afib & sleep apnea

[sleepapy]

I was diagnosed 2 years ago with atrial fibrilation and have undergone a couple of cardioversions to correct this and have been on meds to control it since. In Sept, I was diagnosed with severe sleep apnea. Doing pretty well with my resmed for the last month. I haven't had an afib episode in quite a while. I did not know anything about the correlation between the two until I found this website (Thank You!)
What I am wondering is, what chance is there that I can get off the afib meds? I take flecinide and metoprolol, and of course coumadin.. If my OSA is under control, would it be fair to hope my afib might be cured?
Marla

[apneawho]

That's a question for your cardiologist. I wouldn't want to risk possibility of stroke by thinking you might be cured and stopping your medicines. Cardiologist can give the best opinion on this one. Good luck. I am glad to hear you are doing well.

[Bons]

My husband had his first problems with afib two years ago, and cardioversion worked, and he was started on meds.

He most likely has mild sleep apnea, but refuses to go for a sleep study to confirm my suspicions. The anesthesiologist from his recent outpatient surgery agrees with me.

He has been in the hospital since last Wednesday with afib, along with other medical problems. I should try to get them into the sleep lab while he's there. No coumadin any more for him because he had major bleeds from the incision. Gotta choose the between risk of stroke or exsanguination.

SA can lead to afib, but I'm thinking that once the heart has been out of whack and damaged, treating the apnea might not prevent recurrence of afib. PLEASE talk to your cardiologist before eliminating any meds.

[Hose Head by Night]

I have afib/aflutter. I have had 9 cardio conversions each resetting me back to normal rythym fo various number of days and months. I always reverted back to afib.

I am on a beta blocker - calcium blocker and blood thinner probally for life.

I have had this condidition for about 12 years and went on cpap this past March. I noticed a big difference in reduced waking during the night once on CPAP.

The CPAP helped me with shortness of breath, waking up every hour on the hour to pee and occasional waking gasping for air. The waking every hour I now believe was due to nocturnia.

Using this forum for information I found one night the following:

"Nocturia, or nocturnal urination, is sometimes a symptom of sleep apnea. In fact, nocturia among younger individuals--who are less likely to have other medical causes of nocturia--is a strong indicator of sleep apnea. While the precise relationship has not been thoroughly studied, it appears that the most likely reason patients with untreated sleep apnea have more frequent urination at night is related to the increased pressure in the right side of the heart. This increased pressure is usually the result of low oxygen levels in the bloodstream caused by the apnea events: when oxygen levels fall, the heart works harder to get oxygen to the brain.

An increased pressure in the heart is a sign that there is too much liquid in the body: when the heart receives the stimulus of the increased pressure, higher levels of a hormone called atrial natriuretic peptide (ANP) are secreted. ANP is a diuretic that is associated with the increased need to urinate.

When sleep apnea is effectively treated, nighttime urination is also reduced. Studies have shown that ANP levels in patients with untreated sleep apnea are increased and levels reduced in patients using CPAP effectively. Remember, not all causes of frequent urination are related to untreated sleep apnea; prostrate problems, for example, may cause increased need for urination. Discuss any concerns you may have with your doctor. "

This described me to the T.

To answer your question, if you cannot attain normal sinus rythym after 2 cardio conversions you will probally be on heart meds for life. They did try to go in and do an ablation on me to kill the bad circuit but the afib signal jumped to another area. I now have a pacemaker to control too slow a heart beat due to the heart meds.

[MsBea]

I have afib and while hospitalized with it a year ago, my sleep apnea was discovered. I believe the sleep apnea is what caused the afib. I am on heart meds for afib and my sleep apnea is treated with a bipap. My Dr. says I'll be on meds for life. Once the heart acts up, it probably will again, so meds is the safest way.

