Hello,

Thank you for your query.

I do not think that exterior paint fumes have a direct effect on the cardiac rhythm, unless you develop an allergic reaction which in turn may secondarily trigger the arrhythmia in certain susceptible individuals.

However, in order to answer your question better, I need a few clarifications from you.

1) What did you mean by "sinus rhythm attack"? Sinus rhythm is the normal rhythm of the heart. Did you mean that you developed Atrial Fibrillation? I would like to know your exact symptoms (chest pain, breathing difficulty, palpitations, etc)
2) Are you a hypertensive patient?
3) Are you taking any regular medicines?
4) Do you have any allergies, bronchial asthma?
5) Is it possible to upload your ECGs on this website?
6) Is this the first time you had an Arrhythmia?

Kindly get back to me with these answers so that I can give you a specific reply.

Awaiting your reply.

With regards,
Dr RS Varma

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Hello,
Thank you for the additional data.

You must understand that the initial data given by you was not sufficient to give you a specific reply.

As I said before, AF (atrial fibrillation) is not directly due to the paint or carpet or dust. Rather, it is a secondary response to an allergic manifestation to the paint/carpet/insecticide/dust, etc.

There are a lot of chemicals released in the body including histamines, catecholamines, etc which change the metabolic mileu of the cardiac cells and can trigger extra-systoles in the atria and the ventricles. These extra-systoles, depending on the timing of such events, in turn can trigger AF.

It is also well known that AF begets AF. Once an AF is triggered, there can be many factors which perpetuate the arrhythmia including metabolic issues, electrolyte problems, local factors like fibrosis of atrial cardiomyocytes, etc

Flecainide is a good anti-arrhythmic agent to treat AF. Your dosage also appears to be sufficient. If there are frequent episodes of sustained arrhythmia despite taking this medicine regularly, you may need to consider shifting over to an alternative drug like amiodarone, dronedarone or dofetilide. All these medicines have shown considerable efficacy in the maintenance of sinus rhythm.

The spike in the BP can happen if you were anxious or under stress. It can also happen if the antihypertensive agent Isradipine (dynacirc) was not enough to control the BP. Since your doctor has switched over to another agent, Diltiazem, you will need to monitor your BP closely over the next month to ensure that the values are remaining in the normal range.

Diltiazem will also help to prevent a rapid rate in case there is a recurrence of AF. This is so because it has properties that slow conduction across the AV node and thus, can prevent a rapid ventricular response.

I hope this answers your query. Feel free to contact me for any further clarifications.
With regards,
Dr RS Varma

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