Paroxysmal atrial fibrillation triggered by alcohol

[MagickalKat777]

I've just now learned of the so-called "holiday heart" and realized that I have PAF. I'm well aware of the drugs and the mortality associated with them. It only takes one beer to trigger it with me but after about 7 or 8 it's gone until the next day where I get all the signs of CGF including being unable to catch my breath and the tachycardia. My question is... I've heard that cayenne pepper can stop tachycardia and even a heart attack in its tracks. So I ordered two pounds of cayenne (which I love anyway so it's not a big deal) but my curiosity lies in the fact that what I've been able to find shows no mechanism of action for cayenne pepper, specifically capsaicin, to be able to not only stop arrhythmias but actually prevent them. I'm curious if all these years of panic attacks could be PAF and that the reason why I could never get off of benzodiazepines is not because of GABA down regulation but because of benzodiazepines, even in the low dose I'm on (20mg of diazepam a day), hitting something that counteracts PAF. See, I can take 5mg of Klonopin and I don't feel anything except for the fact I'm tired. No anxiety relief. Xanax actually makes my PAF worse to where I can feel a "skip" every other beat when it hits me. The same goes for etizolam but curiously flubromazepam has the same calming effect on PAF as Valium does. Obviously it takes longer than Valium but when it hits, my heart goes back to a normal rhythm rather quickly.

So here is the question. Does anyone know the link between capsaicin, diazepam, and flubromazepam that stops PAF in its tracks? I mean let's face it. I've been on 20mg of diazepam since 2010. Before that I reached 6mg of clonazepam and before that 8mg of alprazolam. The curious thing is that I was on 3mg of clonazepam for 3 years yet I was able to cut over to 60mg of diazepam and taper that down over the course of a month to 20mg and I've been stable on that dose for 5 years.

Studies have shown cayenne pepper to stop PAF within 10 minutes, diazepam doesn't hit for about 15 but has a calming effect on PAF. Clonazepam has no effect, alprazolam has a worsening effect, and etizolam is just too inconsistent and flubromazepam takes long enough that the PAF could have resolved on its own.

I should note that marijuana triggers PAF in me too, even high CBD strains like Harlequin, which marijuana is known to trigger PAF episodes through some totally unknown mechanism.

So what is it that cayenne and diazepam are doing that nothing else does? It can't be a metabolite of diazepam because 15 minutes just isn't long enough to have the liver process it. Also the fact that a single alcoholic drink can trigger it suggests that it has something to do with GABA, NMDA, or related systems. Does capsaicin have any receptor affinities shared with any of those three systems even through indirect activation?

My ECG shows up clean but PAF has to be diagnosed with a holter which unfortunately I can't wear because of my static mechanical allodynia going nuts. Plus they would push drugs or surgery and neither is an option.

There is one other interesting fact to add. MDMA does not trigger it but cathinones, mephedrone and methylone in particular do and all phenethylamines except 2C-D and mescaline do as well. Mescaline being a beta blocker doesn't surprise me. Caffeine triggers it 100% of the time and all atypical antipsychotics trigger it that I've been on except Geodon. The pharmacist who works with my psychiatrist ran down the list of drugs that trigger tachycardia with me and realized all of them have M2 action but I'm not aware of muscarinic involvement when it comes to cannabis or benzodiazepines to any significant extent so I'm well and truly stumped but if I can solve this equation, I may be able to finally solve the anxiety and panic attacks.

 

[CFC]

It's a while since I did any reading on this, but I'm pretty sure the relationship between alcohol and PAF is attributed to vagal tone acting via SA node. Hence stimulants, alcohol etc can set it off, while benzodiazepines, beta-blockers etc tend to help prevent or restore rhythm.

I can't have more than 1 drink or mine sets off, unless I've taken a sodium-channel blocker or beta-blocker beforehand. Alcohol, for me, is a much more potent trigger than any number of stimulants.

Sorry, I forgot to say that capsaicin possibly exerts it's effect via the sodium-channel (it inhibits certain sodium channels).

 

[MagickalKat777]

It's a while since I did any reading on this, but I'm pretty sure the relationship between alcohol and PAF is attributed to vagal tone acting via SA node. Hence stimulants, alcohol etc can set it off, while benzodiazepines, beta-blockers etc tend to help prevent or restore rhythm.

I can't have more than 1 drink or mine sets off, unless I've taken a sodium-channel blocker or beta-blocker beforehand. Alcohol, for me, is a much more potent trigger than any number of stimulants.

Sorry, I forgot to say that capsaicin possibly exerts it's effect via the sodium-channel (it inhibits certain sodium channels).

Well I'm sorry you have it too but at least I'm not alone.

