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Suggest Treatment For Irregular Heart Rate, Atrial Fibrillation And Prostate Cancer
Question: I had radiation treatment for prostate cancer 4.5 years ago and was put on tamsulosin 400mg permanently. About 2 years ago I was diagnosed with Atrial Fibrillation after 1 attack. I was then put on bisoprolol 3mg but had to reduce this to 1.5 and then come off it altogether due to slow heart rate (down to 40bpm ). For the past 6 months I have been suffering with an irregular heartbeat which has been quite distressing usually at night. I have still been taking the Tamsulosin plus Wafarin prescribed after the a/f episode. I have done some research and found that the irregular heart rate can also be caused by low magnesium and potassium levels neither of which I have had checked. So about 6 to 8 weeks ago I modified my diet to include foods high in these elements mainly fruit and more green veg (careful due to effect on Warfarin) plus a good portion of nuts every morning .. Mainly Brazil, cashew and walnuts. I have been taking these in the form of smothies every morning. I have not taken any supplements yet but intend to ask my doctor about these. My irregular heart rate has improved greatly over the past few weeks and I wonder if This may be caused by the diet change. I also wonder if I should reduce the Tamsulosin by taking a tablet every other day.
Brief Answer:
I would like you to answer a few questions.
Detailed Answer:
Hi,
Wellcome to health care magic.
I am Dr.Muhammad Ahmad , Resident of M.D Cardiology, i have read your question in detail and will try to answer you in the best possible way.
I understand your concerns fully and would like to admire your will to make you health better with natural methods.
I would like you to answer a few questions these will help me guide you in a better way.
1- How often do you get altered pulse?
2- Do you have any ECG which you can upload? or any report.
3- How are your urinary symptoms now?
4- Have you ever counted your per minute pulse rate while having a disturbed pulse episode?
5- Nay history of transient stroke?
6- Any history of heart attack or pain?
Answers to these questions will really help me to give you a better answer waiting for you input.
Dr.Muhammad Ahmad
Resident Cardiology.
I would like you to answer a few questions.
Detailed Answer:
Hi,
Wellcome to health care magic.
I am Dr.Muhammad Ahmad , Resident of M.D Cardiology, i have read your question in detail and will try to answer you in the best possible way.
I understand your concerns fully and would like to admire your will to make you health better with natural methods.
I would like you to answer a few questions these will help me guide you in a better way.
1- How often do you get altered pulse?
2- Do you have any ECG which you can upload? or any report.
3- How are your urinary symptoms now?
4- Have you ever counted your per minute pulse rate while having a disturbed pulse episode?
5- Nay history of transient stroke?
6- Any history of heart attack or pain?
Answers to these questions will really help me to give you a better answer waiting for you input.
Dr.Muhammad Ahmad
Resident Cardiology.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
1. I used to get them every day and night they were particularly noticeable at night and woke me up several times. During the day they were barely noticeable particularly if I was taking exercise which seems to help a lot but I think that they are still there. Now I seem to get them less often and they are not as bad... ie. irregular
2. I do not have an ecg that I can upload but have had them after hospital admission and cardiologist did not advise any treatment but just to try and take my mind of the problem at night by taking a walk around the house I suppose to get my heart rate up, and not cut down on excercise during the day. If I do get them at night it is usually while I am sleeping on my side ( either side) and seem to subside if I lie for a while on my back
3 my urinary symptoms are ok at the monent I get up usually only once maximum twice a night to visit the toilet. However I have not had an extended period off Tamulosin.
4 No I have not done a careful check of pulse rate during an episode but my GP did a check when he took me off Bisoprolol and indicated it was varying between 35 and 80 bpm
5 about 12 years ago I was 'suspected' to have had aTIA but it could not be 100% confirmed
6 no history of heart attack and I have never had any pain however I have a history of excess histamine production which sometimes shows as itchy blisters or swellings which are treatable with anti histamines this happens particularly if I am under stress or emotional situations and is a long standing condition.
