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meds and nightmares cause fast heart rate and possibly a-fib
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meds and nightmares cause fast heart rate and possibly a-fib

I take hyzaar 50/12.5 and taztia for diltiazem 120 mg.

I slept well at night except for a very occasional episode of very fast heart rate when waking up out of sleep.  Now it has been too often that I have vivid dreams and also awaken with a very rapid heart rate and sometimes irregular beat.  It was enough that I have called EMS until I am embarrassed.  However, after being treated like a real panic attack case, I had atrial fibrillation in February.  

The cardiolosits, two of them and my family Dr. all thought I was an anxiety case until the atrial fibrillation.  Now they are all somewhat puzzled.  I am still on the same medications.  I hate to say this , but I do not feel that anyone has asked enough questions in my case to put it together.  Expecially since I was seeking help before the a- fib  attack.  I have been awaking from a sound sleep very rarely for years with the rapid heart beat attacks in the pre-med days.  Since both meds were given this has happened way too often.  Is there a connection?  I just do not know.    

Has anyone else had this problem on these medications?   It is terrible waking up like this.  Is it something with the heart or not.  Could anyone comment on this?  Thanks

lanakaye
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well. what meds are they.  were they prescribed by the same Dr?  Did you check if they are compatible to take together?
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Avatar_f_tn
emergency medical services I would suppose
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97628_tn?1204465633
Could be meds, depedning on what they are, but andrenergic stress ( anxiety would fit into this category) can also trigger A-fib from what i understand.
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Avatar_n_tn
Thanks for your input.  Would anxiety alone and when you are asleep cause this?  Or would you have to have another physical problem with the heart for it to result in a-fib? I thought adrenalin might be a factor .
Thanks

lanakaye
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Avatar_n_tn
Yes, they were prescribed by the same Dr.  They are supposed to be compatible, but then I rely on him and on the pharmacist for knowing that for sure.  How would I find out?  EMS does stand for emergency medcial services.  
Some of whom have been wonderful and some of whom have been unduly rude.
We decided that my husband might drive me to the hospital if I ever have  a problem again since a[fib is nothing to laugh at.  I was horrified when I called someone who treated a heart episode so rudely.


Thanks,


lanakaye
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97628_tn?1204465633
It is not professional to treat any patient rudely. I am sorry to hear that this happened to you. If you Google the words adrenalin and A-fib together you may get more info on what can lead to A-fib. At least take comfort in the fact that it isn't immediately dangerous but you do want to get back to sinus rhythm.

This is an old entry on this board:

Adrian Lewis (UK)
12/9/1999
C4  . re. your answer ". The longer a patient is in afib, the more difficult and less likely it is to restore sinus rhythm. This is due to remodelling of the atrial muscle": I experience AF once or twice per year, always starting with me waking up in the small hours often feeling as if I've had a bad dream. I have always suspected adrenalin as a causal factor. Could this be so, and are there drugs which can control adrenalin secretion during my sleeping hours? Also, how long does it take for remodelling of the atrial muscle? Thanks.

CCF CARDIO MD - DLB
12/10/1999
C5  . The remodeling I refered to likely occurs over weeks to months of being in afib. Adrenaline certainly can trigger atrial fibrillation. Beta blockers can blunt surges in adrenaline.
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Avatar_n_tn
Thank you so very much.  You are a wonderful lady!  I appreciate the caring you have shown in trying to help.  God bless you.  I shall do just as you have shown me.  You do not have to answer this, but you must be a nurse or doctor or medical person.  If not, the profession needs some like you.  Information is wonderful! All most of us need is reassurance and to be able to understand what is happening to us.  Some treat us as if our own medical info is priviledged to them.  I cannot understand this response to any question.    Thanks again!  



lanakaye
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Avatar_n_tn
Thank you so very much.  You are a wonderful lady!  I appreciate the caring you have shown in trying to help.  God bless you.  I shall do just as you have shown me.  You do not have to answer this, but you must be a nurse or doctor or medical person.  If not, the profession needs some like you.  Information is wonderful! All most of us need is reassurance and to be able to understand what is happening to us.  Some treat us as if our own medical info is priviledged to them.  I cannot understand this response to any question.    Thanks again!  



lanakaye
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Avatar_n_tn
Do you know whether a-fib is likely to happen again once it happens the first time?  I did not know whether this means that there is an intrinsic problem with the heart that would be most likely to have this response.  
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66068_tn?1365196781
"Do you know whether a-fib is likely to happen again once it happens the first time?"

