On BiPap for the last 4 years - been having headaches, dizziness and fatigue and noticed that my pulse is low sometimes - dipping to the low 40's. Mentioned this to my fam dr - sent to do Holter monitor and the cardiologist called me tonight and gave me the diagnosis. I have sick sinus syndrome - a combination of tachycardia and bradycardia. He is setting me up to be evaluated for a pacemaker and he is starting me on coumadin next week. Needless to say - i am quite concerned and frightened - he questioned me about my use of the BiPap - told him that the info that my machine gives me is - AHI average for the last month is 2.1 and AI is .2 - course he had no clue what those figures meant. I said I thought those were within the guidelines of successful treatment since I had been retitrated back in June.
My question - anyone else have this atrial fibillation and I'm wondering - could it have been caused by all the untreated years with SA - I mean who knows how many years I had SA before someone thought to check it.
Pers. Info - I'm a 58 yo overweight female - cancer survivor (no chemo) and yes I am considering a second opinion - I really don't want a pacemaker or to take coumadin (side effects). So anyone with a pacemaker or on coumadin - please email me or post.

It sounds like you are getting excellent results from your BiPap. I would doubt that your cardiac arrhythmia has anything to do with your current treatment for SA. Whether past years without treatment contributed to your condition seems beside the point. Heart disease can have many causes and multiple causes, so who can sort that out now.

I certainly don't blame you for not wanting to have a pacemaker or take Coumadin. However, many people live ordinary lives with both. The older I get, the more people I know who are taking Coumadin, often for years on end with no real disruption of their routines.

It is perfectly reasonable to want a second opinion. However, this kind of alternating fast and slow rhythm can generate blood clots and a risk of stroke, so it is a matter of urgency. Dips in oxygen saturation at night can trigger arrhythmias, so it is fortunate that you are getting good results now, and it would be the worst time to take a break from BiPap. Otherwise, though, the heart problem seems like a separate issue from your SA, and I think I'd be prepared to take the cardiologist's advice about treatment.

Thanks for your response - I am an anxious type so calling me at 5:30 with those results - then asking me to do an MRI (I'm extremely claustrophobic) and then mentioning the pacemaker and the coumadin - made my head spin and I had an awards ceremony for one of sons to go to at 6:30. He set me up with the electrophysicist (sp) for Dec 11 and said his secretary will call me re: the coumadin and MRI. So now I have to wait three weeks to see the consultant and I am a worrier so it will be a long three weeks. I don't know anyone with a pacemaker or on long term coumadin so this is new territory for me. I am very concerned about going to sleep tonight - even though my data has been good - I have not been sleeping well and have been having bad headaches. Thank you for responding.

I was diagnosed with AFIB (atrial Fibrillation in May and my cardiologist strongly suggested a sleep study which I had 2 months later. In his 5 offices over half his patients with AFIB also have sleep apnea. Years of sleep apnea plus also being quite athetic all my life and still train heavily contributed to this chronic condition. Some famous athletes with AFIB are Bill Bradely, Larry Bird, Derrick Coleman. Big Pappi of BOSOX, Jerry West etc... Anyway being in great shape with no underlying heart disease (my stress test was perfect), no diabetes or high blood pressure and Cholesterol levels low with low triglycerides I only take Multaq an ani-arrithmic new medication but no rat poison blood thinners. Because threat with afib is strokes blood clots originating from the heart. Go here to educate yourself :

http://www.afibbers.org/toboards.htm

http://www.afibbers.org/homepage.htm

Hi, until you do see the doctor, can I suggest you at least try sleeping on your side (if you normally sleep on your back) as back sleeping always produces more apneas, and if you have any acid reflux, try raising the head of the bed just a few (4-6) inches, as well as maybe cutting out alcohol or coffee near bedtime (though I imagine you don't drink much coffee anyway). If you have a recliner, can you try sleeping in it (but not flat on your back of course) semi-upright?

