It depends on the drug's serum half-life. The EP needs to be able to induce AF in order to ablate AF. If you still have high-enough blood concentrations of an AAR drug, then that could "mask" areas of electrical activity in the LA and cause the operator to miss them. The median half-life for flec is about 20 hours, so after 48 hours you're going to have a little less than 25%by wolfpack - AFIBBERS FORUM
You might try stopping the potassium supplement for a while. Have you assessed dietary sources of K? Also, are your kidneys in good shape?by wolfpack - AFIBBERS FORUM
As always, check with your doctor regarding prescription med changes. I wouldn't make any changes unless I felt there was a need, like I was having more breakthrough episodes or otherwise not feeling well.by wolfpack - AFIBBERS FORUM
No diagnosis of hernia. I had an esophageal ulcer in early 2014 that was caught after a routing physical showed fecal occult blood and low iron in my blood. Subsequent endoscopy found the ulcer. I was on 40mg BID pantoprazole for 6 months until a recheck showed that it had healed. Then I dropped to 20mg BID and continued that until just last year when I decided I did not want to continue long terby wolfpack - AFIBBERS FORUM
It really takes time to "recover" from chronic PPI use. I know, I did it. It sucks. The rebound effect is vicious. You could try DGL (licorice root) instead of Tums, which are going to overload you with calcium. Make sure it's the DGL and not plain licorice root. Plain licorice root can cause "false" aldosteronism and dump potassium. The key here is the darn near unspeby wolfpack - AFIBBERS FORUM
Flutter, being a more organized arrhythmia, can couple 1:1 even in folks without accessory pathways. It's rare, but it can happen. I think Shannon and Carey have both experienced it. Thankfully, I have not.by wolfpack - AFIBBERS FORUM
"Rapid ventricular rate" really just means anything over 100. Maybe 150. At those rates, there is long term risk of heart failure. 1:1 conduction in AF would require a secondary pathway around the AV node, which can exist but is congenital. You don't "get" it with age or time.by wolfpack - AFIBBERS FORUM
The sinus pause would justify a pacemaker. In that case, it probably won't "fire" very often.by wolfpack - AFIBBERS FORUM
Anne, I'm not a highly trained athlete, either. I started running to lose weight. That wound up being about 120 lbs or so. I doubt the medical community has a trove of data on what happens to the body when its mass is reduced by more than a third in the span of a year. Needless to say it's stressful. If you've been running for 3 years then your heart has adapted to it. It isby wolfpack - AFIBBERS FORUM
I’m in the 40s just about every afternoon. Not a problem.by wolfpack - AFIBBERS FORUM
Esophageal cancer is less of a concern than esophageal ulcer. Cancer is slow to develop and if you get in upper endoscopy the precursor will be seen. Ulcers are worse. If they really bleed while you’re sleeping you can choke on congealed blood. In either case, I’d just ask my GP for a referral to a GI doc and make a plan for stopping the PPIs with careful observation. In that context things shoulby wolfpack - AFIBBERS FORUM
LSV8 is fine for potassium. Potassium is easy to get from diet. You should assess that before supplementing, IMO. Taurine is fine at 1-2g/day. It's also really cheap. Your fine on the mag. Don't be in a rush to push it so high that you're making a beeline for the restroom. If 800mg works, give that a couple of months to make a difference. Patience is key with supplements.by wolfpack - AFIBBERS FORUM
I’m not aware of Flec really affecting bradycardia, but it is often prescribed with a beta blocker (rate control drug) to mitigate the risk of flutter induced by the Flec. The beta blocker will slow the rate when in rhythm and may make one feel “sluggish”. It can also cause a lengthy pause in HR immediately following conversion for AF to NSR. Not sure why your EP is thinking pacemaker. A restiby wolfpack - AFIBBERS FORUM
Hi Anne, Get a Kardia if you can. Best measurement device ever for home use! Welcome to what certainly sounds like vagally mediated AF. My episodes were also just a “fish-flopping” 80 or so bpm. I even set a record low of 55 bpm while in AF. Those 2+ second pauses in heartbeat will certainly get your attention!by wolfpack - AFIBBERS FORUM
I second the notion that there’s just no data out there. I do, however, caution against the seemingly trendy notion that marijuana is somehow good for everything. There are myriad ways the drug is BAD. Imagine your gut reaction upon reading that alcohol or tobacco were good for something. Sanity check time.by wolfpack - AFIBBERS FORUM
