Survey Results � Part II
Most survey participants have a vivid memory of their first LAF episode. The most common trigger of that first one was emotional or work-related stress (26%) closely followed by physical overexertion at 24%. Caffeine, alcohol, and ice-cold drinks were next at 10%, 6% and 8% respectively. Other less common triggers were severe illness or a viral infection (experienced by 6% of respondents), dehydration (4%), and rest (4%). Digestive periods, coughing and burping, pharmaceutical drugs, surgery, electromagnetic radiation, and toxic chemicals round off the list of initial triggers with 2% (1 respondent) each.
The triggers of subsequent episodes follow in the footsteps of the first one. The overwhelming favorite for the title of most important trigger is emotional or work-related stress. A full 50% of all respondents listed stress as a trigger. Physical overexertion was next at 24% closely followed by alcohol (including wine) and rest at 22% each. The digestive period following a heavy meal was a trigger for 18%, caffeine was mentioned by 16%, and an ice-cold drink by 12%. Ten per cent reported that MSG (monosodium glutamate) was a trigger for them and 6% said that lying on the left side would set off an episode. Aspartame (NutraSweet) was mentioned as a trigger by two respondents (4%) as was chocolate, coughing and burping, and flying (at high altitudes). Three men over 30 years of age (6%) felt that their episodes were cyclical in nature and not related to any specific trigger. Other triggers mentioned were aged cheese, sugar, food additives, acid indigestion, a hot bath, NyQuil (a cold remedy), electromagnetic radiation, toxic chemicals, hypoglycemia, high blood pressure, and changes in weather patterns. Please note that the percentages do not add up to 100 because many respondents listed more than one trigger.
The triggers uncovered in the LAF survey are similar to those found by James Driscoll in his on-line survey (www.dialsolutions.com/af/database/stats.html). In James� survey based on 105 entries stress again was the clear �winner" followed by alcohol, caffeine, exercises, fatigue, and rest and resting after exercise. Cold drinks, MSG, chocolate, bending over or lying on the left side were other important triggers.
It is clear that the triggers for LAF are many and varied and highly specific to each individual except for excessive emotional and physical stress which is pretty well universal.
The frequency and duration of individual episodes varied considerably among survey participants. The average number of episodes over the past 12 months was 27 (30 for men over 30 years, 6 for men under 30, and 21 for women). The range was 0 to 200 episodes and 5 out of the 50 respondents had chronic LAF.
The average number of episodes for the past 6 months was 16 (18 for men over 30 years, 2 for men under 30, and 11 for women) with a range of 0 to 125. The episodes lasted an average of 30 hours (35 hours for men over 30, 14 hours for men under 30, and 13 hours for women) with a range of a couple of minutes to over 500 hours.
The average total time spent in fibrillation over the past 6 months worked out to 172 hours (203 hours for men over 30, 29 hours for men under 30, and 71 hours for women). The average length of the longest episode was 387 hours (455 hours for men over 30, 16 hours for men under 30, and 187 hours for women). All told the average time spent in fibrillation over the past 180 days (ignoring chronic LAF) worked out to about 4% or about 1 day (24 hours) per month. The range varied widely from 0 to 17%.
The most �popular" time for an episode to start was between 6 PM and midnight (38% of all episodes) followed by the period between midnight and 8 AM (32%). Episodes were rarest in the morning (8 AM to noon) at 13% and a little more common between noon and 6 PM at 17%. This would indicate that about 32% of all episodes are of a purely vagal nature, 13% are probably purely adrenergic, and the remaining 55% could be either adrenergic or vagal. They are most likely vagal if they occur after lying down or during a digestive period.
Half of all participants did not know how to abort an episode. Others have had some limited success in stopping an episode before it takes hold, but there certainly does not seem to be any one surefire way of aborting one. Following are some of the comments received on this subject:
Dealing with LAF
You have experienced your first atrial fibrillation episode. Yes, episode is a less threatening description, but the first time you feel your heart beating wildly and totally out of control it certainly seems more like an attack. Anyway, you survived, as you surely will, your first bout with atrial fibrillation. You probably went to an emergency clinic and saw a cardiologist or electrophysiologist. After a battery of tests you were diagnosed with lone (primary, paroxysmal) atrial fibrillation. More than likely, the doctor told you that LAF is a nuisance, but �it is not going to kill you". You now have four choices to make:
Whatever you decide, do not � ABSOLUTLEY NOT � accept a prescription for digoxin (Lanoxin, digitalis). This drug has been proven to worsen LAF and may make it chronic. Actually, if your doctor prescribes it for you look for another physician � your present one is obviously not up-to-date!
If you have decided on option 1 you probably would not be reading this. Option 2 has been covered in past issues of The AFIB Report and option 3 will be covered in a future issue. In this issue we will concentrate on helping you with option 4.
Next you should eliminate the possibility of medical problems other than heart-related ones that are already known to be non-existent. Thyrotoxicosis or hyperthyroidism (an overactive thyroid gland), pheochromocytoma (a tumor on the adrenal gland) and hypoglycemia come immediately to mind. Thyrotoxicosis and pheochromocytoma both require a surgical solution, but you can take care of hypoglycemia yourself.
Triggers and Lifestyle Choices
The big trigger is emotional and job-related stress. The best approach to this one is to slow down a little and try to take a more relaxed approach to life. Yoga, qi gong, tai chi, deep breathing and other relaxation exercises can also be extremely helpful. Twenty-three per cent of the survey participants do one or more of these exercises and 90% have found them beneficial. Meditation is another good approach. Twenty-one per cent of respondents practice meditation on a regular basis and 80% find it beneficial.
So the bottom line as far as magnesium is concerned is:
Circadian variation in LAF episodes
Isometric exercise may stop AF episodes
Parasympathetic nervous system and insulin
That�s it for this May issue of The AFIB Report. In the next issue we will carry on with the reporting of survey
results, discuss the connection between dental amalgams and LAF, and provide some good advice on
dealing with hypoglycemia. If time and space permits we may also tackle the GERD (gastro esophageal
reflux disease) connection.
The AFIB REPORT is published monthly by Hans R. Larsen MSc ChE
1320 Point Street Victoria, BC, Canada V8S 1A5
Phone: (250) 384-2524
E-mail: [email protected]
Copyright © 2002 by Hans R. Larsen
The AFIB REPORT does not provide medical advice. Do not attempt self-diagnosis or self-medication
based on our reports.