Sorry if I’m asking loads of questions on here but I’m very confused and scared x
I’m asthmatic, have been for years and now the slightest amount of ventolin is sending me into AF straight away so I’m almost choosing between the breathing or heart problems, this is horrible lasting for hours not minutes
I’ve got my 7 day monitor on and hope to get some joy from docs soon but I’m really starting to think that this is it
The weird thing is I recently had a sonagram ( I think it’s called ) and was told by a consultant that my heart was healthy
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Hazel1010
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Yes ashthma meds are contra indicated for AF and vice versa with beta blockers. Structurally sound and healthy as shown by an echocardiogram does not include the electrics. AF is an electrical problem (an arrhythmia) and has nothing to do with the mechanics of the heart.
I have Asthma and was on a variety of meds. As soon as I was diagnosed with PAF, the cardio took me off all the meds with the exception of one inhaler (called Symbicord here in South Africa, but could be something else elsewhere!), My asthma is quite mild, so two puffs in the morning and two at night and extra ones (you can have up to 8 puffs a day) if necessary. Ventalin and its generics were forbidden because it increases your heart rate. You should see a pulmonologist if you can to get you on the right path.
Asthma meds e.g. Salbutamol are not containicated for A.F.They are certainly a precaution when one has A.F.
Many people use these medications without problems.
There is certainly some evidence to show that A.F. can be triggered by salbutamol like medication,so caution should be used,and the benefits of these medications versus side effects would be appropriate.
But just to set the record straight,asthma meds,e.g.Salbutamol,Terbutaline are not containincated with patients with A.F.,but a precaution in patients with A.F.
If you are asthmatic, you need to make sure your Doctors are aware because beta blockers (particularly Bisoprolol) and asthma don’t mix. There are alternatives, such as Calcium Channel Blockers…
Hello Hazel I have mild asthma. I don't tolerate Ventolin well (and that was before I had AF) and just stick to my daily 'preventer' Seretide when possible. I suspect that can sometimes trigger AF too .
I take the betablocker Nebivolol rather than the Bisoprolol that many AFers take because it is usually better tolerated by those with AF.
I'm severely asthmatic and use two preventative inhalers, Wixela (fluticasone and salmeterol) and Incruse Ellipta (micronized umeclidinium bromide, magnesium stearate and lactose monohydrate). I take Diltiazem for my AF. I've been to the hospital once for for AF and have seen my HR reach 105BPM once, but I haven't had a serious episode since March.
I was completely unaware that asthma inhalers are contraindicated. It has been at least a year since I needed my emergency inhaler (albuterol) and, so far, my AF hasn't reached severe levels since, but I use one preventative inhaler twice a day and the other once. That has been my only AF emergency so far.
I dont know whether any of that will help you, but it never hurts to read specifics about a person who shares some of your health concerns.
Like Fulmentium, I wasn't aware my asthma meds were contra-indicated for AF. I have Ventolin and Relvar Elipta for my asthma and Apixaban, Adizem (Calcium channel blocker) and Flecainide for my AF.
I would suggest that the asthma meds probably put the heart rate up, as an antibiotic I had last yeardid which made my AF worse. With my preventer, Relvar, I haven't found I need to use Ventolin apart from very occasionally - perhaps you could change your preventer inhaler?
Your heart can be healthy and still fall into AF easily, like mine. As Bob says, AF is an electrical problem.
I hope you can find a balance as you are between a rock and a hard place now, but you need to stick to your guns for meds which work better for you. Best wishes and good luck.
I used to work in the pharmaceutical industry before teaching in the area of asthma and allergy research. In that time I met many patients who were happy with Ventolin (salbutamol) but some of whom did notice, especially when used frequently, that it could increase their heart rate, cause palpitations and make them feel a little “twitchy” or “edgy”.
Salbutamol is called a selective bronchodilator because it targets the lungs much better than the earlier drugs like isoprenaline, but it can still affect the heart a little. It is just a guess, but perhaps the palpitations it might have caused could have set off your fibrillation since the source of both can be in the heart’s left upper chamber, the atrium - where the pulmonary veins enter.
Why you should have developed AF is likely going to remain a mystery, especially as your echo shows a normal heart. AF is linked to the natural inflammatory and immune systems in the body - that might be one reason, since asthma is also. AF occurs also in people who are older, carry too much weight, have high blood pressure, suffer sleep apnoea, have thyroid problems or have diabetes.
For AF to occur, the cells in the atrium change a little and become “arrhythmogenic”. This occurs when the heart or the atria becomes slightly larger and are “stretched”. This can happen with extreme athletes, even. But your echo was normal. Those cells that cause arrhythmia can change back it seems - lots more needs to be found out yet.
I take a calcium channel blocker instead of beta blocker (can’t tolerate them) and have no problems with ventolin. I take my preventive inhaler regularly and this eases the frequency of needing ventolin. Talk to your GP about it.
