Afib meds and electrolytes

Hi just to let you know that I hope you get an answer on this and I am thinking of you.  By the way what is PAF I only know what AF is. 

Hello Moira, PAF., is intermitent atrial fibrillation, which means it comes and goes. Paroxymal atrial fibrillation (PAF)

Hi, again Moira. I'd like to tell you my voyage of PAF., to give you some idea of

how it was dealt with in my case. I was diagnosed with PAF., in June 2012. I spent

four days in hospital on a mobile ECG., was put on Bisoprolol, Flecanaide and

Aspirin. In Sept., 2012, at a consultation with a cardiologist as an outpatient he

decided to stop the Flecanaide. In October 2013, I asked another cardio to change my beta blocker, (Bisoprolol) to a calcium channel blocker as I could not attend for a medical for the profession that I work in if I was taking a beta blocker. He put me on Adizem and I was still taking Aspirin. I contacted a diving doctor to see if he

would examine me, so I could return to work. It looked like it was going to be

difficult for me to get the medical I required, so I went to my GP., and requested to

stop my Adizem as I was still getting episodes of PAF., he referred me to a heart

clinic and I had a seven day mobile ECG., which when the data was analyzed

showed a 4% intermitent incidence of AF.,so he referred me to an electro-

physiologist for possible pulmonary vein isolation. I had stopped taking the Adizem

of my own choosing as it wasn't stopping my incidences of PAF., I told the electro-

physiologist that I'd stopped taking medication, other than the Aspirin. He came to the opinion that as you are a prime candidate for ablation if you have PAF., he

would have me admitted for cryo-ablation. I had my ablation on the 21st of August 2012 and haven't had one episode of AF.,since, which is now 31 days later. He is

confident that I will be AF.,free in the future. I ahve to go back to see him in 3

months for an ECG., apparently it can take upto 3 months for the scarring in the

pulmonary veins to completely settle down. About me, I'm 66 years old, was also into extreme fitness, do not have any other underlying health problems that could

contribute to AF.,like high blood pressure, diabetes, obesity, so in my case it was

just a case of unexplained rogue electrical impulses interfering with the normal

rythm of my heart, hence ablation to stop the short circuiting. I'm 68kg., 175cm

and in very good health, so hope this gives you some insight as to what in my

opinion and that of my electro-physiologists prognosis was a positive outcome in my case.

Regards

John

Hi Viber and Moira.  I am seeing an electro-cardiologist.  And I'm part of the afib clinic; but there's not much else to say. I go in an out of afib .. mostly when I lie down on my back....despite the meds.  I really think it has something to do with my electrolyte balance. I've been reading around and potassium and magnesium have a significant part to play in regulating heart rhythm.  I follow a mostly organic diet and get plenty of veggies and fruits and grains.  My BP is quite low as is my overall cholesterol.  But I honestly can't say when the next afib episode will be but it will be sometime this week.  They are much less frequent and of much shorter duration with the meds.  I'm also interested in the role of sodium in all of this.  Anyways.  If anyone hears anything, please update me.!!

Hi CMD2 & Moira, if your general health is good, you've got nothing to lose having

ablaan, but ask your electrophysiologist or his staff what success rate their clinic has for ablation and also when I went for my first consultation I asked the cardiologist that I saw about laser ablation, which is the latest ablation procedure and he

told me that his hospital didn't offer that procedure at this time, so he spoke to his collegue, the electrophysiologist, who told him to inform me that cryo ablation is as successful as laser ablation, so I accepted this and asked for it to be done at there

hospital. I then went home and phoned a hospital in London, who have laser

ablation equipment. I asked the electrophysiologists secretary, who I had

contacted previously, if she could ask her people if it was correct what I'd been told at my hospital here in Manchester, UK. She called me back later and told me she

had spoke to the ablation laboratory consultant and he confirmed that the

cryo ablation was as proficient as the laser procedure. The only real difference is

that with the laser catheter they can visualize the pulmonary veins with real time

video as the catheter has a camera in it. The cryo ablation uses x-ray mapping,

which is ok. Apparently its easier to visualize with video than x-ray. Having said

that as long as your electrophysiologist has a good success rate using cryo-ablation, then that is good. My electrophyisiologist is one of the best apparently in the

UK., and his staff that work with him couldn't praise his skills enough when I asked

them,so that was good enough for me and now I'm AF., free and medication free

apart from blood thinner Apixaban that I have to take for three months post

ablation, until I have an ECG., then they will stop the blood thinners.

Excuse any spelling mistakes please as I'm on my tab and it not very good on wifi.

I also take 5mg of Crestor and have been taking 100mg of flecainide 1.5x/day (started with 2x, extended average hours between doses to arrive at the 1.5). I stopped completely yesterday. the day before I had experienced eight episodes of dizziness/nausea and even fainted during one of them hitting my head twice on the way down. my Dr. said it was because I had hyponatremia (130), and he recommended I buy some pickles on the way home. I continued having the episodes afer the pickles, etc., and it suddenly occurred to me to check into  flecainide. it lead me to a lot of places–including here, of course. so my question is since you wrote this, has it been proven to you conclusively that flecainide is the bete noir here. since I stopped taking it, I can already feel palpitation rearing its ugly head (continous afib is my fiend). are you still taking flecainide? I haven't had my sodium level checked again yet, but the episodes I was having, have reduced significantly in terms of recurrence, intensity and length (from a couple minutes to 30 seconds), and no more fainting. did you have symptoms with your hyponatremia? did eating more sodium relieve the condition allowing you to continue flecainide without incident? had you ever had low sodium before due to your dietary restrictions?

I have found several articles connecting flecainide to hyponatremia, but many of them were based on the same case or very limited data. the best was: http://circ.ahajournals.org/cgi/content/meeting_abstract/126/21_MeetingAbstracts/A14890  which concluded "Incidence of serum sodium reduction with flecainide use during hospital stay in this patient population was 8.9%."

I know I've asked a lot of questions, but I would truly appreciate your answers! THANKS, CDM2!