AFIB episode on Retatrutide

[cujet]

62M, former athlete. 192 pounds pretty steady now (about my goal weight) down from 262. Still strong and slow-capable, despite multiple autoimmune diseases. Which did cause AFIB 30 years ago. Since then no problems until now.

While working on my moving truck I fell out of the cab, about 6 feet down. I was building a platform for my puppy and stepped down from the platform and my foot missed the foothold. Hit the adjacent tree with my headphones which were crushed (saving me from injury) and then hit the truck, then the ground. I was pretty beat up and cut up. But the multiple hits prevented broken bones. As each one slowed me down.

My heart immediately hit 160 beats and stayed there. I remained on the ground for 30 minutes trying to let my heart settle down. Apple watch showed AFIB and a slowly reducing high heart rate. The following night, a bit more than 24 hours later I reverted back to a solid sinus rhythm while taking a nice hot shower, with a nice Ahhhh feeling and no problems since.

No question adrenaline from the fall cranked my heart rate up.

Since I have not had any AFIB in 30 years (which was due to a heart infection), despite many dirt bike crashes, SeaDoo ocean wave jumping/racing wildness and bicycle racing crashes w/broken bones, I think Retatrutide pushed me over the edge. I had recently moved up to 5mg/wk. Which is what seems to be my maintenance dose. My resting heart rate is likely higher than my fit-normal on Reta, but by how much I don't really know. As HR was also up when my weight was up. Maybe 82bpm in both cases. Fat or on Reta.

 

[QueenMuntha]

Reta, even in .5mg weekly doses does seem to trigger AFib episodes at the slightest things--like eat tomato sauce or eating within 6 hours of bedtime. These things did not happen before I added small amounts of Reta back in after stopping it due to referential back pain from gall bladder.

Not saying correlation is causation, but mighty peculiar. This is my 5am Kardia on Wed from eating spaghetti and meatballs with tomato sauce at 5pm. (200 mg of Flecainide calmed it down after 2 hours.)

 

[JCO79]

AF is more likely to happen in a high adrenergic state. At 62 and previously carrying too much weight, presumably for years, it’s impossible to say whether this incident would have triggered AF in the absence of Reta or not. This may be a reason to consider Tirz instead, though. It just doesn’t seem to have that same increase in sympathetic tone that Reta does.

 

[SeaGypsy]

I had HR issues on low dose of Reta 2.5mg. I was getting some spikes up in the 130s and 140s just sitting and watching TV. I went back to Tirz and all is normal again.

 

[birdwhacker]

My heart immediately hit 160 beats and stayed there.

This is my 5am Kardia on Wed from eating spaghetti and meatballs with tomato sauce at 5pm.

I had HR issues on low dose of Reta 2.5mg.

Question for all three of you:

Do you supplement magnesium and potassium daily? What supplements do you take, and do you take any for cardiovascular health specifically?

 

[QueenMuntha]

Question for all three of you:

Do you supplement magnesium and potassium daily? What supplements do you take, and do you take any for cardiovascular health specifically?

No, no supplements. Just 75mg Metoprolol, 50 mg Flecainide bid and Xarelto.

Tried magnesium and did not see a difference. But before Reta, I only had AFib attacks maybe 3 times/year. Oh, and my handy-dandy CPAP.

 

[birdwhacker]

No, no supplements.

That's grim. If you do nothing else, please, please just add in 200mg of elemental magnesium from magnesium glycinate daily. Doctor's Best or Now Foods both work fine.

Just 75mg Metoprolol, 50 mg Flecainide bid and Xarelto.

Xarelto, heh, that was a fun one. Got an embolism from the covid vax a few years back. My mom had to get me a sample of it from one of her offices because the doctor I saw after the embolism wouldn't prescribe it because he didn't believe my story. Fun times. Took it for 3 months along with an assload of NAC, natto, fish oil, iodine, vitamin D, and zinc.

If you need to take a blood thinner, it's also a good idea to take omega 3. Now Foods Liquid is the cheapest but if you want to be boujee get the nordic naturals.

Tried magnesium and did not see a difference. But before Reta, I only had AFib attacks maybe 3 times/year.

Sometimes I don't see a difference after brushing my teeth, but you've gotta do it at least a few times a week. It's called taking care of yourself. Not taking any supplements is just crazy to me.

 

[lessthanhalf]

Sounds like something that should result in getting the opinion of a cardiologist, and telling them about the reta. Given what I have seen described on this forum about increased heart rates and even a few panic attacks from reta, I was actually surprised not to see someone with an arrhythmia, logically it must make them more likely, given that it increases sympathetic nervous system activity and heart rate.

You may have done this but there was nothing in the description to suggest you sought medical attention.

A heart rate of 160 with AF is high enough to be a problem in terms of being too high for efficient pump function and could trigger heart failure, and I do not think leaving it that high for long is a safe option, without expert advice. I cannot see why the correct response is not going straight to an emergency department in this situation, especially as it is not something that has happened many times before and has been managed by an expert.

Managing AF used to be all about getting rate control OK to manage this issue, but now a lot more effort is put into re-establishing sinus rhythm if possible , as AF can lead to left atrial clots which can break off and cause strokes. And going into and out of AF can cause it as well as being in AF long term. Which then requires anticoagulant drugs to prevent strokes.

I have yet to see significant research on reta and heart disease, but just going on what I have seen on this forum, in established heart disease and especially arrhythmias there is a good reason to choose tirz instead. And even a single episode of AF requires an expert opinion on management.

