I’m Tall, and My Heart Beats Oddly

I’m six foot three inches tall. In 2002 and 2003, I had two instances of idiopathic atrial fibrillation. That last just means that the contractions of the atrial chambers of my heart got out of sync with the rest, and “idiopathic” means that they couldn’t figure out why that happened.

The first time was during a bad flare-up of the ulcerative colitis. My gastroenterologist did about three minutes of colonoscopy and declared me sick. I don’t think he believed me or my medical history until he saw for himself. I was really in a state, because I not only had the ulcerative colitis, but also had a Clostridium difficile infection on top of that. So I went from the usual maintenance drugs for colitis to higher doses of those, a strong antibiotic to deal with the C. difficile, and my first course of steroids, a high daily dose of prednisone. It was after a couple of weeks of that regimen that I was going about collecting the full list of side effects that they warn of in the prednisone patient data sheet (elevated heart rate, sleeplessness, water retention in the feet and lower legs, irritability, paranoia… I swore that if I discovered a “change in menstrual cycle” I was going off the stuff) that I got the first incident of atrial fibrillation. My heart rate went up to about 130 beats per minute and I felt woozy. We went into the emergency room, and after a few hours, they gave me some medication to convert me back to normal rhythm. After about twenty minutes, I synced up again, and my heart rate dropped to the prednisone “normal” of about 90 beats per minute. After that, they gave me a heart rate monitor that I wore for a day, to try to catch any short-term irregularities that would indicate the sort of problems that they knew about treating. Nothing happened. They did an echocardiogram, which showed only a small amount of mitral valve prolapse. Take an antibiotic before procedures like dental work, they said. But otherwise there was nothing that they knew to do about it, except to take a daily dose of aspirin to “thin” the blood a little, making it less likely that I should throw a clot if I were fibrillating and not aware of the fact for more than 24 hours or so.

The second incident was in 2003. Diane and I visited with our friend Janice B. in Albuquerque on the way back from my dissertation defense at Texas A&M. In the morning, we had stopped by a fast-food place and gotten a great big Coca-Cola soft drink for sipping as we drove there. We had dinner, then Janice took us to ride the tram to the observation platform near the peak of Sandia Mountain. As the doors on the tram were closing, I felt my heart doing something different. I told Diane and Janice that I was having another atrial fibrillation episode, then had a lie-down on the floor of the tram as we had about a fifteen minute ride up. It was another thirty minutes before the next tram went down. On the car ride back to Janice’s place, I converted back to normal rhythm on my own. When we got back home, I had another couple of rounds with the monitor, but nothing further was found. I have stayed away from caffeine since that incident, though. Later, my sister told me that, yes, she has that, too, and she’s known to avoid caffeine for years now.

So today I’m looking at ScienceDaily and find an article there titled, “Taller People More Likely To Develop Atrial Fibrillation”. A study at Emory University found that risk of atrial fibrillation increased with increasing height.

Analysis of data from a registry of patients with left ventricular dysfunction indicates that height is an independent risk factor for an arrhythmia of the upper chambers of the heart, according to a new study in the April 18, 2006, issue of the Journal of the American College of Cardiology.

“Tall stature is a potent risk for the development of atrial fibrillation and is independent of other clinical risk factors. Indeed, the male predominance of atrial fibrillation appears to be explained by the difference in height between men and women,” said Jonathan J. Langberg, M.D. from Emory University in Atlanta, Georgia.

Atrial fibrillation is the most common sustained cardiac arrhythmia. During an episode, the upper chambers of the heart flutter instead of pumping blood effectively. The incidence increases as people age, with a prevalence of more than 5 percent in patients over the age of 65 years.

[…]

“Tall patients may need more aggressive attempts to attenuate risk factors. Controlled trials should evaluate stature in treatment and control arms,” Dr. Langberg said.

[…]

“Although the paper supports previous evidence of a relationship between atrial size and atrial fibrillation, there is no therapeutically applicable outcome from the study, because you can’t alter your height as a risk factor for atrial fibrillation!” Prof. Feneley said.