I should also advise that I take regular excercise, I walk around 1 mile or even slightly more every day or alternatively swim about half to one kilometre, I also try and play golf once a week. I don't smoke or drink alcohol.
Hope this additional information helps, as I said I have an appointment for a review with my GP this week and was really wondering if you could advise what I questions I should ask or even if I should ask for specific tests and of course if you think my diet change is a good thing for this condition and if it may be contributing to the improvement I have noticed.
Thank you
Hello,
Just an addition to my earlier reply.
About 5 or 6 years ago I was diagnosed with very mild aortic stenosis and was under yearly review by echo sound at the hospital but 2 years ago with no progression or additional symptoms I was referred back to my GP for check ups. Also I have also been diagnosed some years ago with a mild heart murmur but have no idea how long I have had that since I know that they can be long standing complaints.
Sorry I did not mention this in my last reply. Also I am on Warfarin at the moment 17mgms a week aiming at an INR between 2 and 3 but this has been affected a bit by my recent change in diet so am due for another test end of February.
2. I do not have an ecg that I can upload but have had them after hospital admission and cardiologist did not advise any treatment but just to try and take my mind of the problem at night by taking a walk around the house I suppose to get my heart rate up, and not cut down on excercise during the day. If I do get them at night it is usually while I am sleeping on my side ( either side) and seem to subside if I lie for a while on my back
3 my urinary symptoms are ok at the monent I get up usually only once maximum twice a night to visit the toilet. However I have not had an extended period off Tamulosin.
4 No I have not done a careful check of pulse rate during an episode but my GP did a check when he took me off Bisoprolol and indicated it was varying between 35 and 80 bpm
5 about 12 years ago I was 'suspected' to have had aTIA but it could not be 100% confirmed
6 no history of heart attack and I have never had any pain however I have a history of excess histamine production which sometimes shows as itchy blisters or swellings which are treatable with anti histamines this happens particularly if I am under stress or emotional situations and is a long standing condition.
I should also advise that I take regular excercise, I walk around 1 mile or even slightly more every day or alternatively swim about half to one kilometre, I also try and play golf once a week. I don't smoke or drink alcohol.
Hope this additional information helps, as I said I have an appointment for a review with my GP this week and was really wondering if you could advise what I questions I should ask or even if I should ask for specific tests and of course if you think my diet change is a good thing for this condition and if it may be contributing to the improvement I have noticed.
Thank you
Hello,
Just an addition to my earlier reply.
About 5 or 6 years ago I was diagnosed with very mild aortic stenosis and was under yearly review by echo sound at the hospital but 2 years ago with no progression or additional symptoms I was referred back to my GP for check ups. Also I have also been diagnosed some years ago with a mild heart murmur but have no idea how long I have had that since I know that they can be long standing complaints.
Sorry I did not mention this in my last reply. Also I am on Warfarin at the moment 17mgms a week aiming at an INR between 2 and 3 but this has been affected a bit by my recent change in diet so am due for another test end of February.
Brief Answer:
Here is a detailed reply.
Detailed Answer:
Hi
Thanks for writing back,
I am pleased to get such a detailed reply back from you.
Here i would like to get as comprehensive as i can get and i hope your questions get
covered up in my answer. Still if any of your questions get missed by me or my answer raises
some more questions in you mind, you can ask me in yet another follow up question.
Complications of A-Fib:
Mostly it is not life threatening, but it can be annoying and it can cause TIA by throwing up blood clots to your brain that is the reason
you are being put on warfarin so that clots don't get formed and if there are any clots formed they get broken or lysed,in medical language.
Can electrolyte imbalance be a cause of A-Fib?
Yes it can be a cause but very rarely, in a patient who has reasons of electrolyte imbalance like nutrition deprived,
kidney failure, liver failure, enzyme problems , gut issues, corrosive intake, gut strictures, profuse vomit etc.
