Re: Question on AF

[Guest guest]

In a message dated 12/23/2001 10:13:25 AM Pacific Standard Time,

fross@... writes:

> My main aim has been to stop the periods of fast irregular

> heartbeat, as this is what I find dibilitating.

Hi Fran,

My understanding is that the irregular beat is Afib.....

I had bad problems with sotalol and Metropolol, both beta

blockers, so am now taking one 180 mg capsule of

Diltiazem each morning. It is to keep my heart rate down

and is a calcium blocker that keeps the blood vessels

open even during times of stress. As you know I take some

nutritional things too....but the Diltiazem apparently is working

just fine with no side effects. Aside from getting tired if I

exert myself like going uphill kind of quickly, I feel fine. My

heart is probably still beating irregularly but I don't notice it.

I think it is keeping my heart rate under 100...... so far so good.

Best wishes,

Bill Utterback

South San Francisco

[Guest guest]

> B BBBB B B BBB B BB B B B

Fran, that sounds like afib to me, but you really need

an ekg to be sure. I think afib does not necessarily result in

a rapid pulse. However, in my afib episodes I typically think my

pulse is not rapid, but when they do an ekg it is 130+. I suppose

I can't really tell the pulse rate myself as things are so irregular,

I probably don't feel all the beats in my wrist.

>I have also noticed that most people expect to progress to the more

serious betablockers like sotalol and Tambacor etc.

I sure hope I don't. Of course, many of us do progress, but my

understanding is many don't.

>Also with my father he needed someone to stand up for him, as in the

end we found out that those who were supposed to be his friends were

walking all over him. I have a nasty time coming up. His so called

business partner ripped him off to the value of ????

I feel for you. One of my brothers(!) has devastated my Mom's estate,

and in another situation, cost me a frightening chunk of my

retirement savings. My other brother and I are having to go to court

against him to try and remove him as executor, an incredibly

drawn out expensive process. It's unbelievable that people do this

type of thing. But I try not to brood too much about it, as it does

cause my heart to react badly. I just try to trust that in the end, I know

I am behaving well, and I feel sorry for anyone who is unethical.

Trudy

[Guest guest]

In a message dated 12/23/2001 3:49:18 PM Pacific Standard Time,

trudyjh@... writes:

> I probably don't feel all the beats in my wrist.

That is probably right Trudy, my cardiologist said to feel

the artery in my neck or better yet just get a stethosope

and I do have one. It was inexpensive but works fine.

I really don't use it because I maybe don't want to know, but

can tell if my heart tries to speed up.

I'm not sure where you can easily get stethoscopes but

here we have Frys Electronics stores and surprisingly they

had blood pressure monitors and stethoscopes there.

The wrist is most unreliable because it is further from

your heart. Just feel the pulse in your neck and count

for 10 seconds.....

Best wishes, Bill

[Guest guest]

on Sun, 23 Dec 2001 at 18:12:49, fross2001 wrote:

>My typical heartbeat goes B BBBB B B BBB B BB B B B

>BB. If that makes any sense. IT also only has one Beat unlike my

>husbands that goes BD BD BD BD BD BD BD BD.

My guess is this: in your lettering, I think you should write your B

BBBB B B BBB's all as D's. In AF, the only beats you feel or hear

are the ventricles. I would say that your husband's BD is B=atrial

beat, D=ventricular beat. In AF, the atria just sit and quiver and

never do a proper beat at all.

Best of health to all,

Vicky

London, UK, 1954 model

http://www.vagalafibportal.fsnet.co.uk/

" You can convert some of the people some of the time,

but you can't convert all of the people all of the time "

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

[Guest guest]

I can feel these extra beats in my heart as they happen. They seem to

come from above and below where the other beats originate. Then it

feels like one should come, but it doesn't. It makes my heart feel

like it is slurring, turning and flipping. When it is really bad it

gives me chest pain and a feeling like there is a bubble in the back

of my throat. The cardio says this is impossible. What a D**k. Are

these what are known as ectopic and missed beats? I have a BP monitor

which also takes my pulse, but of course it doesn't register these.

Nothing like finding out about your disease after 15 -20 years. I

don't know why I chose to ignore it for so long. I think inititally I

thought if I ignored it it would go away. But it didn't. It is quite

a frightening prospect to realise your heart is faulty. So by

pretending it is ok you get by. Then wonder why your'e not

functioning properly. Oh well the Docs won't pull the wool over my

eyes any longer.

Have great holidays everyone. Its at times like these (and especially

new year) I wish I could have a drink. But it is not worth it.

Fran

> In a message dated 12/23/2001 3:49:18 PM Pacific Standard Time,

> trudyjh@a... writes:

>

> > I probably don't feel all the beats in my wrist.

