APNEA vs ATRIAL FIBRILLATION! INTERESTING?

[jazzer4]

I have always wondered so I will ask.

Can't you feel your heart racing? Wouldn't you know if your heart was beating 160 or 180.
I feel it if my heart beats off by a beat or is beating like a string of pearls or doesn't beat then does a big beat.
Am I too in-tuned to my body?
Tell me, can't you tell if your in AF?

[Slinky]

The coumadin/warfarin has nothing to do w/treating A Fib. Its purpose is to hopefly prevent a blood clot form forming as the atrium does its flutter by bit and allows blood to pool which can then clot.

And coumadin/warfarin is not really a blood thinner, it actually just affects one of the clotting agents in blood making it less effective at contributing to clotting.

I started CPAP therapy in 2006. I was switched to BPAP in 2008. I have COPD to complicate matters a bit. And I just joined the A fibbers ranks in August/September this year.

The first episode I was aware of occured in March of this year. Then averaged once a month until July. They never lasted long. Always just a matter of minutes. Until July. That episode was strong enough and lasted long enough I opted to go to ER. I was put on a 30 day event monitor since given the frequency or lack thereof a 24 hour Holter monitor made no sense at all. I had a "critical" episode the second day I wore the event monitor and later during the month a "serious" episode and voila! The coumadin dosage adjustments and blood draws and the recommendation of Rhythmol. I opted to pass on the Rhythmol and to try a calcium channel blocker first so there has been the dosage adjustments for the Diltiazem (cardizem).

And since the 30 day event monitor indicated some less serious arrhythmias going on that I was not even aware of now that I've put in some time on the Diltiazem I'm currently "partnering" w/a 21 day event monitor. We've used eCardio both times and I'm quite impressed w/them and their monitors. Wireless communication of events to eCardio direct from the monitor w/o my having to do a thing or even being aware of it.

Just for the fun of it I've been using the Heart Rhythm Tracker at MedHelp.org to keep track of any symptoms and events I am aware of. It will be interesting to compare them to the printout from eCardio when the 21 days are up. AND eCardio doesn't waste ANY TIME getting the monitor to you or sending the data to your cardiologist!!! They call to verify your address one day and you recieve the monitor the next day! My doctor had the full printout in less than a week.

[tonycog]

Mentioned it to my GP, he did an ECG just 'off the cuff' to have a quick look and said it seemed okay... but sent it along to my other doctors including my cardiologist, who had me in for an echocardiogram the next day. It was hard to spot but they were thorough and lo ad behold, Atrial Fibrillation, shared by six percent of the population! Now I am on rat poison (Warfarin) and have a terrible craving for cheese. They are going to paddle me in February and try to get me back into sinus rhythm.

I don't know why your GP couldn't spot AFib. It shows up on the ECG. Also, ask your doc about getting the cardioversion (paddles) done before February. If I'm remembering correctly, they wait for several weeks of anti-coagulant therapy so as to rule out blood-clots. They can do the conversion sooner if they do a TEE (trans-esophageal echocardiogram) right before they shock you back into rhythm. The TEE is essentially an echocardiogram taken by sending the scope down your throat. This gives them the view they need to rule out clots. Then they can shock you back into rhythm.

You may want to investigate what is sometimes called the "Big Three" supplements - magnesium, potassium and taurine. Do your homework. These have helped me battle AFib. I ended up getting an ablation on September 1 of this year. So far I have 3+ months of normal sinus rhythm since then.

AFib is a beast. I wish you well.

Tony

[Slinky]

Welllll, I had an ECG at a large cardiology clinic in January as well as a chemical stress test in late January and nuttin' showed up in either of them to indicate any arrhythmias. And I had the first "episode" that I was aware of in early March. And I had only two "events" whilst I was on the 30 day event monitor that I was aware of despite there were considerably more "events" recorded.

So it is possible to have arrhythmias you aren't aware of and ECGs can't necessarily pick them up, at least not if you are not having them at the time the ECG is run.

