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I too am vagal, and have given disopyramide a try based on PC's experience with it. So far it is working well to preven afib. You might look into it.by John S. - AFIBBERS FORUM
PC takes disopyramide which has been helpful particularly for vagal afibbers. My guess is that it probably safer to take long term than flecainide but who knows.by Kerry - AFIBBERS FORUM
Karin, Your husband obviously has very strong vagal tone. Such individuals often have a strong endurance sports history. All the dietary recommendations you'll hear on this BB are great, especially for general health. They've certainly helped me. If LAF is a problem, then your husband ought to approach his cardiologist and try disopyramide (Norpace, Rythmodan). It's a strongby PC - AFIBBERS FORUM
this is a little different picture from your first post. If you are in Afib almost every morning then what you are saying is that you experience afib every day. How long? If for any great length of tiime then you are not paroxysmal as I understand it. It sound like your condition is more persistent which isn't so terrible but you might want to rethink the meds situation. I am not a bigby Jon - AFIBBERS FORUM
John and LeAnn, Let's see, insomnia and arrhythmia. Might you have muscle cramps and constipation as well? I had all four. All appear to be gone for now, only one due to a med (disopyramide). The other three have disappeared IMHO due to prolonged magnesium supplementation, presently 700 mg aqueous Mg plus 200 mg magnesium taurate and magnesium lactate. I've averaged 500-1000 mg Mgby PC - AFIBBERS FORUM
John, it looks like the flec may have become proarrythmic for you. Something very similar happened to my with propafenone. I went from using it for prevention to using it on demand. After I stopped taking the propafenone my episodes were 10-20 days apart and much milder than my last episodes on propa. Everything was fine for three months or so. Then the episodes increased in frequency to oneby John S. - AFIBBERS FORUM
Disopyramide, which works well for many vagal afibbers is an anticholinergic. So your instincts are right, I just don't know whether Benedryl would do the trick.by Jon - AFIBBERS FORUM
Excuse me, i meant to say disopyramide. Peggyby peggy - AFIBBERS FORUM
Glenn, I see you have a twin lead pacemaker now. Initially I had "breakthrough" episodes with disopyramide at the recommended adult dosage of 600-800mg per day. These episodes all occurred after going to bed. So I juggled the timing of the doses to ramp up the blood levels at this time of day, given med peak level and half life information. Then the weekly AF abated, but I began toby PC - AFIBBERS FORUM
I understand why you are hesitant. I am taking 750 mg of disopyramide per day with the CoQ10, and as I said no problems.by John S. - AFIBBERS FORUM
Is anyone dealing with afib and hypothyroidism simultaneously? I am, and I can't seem to increase my dosage of Synthroid to what it should be without triggering afib. It seems that anything over 75 micrograms per day triggers afib but at that dosage I am experiencing cold intolerance. I don't want to play around with hypothyroidism nor do I want to have to live with afib all the timeby John S. - AFIBBERS FORUM
Marshal, I'm taking 120 mg of CoQ10 per day while also taking disopyramide (Norpace/Rhythmodan/Dimodan). I can't honestly say that it does anything good for me, but it certainly doesn't seem to be harming me in any way. In truth, I was taking the CoQ10 for some time before I went on to disopyramide. The drug works well for me. I suppose to see if the CoQ10 is doing anything I wby John S. - AFIBBERS FORUM
Kevin, Thanks for asking. Norpace (actually I take the Canadian version of disopyramide called Rythmodan) has been fantastic for me. Mike asked the same question a few days ago. I've been on a school field trip with my 10 year old son for the past few days and have been slow to respond. I eventually did respond to your post, Mike. Kevin, I hope I can continue in your path. The absenceby PC - AFIBBERS FORUM
Mike, Sorry for the delay in responding. I was in the mountains and snow with my son on a five day school field trip, although I only spent three. Regarding your questions, 1) Yes, disopyramide continues to weave its magic for me. It's clearly the vagolytic properties of this med that do the trick, despite occasional dietary and behavioral improprieties. 2) I was diagnosed with LAFby PC - AFIBBERS FORUM
First, determine if you have VMAF or AMAF. A while back I weaned myself from daily use of propafenone. After I had been off a few weeks I went to using it on only demand. That worked well until episodes began coming every other day. Then I saw a post by PC who said that he found that daily use disopyramide worked well for him (I believe he is vagal). Anyway, I am vagal and decided to give iby John S. - AFIBBERS FORUM
PC, Just wanted you to know that my cardiologist is a very personal friend of mine & therefore I am sure ligitation was certainly not an issue. I am also 165 lbs, and I do remember him telling me not to go above 500mg/day. He told me norpace was NOT a drug to fool around with. I didn't like taking drugs much, so it wasn't a problem for me. It could be that my Q-T interval wasby Jim W. - AFIBBERS FORUM
