Re: New to AFIB group

[Guest guest]

- I suggest you begin to keep a diary of your activities, stress

levels, foods, etc. at the time you experience the AFib. This way you can

identify your own personal " triggers. " This is a very individualistic malady

(you will find out as you participate with this group) and each person seems

to have specific factors which cause the AFib. Then again sometimes it just

happens! I adopted the diary approach when I first gathered information

through participation in this group (about 2 1/2 years) with blessings of my

doctors and EP. The result? I believe I have some control over the frequency

and severity of the AFib episodes.

Welcome to the group. And good luck!

Sharon in El Paso

[Guest guest]

<<2. Is it possible for my current prescriptions to increase the

intensity and frequency of my A fib attacks? I never had as hard and

as frequently as I am having A Fib now.>>

Hi , welcome to the group. Yes it is possible that the meds can make AF

worse (Sotalol turned my into a walking zombie with very unpleasant AF). The

good news is that there are quite a few meds one can try - it's a case of trial

and error to find one that works for you.

<<3. Can A-Fib be controlled by diet and if so can I get some

information on this too, I am not overweight and an active person,

(with 3 daughters, they keep me in shape) >>

Some people have improved there situation through diet and a very small number

have even eliminated AF through diet. It's a very individual problem and really

quite hard to determine a strong cause and effect (if you find a food you think

triggers AF you really have to try it a few times to be sure it's not a

coincidence). Beyond that I'm reluctant to give any suggestions since it's such

an individual problem. Eating a healthy balanced diet seems to be a good idea

regardless of whether one has AF but there a many views out there about what

constitutes a healthy diet.

<<I believe I've had AFIB for a while but other than mild chest pains I

never had other symptoms and after a day or so they would go away, it

felt like muscle pains, but since I went to the hospital and now on

this medication I am having A fib attacks more frequently and

stronger. I don't have to tell you the anxiety and emotions that I

feel when these attacks come I just want them to stop.>>

Sadly anxiety/stress can make AF. It's very easy for me to say one of the tricks

is not to get stressed out but it's another to keep calm when you're lying on

your back in the ER with all the alarms going off around you. If you are not

happy with your med don't hesitate to ask about another one.

All the best

--

D (34, Leeds, UK)

[Guest guest]

Pat,

As you enter the world of A Fib, there are many roads you can take. They

involve diet, drug therapy, excercise and surgical. The one you take may or

may not work. It's a trial and error thing in a lot of cases. You have to be

flexible and patient. One of the most important things is, to find the right

Doctor(s). A good cardiologist who is up to date on AFib and a good

Electrophysiologist (heart electrician) or EP. The EP would be the one to

perform a Pulmonary Vein Ablation or Flutter Ablation or both.

THere are other members on this board who may know of some good ones in

Florida. I know north of you is the Univ. oj Alabama Medical Center. It's

supposed to be world class in heart matters.

Welcome. See you down the road!

Rich O

[Guest guest]

Hi ,

Welcome! I don't know any cardiologists in your area, but I am sure that

someone will chime in with some good information for you. If you are interested

in PVA I would suggest you visit www.clevelandclinic.com and leave a note for

Dr. Natale. By many accounts he is one of the best, if not the best, in the

country for this procedure. His office will contact you and give you the

necessary instructions to proceed. You asked, Is it possible for my current

prescriptions to increase the

intensity and frequency of my A fib attacks? It has been mentioned from time to

time that beta blockers can aggravate vagal afib, but I have no facts to verify

this. You also asked: Can A-Fib be controlled by diet? Yes, I think it can,

to a certain degree. In my case eliminating alcohol, caffeine, msg, and all

processed foods from my diet has helped immensely, but not cured me. There are

two members on the list that I know of who have had success by eliminating

dairy. I think you'll be hearing from them. I am puzzled about the chest pains

you have -- having had plenty of afib, I've never experienced any pain. I hope

you'll find some ideas on the list -- we have lots of well-versed members who

will share their experiences. Take care, Sandy, 55, NC

[Guest guest]

> Hi ,

....I am puzzled about the chest pains you have -- having had plenty

of afib, I've never experienced any pain.

When I first was diagnosed with afib, itwas totally out of control,

and I had real pain in my chest and back. Once I was on the correct

meds and things had a chance to heal up, I have never had that pain

since.

[Guest guest]

Can you take beta blockers and verapamil together???

Thanks,

Ross

Re: New to AFIB group

> Hi ,

....I am puzzled about the chest pains you have -- having had plenty

of afib, I've never experienced any pain.

When I first was diagnosed with afib, itwas totally out of control,

and I had real pain in my chest and back. Once I was on the correct

meds and things had a chance to heal up, I have never had that pain

since.

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Nothing in this message should be considered as medical advice, or should be

acted upon without consultation with one's physician.

[Guest guest]

In a message dated 2/12/2003 12:46:42 PM Pacific Standard Time,

rossk@... writes:

<< Can you take beta blockers and verapamil together???

Thanks,

Ross >>

Yes, Ross. I have been taking a beta blocker and verapamil together in quite

large doses for four years. But that doesn't mean that everyone can do this

because we're all different. Your doctor could decide if the combination

would work for you.

in Seattle

[Guest guest]

Beta blocker s are ok but should not be taken by anybody with Asthma.

