I occasionally severely neglect my fluid intake leading to dehydration and a low potassium level. Consequently, I occasionally suffer from an irregular heart rhythm (atrial fibrillation). I had these episodes a couplefewTM times a year for some time before I found out why I was getting them. A few years back during a sustained episode a doctor told me that my potassium was too low (and the possible causes), and after a while wanted to zap me with the electric paddles (YES, those ones!) to temporarily stop and “reset” my heart. My heart started pounding harder, and “shifted” instantly into a normal rhythm. Usually it does this on its own after a short time. That time it took about 12 hours.
Doc said in the short term atrial fibrillation isn’t usually dangerous but if it goes on too long, some of the blood in the negligent chamber can thicken/coagulate, and if jarred loose, a clot could travel to my brain/lungs/extemeties and I could suffer a stroke. (He said I shouldn’t worry. It would take at least 24 hours before that was even a concern.)
I noticed today around noon that my heartbeat was irregular. Okay. I know that I’ve lost alot of fluid in the last 48 hours, and haven’t replenished it. Stands to reason. But it’s not “shifting”…
It’s been twelve hours. I tried overriding its current rhythm by causing it to beat excessively fast (exercise) which often works. I ran down then up 10 flights of stairs at full speed, heart pounding, legs rubbery. No result. I’m starting to worry. My wife’s thinking I should go to the clinic in the morning, but I don’t want to get zapped. The idea scares the bejeezus out of me. I read that some people suffer atrial fibrillation continuously and that sometimes the doc doesn’t even bother to try and convert it to a normal rhythm. Just uses blood thinners to prevent a possible clot.
Should I be worried? If I start taking aspirin as a blood thinner (just in case), can I just wait it out? Atrial fibrillation supposedly isn’t that uncommon. Please don’t tell me I need to be zapped…
Okay. It’s just that in reading medicenet.com I found:
I was hoping to avoid the possibilty of Dr. De Sade with his electo-torture device. (the last guy wasn’t gonna give a painkiller/anesthetic. Just something to make me not remember the pain. Sadistic if you ask me.) But if Q.E.D. says I must, I’ll take his word for it I guess.
Atrial fibrillation means that your atria, the top of your heart, is beating very quickly and in an irregular pattern. It should not be considered a diagnosis in itself – a cause for this condition should be sought. Lung infections, heart attack, an overactive metabolism are among the causes of A fib.
Atrial fibrillation is usually treated with medicine. A patient may be shocked if unstable (chest pain, shock, very low blood pressure), but this is rarely needed. It used to be felt there was a benefit to “shocking” the heart beack into a normal rhythm. However, a fairly recent study showed that a slowing the heart to a normal rate seems to be as beneficial as obtaining a normal rhythm (using electricity or other drugs). For that reason, “cardioversion” is done less often these days. It does present a stroke risk and so usually would not usually be done unless the patient has been on blood thinners for several weeks, or the Afib is known to have occurred for the first time, and is of very recent origin.
Afib itself increases the risk of stroke, of course, so patients are usually started on warfarin or aspirin. The trial that showed “rate control” may be as effective as “rhythm control” is called AFFIRM, and should be easy to find on the net.
Thanks for the info Doc! Its a little comforting knowing that the paddles aren’t used so frequently now. I hope they don’t need them when I go in tomorrow!
In addition to what Dr. Paprika said (and with whom I agree fully), it should be noted that the recent studies that demonstrated no benefit of cardioversion (i.e. restoring the normal heart rhythm either by shocking or with medications) for atrial fibrillation had rather strict entry criteria. Specifically, the patients studied in those trials had to have had recurrent atrial fibrillation (i.e. they’d had at least one previous episode). By definition, then, we still don’t know what the best approach is for people with a first episode of atrial fibrillation.
Although not a flaw, we should also keep in my mind that the large majority of patients in those studies were over age 65. It’s possible that the results may not apply with same robustness to younger people.
Finally, there are some people in whom atrial fibrillation complicates other heart problems (Wolf-Parkinson-White syndrome, aortic stenosis, . . .) Such patients were excluded from the studies cited above since most people would still agree they need cardioversion.
My two episodes were triggered by things I ate: in the first case a caffeinated drink followed by chocolate ice cream (almost deadly combination); my second when I ate a large bag of heavily salted cashews. I’ve since lost 40 pounds and have had no recurrence in 3 years now.
I don’t work for the AMA and I do have the condition. It comes and goes - you may convince yourself you are cured, but you might not be. One cause is the heart’s natural pacemaker. There are drugs that modify the electrical environment here - one worked for me. (I got my heart rebooted once and it didn’t work - I was about to get it done again when they discovered that the drug fixed the problem.)
Warfarin does treat the symptom, in that it makes it less likely for blood to pool, causing a stroke.
If your magic cure has been clinically tested and approved by the FDA people might be interested. If not, not so much.
