RE: Lone A-fib

July 26, 2005

I have Lone Prox Afib....

Many do in this group.

As for Paxil...I have never taken the stuff. But, I can tell you what I

think it might do....

Paxil is a drug called an SSRI - Selective Serotonin Re-Uptake Inhibitor.

This is a relatively new group of drugs focused on treating GI problems and

certain types of depression.

Tryptophan is a amino acid [protein building block] found in most meats,

milk, eggs, etc. In the brain, Tryptophan is converted to Serotonin (5-HT)

and stored in vesicles at synaptic bases.

However, L-Tryptophan uptake is inhibited via competition with other amino

acids. If you eat a carbohydrate rich meal WITH protein, the insulin will

direct most competing Amino Acids to the muscle tissue, resulting in reduced

competition and a higher concentration of Tryptophan (and ultimately

Serotonin) in the brain.

Serotonin is a powerful neurotransmitter. Found in the intestine wall,

Central Nervous System and Cardio Vascular System, Serotonin [and it's

receptors] are critical in functions relating to digestion, behavior,

memory, sleep, mood, cardiovascular function, temperature regulation,

hunger, muscle function and the entire endocrine system.

Possibly 7 groups of serotonin receptors exist with as many as 5 types in

each group. The re-uptake inhibitor portion of the SSRI name causes a

greater concentration of the Serotonin to remain in contact with the neurons

at the targeted receptor site. The result is increased stimulation to the

receptor.

I clipped the next paragraph:

" Three selective 5-HT uptake inhibitors, also referred to as

second-generation antidepressants, have been introduced on the U.S. market.

Fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil) have gained

immediate acceptance, each appearing in the most recent listing of the top

200 prescription drugs. Fluoxetine recently was approved also for the

treatment of obsessive-compulsive disorder. These agents do not appear to

possess greater efficacy than the TCAs, nor do they generally possess a

faster onset of action; however, they do have the advantage of a lower

side-effect profile. Of these three SSRIs, paroxetine is the most potent

inhibit or of 5-HT uptake, Fluoxetine the least. Sertaline is the most

selective for 5-HT versus NE uptake, Fluoxetine the less selective. "

My guess would be that increasing Serotonin at receptor sites could help

prevent Afib - in certain cases.

The interesting thing is that Serotonin regulates all of what you mention

[and so many of us lone Afibbers complain about] - stomach digestion,

cardiac function / adrenalin, depression, mood, etc.

How many times have we had that big carb / protein dinner - then went afib

after....hmmm...vegal afib, after eating, at night, at rest....same times

when serotonin is doing it's thing - including producing melotonin....

It would not surprise me if (some day) a type of Serotonin related drug was

able to " solve " the vagal mystery.

Interesting info:

http://home.tampabay.rr.com/lymecfs/seroton.htm

-Jim

Lone A-fib

I was wondering how many here have this? I think after my echo comes

back this is what they are going to tell me. My echoes were normal

the last time I had them. Also, anyone take Paxil with AF? My MD told

me yeaturday that she was suprised that I was prescribed Paxil by my

therpist for my panic disorder. She said it is very aggravating to

AF. I have not been taking it due to other side effects. Thanks

goodness!!! I finished reading this article below and I really belive

that my problem stems from the central nervous system,digestive

system and too much adernal. If there was a natural way to control

these triggers I wonder if this would help my AF. Anyone gone the

natural way?

Thanks!

Michele

Lone Atrial Fibrillation

by Hans R. Larsen, MSc ChE

A steady, inconspicuous heartbeat is usually taken for granted so

when an attack of atrial fibrillation strikes it is a very

frightening experience. The heart beats wildly with a pulse rate as

high as 200 beats/minute, dizziness and breathlessness and even

fainting may follow and chest pain, extreme fatigue and the need for

frequent urination are common symptoms. Fibrillation attack victims

usually experience one or more of these symptoms, but a few patients

are not aware of any symptoms at all until an electrocardiogram

exposes their irregular heart rhythm(1-4).

Atrial fibrillation is the most common cardiac arrhythmia and affects

more than 1.5 million Americans. Its primary characteristic is a

rapid and irregular heartbeat. The incidence of atrial fibrillation

shows a significant increase beyond the age of 50 years and the

condition is considerably more common among men than among women.

