Posted by Ken Willis on January 17, 2004 at 17:01:17:
I have had a recent revelation and wanted to pass it on because it's possibe someone else could benefit from my experience. I had maze surgery in May '02. Though I had afibs and other arrhythmia from time to time during the first three months post-surgery, I was able to regain physical conditioning pretty quickly had no afibs after those first three months.
About 4 months after surgery my cardiologist suggested I take a moderate dose of niacin to try to adjust my slightly unfavorable ratio of LDL to HDL. It worked, so I continued taking it. Every few months I'd experience a flareup of arrhythmia- PACs, probably flutter and SVT. In October '03 my family physician suggested slightly upping my niacin dose to see if I could improve my ratio still more. Not long afterward I started to get frequent arrhythmia. It wasn't afib, but it was similar, though less debilitating.
We were on a month-long trip to Baja and some islands in the Sea of Cortez, so I just had to deal with it. When the arrhythmia started, I went on propafenone (Rythmol), which didn't prevent it from occuring but allowed me to convert easily to NSR with just a little walking. After about three weeks, at my wife's mention that she'd experienced PACs when she tried niacin, I decided to quit niacin. At the time I was getting what I felt was flutter either preceeded or followed by tachycardia EVERY night. Many times I'd wake up with it, so it could have been going for a few hours. A short walk on the beach in the moonlight (not such a bad thing!) and it was gone.
After quitting the niacin my symptoms improved daily to the point that in three days I wasn't getting arrhythmia at night. I had a few more sessions of flutter before I could see my cardiologist about a month ago. I got a heart card and went off propafenone, because I knew that I'd kick off the arrhythmia by doing so and could get a recording. The recording confirmed that I had flutter and some sort of SVT.
Propafenone is not only anti-arrhythmic but also pro-arrhythmic. Since I've been off of propafenone I've bascially been symptom free for about a month. I've had a few two- or three-second bursts of flutter that immediately abort. And these have gotten fewer and fewer as time goes along. I thought for sure that I'd need a flutter ablation, so I checked to make sure that my insurance would cover me returning to CC (they would), but now I'm thinking and hoping that without any of the niacin or propafenone in my body, I may be in the clear. I haven't had a short burst for probably a week and I only get one or two single PACs a day.
Dr. McCarthy's surgery has returned my life to me. I've been able to hike, climb and backcountry-ski with gusto, and the only limit on my daily exerise is what my feet will allow (they're my weak point). Now if the flutter is gone, things will be perfect.
I wonder if anyone else out there has any experience with niacin apparently causing arrhythmia. If you're taking niacin and also having arrhythmia, you might want to check out whether niacin might be a factor. There are a lot of other options for adjusting blood lipids.
- Re: niacin and arrhythmia Mike Ware 23:48:29 1/17/2004 (0)