From the Cleveland linic Journal of Medicine - Volume 20 Supplement 3 July 2003 Disopramide Actions Disopryamide was approved for use in the US in 1977. Like quinidine, disopramide is vagolytic. It is a potent negative inotrope and should be avoided in patients with systolic dysfunction. Conversely, in patients with diastolic dysfunction, ventricular performance may improve with this drug.by Jackie - AFIBBERS FORUM
Richard, Didn't know that about rubidium and copper. Muscarinic receptors come in 5 flavors (M1,M2,M3,M4,M5) and these are pretty much specific for different organs, although there is a little overlap. M3 is in cardiac muscle. The KACh potassium channel is specific for the heart and is the channel directly affected by disopyramide to cause its vagolysis. There are other cardiac Na channby PC - AFIBBERS FORUM
Norpace is also not recommended for anyone with established/known structural heart disease. blessings, MLMby Marshal - AFIBBERS FORUM
Jim, Thank you for your concern. Cardiologists vary all over the lot wrt anxiety over treating patients. Some cardiologists will not initiate antiarrhythmic unless the patient is hospitalized. Others like my cardiologist don't. I think that more than a little of this has to do with medicolegal issues. If a patient experiences an adverse reaction on a med, then the treating physicianby PC - AFIBBERS FORUM
PC, 1000mg/day?? I know you are a doctor, but I am wondering if you have had EKGs as you adjusted your dosage from 500mg to 1000. My cardiologist did not want me to take over 500gm/day eventhough the PDR states the average dose could be as much as 600mg for a large person, and even higher depending on your weight. How much do you weigh? Just curious. I remember my cardiologist watching my rby Jim W. - AFIBBERS FORUM
Richard, It's all very complicated and I don't claim to understand it. It's my understanding that potassium moves back into the cell during repolarization. That's why it's called the inward rectifying potassium channel. Blocking this, e.g., disopyramide, should theoretically prolong repolarization and with it the refractory period. The cardiac substrate cannot initiaby PC - AFIBBERS FORUM
John, I felt and thought the same as you. However, whenever I took this approach, I would invariably get an episode when I never had before, i.e., when vagal tone was lowest. I personally think that this has to do with 1) the "something building up between episodes" thing and more importantly 2) trough levels are more pronounced when intake of disopyramide is not constant. Peak leveby PC - AFIBBERS FORUM
PC, You seem to take your disopyramide throughout the day, ramping up on dosage late in the day. My episodes of a-fib are always in the wee hours of the a.m. Is there any reason why I couldn't just take my disopyramide from, say, 2:00 to 3:00 p.m. through 10:00 to 11:00 p.m. and not take any from the time I arise through lunch. That is, is there a reason for trying to distribute it unifoby John S. - AFIBBERS FORUM
I was taking taurine 500 mg. routinely for years (LEF Mix), but had *scary* heart-slowdown one night after increasing dosage while on disopyramide and calcium channel blocker.by will - AFIBBERS FORUM
Jackie, Almost every post I make requires that I refresh my memory usually via google, and almost always find that it has failed me. I think that arterial blood is only necessary for blood gases or ABGs (pO2 and pCO2). I don't think it matters for HCO3- measurement. Since there is such a narrow range of acceptable blood pH and since deviation from it is so critical, most clinicians lookby PC - AFIBBERS FORUM
Kevin, Your question is kinda close to that posed by Nick Stone on 1/10/04. I won't repeat my response or those of others, but they can be read at It is my understanding (incorrect though it might be) that loss of efficacy over time applies primarily to flecainide (Tambocor). I've not read about such with disopyramide (Norpace, Rythmodan). I think your doctor is otherwise correby PC - AFIBBERS FORUM
Nick, Hang in there. It seems like the topic for today's BB has been Mg and K. It is my personal opinion that a dietary Mg shortfall (80+% of Americans according to the National Academy of Sciences) only uncovers a genetic predisposition to LAF. Accumulated aldosterone damage (from stress or chronic low grade dehydration) and/or free radical damage (reactive oxygen species) to cardiacby PC - AFIBBERS FORUM
I was diagnosed with paroxysmal atrial fibrillation about two and a half years ago and put on a treatment of sotalol and aspirin. A year or so later the attacks started becoming more frequent and for longer periods. I was hospitalised and my medication changed to fleccanide. This appeared to work for a period although the side effects were awful. Again, after about six months, the symptoms staby nick stone - AFIBBERS FORUM
Michael, You raise an excellent point, especially. Please see 14A in the Proceedings of the Conference Room (http://www.afibbers.org/conference/PCMagnesium.pdf). Mainstream medicine has perpetuated a real fear of potassium supplementation (other than through fruits and vegetables), especially if spironolactone or other K sparing diuretic is thrown into the mix. Furthermore, this fear of inducby PC - AFIBBERS FORUM