Might investigate the following:

Stabilization of heart rhythm via supplemental magnesium (not the oxide form, that's only good as a laxative...I take magesium citrate 600-800 mgs/day which eliminated palpitations, migraines, and has my cardiologist approval). Almost no side effects unless you start gulping Milk of Magnesia, loose stool if you take waaay more than you need. The RDA for women is 320 mgs/day. It used to be in our water, but processing removes it so it's been estimated that 75% of us are deficient..it's used in over 300 biochemical reactions in our body including being critical to heart rhythm, building bone, relaxing smooth muscle tissue such as heart, lung, lining of our blood vessels. Almonds are a good source.

Radio ablation of the firing centers in the heart that cause the extra beats (if that's the cause of the AFIB or tachycardia) my mom works with 3 women in their 40s who've had that procedure -- all successful and all had different doctors. Sounds scary but it's been around for years. I have a dear friend who's been on coumadin for several yrs in lieu of this procedure and now he's tired of the side effects -- his AFIB is from extra firing centers.

Good luck on finding a great resolution!

I have a pacemaker - I got in November 25, 2008. I have had no problems with it, it is easier to deal with than cpap therapy.

I am also 58 and a cancer survivor.

I sent you a message on your yahoo account.

I don't have AFIB, but my uncle does. He also has sleep apnea and doesn't use therapy (I'm trying to change that). He is a pharmacist and also takes Coumadin with no problems (Your Mileage May Vary).

Sleeping on your left side can trigger AFIB from what I understand, so if you sleep on your side try sleeping on your right side. I believe sleep apnea is a big factor in AFIB. Best of luck to you, and take slow breaths... I'm a worrier, too (panic disorder).

Atrial fibrillation is more of a symptom than a disease in and of itself. It can have many causes. Peljbl reports having been diagnosed with something quite specific: the variant of sick sinus syndrome in which the heart alternates between tachycardia and bradycardia. "Sick sinus syndrome" is a funny name, almost like a made-up disease, but it's real. Mayo Clinic has a good discussion at http://www.mayoclinic.com/health/sick-s ... me/DS00930, and the treatment discussed there sounds just exactly like what peljbl's doctor is saying. If it were me, I would be hesitant to self-treat this with remedies that might have been recommended for some other cause of afib.

PST wrote:...If it were me, I would be hesitant to self-treat this with remedies that might have been recommended for some other cause of afib.

Great advice! Know what the cause is, precisely.

Oh, I forgot to add re the MRI. This is what the doc did for my mom who is really claustrophic and needed a brain scan last yr -- if your doc approves. Her doc gave her an Rx for one 10 mg Valium tab with these instrucitons: on an empty stomach take it with water 10 mins before arrival at the hospital (I drove and pulled over so she could take it). It hit her like a ton of bricks!!! She was the happiest "drunk" I've ever seen -- I couldn't leave the car to get a wheelchair 'cause she wanted to walk and couldn't move in a coordinated way she was so high, one of the residents had to come out and help us get her in. When they got her registered and ready for the test, I gave her a washcloth to cover her eyes and reminded her to close her eyes when they were ready to move her inside. IT WORKED! No anxiety, no panic attack, no hysterics. The dye they used and her calm helped them get a great scan that revealed all the areas under investigation were completely normal -- what a relief! As I have the same problem with claustrophobia, I will use this method if I ever have to have a closed MRI and the doc approves this method. Gotta have someone else drive and physically help you unless you are habituated to Valium. We stopped for a bagel afterwards, went home, and she slept the rest of the morning. Oh, we did this really early, 6:30 AM if memory serves.

Muse is right on.

My plumber diagnosed me with atrial fibrillation last year and put me on Metropolol which then induced bradycardia into the low 40's.

A few months ago as I was researching muscle cramps, I came across a link between magnesium deficiency and arrhythmias. Turns out that after I started supplementing with Mg, the the muscle cramps, twtiching and arrhythmias all went away. Been off the metropolol for 3 months now and no arrhythmias and heart rate is back to normal low 60's.

