89 yr old father was hospitalised due to AF after experiencing slight chest pain and abnormal HR
(He was diagnosed with AF SEVERAL years ago and He was on bisoprolol, apixaban and his AF has been under control)
On investigation, magnesium levels were low and his medication was changed from bisoprolol to sotalol and ranolazine. He is experiencing side effects since. GP spoke to cardiology and another consultant said he wouldn’t have started ranolazine for my father in the first place due to pre existing conditions like Parkinsons so now has stopped the ranolazine.
Could the low magnesium level have contributed to his episode of AF where he was experiencing slight chest pain and problems with HR?
Father also has COPD I read that bisoprolol is more effective for people with COPD AND AF so I’m also wondering if sotalol is as effective. I forgot to mention to GP To review this as well
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This sounds to me like an electrolyte problem. In an elderly person you’d need to consider his kidney function and also whether he has problems with eating, especially as you mention Parkinson’s and COPD. I don’t know whether he lives alone, or has carers, but it may well be that you need to look into whether he has adequate nourishment especially if he can’t manage regular food, if there’s are problems with chewing or swallowing, whether he can use a knife and fork or a spoon. In which case he might benefit from liquid nourishment that is available on prescription. You really put to check his kidney function too. He has quite a complex set of conditions. Certain medications could influence his magnesium/electrolyte status but you don’t say whether he’s on medication for his COPD (eg diuretics) or anti Parkinson’s medication. The best people to ask are his healthcare professionals, not an internet forum, simply for the reason that the picture is way too complicated and he has other conditions too. Care for frail geriatric patients is sometimes not straightforward.
Yes it is complicated and unfortunately the consultants at the hospital were never around to discuss treatment. We would try to get in contact but ward rounds were before visiting times. The nurse in charge of my father’s care insisted there was no change in medication until we demanded to see the drug chart. Then we saw he was being given magnesium as well as ranolazine and sotalol.
He has also had a previous episode of low magnesium and fast AF last year.
This time it took the hospital several days to conduct echocardiogram and chest X-rays and unfortunately my father was being pushed down the priority list. It was a difficult time. And we tried to ask questions and inquire but was just told wait for the scan results. The discharge letter was when we saw all the information we wanted to know. After a couple of weeks of father feeling sick, and unwell, stomach pains, GP managed to get in touch with another consultant at the hospital to query whether it was necessary to change the medications given his medical situation. The consultant said he wouldn’t have started the ranolazine in the first place because of fathers medical history.
Therefore I wanted to hear other people’s experience of low magnesium affecting AF. I would consult medical professionals before trying anything.
He is on medication for Parkinson and furosemide and also lansoprazole which I know lowers magnesium. He lives with family so is well supported and has regular meals with no problems swallowing or chewing. Although, he has a low appetite. His kidney function is good.
My mum had Parkinson’s so I know how difficult eating and swallowing can become but thankfully your dad isn’t experiencing all of that so far. I think you need better answers. There’s a lack of joined up care and the way things are now it’s not helping anyone in your dad’s situation. Because of his low appetite his diet might not be providing enough and his medication could be affecting absorption. The question is whether it’s OK to supplement without the risk of causing something else to go out of whack. Probably unlikely, but I understand the imperative to do the right thing. I don’t think there’s any harm in increasing magnesium rich foods in his diet until you feel confident about supplementation. For the record, I have tried magnesium supplements for ectopis but I don’t think they did anything. So far my AF is paroxysmal so I wouldn’t be able to tell how it could impact my AF. I wouldn’t rule out another trial though. I do make sure to have magnesium rich foods but I don’t know how palatable they would be to your dad eg pumpkin seeds, spinach, avocado, though you could disguise these foods in a soup that you could blend or liquidise.
He could try famotidine instead of lansoprazole as it doesn't have such an effect on magnesium. I'm allergic to PPIs so that's what i take to protect my stomach.
Many members on this forum supplement with magnesium and have found that it reduces their AF attacks. I take just 100mg of magnesium glycinate with my breakfast and feel it has helped. In fact it's often given intravenously to people with AF on admission to hospital or A&E. I had it once that way and I honestly thought I was dying, as its effect was that I couldn't move or speak. Somehow, they managed to see my distress (probably when I couldn't answer a question) and turned the drip containing it off.
I believe that whereas our food used to contain ample magnesium, it is now deficient due to the way its mass produced.
Here is a talk about magnesium from Cardiologist Sanjay Gupta who works at York hospital in the UK. Sorry this particular one is only available on Facebook:
After a couple of weeks of father feeling sick, and unwell, stomach pains, GP managed to get in touch with another consultant at the hospital to query whether it was necessary to change the medications given his medical situation.
Not stomach pains but I had a constant feeling of nausea the whole time I was on Sotalol.
Two weeks ago I was in hospital with tachycardia which was brought on by a new
anticholinergic ( similar to antihistamine in the way it works ) and even thou I take 125mg Mag.Taurate every day my blood test showed I was at the low end with magnesium. So I was put on the drip and luckily discharged the same day after having a blood test, urine test and x-ray.
If the nausea persists I would suspect it is the Sotalol and heart arrhythmia can be lessened by magnesium supplementation.
Thank you for your reply. This is the symptom father is struggling with but describes it as pain sometimes. we will get it reviewed by GP again as well as find out if a magnesium supplement will be helpful for him.
I read a book on the importance of magnesium, can't remember the author but she was rubbished by American doctors. I took her advice and had two years free of afib. I obviously had too much in my system then.
Father has been hospitalised twice with low magnesium and Fast AF in the space of a year. This would make me think the doctors would prescribe magnesium supplements knowing the rest of his medications lowers magnesium.
I don’t know how it works but armed with more info I can ask the health professionals about this now.
Sadly, I expect it's impossible to know for certain whether low magnesium is implicated in your father's condition. However, the consensus on this forum is that magnesium supplements are beneficial to sufferers of AF. I doubt that the medical profession are allowed to prescribe supplements for it, due to lack of research.
I'm with jeanjeanie that the root cause of all this is the modern food production methods, both the appalling degradation of the soil condition due to chemical application and aggressive 'production at all cost' approach, and also what is done to the food before it reaches the consumer.
My understanding is that low magnesium levels occur with age. I was diagnosed with it and it was also affecting my sleep. I've been getting extra magnesium supplements for a year now, and am convinced that it helps me sleep better. Studies in the US also show a link between Afib and lower magnesium levels. But please check it over with doctors.
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