Vagal AF again - by the Master

[Jong1945]

I am currently researching vagal AF and gut-heart influences on AF for my own purposes. I have found the most incredible paper (a Comment letter in fact) on vagal AF by Prof Phillipe Coumel (reference courtesy a-fib.com). The reference is PubMed PMID 11863343 and the full text is at academic.oup.com/eurheartj/... (pdf available).

It is (as per usual with Prof Coumel) a masterpiece of medical knowledge, logic and good use of english. It's a slightly tough read unless you're up with medical terminology, but nonetheless worth working through for that. I have highlighted on my copy what I consider to be the most important remarks of his relevant to my research. Almost the whole letter is yellow!

I simply cannot understand why the field of cardiology does not take more active notice of neurogenic AF - vagal or otherwise. I feel that if Coumel's work was better known about, those of us suffering vagal AF would suffer less.

[EngMac]

Is the article titled: Atrial fibrillation: one more sporting inconvenience?

This was published in March 2002 making it pretty old in the AF world. From my experience, the doctors I have seen are unaware of the knowledge found in this article. Which kind of makes me wonder since my experience has proven to me that what is in the article has merit.

[Jong1945 in reply to EngMac]

Yep, my point entirely and one of the reasons I am writing the paper, to submit it to anyoen who might be able to change this. They say it takes 15 years or so for knowledge to propoagate through the medical world. Coumel originally wrote this up in Falk & Podrid in 1992 (!), which is a kind of text book of collected papers on AF.

[Hidden]

John

Thank you for highlighting this amazing article. Having read about Philippe Coumel, it is clear that he was a giant of the electrophysiology world. He wrote in both French and English. His use of the English language is astonishing for a non native speaker.

I am no intellectual, and don't follow his argument completely so it is hard to look at the article critically. But at this point I can say it was a pleasure to read such a beautifully expressed and well constructed piece,

I will need to read his earlier work, to understand this better. From what I have read about him so far, he seems to have been considered a giant of modern cardiology by some, but possibly less well accepted by others.

Have his team developed his ideas over the 13 years since his death?

That you again, a whole new vista has appeared. The autonomic/AF story looks fascinating and I really enjoy the written word of this quality.

Are you planning to write up your review of the literature?

[Jong1945 in reply to Hidden]

My idea is to write up a Letter / Comment style paper and discuss with / submit to anyone who might have influence, such as the AFA, but clearly with the whole area being controversial from the start it needs careful targetting.

[Finvola]

Thank you for the link, John - I've printed the article out as I'll need several reads at it.

If we think that this man was able to write in such detail 15 years ago, explaining causes and factors in arrhythmias which are still being debated, it indicates to me just how far ahead of his time he was.

[CDreamer]

Many thanks for the link - I am very interested in this but not got time to read in run up to Christmas so have booked marked for reading when I have time.

As many know I have been banging on about links between Autonomic Dysfunction, Autoimmune Disease & AF and looking for evidence so will follow this up.

I am going to be starting working with a Functional Medicine Doctor in the New Year - who is completely onside with these links and going to be searching for causes - starting with Mycrocondria testing - which is where I started back in 2012. She is a GP in our practice, recently qualified in Functional Medicine and we are both ready to learn - but she can’t practise within the NHS so is currently negotiating what can and can’t be done to try make it affordable for people.

[secondtry in reply to CDreamer]

Good luck sounds like its going to be a great 2018 for you, keep us posted please.

[Jong1945 in reply to CDreamer]

I've tried PubMed for searches such as "Dysautonomia and AF" but it's not fruitful. Mihgt be a step too far, thought someone had posted here about one of the London Hospitals who had an ANS specialisation.

[CDreamer in reply to Jong1945]

Yes I did - Queen Mary

uclh.nhs.uk/OurServices/Ser...

I am pretty sure there is a Centre in Birmingham and check out the STARS website for list of Autonomic Cardiologists - they have a list on their website.

[secondtry]

Thanks, I am very interested in this aspect and look forward to reading it when work stops for the festivities.

[Meeko]

I'm going to have to read this. I have Holmes adie in both eyes which is autonomic disfunction of the pupils. It also affects my ability to sweat and a few other strange symptoms. None of my symptoms are of interest to most doctors. The first question I asked when they told me it was the electrics in my heart was is it to do with the homes adie.

[ILowe]

If you copy the title of the article into Google Scholar, and look down below, you see two links, "cited by" which means you can get more up to date, using articles which have referenced the original article, and "related articles". Doing it now.

[Jong1945 in reply to ILowe]

Good idea, will do that also when I get the time