> In a message dated 2/12/2003 12:46:42 PM Pacific Standard Time,

> rossk@... writes:

>

> << Can you take beta blockers and verapamil together???

>

> Thanks,

> Ross >>

> Yes, Ross. I have been taking a beta blocker and verapamil together in quite

> large doses for four years. But that doesn't mean that everyone can do this

> because we're all different. Your doctor could decide if the combination

> would work for you.

> in Seattle

>

> Web Page - http://groups.yahoo.com/group/AFIBsupport

> FAQ - http://groups.yahoo.com/group/AFIBsupport/files/Administrative/faq.htm

> For more information: http://www.dialsolutions.com/af

> Unsubscribe: AFIBsupport-unsubscribe

> List owner: AFIBsupport-owner

> For help on how to use the group, including how to drive it via email,

> send a blank email to AFIBsupport-help

>

> Nothing in this message should be considered as medical advice, or should be

acted upon without consultation with one's physician.

>

>

[Guest guest]

In a message dated 2/13/2003 2:36:42 AM Pacific Standard Time,

john.codling@... writes:

<< Beta blocker s are ok but should not be taken by anybody with Asthma.

>>

,

It is certainly true that beta blockers can trigger asthma, but as in the

case of all medications, everybody reacts differently. For the record, I

must say that I have been an asthma sufferer all of my life and was treated

extensively for asthma as a child. Now I am taking 150 m.g. of Tenormin, a

beta blocker, and see no asthma triggering effect at all. I am possibly an

anomaly though because I know the literature says that beta blockers should

not be prescribed for persons with asthma. My doctors were very cautious

about it and amazed that I could tolerate the beta blocker. I started on 25

m.g. and the dose was gradually increased as my doctors saw no ill effects.

in sinus in Seattle (nine months)

[Guest guest]

Dear ,

Maverick678 wrote:

>I am so glad I found this group. I am in need of some assistance.

>

>I am a 41-year-old male, I went to the hospital with mild chest pains

>(have had them before but ignored them) I was diagnosed with A-Fib, I

>stayed in A-Fib 1 day and went back to NSR during my sleep. Having a

>young family this episode has really scared me.

>

>I am currently taking Betapace (sotalol) 120 mg twice a day and

>coumadin 5mg once a day. I have a few questions.

>

Sotalol for most people is the least effective of the antiarrhythmic

medications. It is not recommended for conversion from A-Fib. Have you

and your doctor considered other antiarrhythmic medications such as

dofetilide (Tikosyn) or flecainide (Tambocor)? But you should be aware

that antiarrhythmic drugs often have bad side effects.

You should be on a blood thinner like Coumadin. Does your doctor

monitor the effective levels of Coumadin in your blood? You should have

what is called an INR (International Normalized Ratio) of 2.0 to 3.0

(3.5). A healthy, normal person would have an INR of 1.0. An INR/PT

test measures the time it takes for a person's blood to clot. (PT stands

for Prothrombin Time. A PT of 10 to 20 seconds is considered normal,

indicating normal blood clotting )

>

>1. Where can I find a list of local cardiologist that specializes in

>A-fib? I live in the Tampa Bay area. Specially doctors that are

>experienced with Pulmonary Ablation.

>

I try to maintain a list of doctors and facilities specializing in

A-Fib at http://www.a-fib.com/Facilities.htm, but to date I don't have

anyone I would recommend in Florida. (That doesn't mean there aren't

any. I just don't know about them.)

>

>2. Is it possible for my current prescriptions to increase the

>intensity and frequency of my A fib attacks? I never had as hard and

>as frequently as I am having A Fib now.

>

As mentioned above, Sotalol isn't very effective for most people.

Antiarrhythmic medications do occasionally have what is called a

proarrhythmic effect, that is they actually increase the intensity and

frequency of your A-Fib. However, you may also be experiencing what is

called " remodeling. " When you're in A-Fib. Your heart has a tendency to

change physically and electronically. A-Fib begets A-Fib. You become

more prone to A-Fib and your episodes become longer and/or more frequent.

>

>3. Can A-Fib be controlled by diet and if so can I get some

>information on this too, I am not overweight and an active person,

>(with 3 daughters, they keep me in shape)

>

A-Fib isn't like high blood pressure which can be controlled and

helped by diet. Think of it more as a heart defect. To date scientific

research hasn't identified a diet that will help your A-Fib. But watch

out for things like alcohol, stimulants like coffee, tobacco, etc. Some

people on this site have been helped by avoiding dairy products and/or

MSG. If you drink, for example, try not drinking for two weeks and see

if that helps your A-Fib.

>

>

>I believe I've had AFIB for a while but other than mild chest pains I

>never had other symptoms and after a day or so they would go away, it

>felt like muscle pains, but since I went to the hospital and now on

>this medication I am having A fib attacks more frequently and

>stronger. I don't have to tell you the anxiety and emotions that I

>feel when these attacks come I just want them to stop.

>

We all know what you are going through and have been there

ourselves. It's like your heart is out of control. But realize that an

attack of A-Fib by itself usually isn't life threatening.

>

>Again I am so glad I found this group it's such a blessing to hear of

>other people that have overcome or are going through this condition

>and are helping others go through these tough times.

