Re: Question on AF

[Guest guest]

on Thu, 27 Dec 2001 at 19:15:18, fross2001 wrote :

>What is the Quinidine one?

It is similar to disopyramide, I think.

Best of health to all,

Vicky

London, UK, 1954 model

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

" There is a moment in the life of any problem when it is large

enough to see, but small enough to solve " - anon

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

[Guest guest]

> 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?

Well, the full time for a QRS and T wave is the QT interval (it's worth

looking back over recent posts on QTc which is a 'corrected' version of the

gap which takes into account the underlying heart rate)

> I understand that too long a length between

> these two can give Toraides du pointes (sp).

I think too long a gap is considered a problem (greater than 500ms I think

but this may be for QTc rather than a QT interval on a slow heart rate. But

I don't understand the units of QTc yet and think a QTc of 500ms doesn't

make sense!)

> 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.

How much faith we put in the medical profession is a personal thing but I

don't think it gets as bad as Russian Roulette. Finding the right drug is a

trial an error process but under the right supervision it can be done

safely.

Taking the problem one step at a time and giving the drugs a chance to work

their magic is hard to do but can be only of benefit.

all the best

--

D

[Guest guest]

In a message dated 12/27/2001 11:30:58 AM Pacific Standard Time,

fross@... writes:

<< 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. >>

Fran,

I don't think Toprol is the same as Atenolol, but Atenolol is definitely the

same as Tenormin. Atenolol is simply the generic form of Tenormin and,

therefore, is less expensive. I take Tenormin because a few years ago when I

was only in afib about three or four times a year, I thought that the

Tenormin helped more in preventing afib than did Atenolol, although the

pharmacist told me that they are exactly the same thing. He thought I was

crazy to voluntarily pay $100 for a Tenormin prescription when I could get

Atenolol for $30. Perhaps I was grasping at imaginary straws, but I was

gladly willing to pay more if it meant avoiding afib. Also, I thought at the

time that the Atenolol did a better job of controlling the tachycardia which

so often would lead to afib. In retrospect, I'm not sure that my perception

was accurate, but I continue to take Tenormin rather than the generic

Atenolol. Tenormin is less available than Atenolol simply because it is more

expensive. Pharmacies tend not to stock as much of the Tenormin because

there is not a great demand for it due to the higher price. Most people want

Atenolol. My older brother, who is in permanent afib, takes Atenolol and

can't understand why I hold out for the more expensive Tenormin. Maybe it's

the placebo effect at work on me!

Atenolol does work well for some vagal afib sufferers, and I happen to be one

of them. My cardiologist concurs with me in assessing my recent afib

episodes, which have all started at 1:30 or 2:00 a.m., as vagal. When I saw

him today, he did not want to change my medication since I am virtually

symptom-free when in afib, thanks to Tenormin (Atenolol) and Verapamil.

(I'll write more about other words of wisdom from my cardiologist later when

I have more time.) The Atenolol does not prevent my afib episodes from

happening, but at least it offers me the capacity to live my life normally

whether in afib or in sinus. The Atenolol was difficult to become accustomed

to in the beginning and each time my dose was raised, but now that I am

adjusted, I see no side effects from it. Undoubtedly beta blockers like

Atenolol are not appropriate for some vagal afib sufferers; but because

medication affects different people differently, I would not necessarily rule

out beta blockers for vagal afib.

I agree with 's suggestion that one must give medications a fair trial

for a while, unless, of course, a particular drug is causing unbearable or

life threatening side effects. Initially Atenolol made me extremely fatigued

and short of breath when exercising. I never notice those effects now, but

others have reported that the fatigue caused by Atenolol is unmanageable.

Perhaps Atenolol works for me partially because I desperately want it to

work. The alternative is switching to a proarrhythmic drug, and I don't want

to do that. I guess my point here in this rambling discourse is that I

suspect that attitude may play a role in the effectiveness of a given drug in

the same way that the placebo effect works. At least, attitude seems to

influence my compatibility with certain drugs, and I suspect that may be true

of some others, also.

in afib in Seattle :-(

[Guest guest]

Fran, I am now remembering that toprol in 25 mg splittable pills only comes

in the brand name. The generic starts at 50 mg pills. Of course, my HMO

won't fork out for the 25 mg pills, even though trying to cut them into 12.5

mg reduces them to powder, so, like , I pay for them myself.

I tried atenolol for just one day and thought it had a different effect than

toprol - it didn't have the slight calming effect I find from toprol, and it

seemed to lower my blood pressure more, an undesirable effect for me.

I do think I am slightly adjusting to the hampering effect of toprol, but I

have been on it 2? 3? months now.