Atrial fibrillation may be chronic or intermittent (paroxysmal) and

may be triggered by an underlying heart disease such as mitral valve

prolapse or stenosis, coronary artery disease, hypertensive heart

disease, a heart attack or an inflammation of the membrane

surrounding the heart (pericarditis). Atrial fibrillation is also a

common complication of heart surgery(1-3,5-7).

Lone Atrial Fibrillation.

Many cases of atrial fibrillation are not connected with heart

disease or hypertension at all and not too long ago were described

as " idiopathic " , that is, with no known cause. In recent years

however, intensive research has uncovered many conditions, which may

trigger atrial fibrillation, and the diagnosis " idiopathic atrial

fibrillation " is now much less common. Atrial fibrillation not caused

by an underlying heart disease is referred to as primary or lone

atrial fibrillation(3).

Lone atrial fibrillation (LAF) may be an isolated event or it may

recur on an intermittent basis; it is rarely chronic. It is

significantly more prevalent among men than among women. An attack

may last a few hours or several days, but rarely longer than a week.

The frequency of attacks in intermittent LAF may vary from less than

one a year to three per year or more(4,8).

Lone atrial fibrillation caused by an overactive thyroid gland

(hyperthyroidism) is fairly common and can usually be eliminated by

dealing with the underlying disease(1,2,5,6,7,9).

LAF may also be triggered by hypoglycemia, surgery, chronic

infections, alcohol abuse (especially binge drinking), nicotine and

caffeine (coffee and cola drinks)(1,2,7,9,10). An allergic reaction

may also act as a trigger. Thyramine-containing foods such as cheese,

red wine, yogurt, bananas, and chocolate have been known to trigger

LAF attacks(11). Serious electrolyte imbalances, such as between

sodium and potassium and between calcium and magnesium are other

potent triggers for arrhythmias(5,9,12).

Many drugs, chief among them digitalis (digoxin, Lanoxin) and other

antiarrhythmic drugs, may trigger atrial fibrillation as may

excessive physical and emotional stress(1-3,5,10,13).

The rhythm of the heart is controlled through a fine balance of input

from the parasympathetic (vagal nerve) and sympathetic nervous

system. Thus events, which disturb either of these systems, may

trigger LAF. Dr. Philippe Coumel, MD, a French cardiologist, has done

extensive work on the link between the nervous system and LAF. He has

identified a vagal form of LAF which is most common among men aged 40

to 50, occurs during the night, at rest, after eating or following

intake of alcohol. This type of LAF may be triggered by sudden

stimulation of the vagal nerve through, for example, vomiting or

violent sneezing. Dr. Coumel also describes an adrenergic (adrenal

hormone linked) form of LAF which occurs exclusively during daytime

and which is often preceded by exercise or emotional stress. Frequent

urination is a common feature of this type of LAF(3,13).

Dr. Abram Hoffer, MD, a prominent Canadian physician, also believes

that many LAF attacks are caused by excessive physical or emotional

stress. He postulates that adrenochrome, a metabolite of adrenaline

(epinephrine) is the culprit that initiates LAF attacks. Dr. Hoffer

also believes that adrenochrome's negative effects can be negated by

certain antioxidants(14).

It is clear that there are many types and potential triggers for LAF

and this, of course, makes treatment and prevention extremely

complicated and difficult.

QUESTIONS ABOUT LONE ATRIAL FIBRILLATION? TRY THE AFIB REPORT !

Emergency treatment of arrhythmias

Most people make their way to an emergency clinic when suffering a

violent atrial fibrillation attack. They are usually given

intravenous infusions of various drug combinations in order to lower

their pulse rate (ventricular rate) and prevent the fibrillation from

spilling over into the ventricular heart chambers. Chief among the

drugs used to lower the ventricular rate are digitalis, verapamil,

propranolol and diltiazem(2,3,5-7,15). Although drug therapy can be

effective in lowering the pulse rate it usually does not shorten

duration of an LAF attack nor does it help establish normal (sinus)

heart rhythm(3,15,16). Recent research is also questioning whether

digitalis actually has any effect at all in lowering ventricular rate

in intermittent atrial fibrillation(15,17).

Electric cardioversion is used in serious cases to re-establish

regular heart rhythm once the pulse rate has been lowered(2,7,17).

However, in many cases, sinus rhythm is re-established spontaneously.

Cardioversion is not very effective when it comes to LAF and is not

recommended for this condition(18).