[HoseCrusher]

It is my humble opinion that afib and cellular magnesium deficiency go hand in hand. Blood levels of magnesium may be fine, but the cellular levels are what you need to check.

I have been dealing with this for a little over 10 years now, and have gotten to the point where I can chemically convert to sinus rhythm within 36 hours by simply upping my magnesium dose. I am currently trying to find a dose of magnesium that keeps me in sinus rhythm so I don't have to bother with the conversion process. My history is that I have a major afib episode about every 5 years. It lasts a few months, then I convert back and am good to go for a few more years.

My cardiologist put me on a 30 day event monitor during my last major afib episode. During the first 20 days, I downloaded over 3200 events and was not wearing the monitor during sleeping. I then started on the magnesium bicarbonate and chemically converted within 30 hours. During the final days of my event monitoring I was only downloading 5 - 8 events a day and most of those occurred during sleep.

My cardiologist asked me if I snored and I told him yes, and that my wife tells me that I stop breathing while sleeping. He suggested a sleep study.

Since starting xPAP therapy I have only had 6 afib episodes. During this time I have been trying to figure out the dose of magnesium I need to take to keep in sinus rhythm, and to keep from having loose stools. These afib episodes were chemically resolved within 36 hours using magnesium bicarbonate. I have settled on taking magnesium malate and since I have been taking 850 mg I have had no further afib episodes. I started at 140 mg and have worked up from there. When another afib episode would start, I would mix up some magnesium bicarbonate and take it to bowel tolerance, or a little beyond that. Once the episode resolved, I would up my magnesium dose a little and see if that worked. I have been going for 3 months now without an episode so the 850 mg may be my "sweet spot."

My cardiologist had me stop taking magnesium when I started the xPAP therapy. He was interested if treating the sleep apnea would also take care of the afib. In my case it didn't, so I was turned loose to try my magnesium "theory."

Throughout all of this, my blood levels of magnesium have been within the normal range, but I haven't been able to find a laboratory that is capable of testing cellular levels of magnesium, so that testing hasn't been done. My cardiologist is watching me closely and is pleased with my results. He is also very interested in my pulse oximeter reports and the few abnormal events I have been able to capture on my hand held ECG. My ECG provides a "hobby" view of my heart. I have been able to capture PVC's, afib, and SVT's. While not up to professional standards, my "hobby" view has given my cardiologist insight into what is going on with my heart. This whole process has been very interesting.

I am under the impression that the xPAP therapy is to prevent further problems down the road. I am not sure that xPAP therapy by itself will effectively eliminate afib episodes.

However, I am not a medical professional and am only sharing my particular journey.

[Slinky]

... He is also very interested in my pulse oximeter reports and the few abnormal events I have been able to capture on my hand held ECG. My ECG provides a "hobby" view of my heart. I have been able to capture PVC's, afib, and SVT's. While not up to professional standards, my "hobby" view has given my cardiologist insight into what is going on with my heart. ...

HoseCrusher, what brand and model is your hand-held ECG and approximately what was its cost??

[Borgasmord]

I have always wondered so I will ask.

Can't you feel your heart racing? Wouldn't you know if your heart was beating 160 or 180.
I feel it if my heart beats off by a beat or is beating like a string of pearls or doesn't beat then does a big beat.
Am I too in-tuned to my body?
Tell me, can't you tell if your in AF?

Yes. It is very obvious, sort of like a fish flopping around in your chest. It is scary but one of the "better" heart problems to have if you have to have one!

