In my 2003 research report “Aldosterone: Villain of the Peace” I suggested that an elevated level of aldosterone could be instrumental in the initiation of an episode of lone atrial fibrillation. A small trial involving myself and a curious nephrologist (kidney specialist) confirmed my speculation. My blood levels of aldosterone and cortisol were 50% and 107% higher on the day before an episode as compared to the day after an episode. Urinary potassium and magnesium losses were up 54% and 29% respectively when comparing values for the day before an episode with values on the day following an episode. This supports the idea of aldosterone involvement, but it should be clearly borne in mind that the molecular structure of cortisol is such that it can “dock” at the same mineralocorticoid receptors as aldosterone and thus create the same effects. A group of German researchers now confirms that elevated aldosterone levels can lead to AF and interstitial fibrosis in the left atrium. They suggest that clinical trials are warranted to evaluate the effect of mineralocorticoid receptor antagonists (spironolactone and eplerenone) in the primary and secondary prevention of AF. An afibber reported in one of our early surveys that he had eliminated his AF through the use of eplerenone. Also in this issue we report that vitamin D is effective in the prevention of ischemic stroke, that antioxidant therapy may help prevent AF, that longer duration episodes of AF make ablation failure more likely, and finally, that the results of the CONFIRM trial suggest that focal ablation prior to pulmonary vein isolation may improve the outcome for persistent afibbers. And finally, if you need to restock your supplements, please remember that by ordering through my on-line vitamin store you will be helping to defray the cost of maintaining the web site and bulletin board. You can find the store at www.afibbers.org/vitamins.htm - your continuing support is very much appreciated. Wishing you good health and lots of NSR, Hans
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