>

>Thank you all, (sorry didn't mean to make it so long)

>

>

>

A-FibFriendSteve

>

>

>

>

>Web Page - http://groups.yahoo.com/group/AFIBsupport

>FAQ - http://groups.yahoo.com/group/AFIBsupport/files/Administrative/faq.htm

>For more information: http://www.dialsolutions.com/af

>Unsubscribe: AFIBsupport-unsubscribe

>List owner: AFIBsupport-owner

>For help on how to use the group, including how to drive it via email,

>send a blank email to AFIBsupport-help

>

>Nothing in this message should be considered as medical advice, or should be

acted upon without consultation with one's physician.

>

>

[Guest guest]

> >

> A-Fib isn't like high blood pressure which can be controlled and

> helped by diet. Think of it more as a heart defect. To date scientific

> research hasn't identified a diet that will help your A-Fib. But watch

> out for things like alcohol, stimulants like coffee, tobacco, etc. Some

> people on this site have been helped by avoiding dairy products and/or

> MSG. If you drink, for example, try not drinking for two weeks and see

> if that helps your A-Fib.

>

Sorry Steve

I have to disagree with you here. There is more and more evidence showing

that Lone AF could be in some circumstances be diet related. And in my case

it definately was. I want to draw your attention to an article about

portprandial reactive hypoglycemia.

J.F. BRUN, C. FEDOU, J. MERCIER

http://www.alfediam.org/media/pdf/RevueBrunD & M5-2000.pdf

P J Lefevre proposes the term of " Adrenergic hormone postprandial syndrome "

to describe autonomic symptoms (anxiety, palpitations, sweating,

irritability, tremor..) that are experimentally observed after insulin

infusion, at plasma glucose levels of about 3.7mmol/I. It is likely that in

some individuals, after a meal, such autonomic counterregulation may occur.

This counterregulatory response induces symptoms but also prevents

biochemical hypoglycemia being acheived. In such cases, since low blood

glucose levels do not occur, the term " postprandial " or " reactive "

hypoglycemia should thus be avoided.

This adrenergic hormnone postprandial syndrome is likely to be of clinical

relavence, since Rokas and coworkers published a case report of a patient

with refractory atrioventricular nodal rentry tachycardia in whom it was

possible to document that reactive hypoglycemia was the trigger for

aggravation of the arrhythmia. OVer a period of 6 years, a series of

electrophysiological studies revealed that, when the patient was in a

hypoglycemic state, initiation of tachycardia was easy and most importantly

that tachycardia termination by extra stimulus pacing always failed.

Furthermore, Atrial Fibrillation was inducible or sponaneously occured when

the blood glucose level was reduced by IV insulin administration.

Also...., hyperinsulinemia [thought to be caused by exaggerated response of

GPL-1 ] has been reported to enhance epinephrine, norepinephrine and

cortisol secretion in response to hypoglycemia, while it does not modify

glucagen and GH responses. Thus excess insulin may be a factor involved in

in postprandial adrenergic syndrome whose link with PRH is discussed above.

I think it is quite misleading to think of Lone AF as a heart defect. It is

more probably a defect in the autonomic nervous system. Hope this helps

some.

Fran

[Guest guest]

Steve wrote:

<< You should be on a blood thinner like Coumadin. Does your doctor

monitor the effective levels of Coumadin in your blood? You should

have

what is called an INR (International Normalized Ratio) of 2.0 to 3.0

(3.5).>>

Hi Maverick678,

I'd like to stress this is only Steve's opinion rather than medical

fact.

Whether you should be taking anything to reduce your stroke risk will

depend on your own situation and your doctor is the best person to

advise you. Your stroke risk may or may not be high enough to warrant

coumadin.

This, of course, is only my opinion

This is not a medical site, every message comes with this at the

bottom

" Nothing in this message should be considered as medical advice, or

should be acted upon without consultation with one's physician. "

and is the only advice you should consider to be good advice without

doing your own research.

All the best

--

D

[Guest guest]

Ross Kirtley wrote:

>Can you take beta blockers and verapamil together???

>

>Thanks,

> Ross

>

Yes. Many people on this site do that.

A-FibFriendSteve

>

>

> Re: New to AFIB group

>

>

>

>

>

>>Hi ,

>>

>>

>...I am puzzled about the chest pains you have -- having had plenty

>of afib, I've never experienced any pain.

>

>When I first was diagnosed with afib, itwas totally out of control,

>and I had real pain in my chest and back. Once I was on the correct

>meds and things had a chance to heal up, I have never had that pain

>since.

>

>

>

>Web Page - http://groups.yahoo.com/group/AFIBsupport

>FAQ - http://groups.yahoo.com/group/AFIBsupport/files/Administrative/faq.htm

>For more information: http://www.dialsolutions.com/af

>Unsubscribe: AFIBsupport-unsubscribe

>List owner: AFIBsupport-owner

>For help on how to use the group, including how to drive it via email,

>send a blank email to AFIBsupport-help

>

>Nothing in this message should be considered as medical advice, or should be

>acted upon without consultation with one's physician.

>

>

[Guest guest]

Dear Fran,

I did read that article by Dr. Brun et al. May I suggest that you

try to explain in our terms why you think a particular article or part

of the article is important, rather than just citing from the article.