>

> That is probably right Trudy, my cardiologist said to feel

> the artery in my neck or better yet just get a stethosope

> and I do have one. It was inexpensive but works fine.

> I really don't use it because I maybe don't want to know, but

> can tell if my heart tries to speed up.

>

> I'm not sure where you can easily get stethoscopes but

> here we have Frys Electronics stores and surprisingly they

> had blood pressure monitors and stethoscopes there.

>

> The wrist is most unreliable because it is further from

> your heart. Just feel the pulse in your neck and count

> for 10 seconds.....

>

> Best wishes, Bill

[Guest guest]

Thanks for that. Does anyone with paroxymal AF ever get the BD or the

DB. (which was my way of trying to say atrial and ventricle beat.

Would the two pumps together mean you were in sinus? I have never

felt the two beats together, ever. And want to know what sinus rythym

feels like.

My neighbour down the road can tell when she goes off the beat. I

just wonder if I ever go on the beat. It is never regular, and always

singular.

Thanks. Have great holidays.

Fran

> >My typical heartbeat goes B BBBB B B BBB B BB B B B

> >BB. If that makes any sense. IT also only has one Beat unlike my

> >husbands that goes BD BD BD BD BD BD BD BD.

>

> My guess is this: in your lettering, I think you should write your

B

> BBBB B B BBB's all as D's. In AF, the only beats you feel or

hear

> are the ventricles. I would say that your husband's BD is B=atrial

> beat, D=ventricular beat. In AF, the atria just sit and quiver and

> never do a proper beat at all.

>

> Best of health to all,

> Vicky

>

> London, UK, 1954 model

> http://www.vagalafibportal.fsnet.co.uk/

>

> " You can convert some of the people some of the time,

> but you can't convert all of the people all of the time "

> - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

[Guest guest]

Yep

My Dr says each and everytime he takes my pulse I am in AF. It makes

me wonder why they didn't say that my meds weren't working. I think I

must have chronic AF. The cardio said it was paroxymal, but my GP

says he thinks its chronic. And my cardio wasn't interested in my

condition as I did not have any fault he could pin it on. So I don't

believe a word he says. My GP said I could go for a second opinion a

few months back. But I thought why put myself through that again. I

will now though. I will go to an EP if possible. Maybe he will let me

have an ablation of some description.

You sound like your 'lifes lot' is very similar to mine. My new years

resolution is going to be, not to let things get me down. Easier said

than done. But I think that sometimes we can look at things

laterally, and that can change the way we react. So I will try to

look at negative things and turn them round so they become postitive.

If I'm lucky it will beocme second nature.

Have a great holiday

Fran

> > B BBBB B B BBB B BB B B B

>

> Fran, that sounds like afib to me, but you really need

> an ekg to be sure. I think afib does not necessarily result in

> a rapid pulse. However, in my afib episodes I typically think my

> pulse is not rapid, but when they do an ekg it is 130+. I suppose

> I can't really tell the pulse rate myself as things are so

irregular,

> I probably don't feel all the beats in my wrist.

>

> >I have also noticed that most people expect to progress to the

more

> serious betablockers like sotalol and Tambacor etc.

>

> I sure hope I don't. Of course, many of us do progress, but my

> understanding is many don't.

>

> >Also with my father he needed someone to stand up for him, as in

the

> end we found out that those who were supposed to be his friends

were

> walking all over him. I have a nasty time coming up. His so called

> business partner ripped him off to the value of ????

>

> I feel for you. One of my brothers(!) has devastated my Mom's

estate,

> and in another situation, cost me a frightening chunk of my

> retirement savings. My other brother and I are having to go to

court

> against him to try and remove him as executor, an incredibly

> drawn out expensive process. It's unbelievable that people do this

> type of thing. But I try not to brood too much about it, as it does

> cause my heart to react badly. I just try to trust that in the

end, I know

> I am behaving well, and I feel sorry for anyone who is unethical.

>

> Trudy

[Guest guest]

on Mon, 24 Dec 2001 at 19:16:41, fross2001 wrote:

>Thanks for that. Does anyone with paroxymal AF ever get the BD or the

>DB. (which was my way of trying to say atrial and ventricle beat.

Paroxysmal means you are sometimes in AF and sometimes in normal rhythm.

If you *never* get the normal regular thub-doop thub-doop thub-doop,

then you ain't got paroxysmal - it's either persistent ( " permanent " but

can be affected and converted back to sinus by drugs or whatever) or it

is truly permanent (unaffected by all treatments). It does sound to me

like your Dr is right and not your Cardio (re. your other post and the

other stuff in this posting)

>Would the two pumps together mean you were in sinus?

