Paroxysmal Atrial Tachycardia

Have you tried diltiazem? Is your blood pressure low? If so not a good choice. But it does slow my heart down.

Thanks. Coincidentally I have recently filled a prescription for diltiazem that was prescribed to me a year ago by a doctor who no longer follows me. (Moved his practice to another city)… Thinking I might try it out of desperation. He said at the time that it was sometimes more easily tolerated than a beta blocker. I haven’t tried it yet because I find I feel hesitant about taking something that no doctor I’m seeing right now has prescribed. Because of the low blood pressure issue (beta blockers did that too though) but mainly because of two potential side effects -easily enough tolerated by most people- constipation and urinary frequency (did you get those or edema as a side effect?) are already problems I have that exacerbate the pain I have with pudendal neuralgia . To have more bladder and bowel issues feels like the worst risk to take and with no doctor overseeing- I’ve just been hesitating.
Did you find it just slowed your heart generally overall but you still have episodes-with lower numbers or does it actually control your arrythmia? Can you exercise?

I do "pill in a pocket? for afib with heart rates up to 180+. But it happens infrequently. I cannot tolerate beta blockers at all. I go to the ER for a dilitiazem drip so they can watch my blood pressure, but have also popped a pill. I suggest not getting the extended release at first but the lowest dose of the immediate release. I forget it it can be halved but I believe so.

Afib makes me need to pee really badly so cannot tell about diltiazem!

You can also bear down like you are having a bowel movement or baby and most of the time that will slow heartbeat down. Sneezing and coughing also will do it.

Coughing, sneezing and bearing down as if having a bowel movement or baby also helps to slow heartbeat.

Progression (worsening) of paroxysmal atrial fibrillation is NOT inevitable.

There is only ONE published clinically-controlled study of the temporal patterns & progression of paroxysmal atrial fibrillation--&. not surprisingly, it comes from research conducted in Europe (under the auspices of the European Cardiology Society), which has a very different perspective on the subject than the American Heart Association, which seems at times to be little more than a shill for...interventional (read: surgical) cardiology & Big Pharma & the Medical Device (read: catheter-related cardiological medical devices) industry/industries (don't forget: the average billed cost of cardiac-catheter ablation, a procedure that usually takes about an hour & 50 minutes or so to complete...is $100,000; & catheter ablation is NOT a cure for...atrial fibrillation; to wit: the overwhelming majority of catheter-ablation patients subsequently experience atrial fibrillation relapse/reoccurrence...& go on to have second or even third catheter-ablation surgeries).

In the only study of its kind, the following data/results were obtained--& I quote:

"Compared to the first 6 months, 111 (62%) patients remained stable during the second 6 months, 39 (22%) showed progression to longer AF episodes, 8 (3%) developed persistent AF, and 29 (16%) patients showed AF regression."

For everyone's edification, here's the URL to this groundbreaking--& hopeful (at least in my estimation) study (American cardiology would do well to learn from the Europeans): https://academic.oup.com/europace/article/22/8/1162/5869098

Cheers & all the best!

I see we'll have to disagree, and I don't know why you're arguing that ablation is not a cure. I have never stated as much, unless your reply was included in a reply to me that was authored by another member here.

Look at it this way: if you somehow cured the lesions some time after an ablation, would the heart continue in NSR, or would it revert to its pre-ablation rhythm? Thinking that way, it is rather obvious that an ablation is a temporary abatement measure. Since it is temporary, AF cannot be 'cured'.

As a parting shot, I am disappointed that so many people dismiss American research as shill-like, or intent only upon making an almighty buck. It isn't an advanced form of reasoning, and amounts to an ad hominem fallacy.

But, if an American study or proposal is to be suspect, maybe a Canadian study will help to set the tone: https://pubmed.ncbi.nlm.nih.gov/28232263/

Not sure what to make of your post. You asserted (in a prior post) that...progression of (paroxysmal) atrial fibrillation was a certainty (inevitable).

Put aside the paper I referenced & shared: The assertion that paroxysmal AF is inevitable was stated without any falsifiable/testable basis, empirical or otherwise. And my post was written in response (primarily) in the spirit of addressing the missing justification (whatever the epistemology).

As for my disaffection for...the cost of American cardiological healthcare: Here (in this forum) I cannot & will not enter into a thoughtful critical consideration of the larger subject of American fee-for-service health care.

I specifically mentioned the AHA--& nothing at all about American health-scientific research (which, by the way, is the field in which I work).

The AHA is a...professional...organization (profession = American cardiology).

It is NOT a research organization (though it does provide some modest grants for some research in addition to its paramount concern with advocacy for the profession of cardiology). I can & will continue to critique the AHA & the AMA for that matter--& other professional associations: Their ambit is professional advocacy (not science or even the practice of medicine).

As for the conflation of my critique of the AHA with a larger concern about American fee-for-service healthcare: I can & will continue to regard it (the AHA) with healthy skepticism. Such skepticism has NOTHING to do with the unrelated concept of ad hominem fallacy.

In fact, to suggest that a/my critique of the AHA for its professional & medical-industrial advocacy is some form of...ad hominem fallacy...might well be said itself to be a form...of ad hominem attack (though I personally would not make such a claim).

Critical consideration is integral to any intellectual enterprise, whatever its nature. And critical engagement lies at the heart of all inquiry: It is NOT to be equated with or erroneously dismissed as...ad hominem attack (it could well be but that claim of ad hominem fallacy must itself also be justified according to recognised logical standards).

On the larger subject of what some of us (namely, health services researchers) identify as American healthcare's defining preoccupation with fee-for-service healthcare: Many of us find it problematic.

Studies of cross-national comparative healthcare systems, expenditures, & outcomes abound. Many of us are concerned by the exorbitant amount of money--by any measure, including as a percentage of America's GDP, America spends on healthcare. For quick reference take a look at the Commonwealth Fund's periodic assessment of US healthcare...vis-a-vis other OECD nations, for example:

* The U.S. spends more on health care as a share of the economy — nearly twice as much as the average OECD country — yet has the lowest life expectancy and highest suicide rates among the 11 OECD nations;
* The U.S. has the highest chronic disease burden and an obesity rate that is two times higher than the OECD average;
* Americans have ewer physician visits than peers in most countries;
* Americans use some expensive technologies, such as MRIs, and specialized procedures, such as hip replacements, more often than our peers; &
* Compared to peer nations, the U.S. has among the highest number of hospitalizations from... preventable causes and the highest rate of avoidable deaths.

Back to the cost of American healthcare: The largest single component of the cost? Physician compensation.

For example: As of 2023, American cardiologists earn on average nearly $500,000 per year (those catheter-ablation revenues add up quickly).

Skepticism aside, it's worth asking--& it's an empirical question, given the much higher rate of such interventional cardiological surgical procedures performed in the US versus Europe, whether & to what extent is the higher rate of such intervention driven by behaviors not rooted in medical necessity (or what American EP cardiologist & researcher Dr. John Mandrola terms "medical conservatism")?

That's not an "ad-hominem" fallacy or attack: It's a falsifiable/testable (empirical) proposition. I join Dr. Mandrola & his colleagues in their dedication to "medical conservatism", especially in the practice of cardiology.

Read all about it here: https://www.amjmed.com/article/S0002-9343(19)30167-6/fulltext

Cheers & stay safe.

The old villain...aldosterone 🙂

Read all about it: https://www.afibbers.org/resources/aldosterone.pdf

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