As I understand the article, it seems to primarily be about low

blood glucose after meals (Postprandial Reactive Hypoglycemia) rather

than about A-Fib. Is that correct?

The proposed term " Adrenergic Hormone Postprandial Syndrome " refers

to a small population who have the symptoms of hypoglycemia (like

diabetics), but who don't actually have low blood glucose levels. These

people may have excess insulin or be insulin sensitive. Is this correct?

Are you proposing that " Adrenergic Hormone Postprandial Syndrome " is

a major cause and/or trigger of A-Fib?

The conclusion of the article states, " Most generally, these

hypoglycemias (symptoms of hypoglycemia) occur in situations of high

insulin sensitivity, i.e., the opposite of syndrome X and diabetics.

While this metabolic situation is potentially beneficial, a fall of

blood glucose below the usual levels will result in rather uncomfortable

symptoms (palpitation, tremor, sweating, dizziness, blurred vision) and

in dangerous disturbances in reaction time in some usual tasks like

driving a car or performing a specific exercise. " I can see how

palpitation and dizziness often occur when we have A-Fib, but aren't

tremor, sweating, blurred vision, and disturbances in reaction time more

symptoms associated with hypoglycemia than with A-Fib?

There is nothing in this article that suggests a diet for curing

A-Fib. Is that correct?

Even with regards to Postprandial Reactive Hypoglycemia and diet,

the article states, " There is no doubt that patient's alimentary habits

have a major role in the occurrence of hypoglycemia. However, we are not

aware of specific studies on nutritional habits of these patients, and

well-conducted studies on this subject appear to be almost lacking.

....Clearly, there is very few literature on this subject. "

The only suggestions I could find on diet in the article relate to

Postprandial Reactive Hypoglycemia. They are:

1. low carbohydrate diet and frequent small split meals to prevent a

fall in blood glucose.

2. avoid rapidly absorbable sugars like soft drinks, and avoid

drinks associating sugar and alcohol.

3. possibly adding proteins to breakfast to reduce insulin response

and fall in blood glucose

4. adding soluble dietary fibers

Do you think these recommendations would help people with A-Fib? What

specific diet would you recommend? Why?

If most A-Fib signals come from the Pulmonary Vein openings into the

heart and are often cured a PVA that ablates these problem areas, why do

you not consider these areas as defective areas of the heart?

(That article was really exhaustive to read!)

A-FibFriendSteve

[Guest guest]

> I did read that article by Dr. Brun et al. May I suggest that you

> try to explain in our terms why you think a particular article or part

> of the article is important, rather than just citing from the article.

Hi Steve

Thanks for taking the time and reading the article. I think you have very

much got the gist of it. From my understanding postprandial reactive

hypoglycemia (PRH) is the EXACT OPPOSITE OF DIABETES. When a person with

diabetes eats sugar for example, their pancreas does not produce enough

insulin so sugar levels stay high. When they go hypoglycemic it is a matter

of life and death and need glucose to get some blood sugar back. To control

this they inject insulin.

With PRH the pancreas PRODUCES TOO MUCH INSULIN so blood sugar levels fall

too quickly, this takes me below the fasting level before the liver kicks in

with the help of adrenals, catecholines (SP)... and a lot of other hormones

(I am not fully versed yet as I discovered this in hindsight) to release

glucagen to restore some blood sugar and somewhere in between AF will rear

its ugly head . Both the high blood sugar, and crashes have horrible side

effects and in time excess insulin and low Blood sugar make a viscious cycle

and an AF trap. I even became chronic.

Vagal AFib tends to come on post meal, especially at night, of course when

blood sugar is at its lowest. Many with it will recognise the need to get

out of bed and eat something so we can get back to sleep. Of course this

happens too after exercising. What does the body use when exercising but

blood sugar, it needs a lot of glucose to keep going. Again stress and lots

of brainwork will use excess amounts of glucose leaving one at risk of low

blood sugar. All very vagal. OF course the stomach problems can be part of

the syndrome because many people have PRH because they are intolerant to

certain foods. With me it was grains. I ate these for 42 years and never

realised till I stopped.

> As I understand the article, it seems to primarily be about low

> blood glucose after meals (Postprandial Reactive Hypoglycemia) rather

> than about A-Fib. Is that correct?

The article itself was primarily about PRH, but they make a correlation with

paroxsymal AF and other arrhythmias with PRH. From my understanding the

Adrenergic Hormone Postprandial Syndrome of AF is the bodies defence to stop

blood sugar levels falling completely and real hypoglycemia happening (total

confusion, seizures, coma etc).

I made a correlation with this because my initial diagnosis was epilepsy

(found out not to be 20 years later). Prior to this I had periods of extreme

fatigue, brain fog, shakes and sweats. I used to get angry with myslef as I

could not rely on myself to function. I even began to suspect I had a form

of dysphasia (when words will not come out or form). Then came the times I

would pass out. I then found out from witnesses that I was convulsing so it

was easy for them to tell me I was epileptic (even though they only happened

very rarely). The convulsions occured with very low blood sugar (I started

monitoring my BS after collapsing in a multistory car park. I did not quite

loose conciousness but my brain was certainly on another planet. I remember

stating what happened on this board in the early part of this year..