Yes.

> I have never

>felt the two beats together, ever. And want to know what sinus rythym

>feels like.

>

>My neighbour down the road can tell when she goes off the beat. I

>just wonder if I ever go on the beat. It is never regular, and always

>singular.

Best of health to all,

Vicky

London, UK, 1954 model

http://www.vagalafibportal.fsnet.co.uk/

" We don't have a hopeless end; we have an endless hope "

- anon (?) via Ellen

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

[Guest guest]

Well it is doubtful that my AF has ever been managed. ITs like give

her a pill and she will go away. They seem to think they have done

their part and it is me that is being the problem. Now if they had

told me what AF was really in the first place I wouldn't be in this

situation now.

Through out my digoxin years it was always doop. The only time I got

a thud doop was when I had sinus tachycardia on Tambacor. Was it you

who said you thought the tremors may have been a side effect of

coming off the sotalol? My GP said it was a known side effect of

Tambacor.

I think I would like to try the Tambacor again. I did feel good on

that for the few days. I'm not that enamoured with the atenolol. I

have put myself on such a low dose to spare the full onslaught of

side effects in an effort to get off the d**n things. But if I could

find something that agreed with me, then it would be better. And I

wouldn't have the worry of stroke looming over me. Fingers crossed to

see an EP.

I didn't realise that the Vagalfibportal was yours. Its brilliant. I

have printed stuff off there for my GP's. I am going to send some of

it to the cardiotroll. HE really needs it.

Have a great holiday.

Fran

> >Thanks for that. Does anyone with paroxymal AF ever get the BD or

the

> >DB. (which was my way of trying to say atrial and ventricle beat.

>

> Paroxysmal means you are sometimes in AF and sometimes in normal

rhythm.

> If you *never* get the normal regular thub-doop thub-doop thub-

doop,

> then you ain't got paroxysmal - it's either persistent ( " permanent "

but

> can be affected and converted back to sinus by drugs or whatever)

or it

> is truly permanent (unaffected by all treatments). It does sound

to me

> like your Dr is right and not your Cardio (re. your other post and

the

> other stuff in this posting)

>

> >Would the two pumps together mean you were in sinus?

>

> Yes.

>

> > I have never

> >felt the two beats together, ever. And want to know what sinus

rythym

> >feels like.

> >

> >My neighbour down the road can tell when she goes off the beat. I

> >just wonder if I ever go on the beat. It is never regular, and

always

> >singular.

>

> Best of health to all,

> Vicky

>

> London, UK, 1954 model

> http://www.vagalafibportal.fsnet.co.uk/

>

> " We don't have a hopeless end; we have an endless hope "

> - anon (?) via Ellen

> - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

[Guest guest]

> Thanks for that. Does anyone with paroxymal AF ever get the BD or the

> DB. (which was my way of trying to say atrial and ventricle beat.

> Would the two pumps together mean you were in sinus? I have never

> felt the two beats together, ever. And want to know what sinus rythym

> feels like.

>

The sound of the 'lub-dub' is the sound of valves closing

The 'lub' is the mitral and tricuspid valve closing

and the 'dub' is the aortic and pulmonary valves closing

You get 1 'lub-dub' for each ventricular beat.

Can anyone with MVP say what they get? Is it more of a 'woosh dub'?

Merry Christmas to one and all.

--

D

[Guest guest]

<<

Seemingly there is nothing wrong with my valves. But if you can't

hear it, and there is a wave missing, or very low on my ECG's. The

ECG readout said no ? (I think it was T wave) wave. But my GP says

its there. Just that the recording never picked it up as it was not

strong enough. Sorry for confusing the issue. But what does this mean? >>

Fran, the stuff printed on ekg readouts is the machine's best guess. My

cardio often looks at mine, and says the machine is wrong. So I wouldn't

worry about it.

[Guest guest]

on Tue, 25 Dec 2001 at 00:44:43, Fran, fross2001

wrote:

>Well it is doubtful that my AF has ever been managed.

Fran,

Sounds like too many of us !

>ITs like give

>her a pill and she will go away.

Been there, got the T-shirt.

>The only time I got

>a thud doop was when I had sinus tachycardia on Tambacor.

I think on Tambocor (or any drug, probably) you need to investigate any

unusual rhythms by getting them to do an ECG urgently and to diagnose it

properly - not always easy when the rhythm may only last a few minutes.

Early on after starting Tambocor, I got concerned and went to A & E (=ER

in the US). They said " supraventricular tachycardia " . However, my

cardio reviewed it and it was " atrial flutter with 2:1 atrioventricular

conduction " . It worried me like hell at the time. It did not recur for

a long while and by the time it did, I forgot to correlate it with what

it felt like back then. However, over the years I learnt this strange

rhythm that felt almost like a normal rhythm but just fast. It was

better than the AF, and " felt " OK, and usually didn't last long.