Many clinical trials have shown magnesium injections to be very

effective in stopping fibrillation attacks and some doctors now

advocate its routine use in the emergency department. Unfortunately,

no studies have been made yet to evaluate the benefits of oral

magnesium supplementation in the prevention of LAF(19-24).

Drugs such as procainamide, quinidine, flecainide, sotalol and

amiodarone may also be successful in many cases in restoring sinus

rhythm. However, these drugs are dangerous and their effect often

transient(5,17,25). There is no clear consensus that they are of any

value in treating LAF, especially not in cases where symptoms are

relatively mild(25).

Atrial fibrillation patients usually also receive aspirin when

treated in the emergency ward. The rapid irregular beating of the

heart may dislodge small pieces of atherosclerotic plaque in people

with heart disease and if these pieces of plaque get stuck in the

narrow blood vessels in the brain a stroke may result. There is now

compelling evidence that heart disease patients with atrial

fibrillation can lessen their risk of a stroke significantly by

taking an anticoagulant such as aspirin or warfarin on a regular basis

(2,3,5,7,17).

There is however, considerable controversy as to the benefits of

anticoagulation therapy in the case of LAF patients, that is,

patients with no underlying heart disease, hypertension or other

specific risk factors for ischemic stroke (stroke caused by a blood

clot). Several studies have found that LAF sufferers do not seem to

have a higher risk of stroke than does the general public and

therefore may not benefit from taking warfarin or aspirin on a

regular basis(5,7,9,15). Researchers at the Mayo Clinic believe that

routine anticoagulation is unwarranted for LAF patients under the age

of 60 years and that the dangers (internal bleeding, stomach ulcers)

of such therapy significantly outweigh the benefits(10). Italian

researchers found no difference in the incidence of stroke among LAF

patients under 70 years of age regardless of whether they received

anticoagulation therapy or not(8).

Prevention of recurrence of LAF

Digoxin has long been prescribed as the drug of choice for preventing

LAF(2). However, it is now clear that it does not do so and

undoubtedly does more harm than good(3,6,15-17). Digoxin does not

prevent intermittent atrial fibrillation and its prolonged use may

actually convert the intermittent form to the chronic form

(2,7,16,17). It is ineffective in preventing or halting the

adrenergic form of LAF and may aggravate LAF of vagal origin(3,13).

Recent studies concluded that almost 50% of all patients prescribed

digoxin should not be taking it at all and can safely be weaned from

it(26,27). Another study found that tens of thousands of patients end

up in emergency wards every year with potentially life-threatening

digitalis poisoning(28). In short, digitalis is not recommended for

the prevention of intermittent LAF attacks(7,15,26).

Other antiarrhythmic drugs such as quinidine, amiodarone,

propranolol, sotalol and flecainide may be effective in preventing

some types of LAF, but may have no effect on others or may actually

aggravate the situation. All antiarrhythmic drugs have very serious

side effects and may cause life-threatening arrhythmias themselves.

Several clinical trials have shown that patients treated with

quinidine and other antiarrhythmic drugs have a higher mortality rate

than do patients who are left untreated(3,5,7,15-17,25,29).

Although there is no clear consensus regarding antiarrhythmic drugs

in the treatment of LAF many experts believe that their use should be

limited to cases where symptoms are severe and persistent(17,25,29).

Fortunately, there are several alternative approaches that show

promise in preventing LAF.

Dr. Matthias Rath, MD, a leading American expert on cardiovascular

disease, believes that arrhythmias are primarily caused by

nutritional deficiencies and can be prevented by optimizing the

intake of such nutrients as vitamin-C, l-carnitine, coenzyme Q10,

magnesium and vitamin B complex(30). Magnesium is of particular

importance as it is highly concentrated in the heart muscle and

counteracts excessive calcium, which tends to excite the heart. L-

carnitine has been found to have excellent antiarrhythmic properties

and is also useful in the treatment of heart attack patients and

patients with intermittent claudication(31- 33).

Dr. Abram Hoffer, MD reports excellent results in the prevention of

LAF through the use of mega-doses of niacin and folic acid(14).

Japanese researchers have found coenzyme Q10 to be effective in the

management of arrhythmias(34-36).

Hawthorn (Crataegus oxyacantha) is widely used in the management of

arrhythmias in Europe. It is non-toxic and has been found to improve

the overall performance of the heart(37-39).

