Guest guest Posted August 6, 2001 Report Share Posted August 6, 2001 In a message dated 8/6/2001 2:28:44 PM Pacific Daylight Time, james@... writes: << However I do not believe that the beta blocker is increasing my frequency so I continue to make the most of it until something better comes along. >I'm not tossing the bata blockers in the > toilet yet. >> I agree. My afib is primarily vagal, I think, and the beta blocker Atenolol does a good job of controlling the rate along with a calcium channel blocker, Verapamil. I am now in my tenth day of afib, and like Vicki, hoping it won't be persistent; but my symptoms are nearly zero: just a slight tingling and weakness in my legs when I exercise. I believe that the beta and calcium channel blockers are responsible for controlling my symptoms to the point that I feel normal and must take my pulse to see if I am still in afib. (My primary care physician did verify last week during my yearly physical that I am indeed " fibrillating, " although she had to listen for a rather long period of time to confirm the afib. This is because my pulse can seem absolutely regular for about 10 or 20 seconds before it then becomes quite erratic.) Two years ago when my afib symptoms worsened, an increase of Atenolol from 50 to 150 m.g. slowed the rate to a level which allowed me to function. Before the increase in the beta blocker, I literally felt that fainting was imminent most of the time. The addition of the calcium channel blocker later further stabilized the situation. The beta blocker will not prevent my afib, obviously, but it definitely does help me. Perhaps this is because my afib also has a strong adrenergic component in being caused by stress at times. Could this be the difference? Maybe persons who are both adrenergic and vagal are helped by beta blockers or at least can tolerate them while purely vagal afibbers find beta blockers detrimental! At any rate, I will cling to my beta blocker until I can decide on a possibly better alternative. in Seattle Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 6, 2001 Report Share Posted August 6, 2001 In a message dated 8/6/2001 2:28:44 PM Pacific Daylight Time, james@... writes: << However I do not believe that the beta blocker is increasing my frequency so I continue to make the most of it until something better comes along. >I'm not tossing the bata blockers in the > toilet yet. >> I agree. My afib is primarily vagal, I think, and the beta blocker Atenolol does a good job of controlling the rate along with a calcium channel blocker, Verapamil. I am now in my tenth day of afib, and like Vicki, hoping it won't be persistent; but my symptoms are nearly zero: just a slight tingling and weakness in my legs when I exercise. I believe that the beta and calcium channel blockers are responsible for controlling my symptoms to the point that I feel normal and must take my pulse to see if I am still in afib. (My primary care physician did verify last week during my yearly physical that I am indeed " fibrillating, " although she had to listen for a rather long period of time to confirm the afib. This is because my pulse can seem absolutely regular for about 10 or 20 seconds before it then becomes quite erratic.) Two years ago when my afib symptoms worsened, an increase of Atenolol from 50 to 150 m.g. slowed the rate to a level which allowed me to function. Before the increase in the beta blocker, I literally felt that fainting was imminent most of the time. The addition of the calcium channel blocker later further stabilized the situation. The beta blocker will not prevent my afib, obviously, but it definitely does help me. Perhaps this is because my afib also has a strong adrenergic component in being caused by stress at times. Could this be the difference? Maybe persons who are both adrenergic and vagal are helped by beta blockers or at least can tolerate them while purely vagal afibbers find beta blockers detrimental! At any rate, I will cling to my beta blocker until I can decide on a possibly better alternative. in Seattle Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 6, 2001 Report Share Posted August 6, 2001 > P. Raichel P. Raichel <sraichel@n...> wrote : > > >Thanks to informed members of this group and in particular Vicky's web site > >www.vagalafportal.fsnet.co.uk, I deduced that my afib is vagal, and this was > >confirmed by cardiologist No.2. I threw the beta blockers in the toilet > : My AF is classically vagal but I believe it is being well controlled by a bata blocker (Atenolol) and digoxin. Vicky's excellent FAQ has helped me a great deal but I believe it is only Coumel,in the scientific community,who feels there my be a connection between bata blockers and Vagal AF. He may well be right,in some cases, but as Vicky indicates in a footnote: " The reason Propafenone is mentioned here as possibly contra-indicated, ( and presumabably this can apply to other drugs) is to make the reader aware not that they should necessarily avoid this/these drugs totally, but that if their AF seems worse on such a drug, it may well be the drug itself is causing a reaction " . I don't think any scientific data is extant showing a direct adverse co-relation between bata blockers and Vagal AF. If so, I can't believe the medical profession, particularly Cardiologists and EPs, could be totally ignorant of something so absolutely fundamental. I'm not tossing the bata blockers in the toilet yet. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 6, 2001 Report Share Posted August 6, 2001 > P. Raichel P. Raichel <sraichel@n...> wrote : > > >Thanks to informed members of this group and in particular Vicky's web site > >www.vagalafportal.fsnet.co.uk, I deduced that my afib is vagal, and this was > >confirmed by cardiologist No.2. I threw the beta blockers in the toilet > : My AF is classically vagal but I believe it is being well controlled by a bata blocker (Atenolol) and digoxin. Vicky's excellent FAQ has helped me a great deal but I believe it is only Coumel,in the scientific community,who feels there my be a connection between bata blockers and Vagal AF. He may well be right,in some cases, but as Vicky indicates in a footnote: " The reason Propafenone is mentioned here as possibly contra-indicated, ( and presumabably this can apply to other drugs) is to make the reader aware not that they should necessarily avoid this/these drugs totally, but that if their AF seems worse on such a drug, it may well be the drug itself is causing a reaction " . I don't think any scientific data is extant showing a direct adverse co-relation between bata blockers and Vagal AF. If so, I can't believe the medical profession, particularly Cardiologists and EPs, could be totally ignorant of something so absolutely fundamental. I'm not tossing the bata blockers in the toilet yet. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 6, 2001 Report Share Posted August 6, 2001 I forgot to sign the previous: Don, Ontario Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 6, 2001 Report Share Posted August 6, 2001 I forgot to sign the previous: Don, Ontario Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 6, 2001 Report Share Posted August 6, 2001 In a message dated 8/6/2001 3:15:13 PM Pacific Daylight Time, Starfi6314@... writes: << I can't blame any of my usual triggers for this current afib, so it may just be adrenergic. Whatever it is, I want out! >> Thanks to all who have sent me notes wishing a speedy return to sinus. I joyfully announce that about an hour after I wrote the last post, I returned to NSR, just an hour and a half short of ten full days in afib. This is a new record length for me which I do not want to break in the future. In thinking about my other two previous long episodes, I realized that my previous record of eight days in afib was set exactly two years ago at the beginning of August! The dates for the eight and ten day sessions are nearly the same but two years apart! If I had suffered a long session at this time last year, I would really wonder if it's more than coincidental. Another similarity is that both the eight day session two years ago and the ten day session just completed started when I was at a higher altitude location in the mountains, a vacation place which I bought for a periodic getaway. However, I frequently visit the place for a weekend without going into afib. Before both of the longest sessions, I was on vacation and, therefore, spent a longer period of time at the higher altitude, about 3,400 ft, than I am able to spend at other times of the year. I can't help but wonder if the altitude is a precipitator of afib because I also own another vacation spot at a lower elevation, about 400 ft., on a river, and only twice has afib started at the lower elevation spot whereas I have had numerous (uncounted) afib episodes start at the higher elevation. (Maybe I should stick to the river for vacations!) This is probably idle speculation in an attempt to comprehend a phenomenon (afib) which is basically incomprehensible and which defies logical analysis. However, in the future I will think twice about spending a week at my mountain place in late July-early August! I've paid a high price for that vacation if indeed it triggered my longest afib episode. Anyway, I do wish a speedy return to sinus for Vicki and any others who have been suffering a long afib episode along with me. You have my deep sympathy. I thought I should announce my return to sinus right away to possibly give hope to others who are caught up in a long afib episode and, as I was doing until an hour ago, are wondering if the episode will ever end. Don't give up hope! in Seattle and happily in sinus :-) Hey, maybe that would make a catchy title for a new film: " In Sinus in Seattle! " It's definitely better than being " Sleepless in Seattle " although I've experienced that, too, as a result of afib. If I seem a bit hysterical, it's probably because I am experiencing that return-to- NSR euphoria that others have written about! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 6, 2001 Report Share Posted August 6, 2001 In a message dated 8/6/2001 3:15:13 PM Pacific Daylight Time, Starfi6314@... writes: << I can't blame any of my usual triggers for this current afib, so it may just be adrenergic. Whatever it is, I want out! >> Thanks to all who have sent me notes wishing a speedy return to sinus. I joyfully announce that about an hour after I wrote the last post, I returned to NSR, just an hour and a half short of ten full days in afib. This is a new record length for me which I do not want to break in the future. In thinking about my other two previous long episodes, I realized that my previous record of eight days in afib was set exactly two years ago at the beginning of August! The dates for the eight and ten day sessions are nearly the same but two years apart! If I had suffered a long session at this time last year, I would really wonder if it's more than coincidental. Another similarity is that both the eight day session two years ago and the ten day session just completed started when I was at a higher altitude location in the mountains, a vacation place which I bought for a periodic getaway. However, I frequently visit the place for a weekend without going into afib. Before both of the longest sessions, I was on vacation and, therefore, spent a longer period of time at the higher altitude, about 3,400 ft, than I am able to spend at other times of the year. I can't help but wonder if the altitude is a precipitator of afib because I also own another vacation spot at a lower elevation, about 400 ft., on a river, and only twice has afib started at the lower elevation spot whereas I have had numerous (uncounted) afib episodes start at the higher elevation. (Maybe I should stick to the river for vacations!) This is probably idle speculation in an attempt to comprehend a phenomenon (afib) which is basically incomprehensible and which defies logical analysis. However, in the future I will think twice about spending a week at my mountain place in late July-early August! I've paid a high price for that vacation if indeed it triggered my longest afib episode. Anyway, I do wish a speedy return to sinus for Vicki and any others who have been suffering a long afib episode along with me. You have my deep sympathy. I thought I should announce my return to sinus right away to possibly give hope to others who are caught up in a long afib episode and, as I was doing until an hour ago, are wondering if the episode will ever end. Don't give up hope! in Seattle and happily in sinus :-) Hey, maybe that would make a catchy title for a new film: " In Sinus in Seattle! " It's definitely better than being " Sleepless in Seattle " although I've experienced that, too, as a result of afib. If I seem a bit hysterical, it's probably because I am experiencing that return-to- NSR euphoria that others have written about! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 6, 2001 Report Share Posted August 6, 2001 In a message dated 8/6/2001 5:20:16 PM Pacific Daylight Time, sraichel@... writes: << I think we must all continue to seek what works for each of us. >> Sandy, You are so right. I think your statement above is the first rule we should all remember in dealing with afib. The line between adrenergic and vagal afib is often a very fine one in some individuals like me. Sometimes my afib type is not clear to me. Therefore, any drug must be judged in each individual case by its effects on that individual, not on its reputation or effects on other people. Also, even though beta blockers cause breathing problems for most asthmatics, I have been able to take large doses of Atenolol with impunity, and I am an asthma sufferer. Initially my doctor had serious concerns about prescribing a beta blocker for me because of my history of asthma even though asthma has not given me much trouble as an adult. I think this again points out the role of individual differences. If my doctor and I had assumed that I, like most asthmatics, could not take a beta blocker, I would have lost the benefit of a drug that has worked well for me without causing asthma attacks. Each person must do what he or she must do and whatever works. in Seattle Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 6, 2001 Report Share Posted August 6, 2001 > Vicky's > excellent FAQ has helped me a great deal but I believe it is only > Coumel,in the scientific community,who feels there my be a connection > between bata blockers and Vagal AF. Hi Don, I'm also pretty sure I have a large vagal component to my AF and yet am taking a beta blocker. I'm pretty sure it is more than Coumel who feels that beat blocker are contra indicated for vagal AF though. Camm and Waktare, for example, say beta blockers should be used for adregenic AF in their book 'Atrial Fibrillation'. > If so, I can't believe the medical profession, particularly > Cardiologists and EPs, could be totally ignorant of something so > absolutely fundamental. not wishing to slate the scientific community here. They have to work on current evidence and statistics. I think they try to fix the majority - then look at the rest. (probably not a bad iterative process as long as you carry on until every one is cured!) Sadly there are always exceptions in life and we may be sitting on the wrong side of some statistics. It is probably true that the majority of vagal AFer's will see no improvement or see worsening symptoms given beta blockers. Some, however, may find benefit. Personally I have found little benefit other than a slight reduction in rate when I go into AF. However I do not believe that the beta blocker is increasing my frequency so I