Recently, in for Dofetilide start, I got the same rhythm. They

immediately put me back on a full ECG and there it was again - AFlutter

with 2:1 conduction (one ventricular doop per two atrial thubs (!)). I

then learnt that the flutter was in fact the atria going more slowly

(about 260/minute) than when in AF (about 350/minute) - i.e. the drug

was working somewhat. Where the ventricles couldn't sort out what to do

or anywhere near keep up when at 350 with no clear atrial beat, they

could however do 130/minute when the atria were doing 260.

I can now see that's what happened also when I was on Tambocor, but

nobody ever explained it properly to me.

*However*, there is a risk that, although this rhythm can indicate the

drug is helping quell the atria, the atrio-ventricular conduction can be

1:1 in which case the atria might be going real fast, and the ventricles

manage to keep up on a beat-per-beat basis - can be 200 bpm or more.

This is more serious and needs urgent A & E/ER attention. The pharma

notes also say there can be " ventricular pro-arrhythmic effects "

including ventricular tachycardia.

So, to cut a long story short. Flecainide/Tambocor is a good drug but

needs to be treated with respect and by someone who knows what they are

doing. If you get concerned about what it is doing to you, make sure

you contact a medic soon, get an ECG and get it diagnosed properly.

One other thing - when you do this, don't be worried too much if they

" do nothing " . I have learnt that a lot of AF management involves

checking that things aren't going too far haywire. I used to confuse a

lack of action and explanation with a lack of knowledge by them. Accept

it if they say things are OK, but also get an explanation you understand

!!

>Was it you

>who said you thought the tremors may have been a side effect of

>coming off the sotalol?

No. Sorry can't help on that one - know nothing about sotalol.

>My GP said it was a known side effect of

>Tambacor.

The pharma notes say :

non-cardiac adverse effects (all doses)

Dizziness 18.9% (i.e. 18.9% of all people taking Flec at any does will

experience dizziness)

Visual disturbances 15.9%

Dyspnea (?) 10.3%

Headache 9.6%

Nausea 8.9%

Fatigue 7.7%

Palpitation 6.1%

Chest pain 5.4%

Asthenia 4.9%

Tremor 4.7%

Constipation 4.4%

Edema 3.5%

Abdominal pain 3.3%

so tremor comes in at the low end of probability, though not a zero

probability.

>I didn't realise that the Vagalfibportal was yours. Its brilliant.

Thanks. I owe others, mainly, for its content.

>Have a great holiday.

NSR+E's from 6 a.m. to 4 p.m. Not too bad :-)

Best of health to all,

Vicky

London, UK, 1954 model

http://www.vagalafibportal.fsnet.co.uk/

" It is the theory that decides what can be observed "

- Albert Einstein

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

[Guest guest]

on Tue, 25 Dec 2001 at 00:44:43, fross2001 wrote:

>Vagalfibportal

<snip>

>I have printed stuff off there for my GP's. I am going to send

>some of it to the cardio

Fran, as it says, don't assume your AF is vagal type, necessarily.

Best of health to all,

Vicky

London, UK, 1954 model

http://www.vagalafibportal.fsnet.co.uk/

" You can convert some of the people some of the time,

but you can't convert all of the people all of the time "

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

[Guest guest]

on Tue, 25 Dec 2001 at 08:47:48, Driscoll

wrote :

>The sound of the 'lub-dub' is the sound of valves closing

>The 'lub' is the mitral and tricuspid valve closing

>and the 'dub' is the aortic and pulmonary valves closing

>You get 1 'lub-dub' for each ventricular beat.

>

>Can anyone with MVP say what they get? Is it more of a 'woosh dub'?

Yes, I think so - I have a slightly floppy anterior mitral leaf and I

think they actually diagnose it by the echo machine in this way, though

I might be wrong.

>Merry Christmas to one and all.

Echoed. Snow yet in Leeds?

Best of health to all,

Vicky

London, UK, 1954 model

http://www.vagalafibportal.fsnet.co.uk/

" Recapture Hearing Your True Heart Melody " - R.

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

[Guest guest]

Oh dear. I've just gone two steps forward and one back. I only get a

lub, or a dub. Don't know which one, but assume it is the pulmonary

one. Is it possible that I just don't feel it or hear it. I can hear

and feel it on my husband. Or am I just being thick and this is AF.