QuoteCarey Immediately after the ride my levels were quite high, higher than normal for me, but over the next 6 hours or so they dropped significantly and rapidly. Why is that, I wondered? . The sympathetic nervous system influences the heart cells to increase Na+ and Ca2+ influx which displaces K+ into the extracellular fluid. Conversely the parasympathetic nerve forces K+ back into the cby wolfpack - AFIBBERS FORUM
The iWatch is solid info. That’s good.by wolfpack - AFIBBERS FORUM
PPIs have a nasty rebound effect. You have to titration down over a few days and then still you should expect up to two weeks of acid rebound until things normalize. I’ve done this myself. Now I take B12 and zinc as supplements to produce MORE stomach acid - the theory being that reflux is caused by too little stomach acid which delays gastric emptying and allows undigested food to push open theby wolfpack - AFIBBERS FORUM
Patients manage AF. I learned that quickly and early. Knowledge? You flatter me! I’m just an engineer who takes an analytical approach to everything. Panic is useless. Unless you’re being chased by a sabre-toothed tiger. Then it’s good. Everyone stay healthy!by wolfpack - AFIBBERS FORUM
Anything over 100 is too fast in a long-term sense, as it will cause heart failure. In this case, long-term means weeks to months. Your episodes, while fast, aren't nearly long enough to risk that. In your case, the high rate just mean cardiac insufficiency and poor hemodynamic stability. Thus the dizziness. My rates were thankfully low. I'd say the average was about 85bpm when in AFby wolfpack - AFIBBERS FORUM
Kind of a tangential topic, but with insects being important disease vectors does anyone have experience with planting pyrethrum containing plants such as chrysanthemums around a house or garden for natural repellent? How effective is this compared to spraying pyrethroids inside the home, which is undesirable to say the least.by wolfpack - GENERAL HEALTH FORUM
Patients with an abnormal heart rhythm that can leave them at a higher risk of suffering from stroke still need treatment even after their heart rhythm seems to have returned to normal, say researchers at the University of Birmingham. Operative word here - seems. Sounds like they are talking about “silent AF”, or the community of folks who don’t experience symptoms from AF and are unaware oby wolfpack - AFIBBERS FORUM
Leah, Given your weight of 51kg, the minimum dose of 50mg 2x/day of Flecainide is an option. Along with, say, 12.5 mg 2x/day metoprolol. Ask your EP about that combo. It's about as low as you can go on either med.by wolfpack - AFIBBERS FORUM
Vagal AF is going to be more likely to occur at night, after a meal, or in the hours following exercise. It may be or become quite drug refractory. It is less likely to progress to persistent or permanent AF, although AF still begets AF.by wolfpack - AFIBBERS FORUM
Yes, you can cut the metoprolol pills in half, but only if they are the metoprolol tartrate. The metoprolol succinate is the extended-release formulation and should not be cut in half.by wolfpack - AFIBBERS FORUM
That sounds OK if you're working with your doctor. The important thing is to keep it up for the duration of the blanking period. We all hate it, I know, but this is the one time that it really matters more than any other.by wolfpack - AFIBBERS FORUM
L-arginine is a precursor to the blood gas, nitric oxide, which has a vasodialating (relaxing) effect on blood pressure. In short, it can lower BP.by wolfpack - AFIBBERS FORUM
I can only report improvement after stopping PPIs over a year ago. Remember that PPIs have a nasty rebound effect on stomach acid. You can expect reflux to increase for up to two weeks after cessation, even when titrating down carefully. Never stop them "cold turkey".by wolfpack - AFIBBERS FORUM
Metoprolol has a wide dosing range depending on the patient. Minimum dosages can be 25mg/day and maximum dosages 200mg/day. How much were you on when you noticed the fatigue and did you try titrating down?by wolfpack - AFIBBERS FORUM
Leah, Are you not at least anti-coagulated in the wake of your ablation? That is a minimum standard just about everywhere. You should have been on Eliquis or an equivalent for at least one month prior to the procedure and then for at least 3 months afterwards. Breakthroughs during the blanking period are to be expected, and don't necessarily portend a bad outcome. Stroke risk remains eby wolfpack - AFIBBERS FORUM