Atrial Fibrillation strikes again

Hi
I just thought I'd share some recent experiences I've had with Atrial Fibrillation. I've posted the details here before, but it was AF that initially led to my sleep study, which determined that I do not have obstructive sleep apnea, but rather have Cheyne-Stokes respirations, 46 events per hour. So I spent the last half of 2009 adjusting to my new sleep-life on a mask. We had hoped that with effective sleep therapy, A-Fib would stay under control, but on December 25, while visiting relatives, I had an AF episode which lasted for 36 hours.

Since then, I've had 3 other AF episodes, each lasting from between 4 and 10 hours. When not in A-Fib, I often have a different arrhythmia called Premature Ventricular Contractions (PVC's). My cardiologist has put my on a cardiac event monitor for the next 30 days to determine exactly what is going on and how often.

What I thought I'd share, though, involves a recent discovery I've made. Many people who deal with AF have worked to discover what is their particular trigger. I may have accidentally discovered a significant trigger for me - cheese. I had read awhile back that a substance called tyramine http://en.wikipedia.org/wiki/Tyramine is present in in most aged foods - hard cheeses, aged meats, red wine, to name a few. After a really good 4 days with no heart rhythm issues at all, out of the blue on Monday morning, I noticed that PVC's had returned. It was my wife that reminded me of what I had read and that 1 hour earlier I had eaten some tacos with cheddar cheese.

Yesterday I avoided cheese and I've been in normal heart rhythm for 36 hours again. Tomorrow is supposed to be a snowy day here, so I think I'm going to experiment. Assuming my heart stays in normal rhythm until then, I think I'm going to eat some nachos with cheddar and see what happens. I'd hate to lose cheese from my diet, but if I could discover a significant AF trigger and eliminate it, that would be a big blessing.

I've also added chelated magnesium to my diet as a supplement. People with AF often are magnesium-, potassium- and taurine-deficient.

I'm just throwing this out there to see who else has issues with A-Fib, what they've done to combat it.

My sleep therapy is still going well. Other than during A-Fib outbreaks, my AHI is staying under 2. During A-Fib, it tends to jump up to 3 or 4.

Thanks for reading,
Tony

Thanks for writing, Tony. I hope you do find the trigger.

O.

Tony,
I was interested to read your link, as my mother has been in AF since Dec 23, landing her in the hospital with conjestive heart failure. I'm trying to learn all I can about her condition.

I hope that you are, at least, sleeping well with your machine.

Bev

Just wanted to make a note about PVCs for folks who have those but not A-Fib...

I just had a holter monitor because of some palpitations I have, which are mostly PACs (in the atrium, not the ventricle). NOTE: I do not have atrial fibrillation or flutter.

What I've been told by the cardiologist is: In an otherwise structurally normal (healthy) heart, having PVCs/PACs is a normal variant is not associated with an increased risk of something else serious. The ectopic beats they cause are extremely annoying, cause anxiety, etc., but are NOT dangerous. My triggers are bad digestive events (IBS) and stress.

Thanks for sharing your A-Fib experiences. I don't have it but know someone who does. I had not heard of that possible dietary connection, I'll have to ask my friend with A-Fib if she has.

About PVC's, my doctor said my monitoring showed some couplets and a few runs, but did not merit treatment at this time. My symptoms were spells of overwhelming weakness and feeling close to collapsing or passing out. He said if the runs became longer and caused me to actuality collapse or pass out we'd have to reconsider. Said short episodes are not dangerous, but prolonged PVC's can become a problem due to being a weaker and less effective pumping. Recent visit with PA who said they used to treat PVCs until they found the condition generally not to be much of a hazard, and the treatment risky enough to warrant restraint.

I think your experiment could be interesting (though I'm not sure I'd be so brave) because cheddar is a known trigger for migraines, which are associated with some cardiac problems. I don't know enough to lay out any real science here, but it seems easy to connect some of these dots.

If cheese makes it act up, try Prevacid for 10 days and see if it fixes it. GERD was making mine act up.

Hello
Thanks for the replies. The main reason I wanted to post it was because I figured there are more out there dealing with A-Fib. I found this forum that deals with A-Fib:

http://www.afibbers.net/forum/list.php?f=8

It is not as active as CPAPTalk, but seems to be just as helpful. You'll learn alot by surfing around the site. There are lots of dietary AF triggers.

Tony

tattooyu wrote:Just wanted to make a note about PVCs for folks who have those but not A-Fib...

I just had a holter monitor because of some palpitations I have, which are mostly PACs (in the atrium, not the ventricle). NOTE: I do not have atrial fibrillation or flutter.

What I've been told by the cardiologist is: In an otherwise structurally normal (healthy) heart, having PVCs/PACs is a normal variant is not associated with an increased risk of something else serious. The ectopic beats they cause are extremely annoying, cause anxiety, etc., but are NOT dangerous. My triggers are bad digestive events (IBS) and stress.

Yes, this is true. PVCs are very normal. My doctor told me this fall, after wearing a Holter monitor for 48 hours, that I was having PVCs in 1% of my heartbeats. Anything under 5 is considered normal. The problem I've had comes when I can feel the PVC's more frequently, sometimes as often as every 4th heart beat. I can tell when they start because I instantly feel exhausted and short-of-breath. To me, they feel like a 'skipped' heart beat, a pause between beats, although technically they are really 'extra' beats from the lower chambers of the heart. I was really happy last week at the cardiologist's office. They finally showed up during my EKG so maybe he'll believe me that there really is something going on. These PVC's are not the same arrhythmia as atrial fibrillation, but can at times be just as debilitating when they occur so frequently. It was an hour after eating cheddar cheese that I felt them start up again on Monday - the first I had felt in 4 days. I've felt none since Monday night.

