Vagal AF & some new ideas

[Guest guest]

I just got back from a trip to Costa Rica, which was brave of me since I

never know when my AF is going to appear. And, it did, of course, but I

learned several new things. Sorry for this very long message.

First, I was taking anti-malarial medicine because we were in the jungle.

You take it a week before leaving and while you are there and then for four

weeks afterwards. When I took it the week before, I went into AF,but thought

it was coincidental. Then, while I was there, I took the antimalarial

medicine again, and it put me into AF. The third time I waited until I was

back on US soil and took it and almost went into AF, but was able to rescue

myself as I will describe. I now have to take it for four more weeks, and

will use the same rescue again, and hope that it works.

Second. The rescue remedy. Well, there are really two, so I will describe

them.

The first: As I indicated earlier, I was prescribed Provigil to help me get

over the side-effects of taking so much Norpace which I have to do to bring

me out of AF (The Norpace is given for VAGAL AF, not the other kind). (I

took some of it to find out if it was helpful otherwise, but really don't

believe that it is, contrary to what I said earlier.) But then I asked my

docs if I could take it along with the Norpace, and was told that was

perfectly okey - by the electrophysiologist at U-M, and by my

gastroenterologist. So, I started taking it along with the Norpace for the

last two episodes. What I did discover with this is that it seemingly

shortens the time it takes the Norpace to work by about two-thirds. In other

words, although it often takes 30 hours for the Norpace alone to work, the

last two times, taking the Provigil along with it has shortened the episodes

to eight hours (or less). I will continue to keep you informed of whether

this works, but I have scraped taking the Provigil other than for that

situation.

Secondly, at the same time as I was checking on the Provigil, I asked my doc

if I could take the Norpace as a preventive, that is, whether I could take it

just when I felt that my heart was giving me the prodrome that it was going

to go into AF. (For me, that means that the beat becomes just a little off -

that it is being controlled by the vagus nerve rather than the sympathetic

nervous system. (Others have reported this also). (To recapitulate, my one

doc wanted me to take the Norpace all the time, and the other specialist from

U-M thought that I could take it only when I had gone into AF, since I only

have about ten episodes a year). So, this was a new idea- take it when I

felt that the vagus nerve acting up. This makes sense, since the Norpace

fills the same " keyhole " as the choline from the vagus nerve does, leaving

fewer receptors for the choline to fill (which is why it is called an

anti-cholinergic drug). So, when the anti-malarial medicine stated to cause

my heart to act up, but before it went into AF, I took 100 mg of the Norpace.

This did work, but I felt not really " cured " , so I took a second 100 mg of

the Norpace (I take 200 mg every four hours to get me out of AF, so this is

the " regular " dosage), and it worked marvelously. We ran into problems in

our trip back, with a five hour trip taking 16 hours instead, including an

emergency landing to refuel in Nassau and a really terrible lightening storm

that tossed our airbus about mercilously- and this is certainly the sort of

thing that could cause AF, so I tried this remedy again when we landed, and

it worked like a charm. No AF, and none since I have gotten home.

So, to conclude, I was able to go to Central America and have a great time,

and now feel that I have a great deal of more control over my vagal AF than I

did before. Dorean

[Guest guest]

wrote:

" I'm think about asking my docs about disopyramide (Norpace) on my next

visit. 30

hours seems a long time to react though - I'm usually out in 25 hours

anyway. "

- One of my problems has been that I never come out of the AF except

through cardioversions, and more recently, through taking Norpace. So,

before I had this solution, I had about a dozen cardioversions.

" I've read that it takes around 30 minutes to get into your system. Does it

control you heart rate while you are in AF or do you take something else for

rate control? (I've read that it can increase rate - not something I'm keen

on

when I'm in AF) "

Because I have vagal AF, my heart rate isn't particularly fast even when I am

in AF, so this hasn't been a problem for me. Dr. Fred Marody originally

prescribed a dual prescription, having me take 200 mgs of Norpace and a dose

(I've forgotten how muchy) of Inderol, both at the same time. The Inderol

was for rate control, but we discontinued it because it made me feel worse

instead of better.

" I also often sense when I'm going to go into AF (several hours before the

event)

so I could also take it as a preventative measure. Sometimes AF is a surprise

though and I'm not keen on my heart going like the clappers for the first 30

minutes. "

I have discovered that I have a prodrome too, and it has given me some sense

of control (perhaps misplaced) to know that I can take the Norpace when

needed to prevent an episode. But since the last two episodes were probably

caused by the anti-malarial medicine, I won't know whether it will control

for other triggers until I try it.

Thanks for writing. Dorean