[Little_Peep]

Here is a good source for a-fib information: http://www.a-fib.com/Overview.htm

[Slinky]

... You don't have to take warfarin. A new anticoagulant, dabigatran, was just released in the US last month. It works better, has no drug or food interactions, and doesn't require blood tests. Obviously, it's more expensive than generic warfarin.

http://en.wikipedia.org/wiki/Dabigatran

Dabigatran's brand name is Pradaxa in the US. It has a SIGNIFICANTLY higher risk of GI bleed than Coumadin (warfarin). I am on coumadin for A Fib. My cardiologist was excited about switching me to it until he remembered I have Crohn's disease. W/the Crohn's disease in mind he would not even consider putting me on Pradaxa

Dabigatran will cost the NHS £4.20 per day, which is equivalent to several other anticoagulants,[7] but more than ten times the cost of warfarin. Furthermore, the total cost of warfarin use includes the time and cost of INR monitoring, which is not required with dabigatran.

Dabigatran 110 mg was non-inferior to warfarin for the primary efficacy endpoint of stroke or systemic embolization, while dabigatran 150 mg was significantly more effective than warfarin or dabigatran 110 mg. Major bleeding occurred significantly less often with dabigatran 110 mg than warfarin; dabigatran 150 mg showed similar bleeding to warfarin

[tonycog]

So it is possible to have arrhythmias you aren't aware of and ECGs can't necessarily pick them up, at least not if you are not having them at the time the ECG is run.

That is the key. If you are in AFib while getting the ECG, it is an easy thing for the doctor to spot. If you had one earlier and converted on your own, and are in normal sinus rhythm it will not show up. That is also a frustrating part of a Holter monitor. I wore one for 48 hours and, of course, had no episodes during those 48 hours.

Tony

[tonycog]

Throughout all of this, my blood levels of magnesium have been within the normal range, but I haven't been able to find a laboratory that is capable of testing cellular levels of magnesium, so that testing hasn't been done.

You might want to log-in at http://www.afibbers.net/forum/list.php?f=9 and ask about this testing. I think I remember reading about a test for cellular magnesium levels. Post a question about it and you will get an answer. It may be called "ExacTest" or something close to that. I'm not sure on that one, but it sounds familiar to me.

Best wishes,
Tony

[HoseCrusher]

Slinky, The ECG unit I purchased is this one...

http://www.amperordirect.com/pc/c-ecg-e ... nitor.html

Don't bother with the extra leads and electrode patches. You can get a reasonably decent signal simply by holding it in your hands. The main problem is electrical interference that degrades the signal. However, if you want to do some long term (greater than 30 seconds) monitoring, this cable and clips do work.

http://www.amperordirect.com/pc/c-ecg-e ... clips.html

This is a unit that you have to play with a bit to get a good recording. Body position, skin to skin contact, close proximity to electrical wires and computers and phones all can interfere with getting a good signal. However working with a cardiologist you can figure out what recordings are acceptable. Once you learn enough to recognize a decent signal the rest is easy.

Interpreting the data is involved and best left to the cardiologist, however you can recognize "gross" changes.

The software has some problems, but using PDF creator you can expand the scale to look for subtle changes (like finding the P portion of the beat). With that said, I simply print from the software and hand it to my cardiologist. There is a new version of the software, but I haven't seen it... yet. I have not been able to figure out how to record continuous monitoring, but that is not an immediate interest for me. There is too much interference to get a good strip during continuous monitoring. Every time you move you screw up the signal a little. The hospital grade machines also have this issue, but they seem to tolerate it much better.

It is not perfect, but for me it was $170 well spent.

[HoseCrusher]

Tony, thanks. The test is actually called the Exa Test, but you were close.

http://www.exatest.com/

[M.D.Hosehead]

... You don't have to take warfarin. A new anticoagulant, dabigatran, was just released in the US last month. It works better, has no drug or food interactions, and doesn't require blood tests. Obviously, it's more expensive than generic warfarin.

http://en.wikipedia.org/wiki/Dabigatran

Dabigatran's brand name is Pradaxa in the US. It has a SIGNIFICANTLY higher risk of GI bleed than Coumadin (warfarin). I am on coumadin for A Fib. My cardiologist was excited about switching me to it until he remembered I have Crohn's disease. W/the Crohn's disease in mind he would not even consider putting me on Pradaxa

Dabigatran will cost the NHS £4.20 per day, which is equivalent to several other anticoagulants,[7] but more than ten times the cost of warfarin. Furthermore, the total cost of warfarin use includes the time and cost of INR monitoring, which is not required with dabigatran.

