful ablations.by Carey - AFIBBERS FORUM
I have been interested in taurine for a variety of reasons, including tinnitus. This is a good article from the Cleveland Clinic, which supports the dose that @GeorgeN is taking. Another one form Cleveland Clinic for non-medical readers My main concern is that it is a cytochrome P450 enzyme inhibitor Zumpano explains that taurine works as a cytochrome P-450 enzyme inhibitor. “Tby windyshores - AFIBBERS FORUM
QuoteMeganMN On a similar note, I have done some reading and discovered that Isoproteronol can severely deplete Arginine and Taurine, which I found super interesting. I will take a look at that book and look into starting a regimine. I have the ginger, and taurine already. What type of potassium/magnesium do you use? My friend who increased his taurine to 4g/day had been taking around 250 mgby GeorgeN - AFIBBERS FORUM
On a similar note, I have done some reading and discovered that Isoproteronol can severely deplete Arginine and Taurine, which I found super interesting. I will take a look at that book and look into starting a regimine. I have the ginger, and taurine already. What type of potassium/magnesium do you use?by MeganMN - AFIBBERS FORUM
Obviously I will have to ask she more questions about the plan. Thanks everyone!by MeganMN - AFIBBERS FORUM
QuoteMeganMN George, I would rather not NEED another ablation and would definitely be game for hearing your solutions. I have tried many things, but ultimately, even if I have another ablation, I need to sort out how to keep this from happening in the first place, so I would definitely welcome your experience!! Sorry for a tardy response. I'm traveling at the moment. Here are some thoby GeorgeN - AFIBBERS FORUM
QuoteMeganMN I'm not exactly sure. He wants to induce it first because sometimes introducing the catheters will prevent induction of the Atrial Tachycardia. So he can pinpoint fairly closely where it is coming from before even hitting the EP Lab. I'm not exactly sure,.but I think he is planning to then give me some mild sedation, get the catheters in and then try to induce again,.butby Daisy - AFIBBERS FORUM
I'm not exactly sure. He wants to induce it first because sometimes introducing the catheters will prevent induction of the Atrial Tachycardia. So he can pinpoint fairly closely where it is coming from before even hitting the EP Lab. I'm not exactly sure,.but I think he is planning to then give me some mild sedation, get the catheters in and then try to induce again,.but if they cannoby MeganMN - AFIBBERS FORUM
Daisy, yes, it's as you describe....usually. The 'challenge' is at the end, or near it, where they give it your heart an accelerant and put it under stress to see if other foci can be found. My own EP said the last thing he usually does is to cardiovert...which I thought weird, but maybe it's a final step to ensure the heart really is willing to run normally, even with a goby gloaming - AFIBBERS FORUM
QuoteMeganMN This time, they are planning to try to induce medically and map it, then sedate me, introduce the catheters, and then ablate me. So do I have this right that they are going to give you isoproterenol while you are awake, map you, then give general anesthesia, introduce the catheters and ablate? While with a straight forward Afib ablation they would give general anesthesia first thby Daisy - AFIBBERS FORUM
I have not identified any specific triggers other than nighttime. It used to start like clockwork every night around 6-8pm. Now it is all the time. I have to be careful with caffeine, cannot drink soda, or take Sudafed, or alcohol, or have stress . haha. But it happens regardless every night. And since January, it is now most of the day as well. I don't think it will be so hard this timeby MeganMN - AFIBBERS FORUM
Wouldn't it be great if they could keep patients alert during challenging and mapping, and only anesthetize them once the ablation commences. I think most of us are encouraged to go sedation-free during an angiogram, which is sort of the same initial process. But, it's complicated. Some are in AF, as I always was during my angiogram and both ablations (worked up, maybe loss of some slby gloaming - AFIBBERS FORUM
Daisy, as mine was a straightforward procedure, I was told they would just ablate the pulmonary vein and I think posterior wall. I had an additional minor LAA ablation... Megan, sorry you are suffering so much with your SVTs. Do you know what triggers it? I know my sister has SVTs and atrial tachycardia ,but unlike you she is able to control it with her meds, however if she eats or drinksby Fuzzyduck - AFIBBERS FORUM
Yeah, atrial tachycardia is the devil. It just doesn't offer any easy ways to stop it.by Carey - AFIBBERS FORUM