Seemingly there is nothing wrong with my valves. But if you can't

hear it, and there is a wave missing, or very low on my ECG's. The

ECG readout said no ? (I think it was T wave) wave. But my GP says

its there. Just that the recording never picked it up as it was not

strong enough. Sorry for confusing the issue. But what does this mean?

Yous in confusion (but wanting to learn)

FRan

> > Thanks for that. Does anyone with paroxymal AF ever get the BD or

the

> > DB. (which was my way of trying to say atrial and ventricle beat.

> > Would the two pumps together mean you were in sinus? I have never

> > felt the two beats together, ever. And want to know what sinus

rythym

> > feels like.

> >

>

> The sound of the 'lub-dub' is the sound of valves closing

>

> The 'lub' is the mitral and tricuspid valve closing

> and the 'dub' is the aortic and pulmonary valves closing

>

> You get 1 'lub-dub' for each ventricular beat.

>

> Can anyone with MVP say what they get? Is it more of a 'woosh dub'?

>

> Merry Christmas to one and all.

> --

> D

[Guest guest]

" " Fran, as it says, don't assume your AF is vagal type, necessarily " " .

No I don't. But my GP had never even heard of Vagal Fib, neither had

my 'oh so good' cardiologist. So if they can read up on it, it will

be easier to define what type I have. However I have a feeling, or an

insight, that my vagus nerve is implicated somewhere along the line.

I had natural low blood pressure and orthostatic intolerance before

the AF started (both symptoms of an autonomic disorder attributed to

the vagus nerve). It is even lower now due to the beta blockers (so

that is obviously one of the reasons I can't stand the side effects).

My BP quite often reads 65/35, though it is more normal at 90/40

(also the district nurse checked it against her BP monitor and she

thought mine was reading about 10 high). So mine is lower than my

machine says.

Standing up and sitting down can cause me to go very dizzy and have

white outs before my eyes along with a 'wonky' racing heart. I have

often fallen to the ground. In the early days when it all first

started (20 years ago) I used to pass out and convulse. That is when

I got the epilepsy diagnosis (which has now been disproved). I only

ever get seizures at night now. They are infrequent and I haven't had

one for a year now.

Also some types of vagal action causes convulsive syncope (fainting

with seizures). Many people with it have been misdiagnosed with

epilepsy. Another name for it is neurocardiogenic syncope. My EEG

does not show epilepsy. So I have often wondered if this is a cause

for my 'seizures'. Therefore, it would make sense that my AF was tied

up with it in some way.

But with GP's, who don't seem to know anything about any of these

conditions, it has been, and still is hard work. They said they might

never find out what is wrong with me. But I told them I would. So I'm

trying. I hope I'm not trying you.

I always took my AF to be one of the lesser symptoms. I worried more

about passing out or nearly passing out. Especially when they became

so I was semi concious throughout them (the tunnel and near death

experiences). I always told the Doctors that I thought the heart beat

was connected. BUT The Dr's always told me the AF was nothing to

worry about and quite seperate from this condition. But as they can't

say what is causing the AF (or the seizures or the low BP etc) then

how on earth can they know they are not connected. They are all

symmptoms caused by dysautonomia, which is controlled by the vagus

nerve. And they won't send me to London for the tilt table test.

So that is the reason I am so late in trying to understand the

actions of my heart. I thought AF was a very common complaint with no

risk. Just as well I have started learning about these conditions. I

now know from speaking to others how second rate (or even third rate)

and behind the times my treatment has been.

Thanks for listening.

Fran

>

> >Vagalfibportal

> <snip>

> >I have printed stuff off there for my GP's. I am going to send

> >some of it to the cardio

>

> Fran, as it says, don't assume your AF is vagal type, necessarily.

>

> Best of health to all,

> Vicky

>

> London, UK, 1954 model

> http://www.vagalafibportal.fsnet.co.uk/

>

> " You can convert some of the people some of the time,

> but you can't convert all of the people all of the time "

> - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

[Guest guest]

" " My

> cardio often looks at mine, and says the machine is wrong. So I

wouldn't

> worry about it " "

I don't mean to sound like I'm worrying about it. I'm just trying to

understand what it all means. I'm just one of those people who want

to know why. The condition annoys me, but I'm passed worrying.

I have tried reading the literature and am still trying to get my

head round all the technical terms. But a lot still goes over my

head. I don't seem to grasp the significence of what I'm reading. I'm

off to try again.

Thanks

Fran

> <<

> Seemingly there is nothing wrong with my valves. But if you can't

> hear it, and there is a wave missing, or very low on my ECG's. The

> ECG readout said no ? (I think it was T wave) wave. But my GP says

> its there. Just that the recording never picked it up as it was

not

> strong enough. Sorry for confusing the issue. But what does this

mean? >>

>

> Fran, the stuff printed on ekg readouts is the machine's best

guess. My

> cardio often looks at mine, and says the machine is wrong. So I

wouldn't

> worry about it.