The issue with aged cheeses, meats, etc. (as I understand it) involved this compound called tyramine. Apparently some people are more sensitive to it. I don't want to get another AF episode after eating some nachos, but it would seem to be telling if 1 or 2 hours after eating them I felt the PVC's fire up again. I'd hate to give up cheese, bacon, etc., but will do it in "a heartbeat", if it fended off some of these episodes. I find it very frustrating that my cardiologist hasn't mentioned anything about diet, supplements like magnesium, potassium or taurine deficiencies. If I found out about this by doing a couple of hours worth of reading, certainly he should know these things also. He actually told me he would have no problem at all with me drinking 2 or 3 cokes/coffees per day. (I don't.) Further proof that we need to be our own advocates.

Tony

Wow, I love this forum.

About 8 or 9 years ago I started having PVCs, though I didn't know that's what it was at the time. The doctor did a couple tests and couldn't find anything so pretty much just told me that it was PVC and not anything to worry about as it was normal up to 5 times a minute (thought that did and still does seem pretty high to me). Anyway it pretty much went away on it's own, though I still had them occasionally, say maybe 1 missed beat in a week. I've often wondered about what triggers it and after reading this thread I'm realizing that they mostly happen when I'm having trouble with acid reflux. About 8 years ago is when I was also diagnosed with GERD, and I'm guessing getting treatment for that is what has made my PVCs decline.

Thanks for the info all!

Yes, yes and yes!

Re: ectopic beats

If I have a bout of reflux, it definitely acts up.

If I have a bout of IBS, it definitely acts up.

If I have a bout of emotional stress, it definitely acts up.

If I have salty food, it can act up, but it's usually after sushi. I use tamari which is a fermented soy product (tyramine?).

Sometimes I get runs of these PACs where I'm having one every 4th or 5th beat, but they go away within a half hour, usually.

I have had lone paroxysmal atrial fibrillation for about a year as best as I can recall. It was diagnosed in July of 2009 but I had been having episodes for probably several months before then without really knowing what was wrong with me. "Lone" means there are no underlying structural issues or pathologies with my heart that are causing it. "Paroxysmal" mean it starts and stops on it's own. As for triggers, well that's the big question that all a-fibbers would love to have answered. For me, there seem to be 3 main triggers. Alcohol, intense exercise and apneas during sleep (the kind that wake you up with your heart pounding). I think that well over half of my episodes were triggered in my sleep; I would wake up in a-fib. In fact, at this point, I think that the sleep apnea is what caused my a-fib in the first place and I'm hoping that, with the apnea controlled, I may be able to come off the medication that currently keeps my heart in normal rhythm. We shall see. In any case, I have stopped drinking alcohol, exercise more moderately than before, avoiding the higher training levels, and am working very hard to get my CPAP therapy working effectively. I am trying to achieve an AHI as close to zero as possible.

tonycog wrote:...http://www.afibbers.net/forum/list.php?f=8 ... There are lots of dietary AF triggers.

Wow, food causing AF And for you seemingly cheese, wowowow, learn something new every day...this filled my WEEK's quota . Sure hope the Event Monitor proves nothing serious going on as it did when I had/used it mid-Oct-Nov '08...felt like a nutcase rushing off to some place private to slap it on my chest when my episodes occurred. Waking up at night with 'em was a real challenge as I would still be half asleep, disoriented, fumbling for the thing, half convinced they followed an apnea/hypop, then scared as I realized I had another session of 'em. Thank goodness all my seemingly irregular rhythms were normal...I hope the same is true for you.

Thanks for posting this. Have a good friend with AF taking Coumadin who's starting to experience upsetting side effects. I'll pass this along for investigation.

Muse-Inc wrote:

tonycog wrote:...http://www.afibbers.net/forum/list.php?f=8 ... There are lots of dietary AF triggers.

Wow, food causing AF And for you seemingly cheese, wowowow, learn something new every day...this filled my WEEK's quota . Sure hope the Event Monitor proves nothing serious going on as it did when I had/used it mid-Oct-Nov '08...felt like a nutcase rushing off to some place private to slap it on my chest when my episodes occurred. Waking up at night with 'em was a real challenge as I would still be half asleep, disoriented, fumbling for the thing, half convinced they followed an apnea/hypop, then scared as I realized I had another session of 'em. Thank goodness all my seemingly irregular rhythms were normal...I hope the same is true for you.

Thanks for posting this. Have a good friend with AF taking Coumadin who's starting to experience upsetting side effects. I'll pass this along for investigation.

I should have said "lots of potential dietary AF triggers. Aged cheese does contain tyramine. Also, so does soy sauce, which was referenced in an earlier post. I don't know about me and cheese yet. It's a working hypothesis. I have actually been having another episode of these "skipped beats" again tonight. They are probably PVC's but I'll need to wait until I see the doc and he has seen the event monitor reports.

Tony

My cardiologist confirmed that the 'cardiac events' I'm having most recently are PVC's. He prescribed a different medication, one called sotalol, to treat PVC's. The problem I am having is this: According to what I've read, Sotalol is not effective at combatting Atrial Fibrillation, but it can be helpful for PVC's. However, you can not mix Sotalol with Flecainide, the anti-arrhythmic that I've been taking for 7 months to prevent AF from recurring. Also, from what I've read, it is possible that Flecainide could even be causing the PVC's.

So now, he wants me to stop taking the drug that is supposed to be preventing my original problem (atrial fibrillation) and begin a different drug (which is ineffective in fighting AF) to combat a new, and possibly drug-induced problem (PVC's). Sometimes I don't know if Google is a blessing or a curse, but I really don't think I'll start to take this new prescription. I know that my cardiologist knows more about the heart than I do, but I also know that I have the ability to comprehend what I read for myself. It never ends....

Tony