Unusual AF trigger

[ian16527]

I started with ectopics in 2010 accompanied with bilateral chest aching across the top and sown sternum. I was admitted for tests as my ECG has an abnormality, some part of it was below the midline. Was sent home with a diagnosis of Costochronditus.

This continued on and off and the first PAF attack in 2012. I always felt this was worsened or brought on by using my extended arms to pull or lifting heavy items. The other symptoms are waves of feeling weak, hot and bothered and off colour.

The last 3 AF attacks have been brought on by pulling the dishwasher out, 10 pin bowling and pulling weeds and rubbish up, fairly hard.

This then causes the ache/ectopics to start and then always the next day an AF attacks.

Just been changed to half securon from bisoprolol and the ectopics are now worse, on most days since my last AF attack in Feb. Also my chest aches alll the time at the minute.

So off to see the GP tomorrow to maybe go back on the bisoprolol but I have asthma as well so he may not put me back on it, although was on it for 7 years with no real effect on my chest, only felt slightly breathless on heavy exertion.

Anyone had better results with another betablocker or a similar trigger. I am getting a bit down with this feeling ill all the time.

My echos are all normal so have flecinide as PIP which has worked OK the last 2 times.

[BobD Volunteer]

Since costochronditus is actually a mechanical problem ( inflamation of the joints between ribs and sternum) brought on by strain it may just be that the general inflamation upset the vagus nerve which is close by. (Yes I had it some years back after trying to pull 160ft lbs torque with one hand and also another time after receiving CPR!). The CPR incident took about three months to settle although off morphine after a week. Neither caused AF for me although the latter was a result of it in a round about way.

As far as ectopics go the slow deep breathing exercise usually helps. Like always, we AFers need to listen to your bodies and learn to work within limits but is is hard sometimes I know.

[ian16527 in reply to BobD]

Funnily enough BOB, after the very first diagnosis of costochronditus, I saw a nurse practitioner who said that she didn't think it was this as it does not hurt when you press the chest, but due to the Vagus nerve.

Unfortunately, every other doc I have seen seems to disregard this when I mention it. It waxes and wains so can go off for a while then comes back but seems pretty persistent at the minute. I wonder if this could be an autoimune problem, as when the chest/palps are active I have no problem with my CD.

[Auriculaire in reply to ian16527]

I suffer from chronic costochondritis due to cartilage degeneration in my ribs. This has been caused by being " floxed" ie poisoned by a fluoroquinolone antibiotic in my case Ciprofloxacin. I also had my first attack of afib after taking Cipro. Sometimes I feel the pain in the sternum but it is mostly in the side of the ribs. Sometimes one side or the other sometimes both sides at once. The symptoms of floxing can come on long after taking the antibiotic as it acts in the body like chemo with delayed side effefts due to mitochondrial destruction.

I have seen a major improvement recently with regular magnesium supplementation. With the two things happening together I would look into your medical records to see if you might have been treated with this class of antibiotics in the past. Because of the delayed reactions it is rare for docs to ever make the connection and a lot of "floxies" are diagnosed as having fibromyalgia.

[ian16527 in reply to Auriculaire]

Thanks for that information, very interesting.

I dont think I've had that antibiotic before, but have had prolonged use of Prednisolone and Azathioprine (Imuran) to calm down Crohns Disease flare ups although now not on those.

Also, If I now take Pred, I get a bad reaction feeling ill, go pale and start to sweat so not sure what I will do if I need them again. Sone GP mentioned Fibromyalgia years ago as a possible cause.

Just ordered some magnesium so keeping fingers crossed it will help. I still think its auto imune in nature as the CD is very well behaved while this is active.

What treatment do you take for the Costochrondidtus?

[Auriculaire in reply to ian16527]

If you have been treated with it even once alongside Pred even worse as the two together can make for a more severe reaction. The fact that you have this bad reaction now with Pred makes me very suspicious. I would check your records to make sure. It is very hard to recall what we might have been given 10 years ago!

I don't take any treatment for the costo. It comes and goes and I have learned just to put up with it.

[ian16527 in reply to Auriculaire]

Can fluoxetine be a cause of this as well?

[Auriculaire in reply to ian16527]

To some extent all meds with fluorine molecules are noxious. The quinolone core of FQs is toxic -the addition of fluorine simply allowed greater penetration of the molecule including the abiity to pass the blood / brain barrier. If you have been floxed then avoidance of all fluoride (water,toothpaste, meds) is advised.

[ian16527 in reply to Auriculaire]

Thanks for that reply. I think I will have to live with it as you do.

[Dawsonmackay]

What's with lifting really heavy items? Do you realize you have a heart condition? The heart is a muscle too, although the strongest in the body. You need to figure out what is really important to you. Taking too many meds or backing off the heavy lifting.

[ian16527 in reply to Dawsonmackay]

Cardiologist recommended Cardio pulmonary exercise as mechanically heart is OK apparently and cant understand the link between chest ache and AF. He said it could be polymyalgia if I heard him correctly in April

[Dawsonmackay in reply to ian16527]

You need to start ruling out some things. I would first back off lifting heavy things. Don’t care what the Doc tells you. It’s your body, and you need to start taking care of it.

[cassie46]

Hi there - Ask your GP is he will prescribe Nebivolol, it is often prescribe for people with asthma as it does not effect the lungs as Bisoprolol does. I was changed from Biso to Nebivolol about a year ago because of breathing problems, it also does not seem to make me as tired, feel far more alert on Nebivolol.

Cassie

[ian16527 in reply to cassie46]

Saw GP this morning and asked about Nebivolol. He did not take the hint and doubled the Half Securon and going to inform the Cardiologist of this.

Basically said he has not got a clue as to whats wrong so I have to put up with it as I have been for the last 9 years, although the pain is fairly constant now where before it would come and go.

Thanks for your replies

[Madscientist16]

My costochondronitis seemed to increase my ectopics and it also messed up my spine. My chiropractor said that a certain thoracic vertebrae can affect the heart. As my sternum healed, he kept checking to make sure my spine was properly aligned, and it really helped reduce ectopics and palpitations.

[ian16527]

Apologies for my ignorance of the correct plural of ectopic, so ecotpic beats if this is clear. I can only say that initially and still, these were premature beats that cause a longer beat which last for several hours. Now this can be bangs, rumbles, pauses, short run SVT and full on fast AF but as to the correct definitions you will have to tell me.

I also have been in VF when I had major surgery 33 years ago due to an incorrectly inserted IV line which may be the causation of my current issues

[ian16527]

FYI

bupa.co.uk/health-informati...

litfl.com/ventricular-fibri...

never had to be shocked but had arrhythmia of some sort since then but not as symptomatic as now.

CHADS score of 1 so no blood thinners unfortunately for the moment