continue to make the most of it until something better comes along. >I'm not tossing the bata blockers in the > toilet yet. neither am I -- D Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 6, 2001 Report Share Posted August 6, 2001 > Vicky's > excellent FAQ has helped me a great deal but I believe it is only > Coumel,in the scientific community,who feels there my be a connection > between bata blockers and Vagal AF. Hi Don, I'm also pretty sure I have a large vagal component to my AF and yet am taking a beta blocker. I'm pretty sure it is more than Coumel who feels that beat blocker are contra indicated for vagal AF though. Camm and Waktare, for example, say beta blockers should be used for adregenic AF in their book 'Atrial Fibrillation'. > If so, I can't believe the medical profession, particularly > Cardiologists and EPs, could be totally ignorant of something so > absolutely fundamental. not wishing to slate the scientific community here. They have to work on current evidence and statistics. I think they try to fix the majority - then look at the rest. (probably not a bad iterative process as long as you carry on until every one is cured!) Sadly there are always exceptions in life and we may be sitting on the wrong side of some statistics. It is probably true that the majority of vagal AFer's will see no improvement or see worsening symptoms given beta blockers. Some, however, may find benefit. Personally I have found little benefit other than a slight reduction in rate when I go into AF. However I do not believe that the beta blocker is increasing my frequency so I continue to make the most of it until something better comes along. >I'm not tossing the bata blockers in the > toilet yet. neither am I -- D Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 6, 2001 Report Share Posted August 6, 2001 I have been reading everyone talk about vagal vs. adrenergic afib. Being brand new to this I'm not sure which I have, although I'm leaning toward vagal. I run a lot and my resting pulse is normally in the low 50's during the day and I'm sure a lot slower at night. Three of my four episodes have started after going to bed. The other was a couple hours after exercising. My doctor had me on atenolol after my first attack and it seemed to work fine until about two weeks ago when I started having many more PACs which finally went into afib. He took me off of the atenolol and my rate has stayed around the 80's while being in fib for the last 8 days. I just started taking norpace today but see no changes yet. I'm one of those that only feels my fib during pulse checks and exercise. I'm hoping that my afib is something that goes away for good but I'm also a realist so I'm trying to gather much information as early as I can. My doc mentioned ablation as one alternative if drugs don't work. Is that what MAZE is? As active and young (49) as I am I really don't want to think about pacers. Jack Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 6, 2001 Report Share Posted August 6, 2001 I have been reading everyone talk about vagal vs. adrenergic afib. Being brand new to this I'm not sure which I have, although I'm leaning toward vagal. I run a lot and my resting pulse is normally in the low 50's during the day and I'm sure a lot slower at night. Three of my four episodes have started after going to bed. The other was a couple hours after exercising. My doctor had me on atenolol after my first attack and it seemed to work fine until about two weeks ago when I started having many more PACs which finally went into afib. He took me off of the atenolol and my rate has stayed around the 80's while being in fib for the last 8 days. I just started taking norpace today but see no changes yet. I'm one of those that only feels my fib during pulse checks and exercise. I'm hoping that my afib is something that goes away for good but I'm also a realist so I'm trying to gather much information as early as I can. My doc mentioned ablation as one alternative if drugs don't work. Is that what MAZE is? As active and young (49) as I am I really don't want to think about pacers. Jack Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 6, 2001 Report Share Posted August 6, 2001 Don, there are others in our group who do well on Atenolol and digoxin. I also do not know of any current scientific data available showing a direct adverse correlation between beta blockers and vagally mediated afib. Nevertheless, I recall the second cardiologist I saw say that among his patients he had seen many cases of beta blockers making vagally-mediated afib worse, and I believe this was true in my particular case. Once I stopped taking this medication on his advice, it was certainly a relief to not only have the duration of my episodes reduced by 10 or so hours, but also to not have to deal with the breathing problems I experienced taking the non-cardioselective beta blocker that the first cardiologist had prescribed. btw, this first cardiologist, who works in the same hospital and the same department as the second cardiologist, held no stock whatsoever in the differences between vagal or adrenergic afib, and I feel she ignored the complicating factor of my asthma. In my experience there is a wide variation