[Guest guest]

on Tue, 25 Dec 2001 at 21:48:01, Fran, fross2001

wrote:

<snipped lots of good stuff>

It certainly does sound to me like there's a significant vagal

contribution to your AF, from what you say. The fact that you're on

beta-blockers, if your AF *is* vagal, then is not so good. The

literature says quite clearly that vagal fibbers shouldn't use

beta-blockers, and I've had many e-mails over the last few years where

people have given up the beta-blockers and their AF has reduced or even

near-stopped (- as they say, " don't do this without consulting your

qualified medical practitioner " ).

You certainly are on the right road with your determination to find a

root cause. Best of luck.

I found a new motto which I use in my random sig messages - quite

appropriate in your circumstances, with your Drs., I feel ! :-)

Best of health to all,

Vicky

London, UK, 1954 model

http://www.vagalafibportal.fsnet.co.uk/

" It is the theory that decides what can be observed "

- Albert Einstein

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

[Guest guest]

on Tue, 25 Dec 2001 at 20:18:58, Fran, fross2001

wrote:

>Oh dear. I've just gone two steps forward and one back. I only get a

>lub, or a dub. Don't know which one, but assume it is the pulmonary

>one.

The normal operation of the heart is that first the atria contract (the

small chambers at the top end of the heart), followed soon after by the

ventricles (the large chambers at the base of the heart.) In terms of

keeping one alive, it is the ventricles that are important. No

ventricular contractions, no blood circulation, hence no life. No

atrial beat, you " just " get poor pumping efficiency, breathless, sweaty,

etc (and all the other lovely AF discomforts).

In AF, the electrical signals in the atria that determine the whole

atrial-ventricular sequence go awry. The atria just sit and quiver

(since they can't beat properly when the impulses are at around

350/minute). The ventricles therefore just try and do what they can.

When you are in full AF, you will not get (or at least very very rarely

get) an atrial beat. Therefore *any* sound at all (ditto any beat/pulse

you feel) will be a ventricular beat. The confusion of beats you hear

when in AF is still all ventricular beats (i.e. just the " dub " of a

normal lub-dub), just that they are confused dubs.

The sounds of lub-dub that refers to as being the valves closing

are indeed the valves closing, but they close as a result of the

contractions of the heart (- the valves are merely one-way valves that

close if blood tries to go back through them). The focus on valves in

AF is that sometimes a faulty mitral valve will let blood back from the

ventricles to the atria and make the AF worse - since the stretching of

the atria can make the AF worse.

When a Doctor says that AF is not life-threatening, he/she is looking at

it from the point of view that the ventricles *do* keep pumping. To the

fibber, this often means little, since because they are not already

dead, the fact that the ventricles are still going does not help them

when it is the *rest* of the huge discomfort that is causing them to

have an extremely poor quality of life.

Best of health to all,

Vicky

London, UK, 1954 model

http://www.vagalafibportal.fsnet.co.uk/

" Recapture Hearing Your True Heart Melody " - R.

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

[Guest guest]

In a message dated 12/26/01 2:54:02 PM Pacific Standard Time,

fross@... writes:

<< But he knows how I feel

on them and he even gave me 25mg tablets so I could half them. He

thought they had a score on them so you could half them, but they

don't, so who knows if I am getting 12.5mg each day! >>

Fran, I get 25 mg tablets of toprol, and they are scored. It may be that you

are getting one generic version of atenolol, and some other generic version

is scored. You could ask your pharmacist if you have a choice.

>But I will take the asprin heedless. I'm lucky I have a strong stomach.

Try to get the buffered or coated kind, and take it with food.

[Guest guest]

" It is the theory that decides what can be observed "

> - Albert Einstein

Exactly so. Brilliant man! And did his teachers not say that he

couldn't concentrate? Or something like that.

I have noticed since being on betablockers I have got a lot worse.

But that is because they have supposed that AF is purely adregenic

(sp). That is why your site was such a godsend to me. My Dr's can

further their research and change their theories a bit.

What I need to know is what sort of pills should I try. Can anyone

recommend a good one used for vagal AF with few side effects? I tried

Rythmol for a few weeks but didn't get on well with them. Although

they were better than sotalol and atenolol. I am doing better on the

low dose of atenolol, against my Dr's wishes. But he knows how I feel

on them and he even gave me 25mg tablets so I could half them. He

thought they had a score on them so you could half them, but they

don't, so who knows if I am getting 12.5mg each day! But he said he

would be happier if I stayed on the 50mg. But thats ok for him to

say, he doesn't live with the side effecs. In a way I am scared to go

with nothing.