, I am bummed that you are in afib,

Trudy

[Guest guest]

I don't think you are clutching at imaginable straws. I definatley

felt a difference between the Tenormin and Atenolol. I was halfing

the Tenormin until the Dr gave me the 25mg atenolol. I know they did

not have the same effect. And for Xmas I started halfing and

quartering the Tenormin as they made me feel better. And I wanted to

feel better over the hols. So I am glad you wrote your own

observation. It is not just me. If I had to pay for them I would pay

the extra.

This is my first day without any beta blockers. So far so good.

I agree we have to give the tablets a chance. And I know what is good

for the goose is not necessarily good for the gander. But after a

year on sotalol giving it chance after chance, and anxiety levels as

well as breathing problems, sleeping problems etc I was amazed at how

good Tambacor made me feel. Unfortunately I started tremoring so was

put on the atenolol (tenormin). The next day my anxiety was back. It

had gone on the Tambacor.

The inside of my lips are all lumps and bumps and for some reason I

can't stop chewing them. When on the Tambacor, I felt the pain

different and did not chew them. I felt like some weight had been

lifted. I want that feeling back. And know it is a side effect that

will only go when the chemicals that caused it are gone.

I was maybe a bit harsh when I said about playing Russian roulette

with the sotalol. But that is how it made me feel. And it made my

heart slur, and squeak (really I could feel it), roll over, jump etc.

This happens (and the anxiety, sleeping and breathing) to a lesser

degree on the atenolol. It never happened on digoxin or tambacor.

I do have chemical sensitivities though.

Fran

> In a message dated 12/27/2001 11:30:58 AM Pacific Standard Time,

> fross@e... writes:

>

> << 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. >>

> Fran,

> I don't think Toprol is the same as Atenolol, but Atenolol is

definitely the

> same as Tenormin. Atenolol is simply the generic form of Tenormin

and,

> therefore, is less expensive. I take Tenormin because a few years

ago when I

> was only in afib about three or four times a year, I thought that

the

> Tenormin helped more in preventing afib than did Atenolol, although

the

> pharmacist told me that they are exactly the same thing. He

thought I was

> crazy to voluntarily pay $100 for a Tenormin prescription when I

could get

> Atenolol for $30. Perhaps I was grasping at imaginary straws, but

I was

> gladly willing to pay more if it meant avoiding afib. Also, I

thought at the

> time that the Atenolol did a better job of controlling the

tachycardia which

> so often would lead to afib. In retrospect, I'm not sure that my

perception

> was accurate, but I continue to take Tenormin rather than the

generic

> Atenolol. Tenormin is less available than Atenolol simply because

it is more

> expensive. Pharmacies tend not to stock as much of the Tenormin

because

> there is not a great demand for it due to the higher price. Most

people want

> Atenolol. My older brother, who is in permanent afib, takes

Atenolol and

> can't understand why I hold out for the more expensive Tenormin.

Maybe it's

> the placebo effect at work on me!

>

> Atenolol does work well for some vagal afib sufferers, and I happen

to be one

> of them. My cardiologist concurs with me in assessing my recent

afib

> episodes, which have all started at 1:30 or 2:00 a.m., as vagal.

When I saw

> him today, he did not want to change my medication since I am

virtually

> symptom-free when in afib, thanks to Tenormin (Atenolol) and

Verapamil.

> (I'll write more about other words of wisdom from my cardiologist

later when

> I have more time.) The Atenolol does not prevent my afib episodes

from

> happening, but at least it offers me the capacity to live my life

normally

> whether in afib or in sinus. The Atenolol was difficult to become

accustomed

> to in the beginning and each time my dose was raised, but now that

I am

> adjusted, I see no side effects from it. Undoubtedly beta blockers

like

> Atenolol are not appropriate for some vagal afib sufferers; but

because

> medication affects different people differently, I would not

necessarily rule

> out beta blockers for vagal afib.

>

> I agree with 's suggestion that one must give medications a

fair trial

> for a while, unless, of course, a particular drug is causing

unbearable or

> life threatening side effects. Initially Atenolol made me

extremely fatigued

> and short of breath when exercising. I never notice those effects

now, but

> others have reported that the fatigue caused by Atenolol is

unmanageable.

> Perhaps Atenolol works for me partially because I desperately want

it to

> work. The alternative is switching to a proarrhythmic drug, and I

don't want

> to do that. I guess my point here in this rambling discourse is

that I

> suspect that attitude may play a role in the effectiveness of a

given drug in

> the same way that the placebo effect works. At least, attitude

seems to

> influence my compatibility with certain drugs, and I suspect that

may be true

> of some others, also.