The bottom line

Although an acute atrial fibrillation attack is very frightening it

is rarely life threatening. Several recent studies have concluded

that the mortality rate among people who have intermittent atrial

fibrillation attacks, but no underlying heart disease, is no greater

than that of the general population(8,10).

The first step in preventing LAF attacks is, of course, to avoid the

trigger factors. Staying away from alcohol, caffeine and

antiarrhythmic drugs such as digoxin is extremely important. Foods

that may cause an allergic reaction should be avoided, as should

excessive physical and emotional stress.

There is no magic drug, which will prevent LAF, and the ones

frequently prescribed for the condition are likely to do more harm

than good. Elimination of nutritional deficiencies and judicious,

medically- supervised supplementation with magnesium, l-carnitine,

coenzyme Q10, hawthorn, niacin, folic acid, and the vitamin B complex

can however, go a long way towards preventing recurrence of LAF

attacks.

WHAT TO DO IF YOU HAVE AN ATTACK

If you have been diagnosed with true LONE atrial fibrillation, are

not on antiarrhythmic drugs and are familiar with the symptoms of an

attack you might want to try some or all of these techniques before

you head for the emergency department:

Stop what you are doing, take a deep breath and relax

Plunge your face into a basin with ice water

Apply a cold compress to your neck

Do the Valsalva Maneuver (Sit down and bend forward at the waist -

hold your breath and strain as if blowing up a balloon)

Take three pellets of Aconite (30cc) homeopathic remedy

(sublingually)

Have a warm bath with 6-8 drops of pure orange flower oil (neroli

oil) in it

Ask your doctor about carotid sinus massage or your acupuncturist

about acupuncture to stop the attack. It is also a good idea to take

an aspirin if you are not already on anticoagulants (Take 30 minutes

before or after taking a homeopathic remedy)

Please remember that these techniques should only be used in the case

of true LONE atrial fibrillation attacks. You should check with your

physician to make sure they are safe for you.

Web Page - http://www.afibsupport.com

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.

July 26, 2005

---

Another good post Deutschmann but I disagree with you concerning

SSIR's and AF. I believe that the consensus among many patients and

some doctors is that AF is aggravated by antidepressants generally

particularly AF of the sympathethic variety. AF caused by excessive

vagal tone might be helped by SSRI's but even in this instance these

antidepressants might indirectly cause a sympathethic storm which

could provoke a heightened vagal response. Even though SSRI's are

supposed to be generally if not exclusively selective for Serotonin

receptors, artifically high serotonergic synaptic activity raises CNS

activity generally and thereby can also cause norepinephrine synapses

to fire more frequently as well. Certainly SSRI's are safer for the

AF patient than the traditional tricyclic antidepressants but the

selective serotonin profile of the SSRI's is not absolute given the

interdependancies of many neurons within the CNS.

Whats also interesting is that since serotonin is present in so

many tissues and organs of the human body, its function will vary

depending upon that location. I once had a neurologist at the Mayo

Clinic explain it to me this way. Serotonin receptors in one part of

the body will stimulate adrenergic activity and in other areas they

will suppress it. Therefore you have the paradoxical phenomenon of

one neurotransmitter having a multiplicity of functions and effects

dependant upon its particular biosynthetic pathway within the human

body.

In AFIBsupport , " Deutschmann " <deutschmann@c...>

wrote:

> I have Lone Prox Afib....

>

> Many do in this group.

>

> As for Paxil...I have never taken the stuff. But, I can tell you

what I

> think it might do....

>

> Paxil is a drug called an SSRI - Selective Serotonin Re-Uptake

Inhibitor.

> This is a relatively new group of drugs focused on treating GI

problems and

> certain types of depression.

>

> Tryptophan is a amino acid [protein building block] found in most

meats,

> milk, eggs, etc. In the brain, Tryptophan is converted to Serotonin

(5-HT)

> and stored in vesicles at synaptic bases.

>

> However, L-Tryptophan uptake is inhibited via competition with

other amino

> acids. If you eat a carbohydrate rich meal WITH protein, the

insulin will

> direct most competing Amino Acids to the muscle tissue, resulting

in reduced

> competition and a higher concentration of Tryptophan (and ultimately

> Serotonin) in the brain.

>

> Serotonin is a powerful neurotransmitter. Found in the intestine

wall,

> Central Nervous System and Cardio Vascular System, Serotonin [and

it's

> receptors] are critical in functions relating to digestion,

behavior,

> memory, sleep, mood, cardiovascular function, temperature

regulation,

> hunger, muscle function and the entire endocrine system.