I got on well with the digoxin for ten years. Never noticed any side

effects with it. But it stopped working so well in the end. That was

coz my liver was breaking it down too quick and the levels were not

therapeutic, they say. And there is no way in a million years they

will let me go back on it.

I want an ablation or some other operation to see if that will help.

But so far been given an emphatic NO. My heart is too healthy to

start mucking about with it they say. But what on earth do they think

the drugs and side effects are doing. And not just to my heart. If

only they would send me to an EP. But I need to be recommended by the

cardio. And he says I don't need one. And there is no more he can do

for me. So now for the second opinion, to the first cardio, who they

say put me wrongly on digoxin? Or even better to an Autonomic Dr,

what ever they are called.

Vicky thanks so much for helping me here. And explaining the pumping

action in laymans terms. My valve in my atria is not closing strong

enough to be heard. Obviously my valves are still working, or they

were last spring on the day of the echocardiogram. That is why they

don't think I am a candidate for Stroke. But I will take the asprin

heedless. I'm lucky I have a strong stomach. And probably a strong

heart to cope with the battering its taking.

Fran

>

> <snipped lots of good stuff>

>

> It certainly does sound to me like there's a significant vagal

> contribution to your AF, from what you say. The fact that you're

on

> beta-blockers, if your AF *is* vagal, then is not so good. The

> literature says quite clearly that vagal fibbers shouldn't use

> beta-blockers, and I've had many e-mails over the last few years

where

> people have given up the beta-blockers and their AF has reduced or

even

> near-stopped (- as they say, " don't do this without consulting your

> qualified medical practitioner " ).

>

> You certainly are on the right road with your determination to find

a

> root cause. Best of luck.

>

> I found a new motto which I use in my random sig messages - quite

> appropriate in your circumstances, with your Drs., I feel ! :-)

> Best of health to all,

> Vicky

>

> London, UK, 1954 model

> http://www.vagalafibportal.fsnet.co.uk/

>

> " It is the theory that decides what can be observed "

> - Albert Einstein

> - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

[Guest guest]

on Wed, 26 Dec 2001 at 22:52:38, Fran, fross2001

wrote:

>What I need to know is what sort of pills should I try. Can anyone

>recommend a good one used for vagal AF with few side effects?

Flecainide, or disopyramide are the obvious possibilities. The latter

has " feel-able " side effects (dry mouth, difficulty peeing, blurred

vision) but these are fully reversible if you stop, and may not be too

bad if it works for you at a low-ish dose. Propafenone is a

possibility, but is known to fail more often if the AF is purely vagal.

Amiodarone is a drug of last resort, due to its severe side effects. If

the 1st three don't work, I would try and get Dofetilide, (I don't know

if this is particularly suited to vagal or adrenergic, or even if

there's a preference), before you have to try amiodarone.

> I tried

>Rythmol for a few weeks but didn't get on well with them.

I forget what Rythmol is. Propafenone, I seem to recall?

Best of health to all,

Vicky

London, UK, 1954 model

http://www.vagalafibportal.fsnet.co.uk/

" We don't have a hopeless end; we have an endless hope "

- anon (?) via Ellen

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

[Guest guest]

I made a discovery last night. I ran down the stairs at about 3 in

the morning after not being able to sleep with jittery legs etc. When

I ran back up the stairs and got into bed the lub dub was there. I

was overjoyed. It only lasted for a few beats though, then went back

to the singular irregular ones.

So that must be why I like to rush about. I don't really, but it

makes me feel normal. And of course when your'e rushing about the

last thing on your mind is to check your pulse. I always do it when I

am relaxing. This just confirms to me that my AF is more vagal than

anything else.

I'll ask the nurse for a shot of her stethoscope so I can listen to

AF next time I see her.

You said

The first sound

> comes a little bit after the peek of the QRS - the second sound is

at the

> end of the T wave)

Would that be the QT? I understand that too long a length between

these two can give Toraides du pointes (sp). I looked into this as

mine was slightly long when I was on sotalol. They said it was ok

though, as it was only verging on the longside. But that was enough

for me. Aapart from the side effects,I don't like the idea of playing

Russian Roulette everytime I take a pill.

Thanks for sharing your knowledge.

Fran

>

>

> > Oh dear. I've just gone two steps forward and one back. I only

get a

> > lub, or a dub. Don't know which one, but assume it is the

pulmonary

> > one. Is it possible that I just don't feel it or hear it. I can

hear

> > and feel it on my husband. Or am I just being thick and this is

AF.

>

> I can't feel the lub dub.

