Vagal mediated AF & Dysopyramide

November 23, 2002

I met with a new EP today. This fellow actually talked with

me for about an hour. He said that my AF sounds like the

classic symptoms of vagally mediated AF and felt the best

next step (after yet another holter monitor) is to move

off of my current Betapace (40mg x 3 daily) and onto

Dysopyramide and probably a little Lopressor. I'd like to

find out more about vagally mediated AF. I haven't seen

anything on this board discussing it. Does anyone know about

the treatment options and the long term outlook with it?

Do others on this board have it?

Also, a Google search of Dysopyramide didn't turn up much.

Can anyone tell about this medication?

Thanks,

-- Steve

November 23, 2002

In a message dated 11/23/2002 5:48:23 AM Pacific Standard Time,

stevenbwahl@... writes:

<< 'd like to

find out more about vagally mediated AF. I haven't seen

anything on this board discussing it. Does anyone know about

the treatment options and the long term outlook with it?

Do others on this board have it? >>

Steve,

Although I used to think that my afib was about equally vagal and adrenergic,

I have recently concluded that it is primarily vagal because my afib has

stopped for the past six months after giving up dairy products. When I

discussed the possible connection between dairy elimination and afib with my

E.P., he said that anything that causes vasovagal stimulation can cause afib.

He said that although milk per se could not directly cause afib, if it were

to cause vasovagal stimulation, that vasovagal stimulation could directly

cause afib. In case you don't know, vasovagal stimulation is stimulation or

irritation of the vagus nerve, a large nerve which unfortunately controls

both heart beat and digestion. Because of this connection, if dairy or any

other substance stimulates the vagus nerve, afib can be the result in

susceptible individuals like you and me. In my case giving up dairy foods

and numerous other foods that seem to irritate my digestion has given me a

break from afib. I'm not going to say that my afib is cured because I know

full well that it could return, but any break from it is welcome after

nineteen years of afib with the last three years of being on a " schedule " of

afib every 11-14 days.

If your afib is vagal, you would be wise to pay attention to what you eat and

drink, keeping a record of foods that seem to trigger afib. In the case of

dairy foods, the triggering effect is more subtle, at least for me. I had to

be off of dairy for seven months before I saw improvement, and my afib

actually worsened before it improved. Dairy may not be your problem, but you

can help vagally mediated afib by trying to discover your individual afib

food triggers and avoiding those. These triggers are very individual, and

each person must discover his or her own problem foods. I have a long list,

and the discovery process was very worthwhile because I have been in sinus

for over six months now.

Another consideration is your medication. I don't know anything about

disopyramide, but I do know that Lopressor is a beta blocker, similar to the

beta blocker Atenolol, which I have taken in varying doses for the past

fourteen years of my nineteen year afib career. I have read and you will

probably read that beta blockers are not effective with vagal afib and that

they can actually make the situation worse. From my experience I would say

that this is a generalization that does not apply to all individuals with

vagal afib. Each person must evaluate the effects of a beta blocker on his

or her individual chemistry. As a vagal afibber who has used Atenolol for a

long time, I have found it to be very effective and helpful. Atenolol did

not prevent my afib episodes, but it did keep the symptoms under control so

that I could function normally when in afib. Obviously long term usage of

Atenolol did not encourage the development of permanent afib in me because I

have now been in sinus for half of a year. Although it was stopping dairy

products that seemed to stop my afib, I continue to take the Atenolol, unless

my doctor tells me to do otherwise, because I think it just may be helping

along with my change in diet. At least I can say categorically that the

beta blocker has not had long term negative effects on my vagal afib. I

mention this because I think every vagal afibber should be open to at least

trying beta blockers if they are prescribed and should not necessarily reject

them because of all the bad publicity surrounding beta blockers and afib.

Good luck to you with your new medications. I was fortunate if finding

helpful medication without much trial and error, but it seems that most

afibbers must try different meds before finding the right one.

in sinus in Seattle (Day 185)

November 23, 2002

Try the spelling disopyramide. That may be your problem. Yahoo is

returning 19,700 matches! Also check out ' database at

http://www.dialsolutions.com/af/database/index.html

and enter disopyramide into the search. There are several people taking

it now with success. You can also search through our message archive at:

http://groups.yahoo.com/group/AFIBsupport/messages

and you will find hundreds of messages with the word " vagal " or " vagal

mediated " in them.

As far as information on vagal afib, see:

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

http://archfami.ama-assn.org/issues/v9n4/fpdf/fbf9010.pdf

(a Adobe Acrobat file)

http://carver.pinc.com/healthnews/victor2.html

And while I'm at it, for those of us who are into the hard core

information:

http://www.nlsearch.com/

This is Northern Light search. If you search the " special collections " .

There is a charge for most of the documents, usually around $2.95, but

they are from medical journals and are not otherwise available as far as

I know.

Bobby

NSR with Tambocor - 6 years

Vagal mediated AF & Dysopyramide

I met with a new EP today. This fellow actually talked with

me for about an hour. He said that my AF sounds like the

classic symptoms of vagally mediated AF and felt the best

next step (after yet another holter monitor) is to move

off of my current Betapace (40mg x 3 daily) and onto

Dysopyramide and probably a little Lopressor. I'd like to

find out more about vagally mediated AF. I haven't seen

anything on this board discussing it. Does anyone know about

the treatment options and the long term outlook with it?

Do others on this board have it?

November 24, 2002

> Thanks to all for their kind advice and links to more information.

> .........snip now that I'm on a holter and actually trying to

> provoke this stupid thing that I'm running calm and sinus?

> Hello: Your questions are welcome....I am only going to address

one today. I don't know whether you know that there are one month

monitors.....it is about the size of a large business card and is

called an event monitor....my afib showed up five days after the

fifth day. They usually like to give it to you on the first of a

month...you keep it with you at all times...but you don't wear it.

Check whether they have this type of monitor where you live.

Sorry, I have to go because I have stomach palpitations and I am

trying to avoid afib. Sundays seems to be a day for afib, all

because I dread receiving a phone call from a particular family

member, even when I have the answering machine on....Just the fact

that she has called and left a message gets me ticked off.

So sorry, to include this, but as you may already know that there

are lots of triggers for afib. Let us know how you are doing.

Isabelle

November 24, 2002