I lived, in hindsight, with PRH for many years, until AF set in. My first

and most monumentous AF episode took place when I was bending down to light

the fire. I felt the usual surge of what I had always associated with a

seizure. I threw myself flat down to the floor in the recovery position, but

no seizure happened. But my heart went absolutely crazy. It frightened the

living daylights out of me, I didn't know what was worse, the seizure or the

heart. Form then on all I had was AF with one seizure or so a year, but with

a difference. I stayed concious in my head throughout it. I thought each

time I would never get back and die.

I think my PRH is more severe than most, most people with PRH don't have

seizures or the severe vertigo I had. Although I have since met one or two.

They have heart symptoms but have never been diagnosed with them. Which

reminds me it took 9 years for me to get an AF diagnosis. In many the

symptoms are hardly noticeable, just a feeling that something isn't quite

right. And of course for many AF will stop the severity of blood sugar

crashes. Don't ask me how I started with PRH, got AF, got rid of AF and went

back to PRH. Although I know how I stopped the AF. And I now know how to

stop the PRH.

> The proposed term " Adrenergic Hormone Postprandial Syndrome " refers

> to a small population who have the symptoms of hypoglycemia (like

> diabetics), but who don't actually have low blood glucose levels.

Not quite.It seems that AF is a defence mechansism to stop the total crash

of blood sugar. My understanding is that the force of the hormones kicking

in to rectify sugar levels (releasing stored glucose (glucagen) from the

liver) and prior to this when the blood sugar is low, but not low enough for

clinical hypoglycemia, it will produce symptoms akin to hypoglycemia,

dizziness, foggy thinking, anxiety etc.

These

> people may have excess insulin or be insulin sensitive. Is this correct?

Absolutley. EXCESS INSULIN, or it may be sensitivity. I think over time this

can and will lead to insulin depletion and type two diabetes.

> Are you proposing that " Adrenergic Hormone Postprandial Syndrome " is

> a major cause and/or trigger of A-Fib?

I know it was the cause for my own. I don't know how major it is because

not many people know about it, let alone get tested for it. However, it is

generally recognised by the medical community that hypoglycemia is a known

cause of AF. But the way they measure blood sugar would not show clinical HG

except in the most severe cases. No-one ever did mine. I had to ask for a

monitor from my GP. He concurs this is what I have.

When I stopped my AF (through diet) I discovered that something else was

amiss. The symptoms I had had since a child reappeared. I started crashing

like nothing on earth. Now I did not get Af but horrid runs of ectopics with

the other symptoms. I went to my GP and he told me it was quite possbile

that it was this that had produced my AF and gave me a BS monitor. This led

to further research about diet (and I bored and irritated a lot of people

here at the same time probably, but this was my cure and I had to share it)

> The conclusion of the article states, " Most generally, these

> hypoglycemias (symptoms of hypoglycemia) occur in situations of high

> insulin sensitivity, i.e., the opposite of syndrome X and diabetics.

> While this metabolic situation is potentially beneficial, a fall of

> blood glucose below the usual levels will result in rather uncomfortable

> symptoms (palpitation, tremor, sweating, dizziness, blurred vision) and

> in dangerous disturbances in reaction time in some usual tasks like

> driving a car or performing a specific exercise. " I can see how

> palpitation and dizziness often occur when we have A-Fib, but aren't

> tremor, sweating, blurred vision, and disturbances in reaction time more

> symptoms associated with hypoglycemia than with A-Fib?

Probably. I know that at times I would have some of the symptoms you only

associate with AF, at others occasionally I would have them all. There was

no rhyme nor reason to it. My cardio and Neurologist both dismissed my cold

sweats, rushing in my ears, weakness etc (this would only happen a few times

a year). Obviously in hindsight because a really rich processed carb meal or

after a chinese. The cardio said my AF had nothing to do with the seizures

(once or so a year) cold sweats etc, and was to do with the nervous system.

And the neuro said that they were nothing to do with epilepsy as I did not

have epilepsy and was not from the nervous system. He thought it was down to

my heart.

SO where do you go from there. I ended up doing my own research. What I

needed was an endrochrinologist. But even your average endo does not know

about this. Reactive Hypoglycemia was thrown out in the late 70's or 80's

when it was discovered that normal people would react to the extreme glucose

tolerance test. What they did was throw the baby out with the bathwater. So

it is only a new generation that is re looking at all this.This is how the

breakfast test got started. Reacting to every day food.

> There is nothing in this article that suggests a diet for curing

> A-Fib. Is that correct?

It only gives a rough diet for avoiding symptoms of PRH. One of the

symptoms, or sometimes the only symptom, of PRH is known to be AF. However,

this article was written with endrochrinology in mind, not AF. So the

chances of an EP turning Endo to treat a nuiscance disorder will not be high

on the agenda.

> Even with regards to Postprandial Reactive Hypoglycemia and diet,

> the article states, " There is no doubt that patient's alimentary habits

> have a major role in the occurrence of hypoglycemia. However, we are not

> aware of specific studies on nutritional habits of these patients, and

> well-conducted studies on this subject appear to be almost lacking.

I would suspect these people ate an average modern diet, high in carbs, low

in fat and protein. Following the usual food pyramid, without enough fresh

living food.