[sleepapy]

Thanks for the input.. I have not had an afib episode for months.. thanks to the meds.. I won't stop taking them without talking to my cardiologist. Just wanted to see if there was anyone out there that had a similar experience.. Guess I'm not alone.. I'm still hopeful that cpap therapy can cure afib. If OSA can cause it, maybe cpap therapy can fix it. I just feel so much better since I started using my cpap, guess I figured it cured all my ailments.. morning headaches are non existant, energy level is better than it has been for a long time, I can't get over how much of a difference this has made. The first week I dreaded going to bed and having to strap on my headgear.. I prolonged it as long as possible. Now, I don't mind at all. I know what a better day it will be after a good nights rest.
Thanks again for your replies..
Marla

[sleepapy]

Update..
Yesterday I had an appointment with my cardiologist.. he is the go to guy in the Portland area if you have heart rhythm problems. Highly recommended..
After giving me an EKG, reviewing my records, and examining me, he agreed to take me off ALL my heart meds. I just have to take an aspirin a day. Since I have not had an afib episode in months, and am on the cpap now, he agreed we should give it a try. No guarantees.. If I go back into afib, he said to come in immediately and he will get me back into rhythm and I will have to go back onto the meds including coumadin.. But for now.. I am doing the happy dance..
He did say that it is likely in the future as I age, (I'm 60 now) my afib will return. But if I can have a year or more without meds, I'm all for it!
I am crossing my fingers..
Marla

I never made the connection of afib and OSA until I found this site.. Now I realize, each time I flipped back into afib, It was while I was sleeping.. probably during an apnea event.

[chunkyfrog]

It is good you are doing this under your doctor's supervision.
I have my fingers crossed for you.

[Bons]

My update: Husband's cardiolgist would not discharge him from the hospital without an appointment for a sleep study. Still in afib. Within a few weeks, three of our four nuclear family members will be on pap - I'm hoping he'll end up on bipap since daughter's a cpap and I'm ASV....

[M.D.Hosehead]

SA can lead to afib, but I'm thinking that once the heart has been out of whack and damaged, treating the apnea might not prevent recurrence of afib.

Someone recently posted a link on this board to a study that demonstrated a beneficial effect of XPAP on AFib.

[sleepapy]

I would really like to see that link to a study that demonstrated a beneficial effect of XPAP on AFib. I am a believer now..
So far so good for me.. I have been off meds for 4 days and no afib event...
Bons, hope all goes well for your husband.. I think a sleep study is a good idea for afib patients.
I wish I had listened to my Dr. sooner, but I was just so sure I didn't have sleep apnea!!! Guess that why he has a plaque hanging on his wall and I don't..
Keeping my fingers crossed too...
Marla

[Slinky]

Marla, were you at any time put on a anti-rhythmic for your A fib?? You might want to ask your cardiologist about a "pill in a pocket", one of the anti-rhythmics to take when and if another episode of A fib occurs.

I was Dx'd w/A fib a year ago. I was put on coumadin to hopefully prevent clots and diltiazem (a calcium channel blocker) to slow my heart rate. The diltiazem caused edema for me so I was switched to a beta blocker (metoprolol) to slow the heart rate instead. Rythmol, (an anti-rhythmic) was added. I haven't had an episode (knock, Knock, KNOCK) that I am aware of since the third day of Rythmol. In January we will run aother 30 day event monitor to be sure I'm not experiencing any events I'm just not aware of. If all goes well w/the event monitor my goal, after discussion w/my cardiologist and he agrees, is to go the "pill-in-the-pocket" route w/keeping Rythmol to take w/me at all times if needed - just in case.

[sleepapy]

Slinky,
Yes, I have been on flecinide and metoprolol twice daily for almost 3 years.. I tried the "pill in the pocket" a few times, with a much higher dose of each of those. But, my BP dropped so low I nearly passed out; got VERY nauseated, it wasn't good for me, but I switched into sinus rhythm quickly. Then got very sick for hours.. totally drained the next day.. The last time I tried the pill in the pocket, my dr had me go to emergency room so I could be monotored while I was switching over.. I really think I would go back into sinus rhythm with a lower dose, since I switched over so quickly. Plan to talk to my cardioologist about that next week. I prefer that to the cardioversions.. and a lot less costly..
Good luck with your event monotor.. let me know how that works for you..
Marla

[Slinky]

I didn't recognize the flecainide name or realize it was an antiarrhythmic. However, it is an antiarrhythmic that works by slowing electrical signals in the heart to stabilize the heart rhythm. The metoprolol is a beta blocker to slow down the heart rate. Sheesh, girl!!! Your heart must have been racing and beating a NASCAR!!!