>

> Possibly 7 groups of serotonin receptors exist with as many as 5

types in

> each group. The re-uptake inhibitor portion of the SSRI name causes

a

> greater concentration of the Serotonin to remain in contact with

the neurons

> at the targeted receptor site. The result is increased stimulation

to the

> receptor.

>

> I clipped the next paragraph:

>

> " Three selective 5-HT uptake inhibitors, also referred to as

> second-generation antidepressants, have been introduced on the U.S.

market.

> Fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil)

have gained

> immediate acceptance, each appearing in the most recent listing of

the top

> 200 prescription drugs. Fluoxetine recently was approved also for

the

> treatment of obsessive-compulsive disorder. These agents do not

appear to

> possess greater efficacy than the TCAs, nor do they generally

possess a

> faster onset of action; however, they do have the advantage of a

lower

> side-effect profile. Of these three SSRIs, paroxetine is the most

potent

> inhibit or of 5-HT uptake, Fluoxetine the least. Sertaline is the

most

> selective for 5-HT versus NE uptake, Fluoxetine the less selective. "

>

> My guess would be that increasing Serotonin at receptor sites could

help

> prevent Afib - in certain cases.

>

> The interesting thing is that Serotonin regulates all of what you

mention

> [and so many of us lone Afibbers complain about] - stomach

digestion,

> cardiac function / adrenalin, depression, mood, etc.

>

> How many times have we had that big carb / protein dinner - then

went afib

> after....hmmm...vegal afib, after eating, at night, at rest....same

times

> when serotonin is doing it's thing - including producing

melotonin....

>

> It would not surprise me if (some day) a type of Serotonin related

drug was

> able to " solve " the vagal mystery.

>

> Interesting info:

> http://home.tampabay.rr.com/lymecfs/seroton.htm

>

> -Jim

>

> Lone A-fib

>

> I was wondering how many here have this? I think after my echo

comes

> back this is what they are going to tell me. My echoes were normal

> the last time I had them. Also, anyone take Paxil with AF? My MD

told

> me yeaturday that she was suprised that I was prescribed Paxil by

my

> therpist for my panic disorder. She said it is very aggravating to

> AF. I have not been taking it due to other side effects. Thanks

> goodness!!! I finished reading this article below and I really

belive

> that my problem stems from the central nervous system,digestive

> system and too much adernal. If there was a natural way to control

> these triggers I wonder if this would help my AF. Anyone gone the

> natural way?

>

> Thanks!

> Michele

> Lone Atrial Fibrillation

>

> by Hans R. Larsen, MSc ChE

>

> A steady, inconspicuous heartbeat is usually taken for granted so

> when an attack of atrial fibrillation strikes it is a very

> frightening experience. The heart beats wildly with a pulse rate as

> high as 200 beats/minute, dizziness and breathlessness and even

> fainting may follow and chest pain, extreme fatigue and the need

for

> frequent urination are common symptoms. Fibrillation attack victims

> usually experience one or more of these symptoms, but a few

patients

> are not aware of any symptoms at all until an electrocardiogram

> exposes their irregular heart rhythm(1-4).

>

> Atrial fibrillation is the most common cardiac arrhythmia and

affects

> more than 1.5 million Americans. Its primary characteristic is a

> rapid and irregular heartbeat. The incidence of atrial fibrillation

> shows a significant increase beyond the age of 50 years and the

> condition is considerably more common among men than among women.

> Atrial fibrillation may be chronic or intermittent (paroxysmal) and

> may be triggered by an underlying heart disease such as mitral

valve

> prolapse or stenosis, coronary artery disease, hypertensive heart

> disease, a heart attack or an inflammation of the membrane

> surrounding the heart (pericarditis). Atrial fibrillation is also a

> common complication of heart surgery(1-3,5-7).

>

> Lone Atrial Fibrillation.

> Many cases of atrial fibrillation are not connected with heart

> disease or hypertension at all and not too long ago were described

> as " idiopathic " , that is, with no known cause. In recent years

> however, intensive research has uncovered many conditions, which

may

> trigger atrial fibrillation, and the diagnosis " idiopathic atrial

> fibrillation " is now much less common. Atrial fibrillation not

caused

> by an underlying heart disease is referred to as primary or lone

> atrial fibrillation(3).