 

[SeaGypsy]

Question for all three of you:

Do you supplement magnesium and potassium daily? What supplements do you take, and do you take any for cardiovascular health specifically?

No supplements aside from daily vitamins. I have had low BP and HR my entire life...until Reta. I am staying with Tirz from here on out. I've never had to take anything cardio related.

 

[JCO79]

One of the phase 3 trials for Reta (TRIUMPH-3) is specifically looking at the effects of Reta in people with established cardiovascular disease. No way Eli Lilly would fund that trial without a signal that it’s going to be beneficial. But probably not for everyone. I bet there will be a significant amount of atrial fibrillation, even though on the whole it should decrease AF risk. Tirz doesn’t seem to have this problem and has been shown to be beneficial for AF burden.

 

[QueenMuntha]

That's grim. If you do nothing else, please, please just add in 200mg of elemental magnesium from magnesium glycinate daily. Doctor's Best or Now Foods both work fine.

Xarelto, heh, that was a fun one. Got an embolism from the covid vax a few years back. My mom had to get me a sample of it from one of her offices because the doctor I saw after the embolism wouldn't prescribe it because he didn't believe my story. Fun times. Took it for 3 months along with an assload of NAC, natto, fish oil, iodine, vitamin D, and zinc.

If you need to take a blood thinner, it's also a good idea to take omega 3. Now Foods Liquid is the cheapest but if you want to be boujee get the nordic naturals.

Sometimes I don't see a difference after brushing my teeth, but you've gotta do it at least a few times a week. It's called taking care of yourself. Not taking any supplements is just crazy to me.

Nah, I tried it a few years ago, but now, my Chronic Kidney Disease stops me from messing around with magnesium and a bunch of other stuff. I used to take magnesium for severe muscle cramps and it did not help a bit.

Can't do Omega 3 because of their blood thinning properties.

Thanks for the tips, but I am good without the supplements. Bring on the Peptides, though.

 

[birdwhacker]

Grim.

 

[myboysherman]

I had pretty bad palpitations after a week on Reta. “Health monitor” tripped warnings for afib and flutter, among almost every other thing, but it has been wrong in the past. I took magnesium which has sometimes worked in the past, but not this time or lately. Electrolyte mixes with Mg and potassium did wonders. Better than it’s been in years. I think a potato or banana may have also worked.

 

[birdwhacker]

I had pretty bad palpitations after a week on Reta. “Health monitor” tripped warnings for afib and flutter, among almost every other thing, but it has been wrong in the past. I took magnesium which has sometimes worked in the past, but not this time or lately. Electrolyte mixes with Mg and potassium did wonders. Better than it’s been in years. I think a potato or banana may have also worked.

Potassium was a game changer for me. I supplement a gram per day minimum. Also had to quit nicotine and caffeine.

 

[cujet]

Sorry for the slow reply. I do have a cardiologist who I contacted immediately and we talked extensively about this. He explained about catecholamines triggering a high heart rate with such injuries. He was not surprised the Apple watch said AFIB and very clearly directed me to the ER if it did not settle down quickly, as the window for both natural and cardio-reversion is 48 hours. I did not go to the ER as my heart rate was steadily coming down and repeatedly reaching normal rates more and more often. My choice to wait a bit. I asked about stroke risk and was told that the initial risk is rather low. I did take aspirin. AFIB is stroke risk over time.

No issues since reversion. While I have not been taking magnesium or potassium supplement pills, I do regularly use Brawndo electrolyte drink (Nutricost electrolytes). Which has modest amounts.

I've been loading and unloading my moving truck these last two weeks, heart is working normally. As a former athlete and bicycle racer, and a 0 calcium score, I don't (yet?) experience any chest pain when heart is pushed by exercise. I may do a bicycle ride tomorrow to test. Feeling pretty good lately.

 

[RetCurious]

I think a potato or banana may have also worked.

"A medium banana contains about 450 milligrams of potassium."

"A medium baked potato with the skin contains about 926 mg of potassium."

I had no idea a potato has more potassium than a banana.

 

[RetCurious]

I did take aspirin.

I take 1/2 of a baby aspirin every day just because.

"Aspirin is recommended for individuals aged 40 to 59 with a 10% or greater 10-year cardiovascular disease risk, but not for those aged 60 and older without a history of heart disease due to increased bleeding risks."

I'd guess that by 60 most of us have some kind of "heart disease"?

 

[ProblemChild]

I had pretty bad palpitations after a week on Reta. “Health monitor” tripped warnings for afib and flutter, among almost every other thing, but it has been wrong in the past. I took magnesium which has sometimes worked in the past, but not this time or lately. Electrolyte mixes with Mg and potassium did wonders. Better than it’s been in years. I think a potato or banana may have also worked.

What was your dosage? I'm in my late 50s and had an ablation back in 2021. I'm titrating Reta VERY slowly. This clip talks about supplementing Taurine while on Reta.

 

[myboysherman]

What was your dosage? I'm in my late 50s and had an ablation back in 2021. I'm titrating Reta VERY slowly. This clip talks about supplementing Taurine while on Reta.

I was just starting at 1mg twice a week. Today, I'm up to about 6mg/week equivalent. My last bump was too quick and triggered palpitations again. I agree on the titration speed. I won't be doubling dosages like the studies do, but the level itself isn't the problem, just the rate at which I arrive there.

I'll check on that Taurine vid, thanks.