> I've listened to my heart through a stethoscope and I can spot the

separate

> sounds then. (and if you've had an echo scan they will be part of

the scan

> that they listen to the audio and get some very interesting noises

back - a

> bit too squelchy for me!)

>

> I imagine what you feel at the wrist or neck is a greater volume of

blood

> passing below and there will be only one per ventricular beat.

>

>

> > Seemingly there is nothing wrong with my valves. But if you can't

> > hear it, and there is a wave missing, or very low on my ECG's. The

> > ECG readout said no ? (I think it was T wave) wave. But my GP says

> > its there. Just that the recording never picked it up as it was

not

> > strong enough. Sorry for confusing the issue. But what does this

mean?

> >

> > Yous in confusion (but wanting to learn)

> As I understand it T waves are often hard to spot in certain folk

but I

> don't believe it's something to worry about.

>

> Also, don't confuse heart sounds with EKG readouts they are two

different

> things

>

> ECG is measuring the electrical signals that pass down the heart

and the

> sounds are just valves closing.

>

> (There is, of course, a timing relationship between the two. The

first sound

> comes a little bit after the peek of the QRS - the second sound is

at the

> end of the T wave)

>

> Something I suffer from is 'little knowledge' it can sometimes be

a bad

> thing and make us jump to conclusions that aren't there.(It also

means you

> shouldn't belive anything I say!) I am, however, fascinated by the

subject

> and have a vested interest in knowing more about it so I'll

continue to

> learn but try not to put 2 and 2 together and make 5 - I don't want

my

> anxiety to increase

>

> All the best

> --

> D(in snow free Leeds)

[Guest guest]

Thanks Vicky

I will ask about the disopyramide. As Flecainide is Tambacor and that

gave me the tremors, and Rythmol is Propafenone which also didn't

work with side effects, then that looks like the best alternative. I

wouldn't try amioderone just because I am the type of person who

always seems to get the bad side effects. And a relation of my

husbands nearly lost her life on it. She goes without anything now.

Is anyone on this site on Disopyramide?

What is the Quinidine one? I seem to remember it being mentioned on

your vagal afib site.

Fran

>

> >What I need to know is what sort of pills should I try. Can anyone

> >recommend a good one used for vagal AF with few side effects?

>

> Flecainide, or disopyramide are the obvious possibilities. The

latter

> has " feel-able " side effects (dry mouth, difficulty peeing, blurred

> vision) but these are fully reversible if you stop, and may not be

too

> bad if it works for you at a low-ish dose. Propafenone is a

> possibility, but is known to fail more often if the AF is purely

vagal.

> Amiodarone is a drug of last resort, due to its severe side

effects. If

> the 1st three don't work, I would try and get Dofetilide, (I don't

know

> if this is particularly suited to vagal or adrenergic, or even if

> there's a preference), before you have to try amiodarone.

>

> > I tried

> >Rythmol for a few weeks but didn't get on well with them.

>

> I forget what Rythmol is. Propafenone, I seem to recall?

>

> Best of health to all,

> Vicky

>

> London, UK, 1954 model

> http://www.vagalafibportal.fsnet.co.uk/

>

> " We don't have a hopeless end; we have an endless hope "

> - anon (?) via Ellen

> - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

[Guest guest]

Thanks for that Trudy.

Is Toprol the same as Atenolol? The 50mg ones I got were called

Tenormin LS. They were bright orange and had a score on them. I was

given them in the Dr's surgery. The 25mg ones prescribed are just

called atenolol. So maybe the pharmacist didn't have any 25mg of

Tenormin.

I'm going to try and stop them soon though. I have a feeling I will

do it tommorow. So I have just popped my last atenolol, I hope. I

will keep them on standby incase though. If I feel good without, then

I will tell my Dr's. Hopefully I will be able to sleep again. If I

don't feel better then I am going to ask the Dr next Thurs to try the

one that Vicky mentioned. I have forgotten its name already. But will

go back and do a search on it.

I usually take the dispersable asprin. I quite like the taste

(strange me LOL)

Fran

> In a message dated 12/26/01 2:54:02 PM Pacific Standard Time,

> fross@e... writes:

> << But he knows how I feel

> on them and he even gave me 25mg tablets so I could half them. He

> thought they had a score on them so you could half them, but they

> don't, so who knows if I am getting 12.5mg each day! >>

>

> Fran, I get 25 mg tablets of toprol, and they are scored. It may

be that you

> are getting one generic version of atenolol, and some other generic

version

> is scored. You could ask your pharmacist if you have a choice.

>

> >But I will take the asprin heedless. I'm lucky I have a strong

stomach.

>

> Try to get the buffered or coated kind, and take it with food.