>

> Lone atrial fibrillation (LAF) may be an isolated event or it may

> recur on an intermittent basis; it is rarely chronic. It is

> significantly more prevalent among men than among women. An attack

> may last a few hours or several days, but rarely longer than a

week.

> The frequency of attacks in intermittent LAF may vary from less

than

> one a year to three per year or more(4,8).

>

> Lone atrial fibrillation caused by an overactive thyroid gland

> (hyperthyroidism) is fairly common and can usually be eliminated by

> dealing with the underlying disease(1,2,5,6,7,9).

>

> LAF may also be triggered by hypoglycemia, surgery, chronic

> infections, alcohol abuse (especially binge drinking), nicotine and

> caffeine (coffee and cola drinks)(1,2,7,9,10). An allergic reaction

> may also act as a trigger. Thyramine-containing foods such as

cheese,

> red wine, yogurt, bananas, and chocolate have been known to trigger

> LAF attacks(11). Serious electrolyte imbalances, such as between

> sodium and potassium and between calcium and magnesium are other

> potent triggers for arrhythmias(5,9,12).

>

> Many drugs, chief among them digitalis (digoxin, Lanoxin) and other

> antiarrhythmic drugs, may trigger atrial fibrillation as may

> excessive physical and emotional stress(1-3,5,10,13).

>

> The rhythm of the heart is controlled through a fine balance of

input

> from the parasympathetic (vagal nerve) and sympathetic nervous

> system. Thus events, which disturb either of these systems, may

> trigger LAF. Dr. Philippe Coumel, MD, a French cardiologist, has

done

> extensive work on the link between the nervous system and LAF. He

has

> identified a vagal form of LAF which is most common among men aged

40

> to 50, occurs during the night, at rest, after eating or following

> intake of alcohol. This type of LAF may be triggered by sudden

> stimulation of the vagal nerve through, for example, vomiting or

> violent sneezing. Dr. Coumel also describes an adrenergic (adrenal

> hormone linked) form of LAF which occurs exclusively during daytime

> and which is often preceded by exercise or emotional stress.

Frequent

> urination is a common feature of this type of LAF(3,13).

>

> Dr. Abram Hoffer, MD, a prominent Canadian physician, also believes

> that many LAF attacks are caused by excessive physical or emotional

> stress. He postulates that adrenochrome, a metabolite of adrenaline

> (epinephrine) is the culprit that initiates LAF attacks. Dr. Hoffer

> also believes that adrenochrome's negative effects can be negated

by

> certain antioxidants(14).

>

> It is clear that there are many types and potential triggers for

LAF

> and this, of course, makes treatment and prevention extremely

> complicated and difficult.

>

> QUESTIONS ABOUT LONE ATRIAL FIBRILLATION? TRY THE AFIB REPORT !

>

> Emergency treatment of arrhythmias

> Most people make their way to an emergency clinic when suffering a

> violent atrial fibrillation attack. They are usually given

> intravenous infusions of various drug combinations in order to

lower

> their pulse rate (ventricular rate) and prevent the fibrillation

from

> spilling over into the ventricular heart chambers. Chief among the

> drugs used to lower the ventricular rate are digitalis, verapamil,

> propranolol and diltiazem(2,3,5-7,15). Although drug therapy can be

> effective in lowering the pulse rate it usually does not shorten

> duration of an LAF attack nor does it help establish normal (sinus)

> heart rhythm(3,15,16). Recent research is also questioning whether

> digitalis actually has any effect at all in lowering ventricular

rate

> in intermittent atrial fibrillation(15,17).

> Electric cardioversion is used in serious cases to re-establish

> regular heart rhythm once the pulse rate has been lowered(2,7,17).

> However, in many cases, sinus rhythm is re-established

spontaneously.

> Cardioversion is not very effective when it comes to LAF and is not

> recommended for this condition(18).

>

> Many clinical trials have shown magnesium injections to be very

> effective in stopping fibrillation attacks and some doctors now

> advocate its routine use in the emergency department.

Unfortunately,

> no studies have been made yet to evaluate the benefits of oral

> magnesium supplementation in the prevention of LAF(19-24).

>

> Drugs such as procainamide, quinidine, flecainide, sotalol and

> amiodarone may also be successful in many cases in restoring sinus

> rhythm. However, these drugs are dangerous and their effect often

> transient(5,17,25). There is no clear consensus that they are of

any

> value in treating LAF, especially not in cases where symptoms are

> relatively mild(25).