My understanding is that it takes a combination of two things to cause afib: (1) a willing substrate (atrium); and (2) a trigger (usually PACs). The pulmonary vein isolation (PVI) rf ablation method targets the PACs and is very effective in curing afib in most people (those with not too willing an atrium). The substrate/atrium can become overexcitable due to a chemical imbalance (say a magnesium deficiency or heavy alcohol use [ "holiday heart"]) or a dysauthomia (e.g., vagal nervous system causes) or may be due to atrial enlargement which makes the setup of multiple reentrant wavelets needed for afib easier. I have an enlarged atria and have been told I would as a result be a poor cabdidate for an ablation.

It's likely your atria are not nornally susceptable (i.e, enlarged or chemically imbalanced) except for those times when your anxiety level rises to the point of pumping large amounts of adrenalin into your heart. That causes the heart tissue to become easily excitable. So it's important to control any anxiety.

Best wishes

Tony
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Avatar_n_tn
Thank you so much, Tony.  This is the best explanation I have ever been given .  It tells me much more than I have been able to look up on my own for sure.   I am just one of these people who wants to know what caused something and if there is anything I can do to prevent it.  I really appreciate this.  

Just before I was discharged from the hospital after my first and very much a surprise attack in February, my atrium was mentioned as being just under the enlarged size, 3.8.    This was by my family Dr. The cardiologist had never mentioned this at all.  I have mild left ventricular hypertrophy and that was a surprise too.  Found that out two years ago.

What do you do about your a-fib?  Have you had several attacks, just one or is it  there all the time?  Do you  have irregular heartbeats?   Are you just told , Don't worry about it?  I hope that all will be fine and I trust that it will.  Thanks again for a more than great explanation.  Thanks for trying to help me.  You did ! More than you know.



lanakaye
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66068_tn?1365196781
I  wouldn't call an atrium of 3.8 cm enlarged but it is borderline normal.  Mine is about 5.5 cm.

I've had afib for about 35 years.  30 years of that time I was not taking meds. The afib would come for a few hours and then disappear for several months. Then about 5 years ago, it became chronic (continuous).  By the time I saw the cardiologist, was put on an anticoagulant for the required month or so, and scheduled a cardioversion in the hospital, I had been in continuous afib for a couple of months.  Fortunately, I was started on rythmol at that time and after the cardioversion, that med kept me largely in normal sinus ryththm for the last 5 years. Unfortunately, the rythmol is letting me down recently.  The last couple of months I've been in and out of afib for several weeks at a time. I'm relatively asymptomatic and so it doesn't affect my lifestyle in the least. I can live with the palps whenever they occur (not often...usually after a couple of beers). I've discussed surgical techniques with an EP for ridding myself of afib (such as the min-maze) but was told that it really doesn't make sense to take such a risk for an asymptomatic case of afib. My cardiologist is trying to talk me into just living with afib.  A large scale afib study several years ago (AFFIRM) demonstrated that folks like myself are better off with rate control (taking meds to lower heart rate while in afib) than to try heroic efforts to cure it. In fact, the rate control patients statistically lived slightly longer and spent less time in the hospital.

So if afib eventually becomes a problem for you (unlikely), it won't kill you. It's relatively benign (as long as you take aspirin or coumadin to prevent a stroke).

By the way, I also take diltiazem (brand name cardizem) 240 mg/day to control blood pressure (and heart rate while in afib) as well as 25 mg/day of HCTZ (the generic of  hyzaar) for BP.  I'm very happy with both drugs.

Tony
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Avatar_f_tn
tony, is the knowledge that you have from patient study or have you worked in the medical field?  Your information is generally smack on and well thought out.
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66068_tn?1365196781
Bet

No medical training.  What I know about afib is from reading, the internet and talking to my doctors. My formal training is in physics (Ph.D. Cornell U.) and having worked professionally in science for 40 years have learned to cut through the jargon and devise simple physical models to visualize what's happening. I enjoy learning about new things and, in this case, self-preservation is a motivating factor. I've also recently been diagnosed with CAD and am attempting to come up to speed in that area.

Regards

Tony
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351404_tn?1299492730
At last someone else who wakes with an adrenalin rush and goes into AFib.  It doesn't matter if it is a brief nap in an armchair, the waking is always the same, making me shaky and thumping heart, if not going into AFib at that point.  I don't think I am stressed or anxious and think it is purely a physical trait.  I find very deep in breaths help ward off the adrenalin but whether it could be meds or not, I don't think this has ever been investigated as a whole.
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