> ...Clearly, there is very few literature on this subject. "

You are right there. Although by reading much of the Reactive Hypo

literature connections become obvious. To me it is obvious that one has to

be well read in the subject to make the connection, then play with your diet

by trial and error. If it works then you know this was the cause, if not

then the AF is a symptom of something else. I got a lot of help by asking

questions on a reactive hypoglycemia forum. For insance a lot of hypo's

can't eat fruit, I can. But then there were some who did all right on fruit,

but couldn't cope with grains. I fall under his catagory.

> The only suggestions I could find on diet in the article relate to

> Postprandial Reactive Hypoglycemia. They are:

> 1. low carbohydrate diet and frequent small split meals to prevent a

> fall in blood glucose.

> 2. avoid rapidly absorbable sugars like soft drinks, and avoid

> drinks associating sugar and alcohol.

> 3. possibly adding proteins to breakfast to reduce insulin response

> and fall in blood glucose

> 4. adding soluble dietary fibers

> Do you think these recommendations would help people with A-Fib?

Absolutely, though I would tighen it up a bit. Protein is a must for/with

breakfast. NEver let yourself go hungry, eat small snacks every couple of

hours between meals to keep you going and hence stop blood sugar crashes. I

use nuts, pumpkin seeds, fruit, dried fruit and sometimes slices of cold

roast meat. I would also advocate more fat, as this staves off hunger and

craving for simple carbs. It is now known that a high carb diet is the main

culprit with cholesterol. But my main fat content comes from omega 3, 6 and

9 (olive oil). Another thing that is not mentioned is the use of

preservatives like sulphites and flavour enhancers like MSG. These also

release insulin and make blood sugar levels crash. IT was by ommitting htese

initially that I stopped AF. I ate a pure whole food diet made by myself.

Never used shop sauces, dips, or even canned things such as coconut milk

with emulsifier or preservatives.

What

> specific diet would you recommend?

I would recommend a diet such as the paleolithic or another high protein

diet. Perhaps not as high in protein as the Atkins. The zone may be good for

people who can tolerate grains. It is very important when starting a diet

like this to get plenty of fresh veggies, and fruit if you are able, to keep

electrolytes up. The high protein diet gets rid of all the stored water and

sugars stored in the body cells and takes with it electrolytes. An imbalance

in electrolytes such as Potassium and Magnesium will induce heart

irregularities.

Why?

These diets make for smaller levels of insulin to be released, which reduces

blood sugar crashes. And hence stops AF.

> If most A-Fib signals come from the Pulmonary Vein openings into the

> heart and are often cured a PVA that ablates these problem areas, why do

> you not consider these areas as defective areas of the heart?

I don't doubt that AF can be sourced to the pulmonary veins, and also in

areas of the heart itself. But I had to ask myself why. It was not till I

got down to thinking and reading about the cellular changes that take place

with high insulin levels, carbs and MSG that I began to realise. None of us

were born with AF (that we know of). It was a condition that came and went,

some when we were older, some when we were younger. I was 22. So something

triggered the AF to start without seeming reason. It would also stop without

any seeming reason. So at times the pulmonary veins were not triggered to

fire. Some people went to get EP studies done, but AF could not be

triggered. The article I cited gives a reason for that. It was down to the

blood sugar level at examination. There are many pumps to the cells in our

bodies. If these are not working correctly (due to MSG, hyperinsulinamia

etc) then AF or ectopics will strike. I say MSG as well because it was

eliminating this first that took me back to being just PRH. So in my case

the two were tied up. Ablation may just knock out the rogue cells that have

become unstable because of faulty cell or ion pumps. It may be that if one

follows their old diet after AF ablation then AF might rear its ugly head

again a few or good many years down the line. I don't know. Another thing I

thought of was because MSG elimination stopped my AF, was that it may be

glutamate receptors that are ablated. MSG excites the receptors and the

cells literally stimulate themselves to death. I think that perhpas AF is

not just a problem of PRH, but of additives in diet, foods without enzymes

(processed food) and lack of vitamins and minerals too.

If you think further in many the over excitability of the heart (AF) is not

the only symptom. Many ask about areas in the body that tremor, like a baby

kicking. Or an eye lid that twitches, or other place. Could this not just a

similar cellular symptom as in AF in another area of the body. It could be

if it is the cell pumps or ion pumps that are affected. Long term I got

fibromylagia (after 18 years with AF). Another syndrome/symptom that cannot

be explained. But is now thought to be happening at a cellular level. I

could go on with the analogies, but at the moment that is all they are.

> (That article was really exhaustive to read!) And for me worth every

minute of it.

And I thank you from the bottom of my heart for taking the time. I am not

very good at trying to write about medical matters. I am a total lay person

in this area. I have been working on this alone for nearly two years. I

reported as and when I got a breakthrough and why I thought I got it ( One

day I would like to print everything off this board about my findings as and

when I found them because it is really my journal for my road back to

sinus). My GP concurs that PRH could be the cause as clinically it makes

sense and it affects the same hormones as AF.

I only came across this article a few weeks ago, thanks to PC a Dr who

writes on Hans AF forum. He is doing diet changes with good results. I had

got the diet right by trial and error (also blaming other things such as

tyrmine on my road). When I read this article it gave me the WOW factor. It

explained it all. And could I have done with this when I first started!! I

now know the cause of my AF. I don't believe for a second that I am the only

one with this variation. I concede that AF may be a symptom of many other

things. But to follow a diet for a few weeks to see if it helps is surely

better than ignoring it as a possiblilty. If it does not work then what have

you lost - a few pounds of your weight and a healthy diet!. Then back to the

drawing board.

