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Atrial Fibrillation and Fibromyalgia
An_245892 posted:
Hi, I'm new here. I've had fibro for many years, and have a myriad of symptoms to manage. Four years ago, I went into A-fib after a long flare of uncontrolled pain in my sternum/ribcage. I've since had several more episodes, followed by complete cardiac workups (stress tests, echo, holters, etc) which were all normal.

These episodes often happen when the burning and squeezing pain in my respiratory muscles cause my pulse and blood pressure to elevate.

I'm wondering if there has been any proven medical connection to fibro and A-fib? My cardiologist kind of blew this question off.

jillylin responded:
sorry don't know the answer to your question but just wanted to say welcome. I am sure someone will be able to help as there are so many really knowledgable people here.
Jilly in the UK
booch007 responded:
Good Morning,

I have to say no to this question. ( Not Dr P...but I have a few years in the cardiology business (35) I think that isn't even Dr P's age!)

Atrial fibrillation is an electrical event in the top of the heart. Often when it is a one time had a palpatation just at the right time in the cardiac cycle to create chaos in the rhythm.

And that is what AF is. Chaos...the chamber is beating at 400-800 beats per minute, the squeeze of the chamber become ineffective....thanks goodness there is a junction box right below to slow down things and let only a few impulses through or you will pass out!

Normally the sinus node (a piece of tissue is the boss) he dictates the pace of the heart....60-80 being around normal. Then as God planned it....every cell in the hearts upper chambers or lower chambers have the ability to take over if he gets sick. As in Sick Sinus Syndrome.....where (if you think of a car..) The sinus node at one time, slow at another...

Now in saying that. One time episodes from a palpatatin at an early spot in the start this off.

There is another cause as the case of a murmur or leaky valve, which blood backs up to the upper chamber and then the chambers get *stretched out*....enlarged and the tissue becomes damaged.

Knowing that each cell is given the power to keep you alive if the sinus becomes ill....NOW THEY ARE DAMAGED by stretching they spark OFTEN.

Not everyone who has palpatations get AF. But those who have a propensity for it. There is a few fixes for this, as it is dangerous to be in and out of it. You need to be on ASA or a blood thinner to prevent stroke.

I can see that in pain heart rate rises and you may have more palpatations with fright and you are at risk as this happens to you. At a large facility (tertiary hospital they have EP cardiologists...(electrophysiologists that do this following and maping of the electricity of the heart)

If your echo proves normal and no enlarged chambers....maybe a med "in pocket" they call it may be the helper you need....that when in a flare and you feel the palpatations starting you take this med.

We use Beta blockers or Amiodarone for this purpose.

If they find this is happening too much and there are risks to you, they can go in the cath lab and ablate (microwave) the tissue that is the offender in the loop of electricity. They map the area...find the culprit section and rid it from speaking out.
(remember we talked of tissues that can spark, well they find the guy and microwave him quiet. (NOT PAINFUL...)

You are asleep during most of all this.

But remember this is a large teaching facility with an active EP lab I am talking about.

If you smoke or have lung disease you are at risk of having this often and then staying in it as you age. There is nothing wrong with being in AF as long as you 1) tolerate it (B/P, dizzyness,SOB, feel it and are annoyed by it, it doesn't alter the cardia output too much) 2) are protected from stroke from it

OK, in saying this, I hope you are well now and they have you on an ASA if warrented. There is a CHAD score they match you to to figure out your therapy for this protection.

All my best, Nancy B
Mark Pellegrino, MD replied to booch007's response:
Nancy B,

Funny comment about my age. You had the right 2 numbers, wrong order!

Superb response!!

Dr. P
Mark Pellegrino, MD responded:

There's no reported relationship between fibro and A-fib. People can have both conditions. People can have thyroid problems, mitral valve prolapse, medicine side effects, viral infections, sleep apnea, and stressors that can be seen with either fibro or A-fib, or both; but no direct relationship exists between having fibro and getting A-fib, or vice-versa.

Dr. P
booch007 replied to Mark Pellegrino, MD's response:
You are 53? Man you look great!

I just saw a Retinal guy for that eye problem I had....."wrinkles back there in the eye....(who woulda thought!)
Once you turn 50 it does all change, no patients have lied to me yet......BTW..great response from you too. I didn't go inot everything that can bring a patient in......thyroid is a big one.

We echo and then bloods......hope there is a fix here for her.

Nancy B
tisheast responded:
I'm always skeptical about dismissals of any relationship to fibromyalgia since the condition has only had one major study to date. That study linked it to various potential causes including brain, core body, lactic acid buildup etc. So no one is qualified IMHO to authoritatively dismiss its effect on the heart muscle. It is a disease that affects every muscle in the body, even the heart. That much we know. I too have had correlations between a recent increase in A-fib episodes being trigger simultaneously with massive tightening and cramping spasms in the pectorals and back muscles in my trouble area, muscular ly, on my left side. the muscle spasms in fibromyalgia can be so strong, I actually had one dislocate my hip, and frequently rotate my entire leg on the same way a foot cramp kits out your toes. And yes it can feel like massive pressure when it happens in torso muscles. So if all of the muscles AROUND the heart are spamming and contracting HOW COULD IT NOT affect the heart? If massaging a heart during surgery can restore sinus rhythm, the why wouldn't compression trigger...any number of things. So I am, as I said, skeptical of anyone who has a black and white answer at this early stage of understanding the condition.