So I have a specific and rare type of SVT, Atrial Tachycardia. There are three main types. One of the types is when the SA node sends a signal in a circle and at the AV node, it comes back to the SA node. The second kind is when the signal gets looped at the AV Node. My kind, Atrial Tachycardia, is an errant signal somewhere else in the Atria that is also sending a signal. In addition to the SA nby MeganMN - AFIBBERS FORUM
QuoteFuzzyduck What do you mean by your arrhythmia being paroxysmal, your SVTs or your Afib? Because when I had my ablation in April I hadn’t had any afib since November but I had svts, not nearly as many as you but runs of them. But he managed to get my afib going for a ‘very short time’. Enough to know what to ablate…although I appreciate our cases may be very different… This touches onby Daisy - AFIBBERS FORUM
What do you mean by your arrhythmia being paroxysmal, your SVTs or your Afib? Because when I had my ablation in April I hadn’t had any afib since November but I had svts, not nearly as many as you but runs of them. But he managed to get my afib going for a ‘very short time’. Enough to know what to ablate…although I appreciate our cases may be very different…by Fuzzyduck - AFIBBERS FORUM
Thanks Jim! I have actually checked out the Nurosym. I have tried another vague nerve stimulator with a TENS unit, without much success, but always willing to look at other options!! I am determined to feel better!!by MeganMN - AFIBBERS FORUM
One interesting alternate approach might be the Nurosym device which stimulates the vagus nerve. A similar device, by the same company, was used in the TREAT AF trial and showed great promise in reducing afib burden. It may also be helpful for other arrhythmia's. Neurosym is currently not available in the US, but there are workarounds such as getting it on the secondary market, etc. Considby mjamesone - AFIBBERS FORUM
Gloaming is right. The risk of serious complications from isoproterenol is primarily limited to people with compromised cardiac circulation. All it does is raise your heart rate and make your heart more reactive. It doesn't constrict blood flow as many other stimulant drugs do. It's very commonly used in ablations without issue, especially by more experienced EPs. It's pretty muchby Carey - AFIBBERS FORUM
I would think the risk of heart attack would be for those with significant ischemia. If your cardiac blood supply is not compromised, or close to being compromised, say with a largely obstructed LAD, you'd probably not be a candidate for that kind of challenge. But, if a recent angiogram shows minor deposits here and there, I don't see why isoproterenol would cause a heart attack. Tacby gloaming - AFIBBERS FORUM
Thanks for the replies! Carey and George, I will do everything and anything I can to have a successful ablation! George, I would rather not NEED another ablation and would definitely be game for hearing your solutions. I have tried many things, but ultimately, even if I have another ablation, I need to sort out how to keep this from happening in the first place, so I would definitely welcome yoby MeganMN - AFIBBERS FORUM
QuoteMeganMN He did say that most EP labs are afraid to use the high doses of Isoproteronol that are needed. Did he explain what the cautions are with using high doses of Isoproteronol?by Daisy - AFIBBERS FORUM
Megan, Where my mind goes is to experiment and find a formula that creates your arrhythmia on demand. I realize this would suck, but if you can figure out a formula that works, then you could be confident that you could create the arrhythmia for the time when you schedule your ablation. The second thought I have & this is on the other side -- making the arrhythmia not happen. How mucby GeorgeN - AFIBBERS FORUM
Follow his advice? Is your local EP willing to use high doses of isoproterenol? I would get that question answered first. Are you willing to tie one on the night before the procedure?by Carey - AFIBBERS FORUM
I finally had my Telehealth Consult with Natale and Shannon on Monday. Shannon did her homework and had looked over all my records. She was definitely in my corner with the quality of life issues with my arrhythmia. Natale gave me some very valuable advice with the meds, and basically told me that none of them are going to work for my rhythm if nothing has helped up to now. He said to not botherby MeganMN - AFIBBERS FORUM
thanks Gloaming. I have tried Cardizem, Rhythmol, Multaq, Flecainide, Norpace, Metoprolol, Propranolol, Sotolol, Bisoprolol, Ivabradine... I think that is it. I had my consult with Natale. It was okay. He was very clear that probably none of the medications are going to work. He said I just need an ablation but that with my rhythm being so paroxysmal it is going to be super hard to catch and treby MeganMN - AFIBBERS FORUM
I forget it you had tried diltiazem, Megan. Propafenone, Multaq,...any of these in your history already? There is a surprisingly high number of other drugs used for arrhythmia and rate control. I'm continually amazed. I'll keep my fingers crossed for you with Natale.by gloaming - AFIBBERS FORUM