Please if this has holes in it (very likely) ask more. I would like to

become as conversant in it as possible. For me the discovery was personal.

Now I know that medicine is finding out about it too. My heart is singing

now.

Fran

[Guest guest]

I'd like to stress this is only Steve's opinion rather than medical

fact.

Whether you should be taking anything to reduce your stroke risk will

depend on your own situation and your doctor is the best person to

advise you. Your stroke risk may or may not be high enough to warrant

coumadin.

Dear ,

In general people with A-Fib should be on blood thinners, as of course

determined with your doctor and with tests. People with A-Fib " ...are five times

more likely to have a stroke (caused by blood clots traveling to the brain) than

the general population. Clots can also travel to other parts of the body

(kidneys, heart, intestines) to cause damage. " (Source WebMD Health, the

Cleveland Clinic). Because your heart isn't beating properly in A-Fib, blood

tends to pool and clot in the atria, particularly in the Left Atrial Appendage.

These clots can get pumped into the rest of your body, particularly when your

heart starts beating again in normal sinus rhythm.

Blood thinners don't prevent all risk of stroke. Warfarin (brand name Coumadin)

is currently the most effective, reducing the risk of stroke by approximately

68%. With warfarin (Coumadin) your blood does take longer to clot, and there is

a slight risk of a hemorrhagic stroke (stroke from bleeding). Dr.

Ezekowitz of the Drexel School of Medicine in Philadelphia, speaking at the

recent A-Fib Symposium in Boston, said the risk of hemorrhagic stroke from

Coumadin is 0.3%. People under the age of 65 who are pretty active are less at

risk of stroke from A-Fib and are often given aspirin as a blood thinner. But

Dr. Ezekowitz says there is little evidence that aspirin works. I've read other

studies where aspirin is barely more effective than a placebo.

I think on this Web site we should err on the side of caution. In general

people with A-Fib have an increased risk of stroke. They should check with their

doctor about being on a blood thinner. If there are mitigating factors, the

doctor and patient can decide what's appropriate.

A-FibFriendSteve

[Guest guest]

I think we should all yell Amen and eat a big jelly donut!

Rich O

[Guest guest]

I think on this Web site we should err on the side of caution. In general

people with A-Fib have an increased risk of stroke. They should check with their

doctor about being on a blood thinner. If there are mitigating factors, the

doctor and patient can decide what's appropriate.

A-FibFriendSteve

I think on the web site, we should not err one way or another. My opinion is

that regarding blood thinners, the decision should always be made between the

doctor and the patient. Sandy, 56, NC

[Guest guest]

Im with you rich, hot krispy kreme with ice cream on top. Walt

Re: New to AFIB group

I think we should all yell Amen and eat a big jelly donut!

Rich O

[Guest guest]

Sorry Steve, but I'm afraid I disagree with your comments about blood

thinners. It's very widely known that there is a stratification when

considering stroke risk and AF. The range varies massively from people with

a very low risk to people with very high risk.

Assuming that erring on the aside of caution means suggesting that people

should be on blood thinners is quite wrong in my view. I think the best we

can do is point people towards medical research so the they can read

statistics in context and we should be very careful when extracting

statistics and quoting them out of context.

I'm sure I've made many mistakes in the past when quoting statistics and I'm

trying to switch to providing links to the original material when I do quote

so people can read the details for themselves.

As I've said before, please do not take this as a sign that I'm 'anti-blood

thinner', I most certainly am not. What I believe is that one should take

medication most appropriate to ones personal circumstances.

Being well informed and talking to a good doctor is surely the right way

to come up with the individual solution?

Apologies Steve, if you think you are taking a lot of flak. I do appreciate

you contribution to the group, we just seem to disagree on a few things.

Your opinions are as valid as mine, please keep expressing yours and

disagreeing with mine when you feel the need

All the best

--

D

[Guest guest]

>

>

>what is verapamil..what class of drugs?

>

Dear Ken,

Verapamil (brand name Calan) is a rate control calcium-channel

blocker. I think it's a Class IV.

A-FibFriendSteve

[Guest guest]

>

>

>Apologies Steve, if you think you are taking a lot of flak. I do appreciate

>you contribution to the group, we just seem to disagree on a few things.

>

Dear ,

I don't think we really disagree all that much on blood thinners. I

know that people with Lone A-Fib under age 65 who lead an active life

probably don't need the protection of blood thinners. But the problem,

at least in the US, is that blood thinners are under prescribed. Dr.

Ezekowitz from Drexel says that only 15 to 45% of patients with A-fib

are actually anticoagulated. What I try to encourage people to do on

a-fib.com is " ...to consult with your doctor about taking a blood

thinner like warfarin (Coumadin) or aspirin (Plavix, Ticlid). Because

the upper part of your heart isn't pumping out properly, blood clots can

form and travel to your brain causing stroke. " The doctor can work out

with each person whether or not he/she needs to be on blood thinners.

When I had A-Fib five years ago, I was 57 years old with Lone

Paroxysmal A-Fib and leading a fairly active life. My doctor had me on

Coumadin. I might have intellectually accepted that I didn't need blood

thinner protection; but when my heart felt like it was going to jump out

of my chest, emotionally I needed the Coumadin and was very glad I was

being protected from stroke.

