| Name | Nykos |
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| Location | Vermont, USA |
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| Age | 53 |
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| Diagnosed condition | Atrial Fib and Flutter |
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| Years with condition | 10 |
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| Frequency of episodes | Extremely variable. From zero/month to several days continuous |
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| Duration of episodes | several minutes to several days |
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| Event preceding first AF | none |
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| General health | excellent. No substances |
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| Current state | episodic symptoms but currently none. When I'm in NSR, I feel terrific. |
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| Triggers | Exhaust fumes the most predictable trigger, e.g. outboard motors, chainsaw, standing behind the schoolbus, smoke from woodstove. Don't know whether this is carbon monoxide or fine particle air pollution.
Coffee and caffeine, alcohol.
MSG possibly.
Both vagal and adrenergic can trigger |
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| Preventions | Avoiding the above. |
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| Current medications/side effects | None
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| Past medications/side effects | Tried Flecainide. Side effects too much: nausea, swollen tongue, muscle weakness, diarrhea.
Tried "pill in the pocket" method of taking Flecainide plus Inderal (see JAMA 12/5/05). Not successful. |
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| History of surgery | none |
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| Future plans | Avoid known triggers and buy time until the technology matures for cardiac ablation and long term outcomes start to emerge.
I am reluctant to have pva because of the irreversability of the decision - but I still consider it. |
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| Personal comments |
There is a very interesting article in Havard Magazine May-June 2005 about research led by Petros Koutrakis pointing to fine-particle air pollution as a significant trigger for arryhthmia. I think this is a promising line of inquiry.
I'm about to experiment with use of vapor dust mask when using combustion engine tools. |
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| Check list |  acebutolol | amiodarone (cordarone,pacerone) | anisindione (miradon) | | atenolol (tenormin) | aspirin | azimilide | | bepridil | betaxolol | bisoprolol (monocor,emconcor) | | bretylium | bucindolol | carvedilol | | cibenzoline | dicumarol | digitoxin | | digoxin (lanoxin) | diltiazem (cardizem) | diphenylhydantoin | | disopyramide (norpace) | dofetilide (tikosyn) | dronedarone | | encainide | esmolol (brevibloc) | ersentilide | | flecainide (tambocor) | gallopamil | ibutilide (corvert) | | lidocaine | mibefradil | metoprolol (lopressor,toprol xl) | | mexiletine | moricizine | nadolol | | phenytoin | procainamide | propafanone (rythmol) | | propranolol (inderal) | quinapril (accupril) | quinidine (quinaglute) | | sotalol (betapace) | tedisamil | timolol | | tocainide | trandolapril (mavik) | valsartan (diovan) | | verapamil (calan,isoptin) | warfarin (coumadin) | asthma | | diabetes | GERD/acid reflux | hypertension | | hypotension | hyperthyroidism | hypothyroidism |  adrenergic | vagal | familial | | idiopathic/lone | paroxysmal | permanent/chronic | | atrial flutter | cardiomyopathy | CHF | | PAC | PVC | SVT | | syncope | bradycardia | tachycardia | | heart block | myocardial infarction | rheumatic heart diease | | sick sinus syndrome | stroke | WPW | | electrical cardioversion | defibrillator | pacemaker | | ablation | bypass | maze | | Male | Female | |
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