Dabigatran 110 mg was non-inferior to warfarin for the primary efficacy endpoint of stroke or systemic embolization, while dabigatran 150 mg was significantly more effective than warfarin or dabigatran 110 mg. Major bleeding occurred significantly less often with dabigatran 110 mg than warfarin; dabigatran 150 mg showed similar bleeding to warfarin

Slinky, where did you read that the risk of GI bleeding is significantly higher higher for Pradaxa? Your citation above says the bleeding rates for warfarin and dabigatran are SIMILAR, but dabigatran's efficacy is greater (at the 150 mg. dose).

For some reason, the FDA did not approve the significantly safer 110 mg. dose for sale in the US, though that may come later. The 110 mg. dose might be preferable to warfarin for someone like you.

[torontoCPAPguy]

Anyone investigated ubiquinol (active form of Co10) for AFib in addition to magnesium to stabilize rhythm probs? I have a good friend on rat poison and would like to suggest things he can ask his cardio doc about.

OK, here we go again guys. OSA folks have generally up to a 100% greater chance of developing Atrial Fibrillation early on in life than the general population. If you have other risk factors, such as diabetes, obesity, sedentary life style, hypertension, liver or kidney issues, and about a dozen others your chances of developing AF skyrockets. If you are not getting the proper nutrition or are consuming a 'trigger' you are headed STRAIGHT TO HELL IN A HANDBASKET and studies by several prominet universities and medical centres indicate that your electrolytes need to be A-1 as well and there are entire studies on the use of Magnesium, Potassium and Taurina dietary supplements (under close medical supervision on request) to deal with AFIB. The AFIBBERS website has tons of information, studies, supplies, links, etc. http://www.afibbers.com

And I am sure that there are other websites and forums for AFIBBERS as well that will be of great service. I have begun my quest today in earnest as this is a crippling disease for many - regretably, it is for me it would appear (lack of air,chest pressure, fatigue, high risk of stroke, etc.) For some it is just an inconvenience in passing. On whichever end of the scale you may fall, PLEASE GET EDUCATED! I already have questions for my cardiologist and pulmnologists; perhaps the AFIBBERS on here can answer some of them. Regardless, EVERYONE ON THIS FORUM NEEDS TO KNOW THAT ATRIAL FIBRILLATION IS CLOSELY LINKED TO SLEEP APNEA AND IF YOU THINK YOU HAVE DEALT WITH YOUR APNEA AND ARE STILL EXPERIENCING SYMPTOMS (AS I WAS) YOU NEED TO BE PROACTIC AND TENACIOUS LIKE A PITBULL OR YOU MAY BE THE LOSER. IN MY CASE THERE WAS SOME SHORTNESS OF BREATH AND IT WAS JUST ON A WHIM, AFTER HAVING HAD EVERY CARDIO TEST ON TE MARKET, THAT MY GOOD FAMILY DOCTOR GAVE ME A QUICKIE EKG IN HIS CLINIC/OFFICE AND SENT A COPY OFF TO MY CARDIO FOLKS. THAT IS WHEN ALL HELL BROE LOOSE. MY LIFE WAS IN PERIL IMMEDITELY AND I WAS IN THE CARDIO OFICE BEING EXAMINED EVERY WHICH WAY BUT UP (again!) WITHIN 24 HOURS. KNOW THIS AND BE PREPARED TO ASK QUESTION OF YOUR MEDICAL TEAM.

I know that I will be "paddled" at the beginning of February and my chances of being "convrted" are about 63 - 69% becase of what I am learning and because my cardiologist appears to know of what he doth. The next choice is a surgical procedure. Before that I am going to try and get my chances of having this go away on its own up as high as I can by self education. Same as my sleep apnea story - I am going tohave to teach my doctors of all the latest treatments and drugs and so on.