> in afib in Seattle :-(

[Guest guest]

In a message dated 12/27/2001 9:45:22 PM Pacific Standard Time,

trudyjh@... writes:

<< , I am bummed that you are in afib,

>>

Trudy

Thanks for your concern! I am also " bummed " about being in afib. This has

been a bad month with afib happening on a weekly basis after three months of

practically no afib. The only explanation I can think of is that December

has been a more stressful month because I have done more performing than

usual. The stress happens not just during the performance but also in the

days ahead of the performance. With at least one performance a week, I have

definitely not been in my usual frame of mind. I was especially concerned

about my two performances on last Saturday and Sunday which were at the Space

Needle Restaurant atop one of the tallest buildings in Seattle. (You've

probably seen it if you've seen pictures of the Seattle skyline because it

dominates the skyline.) My concern was the fact that the restaurant is at an

altitude of 520 feet, compared with the city altitude of 20 feet. The ascent

is much faster than would be the case of driving to a higher altitude because

a very efficient elevator takes one suddenly from 20 feet to 520 feet in

about two or three minutes. As my ears were popping wildly and my stomach

was sinking during the rapid ascent, I could only wonder what was happening

in my heart. However, I had no immediate effects other than the popping ears

during or after either performance. (Two years ago when I performed there I

noticed several episodes of palpitations and tachycardia, but I was on a much

lower Atenolol dose.) Three days ago, actually Christmas Eve/Day at 2:30

a.m., after sitting up to sleep because of stomach upheaval which usually

precedes afib, I awakened with afib right after I had lain down, thinking

that the afib possibility had passed. While I have been attributing the

increased incidence of afib to increased stress, the afib episodes have

actually been typical vagal sessions, all starting at 1-2:30 a.m. while I was

sleeping amid acute stomach discomfort. My cardiologist agrees that December

has been a vagal month for me. Perhaps the stomach symptoms are caused by

the stress attacking that vagus nerve and translating what would have been an

adrenergic response into a purely vasovagal response. If I knew for certain

that the performances were causing the afib, I would definitely give up the

performing, but I really have no proof, given the esoteric and unpredictable

nature of afib. The quest for knowledge and causes goes on!

in afib in Seattle

[Guest guest]

,

Can you stop at some intermediate point when you take that elevator?

>Anyway, of interest to me and possibly to others here, was his statement

that

afib can indeed be caused by stomach problems in some people!

Stomach trouble is certainly one of my suspects. One of the things I have

changed during this past few weeks when my heart has been much better is

taking Mylanta Gas. For sure I take it if I am having bothersome symptoms,

but I will also take it if the symptoms are almost subliminal. Besides this

I have been taking prescription-strength Zantac (which is double the over the

counter dose) twice a day for the past year. If either of these has been

helping wiht my heart, it has to be the Mylanta Gas, since that is the new

one.

When I had a colonoscopy last year, they didn't find much either. Some minor

inflammation, if I recall correctly, and the gastro doc said it would be

healed in 1-2 months of taking the Zantac. So maybe whatever is causing this

is not causing noticeable physical damage.

Do you take stomach meds?

Trudy

[Guest guest]

In a message dated 12/28/2001 11:45:38 PM Pacific Standard Time,

trudyjh@... writes:

<< When I had a colonoscopy last year, they didn't find much either. Some

minor

inflammation, if I recall correctly, and the gastro doc said it would be

healed in 1-2 months of taking the Zantac. So maybe whatever is causing

this

is not causing noticeable physical damage.

Do you take stomach meds? >>

Trudy,

I'm so glad that my suggestion about Mylanta Gas has helped you. It has

certainly helped me to avoid numerous afib episodes although there are times

when nothing seems to help me. The only stomach meds I take are the Mylanta

Gas and Pepto Bismol. I have found that the magnesium/ aluminum hydroxide

based over the counter remedies cause more trouble. I tried Prilosec two

years ago, and that, too, aggravated the problem. The gastroenterologist

prescribed Aciphex for me, but I haven't tried it yet. I am hoping that the

colonoscopy test will reveal some cause for my stomach problems that can be

treated. He said that he did some biopsy of tissue and scraping for cultures

to test for bacterial infection. He will discuss the results of these tests

at an appointment in two weeks. Thus I still have hope that he will come up

with some fixable problem that may be causing my afib. Coincidentally it

was during October and November when I was having no stomach problems that I

also was having no afib. Of course, there is always the possibility that the

stomach problems are emotional in origin since it's a well known fact that

emotional stress can cause digestive upheaval. It may be more than

coincidental that as my work load and activity level increased in December,

the stomach problems and afib returned.

On another note, regarding the Space Needle elevator causing a rapid change

in altitude, your suggestion about stopping at an intermediary spot is a good

one. I don't perform there that often, though, because performing is a

sideline with me that I do sporadically as occasions arise. I don't think

that the altitude change caused this afib bout, but it may well have been the

stress level involved in recent activities. At any rate, I'm sure that the

major assault on my stomach in yesterday's test was not conducive to

returning to sinus. In fact, I had put off that test for a long time because

my primary care doctor thought that the vasovagal stimulation of the test

would put me in afib. Since I was already in afib, I didn't have anything to

lose this time. I'll let you know if any significant results from that test

apply to the afib problem.

still in afib in Seattle