Possible Afib & Cpap????

Check out http://www.afibbers.net - it is the best board for aFib information online, bar none.

OSA and aFib are interlinked - a fact.
Untreated OSA and aFib is bad news - a fact.

Just for the record, for those that do not understand the process. Atrial Fibrillation comes in a few varieties and complexities. It can be occasional or it can be permanent or somewhere in between. It can be the atria completely out of time or it can be 'simple' flutter of the atria. Whatever it is, many folks live long with aFib but I would not put money on it and I would not want the quality of life that permanent aFib or aFlutter presents. In a nutshell, it robs you of your quality of life and it takes a huge toll on your overall health.

The atria are the 'reservoirs' of deoxygenated blood returning to the heart to be fixed up and pumped out again. The atria fill with blood in a normal situation and then drop the blood into the ventricles at the appropriate time from where one ventrical pumps the deoxygenated blood into the lungs for oxygenation and the other ventrical pumps with sufficient force to distribute oxygenated blood through the body's venous system. This is called Normal Sinus Rhythm and it is what all aFibbers pray for.

When the synchronization of the atria and the ventricles go awry it is generally a valve problem or aFib. aFib in and of itself can cause severe valve issues by deforming the heart (i.e. enlarged left atrium stretching the valve's seat into an oblong shape where the valve is round.... sorta). aFib usually presents as the ventricals attempting to pump out a load of blood before they are filled. Bad news. Very bad news. Shortness of breath, a myriad of health issues, chronic fatigue that makes OSA fatigue seem like kids play, etc.

Now, checking your SpO2 when in aFib you will find it is lacking and you may even be in respiratory distress. You may show pleural effusion (water around the lungs) or cardiac effusion (water around the heart) or a number of other symptoms that are well hidden to you and I. Compound this with the desaturations caused by sleep apnea and you have a very serious problem indeed. Diagnosed with ANY kind of aFib and you are immediately on blood thinners to prevent clots from forming from pooling blood and being fired out to various parts of the body. Add to this desats due to sleep apnea and the resultant skyrocketing blood pressure and you begin to see wherein your problems lie. Chances of dying in your sleep are pretty darned good. "He was a good person and he died peacefully in his sleep" Remember that one?

If you suspect aFib you need to seek out a Cardiologist that specializes in aFib. They are called cardiologist/electrophysiologists. The best in the world are few and far between and are listed on the aforementioned site. I am extrememly fortunate to have two just up the street at Southlake Regional Health Centre and am under their care at present. Doing great. OSA under control totally and aFib under control at the present time using a very 'caustic' drug called TIKOSYN, which is absolutely free in Ontario, as is the care. How long the TIKOSYN will keep me in Normal Sinus Rhythm is anyone's guess but asides from mild nausea in the mornings and a 'buzzing feeling' as if withdrawing from pain meds it is doing its job quietly unless I consume a trigger like chocolate, caffeine, salt, MSG, etc. I am waiting for left atrium to return to normal size at which time I have the option of continuing on with TIKOSYN as long as it is working for me.... or booking a catheter ablation to eradicate the problem (sorta).

Here is an interesting observation to give you an idea of what the ramifications are: OSA detected and treated first. I needed supplemental oxygen at night as my breathing becomes so shallow in REM sleep that my SpO2 plummets andmy BP skyrockets. A bad situation. With the supplemental O2 in my airline (small amounts.... 4L/M) my SpO2 runs about 93-95% all night long. aFib diagnosed and when ultimately treated and returned to Normal Sinus Rhythm, my heart is pumping well oxygenated blood and my SpO2 pegs the meter at 99% (that's as high as it reads). And stays there.

The downside of aFib has been mentioned already. It will carve years off your life expectancy asides from robbing you of quality of life that makes the issues with sleep apnea seem like a cakewalk.

SO.... do yourself a BIG favour and ensure that your annual physical includes a top notch, quality ECG on a top notch, state of the art machine and not one of those 3 or 5 lead jobbies. You want to be wired up like an F18. The newest state-of-the-art ECG's are computerized and will try to diagnose any irregularities that should be followed up on, like aFib, bundle branch block, PAC's, PVC's etc. The last one I had before starting TIKOSYN and returning to Normal Sinus Rhythm printed ATRIAL FIBRILLATION WARNING across the strip in bright red letters. Sure as heck caught MY attention and the point is just that. The technician or cardiologist reading your strip should be watching out for aFib which can show up well disguised, especially as aFlutter. It needs to be diagnosed, a full workup done, and it needs to be treated as urgently as possible. The longer you wait, the longer suffering from aFib episodes, the more like you are to have heart enlargement and insufficiency and valve problems, etc.

OSA and aFib are linked in iron chain. OSA begets aFib. aFib begets OSA too.