Beta blockers and I don't get along. I actually get fluid vision (like I would from AMT) when I take atenolol which is crazy but it just makes me sick.

Interesting on the sodium channel. That could potentially explain why high dose alcohol stops it but low dose alcohol triggers it since alcohol has a variety of targets that it hits (basically everything eventually). I don't know a lot about sodium channel blockers but I do know that I crave the hell out of spicy foods. I've literally been going through withdrawal not having Frank's around and I pretty much pour Sriracha on everything I eat. But I crave salt all the time. I'm a habitual midnight ramen consumer and I actually hate salt with a passion but I crave it all the damn time. Sometimes I even add extra salt via Himalayan sea salt which actually makes the ramen taste less salty.

There's got to be some connection here.

And since I didn't make it clear before, diazepam post-alcohol is only minimally effective. Basically just keeps me from compulsively checking my pulse and stops there. But when it's not alcohol induced, it works pretty well. I'm not in the danger zone when I get PAF, usually around 100-110. It's definitely not like the panic attacks I used to have where I would hit 200 easy, it's been years since one of those, it just lasts a lot longer. I can have a PAF flare up that lasts hours or if I went on a bender, days. I remember when I quit drinking in March after a binge from November until March that I had PAF for a good week. No seizure activity, nothing close to that. I drink, I might have a headache the next day but I'll have PAF most of the day. I'm going to try a teaspoon of cayenne and report back.

I just looked up sodium blockers. Lidocaine? A drug that has absolutely no side effects that I've ever discerned? Sounds too good to be true.

My family doctor wanted to try me on verapamil years ago...

But damn it I don't want to be on more meds. I'm on Valium and that's bad enough.

 

[CFC]

You'd probably be better off with something more typically used for PAF like Flecainide. You can take a bolus after it's already set off to achieve cardioversion, or you could take a small dose before you intend to do something that you know may trigger your PAF (ie prophylactically).

Do bear in mind that sodium-channel blockers can affect the subjective experience of other drugs though, not unlike how CCBs like verapamil tend to.

 

[MagickalKat777]

You'd probably be better off with something more typically used for PAF like Flecainide. You can take a bolus after it's already set off to achieve cardioversion, or you could take a small dose before you intend to do something that you know may trigger your PAF (ie prophylactically).

Do bear in mind that sodium-channel blockers can affect the subjective experience of other drugs though, not unlike how CCBs like verapamil tend to.

The problem is I have Medicare and I'm at the mercy of a system that wants to save money at my expense. I've stopped recreational drug use since I've developed the arrhythmia issue other than alcohol but unfortunately alcohol makes it worse than anything other than marijuana so I either find a way to work around it or no more drugs of any kind for me and quite frankly, I don't think I can live a life like that. My doctor is going to want me on a damn holter but he already knows from trying to get an ECG from me on a calm day that getting me to wear a holter is just going to elevate my stress anyway unless I pile a good 50 pounds on top of it (allodynia is a real bitch - things that are light, even shirts, cause my nerves to flip out but things that should cause a pain response cause a normal pain response and things in the middle eliminate it entirely but walking around in two bulletproof vests is not only shady but in the 80s we have been having would be a death sentence lol) so the readings wouldn't be accurate.

If rather try something natural first anyway and I already love capsaicin so I'm going to give the cayenne a dive. If nothing else it will lower my cholesterol lol

 

[CFC]

I do appreciate that it's going to be difficult and painful, but you really need to get this properly diagnosed. AF isn't a condition to be trifled with, it can quite easily lead to a thrombosis, MI, stroke or death.

And generally the longer your heart stays out of rhythm, the more permanent the condition becomes. Being on anticoagulants for life isn't much fun.

This is one reason whenever it goes into AF, you should head down to ER/A&E and get a cardioversion.

So by all means give the capsaicin a go, but if AF kicks off, you need to revert it ASAP.

 

[Limpet_Chicken]

Sounds like excessive salt loss. K or/and Na. I'd get looked at for diabetes insipidus, or corticosteroidal abnormalities.

 

[MagickalKat777]

I do appreciate that it's going to be difficult and painful, but you really need to get this properly diagnosed. AF isn't a condition to be trifled with, it can quite easily lead to a thrombosis, MI, stroke or death.

And generally the longer your heart stays out of rhythm, the more permanent the condition becomes. Being on anticoagulants for life isn't much fun.

This is one reason whenever it goes into AF, you should head down to ER/A&E and get a cardioversion.

So by all means give the capsaicin a go, but if AF kicks off, you need to revert it ASAP.