TAKING MAGNESIUM AND POTASSIUM rich foods can be helpful if you are not over eating them , taking electrolyte supplements is not required if you dont have any mal-nutrition or gut or any other medical issues.Your A-fib might have got better with magnesium intake though theoretically it isn't expected if it was normal on lab reports, but still if it has got better it is great but you don't have to take an over intake of magnesium in the form of supplements.
How can A-Fib be dealt:
You are most probably suffering from chronic A-Fib this goes on for years and years and doesn't cause any harm for a patient on warfarin,and whose heart rate is controlled.
The only harm it does cause is irritation , palpitation,anxiety and sense of abnormality.
What is the best treatment for A-Fib:
Best treatment for A-Fib these days is catheter ablation. You can discuss this option with your Gp and your cardiologist,It has 90% success rates unless A-Fib has some etiology which can not be treated with it or a new focus of impulses get developed which cause A-Fib. I am quite happy that you are very well aware of your health condition so i would like you to read about ablation too.
What can be done other than intervention (ablation)?
Other than ablation we go for rate control with beta blockers, like you got started with bisorolol but as your heart rate got lower than safe limits (35) they decreased the dose and then stopped it.
You were started with warfarin to protect you from clots fired into your brain and other parts of body.
Your life style:
Your healthy life style like swimming and walking is good if you don't get too aggressive and don't over exert they can be of real health.
What you won't like is putting extra pressure on your heart. Swilling a couple of miles shows me how well you are maintaining your health. I expect you to keep doing so in future too.
Your diet modifications:
Well if you have aortic stenosis, you gotta avoid extra salt intake , and control your blood pressure , other wise if your echo hasn't shown any
deterioration of the heart function, hypertrophy of left ventricle, severe diastolic dysfunction and worsening of stenosis, you can definitely lead a normal life with minor diet modifications and regular check ups.
Nuts you are taking can definitely help but don't over eat them , avoid salted and fried ones plus don't eat more than 10-15.
It's great to know that you don't smoke or drink, indeed you are doing yourself a favour by avoiding these things.
Tamsulosin:
You asked me if your can get off tamsulosin after these diet modifications, actually tamsulosin is suggested to control urinary symptoms of a person with prostate issues, I would suggest you to talk to your respective doctor about dose reduction, using nutrient rich diet and exercise don't always guarantee an improvement in urinary symptoms, sometimes a patient shows improvement with time as he recovers and we reduce the dose of tamsulosin , you can discuss it with your G.P or urologist if they suggest you can definitely give it a try , they might reduce the dose instead of alternate day dosing , but for that they should see convincing evidence that you have recovered enough and showing enough improvement, this can be discussed.
Heart Murmur:
It's just an extra sound in heart most probably due to stenosis if heart valves are fine and stenosis isn't affecting much, then you don't have to worry much.
Possible causes of heart rate improvements:
1- You are leading an active life style so you might be sleeping better and not noticing heart irregularities.
2- Your sub conscious is making your sleep in those postures in which you get lesser disturbance due to A-Fib. This is a very common defence mechanism.
3- Due to diet and healthy life style changes.
Suggestion:
Don't panic and discuss all the things with your GP , if any more questions are raised in your mind, I am happy to answer , Otherwise rate and close the discussion.
You can always write to me about all your general issues specially heart issues at :
http://doctor.healthcaremagic.com/doctors/dr-muhammad-ahmad/69304
Dr. Muhammad Ahmad
M.B.B.S
Resident M.D Cardiology.
Here is a detailed reply.
Detailed Answer:
Hi
Thanks for writing back,
I am pleased to get such a detailed reply back from you.
Here i would like to get as comprehensive as i can get and i hope your questions get
covered up in my answer. Still if any of your questions get missed by me or my answer raises
some more questions in you mind, you can ask me in yet another follow up question.
