AF, medication, histamine and rhinitis

[Canale]

Hi

I have now been through my third Cardioversion. Next step is Ablation if/ when the AF comes back.

Has anyone else experienced anything like this?

While in AF I had been having issues with Bisoprolol side-effects and blamed it on several things – medication brand, what time of day I was taking the meds or whether taking them with food, or what kind of food… I clutched at a few straws.

Around four weeks ago before CV I found a lump behind my left ear on my lymph node. I have had this before as I have rhinitis. It was diagnosed years ago and affects my left ear, left nostril and throat. When it flares up my lymph node swells. As usual I took Loratadine to treat the inflammation and in addition to reducing the swelling, which has now gone, all my side-effects stopped – immediately – and I felt as close to normal as I had done for a while. I have been keeping up the anti-histamine, and since Cardioversion I have felt great; ‘clear’ – clearer than the last time. Possibly just wishful thinking, but it does feel different.

Does anyone have any insight/ opinion as to whether there could realistically be a link between histamine levels, rhinitis and my AF? I have researched online, and what I do know is beta-blockers can cause rhinitis, high histamine levels can cause palpitations and arrhythmias, and high histamine levels cause rhinitis to worsen. Given the rapid clearing of symptoms once I started taking Loratadine I can’t help but think there is some kind of a connection.

I’m out of AF now, but if there is a chance I could help prevent it by managing histamine levels and in turn come off the medications I am on, I would be all for it. Flecainide is hardcore.

[En85]

I'm not sure about rhinitis, but what I learned from scanning research on AF is that at the moment they don't have a clue on the real pathogenesis of AF. Besides some obvious causes like pre existing heart conditions and heart inflammation, all the others, such as professional sport training and similar are not well understood.

I will be unpopular now, and say that everyone saying they control it with diet, vitamins, water temperature, exercise... are just practicing witchcraft. There is no scientific basis for that, but I understand we need sometime to feel in control of something that is not really up to us.

I agree flecainide is not fun and it is arrhythmogenic in itself. The most certain way to get rid of flecainide and on the longest term is to go for an ablation, that's what science says. I don't know your personal situation and I don't know if you have a specific reason to wait for AF to come back, but I personally went for ablation straight after my second cardioversion.

[Canale in reply to En85]

Yeah. I know the solution will most likely surgery. I think it’s an explanation I am seeking, rather than a cure.

I agree with you on the controlling it point. I don’t think you ever control it. You just find a balance make it liveable.

Waiting to see what happens after this third CV was the advice from the specialist- made sense at the time.

[En85 in reply to Canale]

I understand, I had similar advice from UK cardiologist, he was a bit surprised I wanted an ablation straight after the second cardioversion. My context was 2 cardioversions at 3.5 months from each other for persistent, I had nightmares thinking that my heart was not going to revert anymore and I would live on low power mode for the rest of my life😅 but some people had cardioversions lasting years, so in that case would make more sense to wait.

[Canale in reply to En85]

My first lasted four years. I would take that on the basis it’s an ablation after.

[Ppiman in reply to En85]

Well said! I have a theory that the pathogenesis for many is a slightly enlarged heart since it is known that the atrium likes to be its "natural" size and, if stretched, becomes arrhythmogenic. This is related to Western diet with us all being too fat and too lethargic, relative to the past, and thus having somewhat larger hearts.

Steve

[WildIris in reply to Ppiman]

That makes sense to me, and the post above about accepting lack of control does not. My experience with PAF is that I had a lot of episodes when I was fat, (with a slightly enlarged heart) but since giving up sugar and going vegan and exercising regularly and losing the weight-its been 3 years now-I normally have none. This seems like a not very modern diet, though the range of fruits and vegetables we spoiled folks have access to is very dependent on modern technology. Anyway, maybe my slightly enlarged heart shrunk a bit. I say normally because I recently had a severe allergic reaction to Paxlovid (itching and a bad rash), gained about 5 pounds of water weight, and took prednisone and had a few AF episodes. Now I'm back to normal weight/no more AF but I have lots of residual itching and use a lot of anti-histamine gel, which is what drew me to this post.

[Ppiman in reply to WildIris]

Well done and that was lovely to read.

I gather the heart most certainly does resize when weight is lost and becomes less "arrhythmogenic" as a result. It has a fixed number of cells and, as the body mass and size increases, it follows suit to pump more blood around. Sadly this means each of its cells needs to stretch slightly and that seems not to be a good thing at at all. It seems its ability to return to normal size might diminish after a certain age but still it seems sound advice to reduce weight and increase daily exercise. We are fools to ourselves in so many ways in this country and really must, for the sake of our health, of the NHS and of our families, get our weight down and exercise up and back to something more healthy.

Steve

[OzJames]

this might be nothing but if your taking vitamins like me it is recommended to take them 2 hours either side of drugs like Beta Blockers and Flecanide. I was told it can interfere with absorption of the drugs. I have read that higher histamine levels can trigger AF in some so maybe check with cardiologist about drugs you are taking