of treatment for afib, judging from the ten or so times I went to the ER in the first year of afib, and having been treated ten different ways. I am grateful to have finally connected with a medical professional in whom I have confidence, who seems (considering my very limited knowledge) to be " up to snuff " on afib, and who is interested in me as a patient. I suppose that it is all very subjective in the total experience. I think we must all continue to seek what works for each of us. Sandy, 54, NC : My AF is classically vagal but I believe it is being well controlled by a bata blocker (Atenolol) and digoxin. Vicky's excellent FAQ has helped me a great deal but I believe it is only Coumel,in the scientific community,who feels there my be a connection between bata blockers and Vagal AF. He may well be right,in some cases, but as Vicky indicates in a footnote: " The reason Propafenone is mentioned here as possibly contra-indicated, ( and presumabably this can apply to other drugs) is to make the reader aware not that they should necessarily avoid this/these drugs totally, but that if their AF seems worse on such a drug, it may well be the drug itself is causing a reaction " . I don't think any scientific data is extant showing a direct adverse co-relation between bata blockers and Vagal AF. If so, I can't believe the medical profession, particularly Cardiologists and EPs, could be totally ignorant of something so absolutely fundamental. I'm not tossing the bata blockers in the toilet yet. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 7, 2001 Report Share Posted August 7, 2001 > My doc mentioned ablation as one alternative > if drugs don't work. Is that what MAZE is? As active and young (49) as I am I > really don't want to think about pacers. > Jack Hi Jack, MAZE and ablation are two different things (but they try to fix the AF in a similar way) it may be worth checking the following link out.... http://www.mayo.edu/cv/wwwpg_cv/ep_lab/new-nonpharmacologic-therapies-f.htm There also a great discussion site for people interested in the MAZE at http://www.mddietofutah.com/wwwboard/index.html cheers -- -- D (32, Leeds, UK) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 7, 2001 Report Share Posted August 7, 2001 > My doc mentioned ablation as one alternative > if drugs don't work. Is that what MAZE is? As active and young (49) as I am I > really don't want to think about pacers. > Jack Hi Jack, MAZE and ablation are two different things (but they try to fix the AF in a similar way) it may be worth checking the following link out.... http://www.mayo.edu/cv/wwwpg_cv/ep_lab/new-nonpharmacologic-therapies-f.htm There also a great discussion site for people interested in the MAZE at http://www.mddietofutah.com/wwwboard/index.html cheers -- -- D (32, Leeds, UK) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 7, 2001 Report Share Posted August 7, 2001 on Mon, 6 Aug 2001 at 22:24:17, Driscoll wrote : >Camm and Waktare, for example, say beta blockers should be used for >adregenic AF >in their book 'Atrial Fibrillation'. Just got this today - some book! Have 3 weeks loan to read it in! Amazing amount of experience in it! Best of health to all, Vicky Status : looks like it's going persistent? Hope not. - awaiting Propafenone pre-post ECGs with fingers crossed 1954 model, North London, UK http://www.vagalafibportal.fsnet.co.uk/ " We don't have a hopeless end; we have an endless hope " - anon (?) via Ellen " Science may be described as the art of systematic over-simplification " - Karl Popper " All truth goes through three stages: first it is ridiculed, then it is violently opposed, finally it is accepted as self evident. " - Schopenhauer " There is a moment in the life of any problem when it is large enough to see, but small enough to solve " - anon " Wisdom is the quality that keeps you from getting into situations where we need it " - Doug Larsen - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 7, 2001 Report Share Posted August 7, 2001 on Mon, 6 Aug 2001 at 22:24:17, Driscoll wrote : >Camm and Waktare, for example, say beta blockers should be used for >adregenic AF >in their book 'Atrial Fibrillation'. Just got this today - some book! Have 3 weeks loan to read it in! Amazing amount of experience in it! Best of health to all, Vicky Status : looks like it's going persistent? Hope not. - awaiting Propafenone pre-post ECGs with fingers crossed 1954 model, North London, UK http://www.vagalafibportal.fsnet.co.uk/ " We don't have a hopeless end; we have an endless hope " - anon (?) via Ellen " Science may be described as the art of systematic over-simplification " - Karl Popper " All truth goes through three stages: first it is ridiculed, then it is violently opposed, finally it is accepted as self evident. " - Schopenhauer " There is a moment in the life of any problem when it is large enough to see, but small enough to solve " - anon " Wisdom is the quality that keeps you from getting into situations where we need it " - Doug Larsen - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 8, 2001 Report Share Posted August 8, 2001 Vicky , Thank you for your post . I'm sure there will be many gems to be found in the text even though the going may be tough . Do let us know whether Professor Camm advances a scientific definition of Adrenergic Atrial Fibrillation ( scientific preferred and if not scientific then any other definition ) . So many of us seem to be not completely sure whether we have vagal or adrenergic AF or some mix of the two . And we know that much hinges on a correct diagnosis . Hope you are continuing well , Tom In AFIBsupport@y..., Vicky <vmpaf@v...