Considering the risk of hemorrhagic stroke from Coumadin is fairly

low (somewhere around 0.3% according to Dr. Ezekowitz), what would you

say to someone with Lone A-Fib under 65 years old who still wants to be

on Coumadin to be protected from stroke?

A-FibFriendSteve

[Guest guest]

Steve wrote:

<< Considering the risk of hemorrhagic stroke from Coumadin is fairly

low (somewhere around 0.3% according to Dr. Ezekowitz), what would you

say to someone with Lone A-Fib under 65 years old who still wants to be

on Coumadin to be protected from stroke?>>

Hi Steve,

I'd say talk to a good doctor and do some research to make sure you are not

putting yourself at risk......

I don't believe there are any constants here (risk of hemorrhagic stroke

from Coumadin varies with individual circumstances).

but since I'm 33 I'll plug my numbers in....

My cardiologist reckons my yearly risk from stroke is about 1% (I think it's

a little less than this but no matter let's use his numbers)

The gain I would get from coumadin is nowhere near 68% (68% is the best case

but again it varies from individual to individual) - I'd be lucky to get my

ischemic stroke risk down to .6 or .7%

Add on to this the coumadin stroke risk of .3% (which is too low for me

since I ride a motorbike and am still fairly active) and at best I'm back

where I started and at worst I'm putting myself at a greater risk by taking

it.

So, for me, this would be a false sense of security.

My situation may, of course, change - I'll consider warfarin if I get to the

point that taking it will reduce my risk of stroke by any reasonable amount.

(and I'd make the lifestyle changes too)

Stroke can indeed be devastating and it's not a decision I make lightly but

to assume that warafin is a 'better safe than sorry' medication I believe is

a misleading approach to a useful drug.

Yes, a lot of people that aren't on warfin should be taking it but around 15

to 25% of AFers are taking anticoagulation therapy for no clinical reason.

(see http://stroke.ahajournals.org/cgi/content/full/30/6/1218?maxtoshow=)

Just my view but I do believe the balance is sometimes skewed because of the

fear factor. (and I believe some people taking warafin think they are at 0

risk from having a stroke because of warfarin which sadly is not the case

either)

All the best.

--

D

[Guest guest]

>

>

>Yes, a lot of people that aren't on warfin should be taking it but around 15

>to 25% of AFers are taking anticoagulation therapy for no clinical reason.

>(see http://stroke.ahajournals.org/cgi/content/full/30/6/1218?maxtoshow=)

>

Dear ,

There is a problem with the Karla study. The age cutoff they use for

A-Fib patients who do not need any form of stroke prevention is 75

years old. Most doctors in the US, including Dr. Ezekowitz of Drexel,

use 65 or 60 as the age cutoff. (In the last E-mail I received from Dr.

McGovern before his tragic death, he suggested that researchers

today consider 60 years old as the age cutoff.)

In the Karla study " Anticoagulation was being undertaken in 7 of 49

patients (14%) who were 75 years old or less despite no clinical or

echocardiographic risks. " But if you make the cutoff age 65 or 60, how

many of those seven patients would now fall in the range of patients who

need stroke prevention? Let's say half. That would make the percentage

of A-Fib patients anticoagulated unnecessarily only 6% or less. In any

case it's pretty hard to draw valid conclusions from a sample of only

seven people.

In general as the Karla study points out " anticoagulation is

underused in patients with AF in clinical practice. " In A-Fib patients

over age 75 " only 12% of those patients eligible for anticoagulation

were being anticoagulated... "

Another interesting point of the Karla study is that they found

through the use of echocardiogram that many A-Fib patients without

apparent risk factors needed to be on anticoagulants. " The study showed

that a significant proportion of these patients had echocardiographic

risk in the absence of clinical risk factors and would not have been

identified if clinical criteria alone were used. "

>Considering the risk of hemorrhagic stroke from Coumadin is fairly

>low (somewhere around 0.3% according to Dr. Ezekowitz), what would you

>say to someone with Lone A-Fib under 65 years old who still wants to be

>on Coumadin to be protected from stroke?>>

>

>Hi Steve,

>I'd say talk to a good doctor and do some research to make sure you are not

>putting yourself at risk

>

What if you were a doctor and one of your patients who was 57 years

old with Lone A-Fib came to you and asked to be put on Coumadin for his

peace of mind? What would you say to him? That was my situation before I

was cured. I had Lone A-Fib and led a fairly active life. I would have

short episodes of A-Fib usually never longer than five minutes but

fairly often, three to twenty times a day. When you feel your heart

bouncing around like mice playing basketball, statistics don't mean

anything. I knew in my gut with absolute certainty that I needed to be

on Coumadin.

And in fact later studies showed that my heart would actually stop

beating after an A-Fib episode for three or six seconds before kicking

in again. I would get dizzy and had to take a leave of absence from work

and go on disability. Not only was blood possibly pooling and clotting

in the left atrium but in my whole heart.

The point I'm trying to make is there is an emotional, mental, and

psychological aspect of A-Fib that we need to address. If Coumadin can

give someone peace of mind, this can be very important and a huge health

benefit.

A-FibFriendSteve