[This physician-author is a professor of Medicine at the University of Toledo College of Medicine, 5600 Monroe Street, Suite 106B, Sylvania, Ohio 43560, United States]
'Lone' atrial fibrillation infers absence of hypertension, heart failure, and coronary artery disease as the cause of this tachycardia.
Korantzopoulos identified underlying causes and links associated with this entity, but failed to mention two epidemiological causes that receive considerable press, namely a flavor enhancer, monosodium glutamate (MSG) and an artificial sweetener, aspartame as the culprit of lone atrial fibrillation.
As an aside, Donald Rumsfeld was most significant in the release of aspartame. He was the Chief Executive Officer, President, and Chairman of G.D. Searle & Company, a worldwide pharmaceutical company which sought approval of aspartame for human usage. To be exact, on the second day of Reagan's first term in 1980, he appointed Dr. Arthur Hull Hayes as FDA Commissioner because no FDA Commissioner in 16 years would approve aspartame. Dr. Hayes immediately over-ruled the resistance of the FDA's own scientific panel, the Board of Inquiry, and then Dr. Hayes proceeded to leave the FDA and work for Searle himself.
1. Case report
A healthy 57-year old physician with a normal cardiac exam and echocardiogram, had a four month history of persistent atrial flutter. This was resolved with catheter ablation in 2007 leading to a temporary return to sinus rhyme. Over the last several months he developed paroxysmal atrial fibrillation which was confirmed by outpatient monitoring. Patient was placed on beta blockers and was being considered for a second ablation.
In the interim, the patient eliminated monosodium glutamate and all artificial sweeteners from his diet. Surprisingly, he experienced elimination of occurrences of arrhythmia. To test the validity of this dietary elimination, he performed three separate patient challenges with Chinese food (with MSG), three glasses of Crystal light (aspartame), and a bag of beef jerkies (MSG). All of these challenges resulted in development of atrial fibrillation within a few hours.
The reaction to MSG and aspartame is to a derivative of the amino acid, respectfully, glutamate and aspartate. Aspartame, for example, releases aspartate during digestion.
Free glutamate can occur in food as a consequence of manufacturing. MSG-sensitive persons do not react to protein in which there is bound glutamate and/or bound aspartate, nor are they affected by minute amounts of free glutamic and aspartic acids that might be found in unadulterated, unfermented food.
Both glutamate and aspartate are known neurotransmitters in the brain and central nervous system. Any central nervous system effects appear to occur due to the excessive levels of neurotransmitters which develop in a short time period. Normally glutamate and aspartate are bound within proteins and broken by enzymes in the process of digestion.
As this process is gradual, controlled levels of free glutamate and aspartate are achieved in the body. When these amino acids are eaten in the free form with no peptide linkages, glutamate and aspartate enter the bloodstream quickly causing much higher concentration levels of these amino acids. MSG and aspartame have been associated with numerous symptoms including headaches, dizziness, seizures, nausea, numbness, muscle spasms, fatigue, heart palpitations, anxiety attacks, vertigo, and memory loss.
Of note, the brain is not the only tissue having glutamate receptors. Numerous glutamate receptors have been found both within the skin epidermis, heart's electrical conduction system, and the heart itself
Thus, MSG and aspartameare both excitotoxins of cardiac tissue as well. The AFIB Report found that 10% of patients with atrial fibrillation found MSG and 4% listed aspartame as triggers for their attacks. In a study of 200 cardiac patients, 16% experienced detectable changes in their heart rate or rhythm after consuming aspartame.