> wrote: > on Mon, 6 Aug 2001 at 22:24:17, Driscoll > <james@d...> wrote : > >Camm and Waktare, for example, say beta blockers should be used for > >adregenic AF > >in their book 'Atrial Fibrillation'. > > Just got this today - some book! Have 3 weeks loan to read it in! > > Amazing amount of experience in it! > > Best of health to all, > Vicky > Status : looks like it's going persistent? Hope not. > - awaiting Propafenone pre-post ECGs with fingers crossed > > 1954 model, North London, UK > http://www.vagalafibportal.fsnet.co.uk/ > > " We don't have a hopeless end; we have an endless hope " > - anon (?) via Ellen > > " Science may be described as the art of systematic > over-simplification " - Karl Popper > > " All truth goes through three stages: first it is ridiculed, then > it is violently opposed, finally it is accepted as self evident. " > - Schopenhauer > > " There is a moment in the life of any problem when it is large > enough to see, but small enough to solve " - anon > > " Wisdom is the quality that keeps you from getting into > situations where we need it " - Doug Larsen > > - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 8, 2001 Report Share Posted August 8, 2001 Vicky , Thank you for your post . I'm sure there will be many gems to be found in the text even though the going may be tough . Do let us know whether Professor Camm advances a scientific definition of Adrenergic Atrial Fibrillation ( scientific preferred and if not scientific then any other definition ) . So many of us seem to be not completely sure whether we have vagal or adrenergic AF or some mix of the two . And we know that much hinges on a correct diagnosis . Hope you are continuing well , Tom In AFIBsupport@y..., Vicky <vmpaf@v...> wrote: > on Mon, 6 Aug 2001 at 22:24:17, Driscoll > <james@d...> wrote : > >Camm and Waktare, for example, say beta blockers should be used for > >adregenic AF > >in their book 'Atrial Fibrillation'. > > Just got this today - some book! Have 3 weeks loan to read it in! > > Amazing amount of experience in it! > > Best of health to all, > Vicky > Status : looks like it's going persistent? Hope not. > - awaiting Propafenone pre-post ECGs with fingers crossed > > 1954 model, North London, UK > http://www.vagalafibportal.fsnet.co.uk/ > > " We don't have a hopeless end; we have an endless hope " > - anon (?) via Ellen > > " Science may be described as the art of systematic > over-simplification " - Karl Popper > > " All truth goes through three stages: first it is ridiculed, then > it is violently opposed, finally it is accepted as self evident. " > - Schopenhauer > > " There is a moment in the life of any problem when it is large > enough to see, but small enough to solve " - anon > > " Wisdom is the quality that keeps you from getting into > situations where we need it " - Doug Larsen > > - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 8, 2001 Report Share Posted August 8, 2001 on Wed, 8 Aug 2001 at 10:01:31, seeyamate@... wrote : >Do let us know whether Professor Camm advances a scientific >definition of Adrenergic Atrial Fibrillation ( scientific preferred >and if not scientific then any other definition ) . Well, I am not sure exactly what counts as scientific - my own definition is " valid observation " . He has a table in the chapter on " classification " which lists: " Vagotonic AF : Younger (30 to 50 yr); male>female; " normal heart " ; post-prandial episodes; evening or nocturnal attacks; slow ventricular rates in AF; antecedent bradycardia. Therapy: Disopyramide; Class I antiarrhythmic agents; atrial pacing; (aggravated by digoxin) " " Adrenergic AF : Older (50+ yr); no gender bias; structural heart disease; episodes during or after exercise; early morning attacks; fast rates; prior tachycardia. Therapy: Propafenone; sotalol; beta-blockers " " Perhaps as much as one-quarter of paroxysmal AF is vagotonic, one fifth adrenergic or predominantly adrenergic. Many patients present mixed or indeterminate patterns. " The key reference for this chapter is " Gallagher MG, Camm AJ. Classification of atrial fibrillation. Pacing Clin Electrophysiol (1997 20: 1603-5 " HTH One very interesting pointer I had not seen or appreciated before is that a low ventricular rate is a feature of AF attacks in vagal. I definitely get this - ventricular rate control has never had to be an objective of my AF management. There are many other classification schemes outlined. Generally, I think his chapter outlines why there may be a difference in perception between the medical professionals and patients with LAF. Statistically, the number of patients they see with all forms of AF is biased towards older patients with heart disease. The classification schemes are manifold. The number they see of young LAF patients who may be vagal is thus probably quite