Complications of A-Fib:
Mostly it is not life threatening, but it can be annoying and it can cause TIA by throwing up blood clots to your brain that is the reason
you are being put on warfarin so that clots don't get formed and if there are any clots formed they get broken or lysed,in medical language.
Can electrolyte imbalance be a cause of A-Fib?
Yes it can be a cause but very rarely, in a patient who has reasons of electrolyte imbalance like nutrition deprived,
kidney failure, liver failure, enzyme problems , gut issues, corrosive intake, gut strictures, profuse vomit etc.
TAKING MAGNESIUM AND POTASSIUM rich foods can be helpful if you are not over eating them , taking electrolyte supplements is not required if you dont have any mal-nutrition or gut or any other medical issues.Your A-fib might have got better with magnesium intake though theoretically it isn't expected if it was normal on lab reports, but still if it has got better it is great but you don't have to take an over intake of magnesium in the form of supplements.
How can A-Fib be dealt:
You are most probably suffering from chronic A-Fib this goes on for years and years and doesn't cause any harm for a patient on warfarin,and whose heart rate is controlled.
The only harm it does cause is irritation , palpitation,anxiety and sense of abnormality.
What is the best treatment for A-Fib:
Best treatment for A-Fib these days is catheter ablation. You can discuss this option with your Gp and your cardiologist,It has 90% success rates unless A-Fib has some etiology which can not be treated with it or a new focus of impulses get developed which cause A-Fib. I am quite happy that you are very well aware of your health condition so i would like you to read about ablation too.
What can be done other than intervention (ablation)?
Other than ablation we go for rate control with beta blockers, like you got started with bisorolol but as your heart rate got lower than safe limits (35) they decreased the dose and then stopped it.
You were started with warfarin to protect you from clots fired into your brain and other parts of body.
Your life style:
Your healthy life style like swimming and walking is good if you don't get too aggressive and don't over exert they can be of real health.
What you won't like is putting extra pressure on your heart. Swilling a couple of miles shows me how well you are maintaining your health. I expect you to keep doing so in future too.
Your diet modifications:
Well if you have aortic stenosis, you gotta avoid extra salt intake , and control your blood pressure , other wise if your echo hasn't shown any
deterioration of the heart function, hypertrophy of left ventricle, severe diastolic dysfunction and worsening of stenosis, you can definitely lead a normal life with minor diet modifications and regular check ups.
Nuts you are taking can definitely help but don't over eat them , avoid salted and fried ones plus don't eat more than 10-15.
It's great to know that you don't smoke or drink, indeed you are doing yourself a favour by avoiding these things.
Tamsulosin:
You asked me if your can get off tamsulosin after these diet modifications, actually tamsulosin is suggested to control urinary symptoms of a person with prostate issues, I would suggest you to talk to your respective doctor about dose reduction, using nutrient rich diet and exercise don't always guarantee an improvement in urinary symptoms, sometimes a patient shows improvement with time as he recovers and we reduce the dose of tamsulosin , you can discuss it with your G.P or urologist if they suggest you can definitely give it a try , they might reduce the dose instead of alternate day dosing , but for that they should see convincing evidence that you have recovered enough and showing enough improvement, this can be discussed.
Heart Murmur:
It's just an extra sound in heart most probably due to stenosis if heart valves are fine and stenosis isn't affecting much, then you don't have to worry much.
Possible causes of heart rate improvements:
1- You are leading an active life style so you might be sleeping better and not noticing heart irregularities.
2- Your sub conscious is making your sleep in those postures in which you get lesser disturbance due to A-Fib. This is a very common defence mechanism.
3- Due to diet and healthy life style changes.
Suggestion:
Don't panic and discuss all the things with your GP , if any more questions are raised in your mind, I am happy to answer , Otherwise rate and close the discussion.
You can always write to me about all your general issues specially heart issues at :
http://doctor.healthcaremagic.com/doctors/dr-muhammad-ahmad/69304
Dr. Muhammad Ahmad
M.B.B.S
Resident M.D Cardiology.
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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