>

> Atrial fibrillation patients usually also receive aspirin when

> treated in the emergency ward. The rapid irregular beating of the

> heart may dislodge small pieces of atherosclerotic plaque in people

> with heart disease and if these pieces of plaque get stuck in the

> narrow blood vessels in the brain a stroke may result. There is now

> compelling evidence that heart disease patients with atrial

> fibrillation can lessen their risk of a stroke significantly by

> taking an anticoagulant such as aspirin or warfarin on a regular

basis

> (2,3,5,7,17).

>

> There is however, considerable controversy as to the benefits of

> anticoagulation therapy in the case of LAF patients, that is,

> patients with no underlying heart disease, hypertension or other

> specific risk factors for ischemic stroke (stroke caused by a blood

> clot). Several studies have found that LAF sufferers do not seem to

> have a higher risk of stroke than does the general public and

> therefore may not benefit from taking warfarin or aspirin on a

> regular basis(5,7,9,15). Researchers at the Mayo Clinic believe

that

> routine anticoagulation is unwarranted for LAF patients under the

age

> of 60 years and that the dangers (internal bleeding, stomach

ulcers)

> of such therapy significantly outweigh the benefits(10). Italian

> researchers found no difference in the incidence of stroke among

LAF

> patients under 70 years of age regardless of whether they received

> anticoagulation therapy or not(8).

>

> Prevention of recurrence of LAF

> Digoxin has long been prescribed as the drug of choice for

preventing

> LAF(2). However, it is now clear that it does not do so and

> undoubtedly does more harm than good(3,6,15-17). Digoxin does not

> prevent intermittent atrial fibrillation and its prolonged use may

> actually convert the intermittent form to the chronic form

> (2,7,16,17). It is ineffective in preventing or halting the

> adrenergic form of LAF and may aggravate LAF of vagal origin(3,13).

> Recent studies concluded that almost 50% of all patients prescribed

> digoxin should not be taking it at all and can safely be weaned

from

> it(26,27). Another study found that tens of thousands of patients

end

> up in emergency wards every year with potentially life-threatening

> digitalis poisoning(28). In short, digitalis is not recommended for

> the prevention of intermittent LAF attacks(7,15,26).

>

> Other antiarrhythmic drugs such as quinidine, amiodarone,

> propranolol, sotalol and flecainide may be effective in preventing

> some types of LAF, but may have no effect on others or may actually

> aggravate the situation. All antiarrhythmic drugs have very serious

> side effects and may cause life-threatening arrhythmias themselves.

> Several clinical trials have shown that patients treated with

> quinidine and other antiarrhythmic drugs have a higher mortality

rate

> than do patients who are left untreated(3,5,7,15-17,25,29).

>

> Although there is no clear consensus regarding antiarrhythmic drugs

> in the treatment of LAF many experts believe that their use should

be

> limited to cases where symptoms are severe and persistent

(17,25,29).

>

> Fortunately, there are several alternative approaches that show

> promise in preventing LAF.

>

> Dr. Matthias Rath, MD, a leading American expert on cardiovascular

> disease, believes that arrhythmias are primarily caused by

> nutritional deficiencies and can be prevented by optimizing the

> intake of such nutrients as vitamin-C, l-carnitine, coenzyme Q10,

> magnesium and vitamin B complex(30). Magnesium is of particular

> importance as it is highly concentrated in the heart muscle and

> counteracts excessive calcium, which tends to excite the heart. L-

> carnitine has been found to have excellent antiarrhythmic

properties

> and is also useful in the treatment of heart attack patients and

> patients with intermittent claudication(31- 33).

>

> Dr. Abram Hoffer, MD reports excellent results in the prevention of

> LAF through the use of mega-doses of niacin and folic acid(14).

>

> Japanese researchers have found coenzyme Q10 to be effective in the

> management of arrhythmias(34-36).

>

> Hawthorn (Crataegus oxyacantha) is widely used in the management of

> arrhythmias in Europe. It is non-toxic and has been found to

improve

> the overall performance of the heart(37-39).

>

> The bottom line

> Although an acute atrial fibrillation attack is very frightening it

> is rarely life threatening. Several recent studies have concluded

> that the mortality rate among people who have intermittent atrial

> fibrillation attacks, but no underlying heart disease, is no

greater

> than that of the general population(8,10).