small. However, if you are one of those, (like me), then vagal LAF is 100% of your world, and not to have it recognised is devastating. >Hope you are continuing well , Tom 'fraid not so good, Tom. The disopyramide stopped working and was lately giving me excessive side-effects. I am now off it and waiting for it to clear out, then to get a pre- and post-ECG for going onto propafenone. In the meantime, my AF has gone almost persistent - I have been in AF as I write for 11 days continuous, apart from a 14-hour respite last Friday. I don't think it is coming off the disopyramide that has done it, as I was starting to get longer and more frequent AF runs even on it. What is concerning for me is that my digestion is almost back to normal. In the past this has always been my cause/trigger. But now my digestive status is no longer the way in which I can actually stop an attack, though it does still seem to have an effect. The only consistent thing about AF is it inconsistency ! Best of health to all, Vicky Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 8, 2001 Report Share Posted August 8, 2001 on Wed, 8 Aug 2001 at 10:01:31, seeyamate@... wrote : >Do let us know whether Professor Camm advances a scientific >definition of Adrenergic Atrial Fibrillation ( scientific preferred >and if not scientific then any other definition ) . Well, I am not sure exactly what counts as scientific - my own definition is " valid observation " . He has a table in the chapter on " classification " which lists: " Vagotonic AF : Younger (30 to 50 yr); male>female; " normal heart " ; post-prandial episodes; evening or nocturnal attacks; slow ventricular rates in AF; antecedent bradycardia. Therapy: Disopyramide; Class I antiarrhythmic agents; atrial pacing; (aggravated by digoxin) " " Adrenergic AF : Older (50+ yr); no gender bias; structural heart disease; episodes during or after exercise; early morning attacks; fast rates; prior tachycardia. Therapy: Propafenone; sotalol; beta-blockers " " Perhaps as much as one-quarter of paroxysmal AF is vagotonic, one fifth adrenergic or predominantly adrenergic. Many patients present mixed or indeterminate patterns. " The key reference for this chapter is " Gallagher MG, Camm AJ. Classification of atrial fibrillation. Pacing Clin Electrophysiol (1997 20: 1603-5 " HTH One very interesting pointer I had not seen or appreciated before is that a low ventricular rate is a feature of AF attacks in vagal. I definitely get this - ventricular rate control has never had to be an objective of my AF management. There are many other classification schemes outlined. Generally, I think his chapter outlines why there may be a difference in perception between the medical professionals and patients with LAF. Statistically, the number of patients they see with all forms of AF is biased towards older patients with heart disease. The classification schemes are manifold. The number they see of young LAF patients who may be vagal is thus probably quite small. However, if you are one of those, (like me), then vagal LAF is 100% of your world, and not to have it recognised is devastating. >Hope you are continuing well , Tom 'fraid not so good, Tom. The disopyramide stopped working and was lately giving me excessive side-effects. I am now off it and waiting for it to clear out, then to get a pre- and post-ECG for going onto propafenone. In the meantime, my AF has gone almost persistent - I have been in AF as I write for 11 days continuous, apart from a 14-hour respite last Friday. I don't think it is coming off the disopyramide that has done it, as I was starting to get longer and more frequent AF runs even on it. What is concerning for me is that my digestion is almost back to normal. In the past this has always been my cause/trigger. But now my digestive status is no longer the way in which I can actually stop an attack, though it does still seem to have an effect. The only consistent thing about AF is it inconsistency ! Best of health to all, Vicky Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 8, 2001 Report Share Posted August 8, 2001 Vicky , Thank you very much for the excellent classification of vagal and adrenergic AF . Hitherto I have not seen such succinct descriptions . This information is very helpful notwithstanding the ambiguity centered on the reference to structural heart disease with reference to adrenergic AF and then later there is a reference to AF in older patients with heart disease which I expect is a reference to atherosclerosis . It seems that there are many Afibbers who have a structurally sound heart ( Echo ) and who in addition have not manifest symptoms of heart disease such as angina . I am really sorry you are going through a rough patch and that your episodes are stretching out the way you describe . One of the things about this Support group is that with our AF we have all at one time or another experienced the dark night of the soul and so we might be better equipped than others to empathise with those who might be to some extent struggling . I suppose you have tried moderately long walks and and maybe a half hour soak in a hot bath . Other tricks that have on occasion worked for me are gentle swimming in a heated pool or indeed simply