Help to decide diagnosis

[Crystalbowl]

I am a relative newbie to this forum but am finding it most interesting and helpful. I was first diagnosed with paroxysmal AF in 2011 but apart from some tests at the time, nothing much was done about it. Gradually, things have deteriorated and I saw the Cardiac Consultant last week. Last visit was over a year ago. Yesterday, I received a copy of a letter he has sent to the Cardiac GP I have been seeing recently. The letter states the following:

Diagnosis: Permanent atrial fibrillation since 2017

Heart failure with significant LVSD 2017

ECG - left bundle branch block, no significant coronary artery disease on angiogram 2017

NYHA 2-3 symptoms

Recent shingles right lower chest

The shingles attack started on 24.1.19 when I was on holiday in Madeira and where I had earlier that month been hospitalised for a chest infection which had affected my heart markers. I was already taking Bisoprolol by then (now on 10mg) but was put on Riveroxaban 20mg, and Furosemide 40 mg amongst other things and am now also taking Candesarten 32mg and Spironolactone 25mg. I have been left with post herpetic neuralgia from the shingles and am taking Amatriptilyne 30 mg plus using lidocaine plasters (2 or 3 a day for 12 hours on and 12 hours off) for the pain. I have had issues with breathlessness because of fluid retention but the diuretics do seem to be keeping this reasonably at bay. I am now n the Consuktants list for a CRT pacemaker although he says there is m guarantee that this may dramatically improve things although he says my heart rate is better controlled because f the medication which I resisted for quite a long time.

I presume LVSD stands for left ventricle but what is the SD? The letter states “...her LV dysfunction is only borderline severe to moderate and we thought it was more severe than moderate and also there was no ischaemic heart disease with significant coronary artery disease or scarring”. (I think this was from a recent Echocardiogram). And what is NYHA? Any comments or advice gratefully received! I am 73, female and live in the NW of the UK. I have not been referred to an EP and do not know if there are any in this locality.

[BobD Volunteer]

LVSD stands for Left ventricle systolic dysfunction

NYHA is New York Heart Association followed by a number which is an internataional measure of heart failure.

Hope that helps.

[Crystalbowl]

Thanks, Bob. Have now looked up New York Heart Association. The letter says 2-3 symptoms not a number as such but I would place myself between 11 and 111 looking at what it says on Wikipedia except that the AF is permanent now and I don’t notice it much any longer as presumably I have got used to it. I have the one lead Kardia which always shows “possible AF” when I can get it to work as I now have Raynaud’s Disease thanks to the Bisoprolol apparently so the Kardia won’t always register when my fingers are “dead”. Happy days!

[jennydog]

Where exactly in NW England do you live? When we know this we can point you in the direction of an Electrophysiologist who might be able to give you specialist advice.

[Crystalbowl in reply to jennydog]

Thanks for your reply, jennydog. I live in Lancaster. Yesterday, I received a letter with the date for my pacemaker op - 31 October!

[Hidden]

The following helps my Afib - it either stops it or makes it much less severe. You might want to give it a try:

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After 9 years of trying different foods and logging EVERYTHING I ate, I found sugar (and to a lesser degree, salt – i.e. dehydration) was triggering my Afib. Doctors don't want to hear this - there is no money in telling patients to eat less sugar. Each person has a different sugar threshold - and it changes as you get older, so you need to count every gram of sugar you eat every day (including natural sugars in fruits, etc.). My tolerance level was 190 grams of sugar per day 8 years ago, 85 grams a year and a half ago, and 60 grams today, so AFIB episodes are more frequent and last longer. If you keep your intake of sugar below your threshold level your AFIB will not happen again (easier said than done of course). It's not the food - it's the sugar (or salt - see below) IN the food that's causing your problems. Try it and you will see - should only take you 1 or 2 months of trial-and-error to find your threshold level. And for the record - ALL sugars are treated the same (honey, refined, agave, natural sugars in fruits, etc.). I successfully triggered AFIB by eating a bunch of plums and peaches one day just to test it out. In addition, I have noticed that moderate exercise (7-mile bike ride or 5-mile hike in the park) often puts my Afib heart back in to normal rhythm a couple hours later. Don’t know why – perhaps you burn off the excess sugars in your blood/muscles or sweat out excess salt??

Also, in addition to sugar, if you are dehydrated - this will trigger AFIB as well. It seems (but I have no proof of this) that a little uptick of salt in your blood is being treated the same as an uptick of sugar - both cause AFIB episodes. (I’m not a doctor – it may be the sugar in your muscles/organs and not in your blood, don’t know). In any case you have to keep hydrated, and not eat too much salt. The root problem is that our bodies are not processing sugar/salt properly and no doctor knows why, but the AFIB seems to be a symptom of this and not the primary problem, but medicine is not advanced enough to know the core reason that causes AFIB at this time. You can have a healthy heart and still have Afib – something inside us is triggering it when we eat too much sugar or get (even a little) dehydrated. Find out the core reason for this and you will be a millionaire and make the cover of Time Magazine! Good luck!

- Rick Hyer.

[Jupiter33]

Hi, the nearest EP's to your locality are at the Lancashire Cardiac Centre based at Blackpool Victoria Hospital. Your GP will be able to refer you. I've had a successful ablation there myself.

Hope this helps,

Steve

[Crystalbowl in reply to Jupiter33]

Thanks, Jupiter33. I have never been referred to

Blackpool. My pacemaker op is at Westmorland General in Kendal in the Cardiac Centre there.