I actually drank so much that I became manic and couldn't sleep. I took half a teaspoon of cayenne pepper, dumped it on my tongue, washed it down, and I was out cold in less than 15 minutes. I even smoked bud tonight... My roommate has only been trying to get me to share a bowl with him since I moved in... It was LA Confidential with crystalized trichomes unlike anything I've seen for the strain... Took three hits and it was ridiculously intense. I know my heart rate was up but I didn't want to throw another half a teaspoon of cayenne not even 5 hours later so I rode it out. I'm still high and I smoked at 10.

Going to the ER just isn't an option for me. Especially with a 400 dollar ambulance copay to deal with.

I will say the cayenne was not placebo... I actually felt like I took a moderate dose of hydro before i crashed. And when my roommate woke me up less than an hour later I wasn't even miffed about it. So basically I know that cayenne is good for me either way but it specifically put an end not only to the afib but the norepinephrine overload as well tonight and put me out better than any sleeping pill I've ever taken. And outside of Z drugs, I've taken all of them except temazepam and Xyrem and whatever the new modulators are... Either way, I smoked 3 hits of LA Confidential, a 50 50 hybrid and I got a psychedelic high and a rapid heart beat and I just pushed through it and it stopped. I don't drink often so PAF is something I rarely have to deal with but the fact I had it plus all of the signs of going full blown manic and cayenne shut both down... Thats saying something.

Sounds like excessive salt loss. K or/and Na. I'd get looked at for diabetes insipidus, or corticosteroidal abnormalities.

Both my potassium and my chloride levels are perfect. No sign of any type of diabetes through fasting blood sugar (wasnt even dating, had a banana) which was 88 and A1C which was like 4? I can't remember.

Corticosteroidal abnormalities wouldn't surprise me. Also I just had a breast cancer scare... Turns out it's not breast cancer, it's full blown real gynecomastia where I'm developing real female breasts. So I have to get my hormones checked... I've had thyroid, even demanded a free T4 test... Flawless even with my genetic markers which suggests hypothyroidism. I'm running out of things for them to look for to be honest and my doctor lets me guide him because he's never seen someone with a "constellation of symptoms" (his words) be so completely healthy. I dropped from 245 to 175 in less than a year... Sitting on my ass... My liver enzymes went from suggesting permanent liver damage (200 AST and 198 ALT) to 13 and 17 respectively in just four months. My liver enzymes are lower than they should be given that diazepam has so many metabolites.

I do know the cayenne wasn't placebo and on top of that, I didn't even get an upset stomach from just taking a heaping half teaspoon and washing it down. 2 pounds coming in Monday and I don't see any reason not to take it twice or three times a day.

I have a bottle of KSM-66 ashwaghanda as well that I'm going to start messing with. I've also thought about picking up some bulk memantine as well... If nothing else it will help me get off the Valium. But I have to wait until my 3 year disability review passes next year before I embark on that journey.

It's really interesting that the cayenne helped... Especially since I have rosacea and it didn't flare it up at all. What it did do is make my blood circulation go through the roof so I'm hot as hell tonight.

 

[Limpet_Chicken]

Diabetes insipidus is rare to very rare. Its a disorder of vasopressin release, (central diabetes insipidus) or there is nephrogenic DI (this is the result of insensivity to vasopressin, and not a disorder of release although end result is functionally extremely similar) Sugar levels are not primary focus although dietary sodium and potassium are often lost due to intense thirst and passing copious dilute piss.

 

[MagickalKat777]

Well I had a nice long response typed up but somehow it got lost.

My chloride, sodium, and potassium levels were all actually closer to the high side. I'm looking at my labs right now. These were from 7/9/16

Sodium - 139 mmol/L
Potassium - 4.4 mmol/L
Chloride - 100 mmol/L

The only bad thing I had on my labs was low HDL and I don't actually buy into the cholesterol nonsense to begin with because the body gets rid of cholesterol it doesn't need and people with lower cholesterol artifically dropped by drugs actually tend to be less healthy than people with high cholesterol and never went on drugs for it. I had a total cholesterol number of 254 back in August of last year and it dropped to 146 without drug interference while they were saying I didn't have a choice but to take a statin and I told them to shove it. Shut them up real quick when they saw the drastic change. Interestingly enough though, my HDL went from 60 to 32. So again I call shenanigans.

Anyway the cayenne pepper has many health benefits I can use any, including increased testosterone production, so I'm going to just keep taking it anyway. For what it's worth, my pulse is elevated today but I was also on a bender from Friday including no sleep until last night but I can breathe and there are no flutters. Also seems to be around 90 rather than 110-120 which is impressive considering how many beers I drank vs how little water I drank over the same period. So it definitely did something.

Oh and I woke up with a toothache... Within 10 minutes of drinking the cayenne, a nice euphoria settled over me and the tooth pain vanished entirely.