using a floatation board to kick your way up and down the pool . Gentle exercise in a hydrotherapy pool or relaxing and pampering yourself in a spa may do the trick . I can relate to your comment that the only consistent thing about AF is its inconsistency . From time to time different ones here float the idea that somewhere in the AF equation there is a psychological factor . I mention this here because more than a few times I have realised that it is when I am able to rid my mind of the anxiety associated with AF that I give myself a better chance to revert . Hence my reference to the sensuous experience of a long hot bath or the pampering of oneself in a spa . If you think much of the above is much ado about nothing at very least I may have distracted you and if that can happen who knows what else might follow ! In spite of the twelve thousand miles that separate us what I can do for you is keep you in my prayers and so I will . God bless you , Tom > on Wed, 8 Aug 2001 at 10:01:31, seeyamate@o... wrote : > > >Do let us know whether Professor Camm advances a scientific > >definition of Adrenergic Atrial Fibrillation ( scientific preferred > >and if not scientific then any other definition ) . > > Well, I am not sure exactly what counts as scientific - my own > definition is " valid observation " . > > He has a table in the chapter on " classification " which lists: > > " Vagotonic AF : Younger (30 to 50 yr); male>female; " normal heart " ; > post-prandial episodes; evening or nocturnal attacks; slow ventricular > rates in AF; antecedent bradycardia. Therapy: Disopyramide; Class I > antiarrhythmic agents; atrial pacing; (aggravated by digoxin) " > > " Adrenergic AF : Older (50+ yr); no gender bias; structural heart > disease; episodes during or after exercise; early morning attacks; fast > rates; prior tachycardia. Therapy: Propafenone; sotalol; beta-blockers " > > " Perhaps as much as one-quarter of paroxysmal AF is vagotonic, one fifth > adrenergic or predominantly adrenergic. Many patients present mixed or > indeterminate patterns. " > > The key reference for this chapter is " Gallagher MG, Camm AJ. > Classification of atrial fibrillation. Pacing Clin Electrophysiol (1997 > 20: 1603-5 " > > HTH > > One very interesting pointer I had not seen or appreciated before is > that a low ventricular rate is a feature of AF attacks in vagal. I > definitely get this - ventricular rate control has never had to be an > objective of my AF management. > > There are many other classification schemes outlined. Generally, I > think his chapter outlines why there may be a difference in perception > between the medical professionals and patients with LAF. Statistically, > the number of patients they see with all forms of AF is biased towards > older patients with heart disease. The classification schemes are > manifold. The number they see of young LAF patients who may be vagal is > thus probably quite small. However, if you are one of those, (like me), > then vagal LAF is 100% of your world, and not to have it recognised is > devastating. > > >Hope you are continuing well , Tom > > 'fraid not so good, Tom. The disopyramide stopped working and was > lately giving me excessive side-effects. I am now off it and waiting > for it to clear out, then to get a pre- and post-ECG for going onto > propafenone. > > In the meantime, my AF has gone almost persistent - I have been in AF as > I write for 11 days continuous, apart from a 14-hour respite last > Friday. I don't think it is coming off the disopyramide that has done > it, as I was starting to get longer and more frequent AF runs even on > it. What is concerning for me is that my digestion is almost back to > normal. In the past this has always been my cause/trigger. But now my > digestive status is no longer the way in which I can actually stop an > attack, though it does still seem to have an effect. > > The only consistent thing about AF is it inconsistency ! > > Best of health to all, > Vicky Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 8, 2001 Report Share Posted August 8, 2001 Vickey, I am a new " member " in the afib club and this is my third attack in 8 months, one that is now in it's 12th day! I just started on norpace and I hope it works soon. I understand, as a new sufferer, that times come that can be very frustrating. Just do like I say I'm going to do......Have faith and think about all those poor souls that are " really " sick in the world... Jack Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 11, 2001 Report Share Posted August 11, 2001 ----- Original Message ----- From: Starfi6314@... >I can't help but wonder if the altitude is a precipitator of afib... Happy to report that the six days I spent in the mountains in Wyoming earlier this summer (at 6,000+ ft) produced no arrythmias or afib. A couple of days I hiked up to 8,000 feet and though I was slightly winded for the effort, it was exhilarating. Now home in hot and humid North Carolina, I have just had a couple of episodes back to back, perhaps brought on in part by the heat, humidity, and poor air quality? Who knows??? Sandy Quote Link to comment Share on other sites More sharing options...
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