I have just watched this video by our favourite doctor - Sanjay Gupta. He talks about vagally mediated AF - near the end he discusses medication and recommends Flecainide but says that calcium channel blockers/antagonists (such as Verapamil) can actually make it worse.
Well! After spending the last 5 months on Verapamil and getting steadily worse (even after suggesting to medical staff that I believed my AF to be vagally mediated - I'm a little shocked to be honest.
Just wondering if any one else has doctors who are aware of this and have been prescribed accordingly, or if anyone else has been prescribed potentially inappropriate medication for vagally mediated AF?
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WendyWu20
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My EP is aware that my AF is predominantly vagally triggered and I'm prescribed Disopyramide as an anti arrhythmic which is the only drug which gives any kind of help.
Whenever I present at A&E they always load me with bisoprolol and its virtually useless. It seems to be the default drug for AF
I'm waiting for my first EP appointment, so hopefully will get the meds sorted out then. I was happy taking Verapamil as it's lowered my high blood pressure, but now hoping there will be an alternative that doesn't potentially make the AF worse.
Yes, wrong medication made my AF worse; so, against doctor's recommendation, I stopped taking it and my AF became a lot less frequent. That was four years ago and I haven't taken any medication since, partly, because I can't get an appointment with an EP. My cardiologist does not know about vagal AF and only recommends the wrong drugs. It took about 6 weeks for the AF to gradually become less frequent. I have read at least one study that concluded continuing to take the wrong medication for vagal AF can cause persistent AF.
Not sure about this. I had vagal AF. Flecainide, bisprolol, sotalol didn't work. Diltiazem (a calcium channel blocker) did work in suppressing the symptoms.
Hi Wendy, I have vagally mediated PAF and my Cardio gave me just Flecainide. I checked with him twice re Calcium Channel Blockers as some medics recommend these as a safety measure to be taken with Flec.
My cardio's reason was not re the Vagus Nerve (he doesn't go there) but he said as my pulse was quite low just under 60, they would make me unwell. I think most medics overmedicate following 'Big Pharma's manual' and it is then up to you to adjust with their begrudging approval to cover their insurance.
Thanks for posting the video and have a great day!
I'm on 100mgs x2 per day. As you know it's very difficult to say what single or combination of measures are the effective ones; particularly in my case as I have done pretty much everything on lifestyle, diet, supplements and exercise.
What I can say is that I haven't had an episode for 3+ years and I know what my triggers are, mostly mentioned by Dr Gupta in his video. I would add a further trigger and that is visiting sites where you have had bad episodes in the past - that may be in the past now for me as I have taken time to reduce the Vagal Tone over 3 years.
Thanks for sharing this information and video. Very informative. Can't wait for my EP and Cardiologist appointment so I can ask them both more about this. Hopefully their aware of it.
WendyWu20 I just found this thread. The vagal connection really isn't well known about, by GPs or even by Cardiologists/EPs. I don't really know why but it's such a basic item and so influential as to what the treatment should be. I popped some information in this thread, towards the bottom, one about Vagal AF and one above that about the gut-heart connection, which is also associated with the vagal connection healthunlocked.com/afassoci...
It's absolutely clear that Beta Blockers will make things worse. I did have disopyramide at one point and it worked like a miracle drug to end an AF attack, but after a couple of weeks while it stopped working for me, and the side-effects (dry mouth and various other "anti-cholinergic" side effects) were so bad I could not tolerate it. I took this up with my current Cardiologist when my ectopics were really bothersome and he said "we really don't want to go there" and though he wasn't so specific and didn't want to get into a big discussion about it, I think it was because of the side effects.
The gastric connection can make things worse on the vagal front. With me that was and still is a huge influence
I just found this conversation, having only recently learned about Vagal AFib. As soon as I learned about it, I made some lifestyle changes that have helped. I had already started weaning myself off of Metoprolol, which I'd taken for 4 years. No wonder I kept having episodes even after the recovery period from my ablation! The best part is the lifting of the depression as soon as I stopped taking it. I told my EP I want to go off it, having basically already weaned myself off it. Fortunately, he's OK with it, but didn't respond to the information I sent him on Vagal AF. I'll see him next month and talk to him about it then. Thank you for posting this information and for sharing your stories to all who posted.
Wasn't follow to close Healthunlocked last year. Now came across the dr.Guptas' Vagal AF video , that you've displayed . Thank you!
It gives me second thought for my PAF, that I experience for many years.
Ignored at first. But now getting older woman, my CHAT score 2. I do not have elevated BP, DIABETES, HEART DECEASE , or overweight .Usually I managed to stop AF in an hour by Bisoprolol 2.5 -5 mg. PIP. If it doesn't help in an hour, I am taking FLECAIDINE , that stop arrhythmias quick, but literally knock me out. Never agreed with Cardio to do ablation, but convince him for taking my meds. as PRN, because Bisoprolol is lowering BP, that always normal. Never heard about Vagal AF before. My episodes of AF lately became more often, and could start of stress, very little occasional drink, even weather change, fast walking, stairs, or out of the blue in any time of days.
Just found that Vagal AF mostly in younger person.Is it right?
Wander, how do determine if it is Vagal AF ? And perhaps I need to change or reconsider the med.? Thank you for reading.
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Dr Sanjay Gupta
Calcium tablets and Calcium Channel Blockers
Dr Sanjay Gupta
Calcium channel blockers
Also Inspired by Paul's Post: beta blocker vs. calcium channel blocker