>

> The first step in preventing LAF attacks is, of course, to avoid

the

> trigger factors. Staying away from alcohol, caffeine and

> antiarrhythmic drugs such as digoxin is extremely important. Foods

> that may cause an allergic reaction should be avoided, as should

> excessive physical and emotional stress.

>

> There is no magic drug, which will prevent LAF, and the ones

> frequently prescribed for the condition are likely to do more harm

> than good. Elimination of nutritional deficiencies and judicious,

> medically- supervised supplementation with magnesium, l-carnitine,

> coenzyme Q10, hawthorn, niacin, folic acid, and the vitamin B

complex

> can however, go a long way towards preventing recurrence of LAF

> attacks.

>

> WHAT TO DO IF YOU HAVE AN ATTACK

> If you have been diagnosed with true LONE atrial fibrillation, are

> not on antiarrhythmic drugs and are familiar with the symptoms of

an

> attack you might want to try some or all of these techniques before

> you head for the emergency department:

>

> Stop what you are doing, take a deep breath and relax

> Plunge your face into a basin with ice water

> Apply a cold compress to your neck

> Do the Valsalva Maneuver (Sit down and bend forward at the waist -

> hold your breath and strain as if blowing up a balloon)

> Take three pellets of Aconite (30cc) homeopathic remedy

> (sublingually)

> Have a warm bath with 6-8 drops of pure orange flower oil (neroli

> oil) in it

> Ask your doctor about carotid sinus massage or your acupuncturist

> about acupuncture to stop the attack. It is also a good idea to

take

> an aspirin if you are not already on anticoagulants (Take 30

minutes

> before or after taking a homeopathic remedy)

> Please remember that these techniques should only be used in the

case

> of true LONE atrial fibrillation attacks. You should check with

your

> physician to make sure they are safe for you.

>

> Web Page - http://www.afibsupport.com

> 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.

>

July 27, 2005

I think we are on the same page...I just did not convey my thoughts as

clearly as I had hoped.

To clarify, in response to Michele's original post.....

- I would always recommend listening to your cardiologist first; especially

if you are taking any drugs he/she might have prescribed.

To respond to the original question:

"

!!! I finished reading this article below and I really

believe

> that my problem stems from the central nervous system, digestive

> system and too much adrenal. If there was a natural way to control

> these triggers I wonder if this would help my AF. Anyone gone the

> natural way? " [the article related to lone AF with a specific reference to

Adrenal induced LAF...not the Vagal type..]

My thought was, assuming Michele is on no other drugs, her Cardiologist is

" OK " with trying an SSRI, etc, I believe Paxil may reduce the adrenal

flooding that she describes above, thus, preventing the so called " LAF " .

An interesting question for the group - has someone with Panic induced " LAF "

[Adrenal mediated] been successful with using a SSRI?

AS for the " big picture " - LAF - Vagal type and SSRI's or Serotonin and

Vagal stimulation....I agree with your points - the receptors can stimulate

or block Adrenal and Vagal type functions.

As for Vagal stimulation....you eat carbs+protine [in the same meal] =

Serotonin in the brain = Vagal response = Afib potential.....

Might be a good idea to have the pasta for lunch and just chicken for dinner

- not the combined meal....

, you asked for a " natural " approach - you could try taking an

L-Tryptophan supplement + Pedialite - it's going to make you sleepy, but,

not depressed. Do not do this if you are taking an SSRI!!! You might ask

your DR. first...

As for the SSRIs in solving the LAF vagal mystery....this is a new front in

drug development. Unraveling the mysteries of Serotonin receptors will allow

the development of specific drugs with limited side effects to come to

market. Further, development in understanding the problems at the cellular

and genetic level will only enable better treatment. Paxil is very new and a

class leader in what it does - but this is just the beginning.

Someone posed the thought that Cardio / Afib is not getting the attention it

needs from the science / bio-med community....I disagree, the money flowing

into Bio-sciences / pharm companies and Bio-engineering has exploded.

Advances are happening very rapidly. Speculation of an aging baby boom

market for cardio specific drugs is marking investment more attractive.

I promise you one thing, 20 years from now medical drugs, procedures and

testing are going to make today's medical practices look like medieval

times...This stuff is going " exponential " with development.

IT's a good time to be ALIVE - we all need to remember how fortunate we are!