I had even told the cardio doc that it was weird that I was experiencing muscle cramps and twitching only on the left side of my body and he totally ignored that bit of information and instead Rx'd the metropolol.

I would go ahead and supplement with Mg as Muse suggests while you are waiting for follow-up with your doc.

Well - my cardiologist tested for magnesium and it came back 1.9 (normal is 1.6 - 2.6) so he would not consider that that is my problem but I looked at the list of symptoms for magnesium deficiency and I agree - I have so many of those symptoms. I only have one kidney - had one removed due to kidney cancer - called my nephrologist and asked about supplements - he said no since I was in normal range. Info from several websites say that serum magnesium results are not always indicative of a deficit - so i have decided to increase my intake of nuts, green leafy vegetables to see if I can alleviate some of my symptoms. I have to wait three weeks until seeing the electrophysiologist so maybe I can start to feel a little better. I will explore the possibility of magnesium deficit with him. Thanks for your help.

I do not have AFIB, but I have something related-- Paroxismyl Aricular Tachacardia (PSAT). Tends to occur randomly, but it is more common when I am under stress, or 'coming down' after a stressful time. Caffeine and chocolate have a minor effect on it. I have also noticed that, just like AFIB, sleeping on my left side can trigger an 'attack'. Most of the time, if I catch it starting, I can immediately 'convert' it with a sharp, deep breath. But sometimes, I have to just relax, or lay down if I can. These attacks rarely last more than a few minutes (but some people have it go on for days).

Losing weight and eating a low carbohydrate diet seem to help this condition a lot. CPAP therapy seems to have helped as well, and if it starts while 'on the mask', it usually is easy to stop.

peljbl,

Sorry to be late to this topic but I just found out about it today.

It' s very likely that past untreated sleep apnea (or maybe your current BiPap settings are not optimal) is a possible reason that you are dealing with atrial fibrillation. Untreated sleep apnea is a very common cause of atrial fibrillation, and up to half of those with atrial fibrillation also have sleep apnea. Recent research (see link #2 below) indicates that the odds of an irregular heartbeat are 18 times greater after an apnea than after normal sleep breathing.

Atrial fibrillation (afib) is a very difficult condition to deal with so I'd encourage you to learn everything you can about it. Here are some helpful resources about the relationship of sleep apnea and afib, and you'll find much more on the site about treating and managing afib:

(1)What Causes Atrial Fibrillation: http://stopafib.org/causes.cfm (the section on sleep apnea is about halfway down the page)
(2)Sleep Apnea Multiplies Risk of Arrhythmias Like Atrial Fibrillation: http://stopafib.org/newsitem.cfm/NEWSID/211

After being "cured" of atrial fibrillation by surgery, I couldn't stand on the sidelines and watch others suffer so I started a resource to help those with atrial fibrillation (StopAfib.org). It was only after I was cured of afib that we discovered that I have sleep apnea. It often runs in families and we subsequently discovered that my mother also has afib and sleep apnea, and we believe that my grandmother may have as well.

Many people find that taking magnesium glycinate and staying properly hydrated can help, and most doctors that specialize in afib will confirm this. In addition, omega-3 fatty acids (from fish or fish oil) are highly recommended by doctors as they have been scientifically proven to head off arrhythmias (http://stopafib.org/newsitem.cfm/NEWSID/181/).

Regarding the sick sinus syndrome, are you on any kind of medication, such as a beta blocker for blood pressure, that could suppress the heart rate? Some beta blockers can "cause" atrial fibrillation in some people.

Please make sure you do your homework before you get a pacemaker. A pacemaker is good, but please don't let them talk you into an AV node ablation--pacemakers are often put in as step 1 to prepare the patient for an AV node ablation. AV node ablation is the treatment of last resort and there are so many other options to consider first. (Here's why: http://atrialfibrillationblog.com/av-no ... t-have-it/)

Good luck.

Mellanie