Any way you look at it, you NEED to be treated if you have one or both. XPAP makes no difference to aFibbers asides from improving oxygenation. XPAP is URGENTLY needed and needs to be working well for those with aFib as all of the OSA issues and symptoms are going to be compounded by the aFib and vice-versa. If you suspect aFib along with your OSA do yourself a big favour and get yourself educated... well educated in all things aFib. It could prolong your life significantly.

One can have asymptomatic A fib and experience an "event" w/o being aware of it.

"Intermittent" A fib is NOT that easily detected by EKG unless you should happen to have an "event" whilst the EKG is attached. In such cases it is often necessary to wear an "event monitor" for a period of time, i.e. a week, a month .... it is easiest to call them a "glorified holter monitor" in that there is a similarity but a holter is only good for a short period of time.

There is discussion on which medication method better "treats" A fib - rate control or rhythm control.

There are some new meds to take the place of warfarin to reduce the blood clotting factor. Pradaxa being one in the US.

Kaiya,

One possible issue could be if you suffer from aerophagia due to cpap use. My dad has AFib, well controlled by medication, but if he gets gas in his belly due to something he has eaten, it sets off the AFib.

Good luck!

Slinky wrote:

jimnsc wrote:I had A. Fib. and cpap did not affect my treatment one way or the other. I can't imagine what tests you might be waiting to hear from as a simple EKG will show if you are or aren't. I always knew when I went into it as I could feel it in my chest (fight or flight feeling). My cardio also referred me for my sleep study. I had osa before I ever knew what it was and do know it preceded A. Fib.

I don't have A. Fib now and haven't since I was put on Tikosyn. I was electrically cardioverted 5 times previously. If Tikosyn doesn't continue to work I have another option and that is surgery - the Maze (sp) procedure. My doc is trying Tikosyn first as I am almost 71.

A simple EKG will NOT NECESSARILY reveal A fib (atrial fibrillation). It will only detect and report A fib IF an event occurs during the EKG. Even a Holter monitor will NOT report A fib if an event doesn't occur during the wearing of the Holter monitor.

And there are those who can experience asymptomatic A fib. Some respond well to medication(s) for A fib their heart to either regulate rate or their heart rhythm or both. Some require various procedures to control, reduce, stop their A fib. There is A fib due to heart valve or other cardiac problems and there is paroxysmal A fib of unknown cause.

It HAS been established that there is a relationship between OSA and A fib.

Question,

Slink, is there a difference between Heart Rate and Heart Rhythm?

avi123 wrote:

Slinky wrote:

jimnsc wrote:I had A. Fib. and cpap did not affect my treatment one way or the other. I can't imagine what tests you might be waiting to hear from as a simple EKG will show if you are or aren't. I always knew when I went into it as I could feel it in my chest (fight or flight feeling). My cardio also referred me for my sleep study. I had osa before I ever knew what it was and do know it preceded A. Fib.

I don't have A. Fib now and haven't since I was put on Tikosyn. I was electrically cardioverted 5 times previously. If Tikosyn doesn't continue to work I have another option and that is surgery - the Maze (sp) procedure. My doc is trying Tikosyn first as I am almost 71.

A simple EKG will NOT NECESSARILY reveal A fib (atrial fibrillation). It will only detect and report A fib IF an event occurs during the EKG. Even a Holter monitor will NOT report A fib if an event doesn't occur during the wearing of the Holter monitor.

And there are those who can experience asymptomatic A fib. Some respond well to medication(s) for A fib their heart to either regulate rate or their heart rhythm or both. Some require various procedures to control, reduce, stop their A fib. There is A fib due to heart valve or other cardiac problems and there is paroxysmal A fib of unknown cause.

It HAS been established that there is a relationship between OSA and A fib.

Question,

Slink, is there a difference between Heart Rate and Heart Rhythm?

Obviously, I'm not the Great Wise Slink ... but yes. Heart rate is a measure of heart beats per minute. Heart rhythm refers to whether it is sinus or not -- typical "lub-dub" sound or curve.



Beta-blockers and calcium channel blockers are used to control heart rate. Antiarrhythmic agents are used to re-establish sinus rhythm.

RandyJ wrote:Kaiya,

One possible issue could be if you suffer from aerophagia due to cpap use. My dad has AFib, well controlled by medication, but if he gets gas in his belly due to something he has eaten, it sets off the AFib.

Good luck!

I noticed this relationship last year when I was having episodes. I wasn't sure if the Afib was causing the gas or the other way around. It is what led me to research the vagal nerve relationship which I never concluded.

DreamStalker wrote:

RandyJ wrote:Kaiya,

One possible issue could be if you suffer from aerophagia due to cpap use. My dad has AFib, well controlled by medication, but if he gets gas in his belly due to something he has eaten, it sets off the AFib.

Good luck!

I noticed this relationship last year when I was having episodes. I wasn't sure if the Afib was causing the gas or the other way around. It is what led me to research the vagal nerve relationship which I never concluded.

I'm pretty sure in my dad's case the gas comes first. He'll notice the gas and then a little while later the pressure and AFib episode begins.

Yup, yup, Avi, what DreamStalker says.