I take a combined inhaler - reliever and preventer (and diltiazem) with no noticeable problems, but if I miss doses or have any kind of respiratory virus or chest infections my arrhythmias flare up but I have to do whatever it takes to treat asthma. So you really need to get this sorted because it is a vicious spiral downwards. Remember, asthma can be fatal but AF very rarely is so the asthma takes priority. Anyone needing ventolin regularly should be taking a preventer and definitely having regular reviews. My asthma is very well controlled but I still have a nurse review annually.
I can’t stress enough - Asthma is much more dangerous than AF and can also cause it 💜
Looking at your profile I see you are already having some heavy duty treatment for asthma but I’m leaving my reply because it is important info for others!
The only time I think Ventolin ( which I have used for 40 years) has ever contributed to an af attack was after a major op when I used it excessively to help with post op mucous. Even the preventer inhalers have similar broncho dilators in them. I am far more concerned about beta blockers worsening my asthma than about asthma treatments provoking afib.
On 8 November 2022, I had been taking loratadine daily for about a month to cope with allergy to pollen storms and had begun feeing strangely stressed for a number of days and maybe a little breathless on hills. Suddenly it felt as if my throat had relaxed but a cage was hardening aroind my neck and upper ribs, preventing me from taking deep breaths. I felt so strange and in danger that I cancelled my holiday and drove straight home. I stopped taking the loratadine.
I could not get an appointment with my doctor for 3 days, and basically laid up in bed with these terrible symptoms. (I avoided E R due to covid.) I decided I must have asthma and convinced my doctor, who prescribed ventolin. He prescribed ventolin but also requested a chest scan.
The painful rigidity seemed to resolve for a few days. But then it came back with a vengeance and I also felt as if I was choking. Because it was the Xmas season it was difficult to see anyone quickly at the practice about the results of the chest scan, but eventually I was told that I had small bilateral perfusion at the base of my lungs, but anatomically things looked normal. I was experiencing a tiny bit of ankle swelling and my breathing was worsening. I finally saw one of the GPs in the practice and he had the nurse do an EEG which showed I was in rapid atrial fibrillation.
I finished up being admitted to ER and after the effects of the ventolin wore off, so did my difficulty breathing. In other words the breathing and the AF didn't seem related. During my several days admission I experienced no difficulty breathing at all.
I was admitted to cardiac unit. Path results disclosed that my FT3 thyroid hormone had doubled in the space of a week. The cardiac team were sure that this must be the fault of my NDT cardiac medication, which they had never heard of and suspected to be devil's work. This did not make sense to me because there had been no sudden change in dosage. Some research on my phone revealed that ventolin could cause low potassium by blocking calcium channels (which can cause AF) as well as causing hypothyroidism. None of the cardiac team, and not even the pharmacist had been aware of this. ( Isn't that shocking!) They acknowledged it but still focused on the thyroid meds.
After transfer to another cardiac unit where the cardiologist also focused on the thyroid medication (which had been stopped cold) to the exclusion of ventolin as a cause, I was moderately stabilised on a drug cocktail which included empagliflozen. The latter was introduced the day of my discharge.
After 2 days at home I began again to experience that awful painful cage feeling round my chest. The cardiologist said it did not sound like heart pain and left me to deal with it. I was on an emergency list for ablation and had to cease the empagliflozen anyhow. After a couple of days I felt okay.
On discharge the day after the ablation, I did not feel too bad. I was sent home with a new sript for empagliflozen. Soon the pain restarted and became excruciating. By this time I was reviewing what might have happened way back around the 8th of November, and I remembered that I had been taking Loratadine daily. A search revealed that loratadine had been implicated (as a calcium channel blocker) in low potassium and atrial fibrillation in studies in the mid to late 1990s. The Lancet had even done a special on it. Since the medication had been released for sale without prescription, it looked like those studies had been buried. There was one Dutch study based on self-reporting that had come out prior to the release of loratadine over the counter. Curiously the reviewer cast a lot of doubt on that study, instead of just commenting soberly.
I discovered that empagliflozen also lowers potassium (calcium channel blocker) and I have replaced it with magnesium, with cardiologist's phone agreement. But in fact nearly all my heart meds lower potassium.
However, if the cause of my atrial fibrillation was actually low potassium, surely this is not the way to go. I am seeing a GP tomorrow (my favorite GP who was was away and knows thyroid well) to find out the results of numerous tests, and my cardiologist in 3 days. I just hope I can get thecardiologist to listen.
So I am writing this to alert people to what I have found out so far.
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I have mild asthma. I don't tolerate Ventolin well (and that was before I had AF) and just stick to my daily 'preventer' Seretide when possible. I suspect that can sometimes trigger AF too . 
Asthma
Asthma
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Magnesium with heart meds?
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