AF Association
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Paroxysmal AF ? Causing

AF triggers any help please: since late 2012 have had AF ( now 8 events): 1st trigger eating pastry quickly following brisk walk uphill 2weeks after strange virus which wiped all energy and produced palpitations.

Associated with Acute Anxiety a culmination of major close family members illness including bereavements most recent my father 3 months ago.

Each of the AF events have responded to Sotalol 40-80 mg 'pill in the pocket' Did try taking it 40mg twice daily for about 4 days but it nearly floored me couldn't function emotionally physically terrible sleep.

Have seen Cardiologist had Echocardiogram 24 hr BP all normal which was reassuring!

So does anyone else have eating as a trigger and possibly the mechanism of swallowing too quickly when the heart is ' primed' with in my case post viral or anxiety as further triggers.

21 Replies

Hi Trilby8. Certain foods trigger my AF. For example I cant eat anything with nuts in. Even coconut milk can tip me over into AF. I have cut out caffeine and try to eat smaller meals, nothing too late at night. I have acid reflux which doesn't help either. The Vagus nerve plays a part in my case. Finding your personal triggers is important.

The overwhelming trigger for me is stress. I have recently read an article by a lovely American EP, have a look at his Blog. It is lighthearted and informative. There is a post about stress and a link to useful stress busting tools. You can find his blog here:

Unfortunately for me eating the wrong thing and being stressed sets up the perfect AF storm which I work hard to avoid wherever possible !

Good luck ongoing and take care.




Dee thanks for that yes I've a strong feeling the Vagus nerve plays a big part. Have you ever been given PPI's for reflux? If so did they make any difference for your AF also how do you manage your AF ' pill in the pocket' or more?


Hi Trilby8. Yes I take PPI's for acid reflux. I take Lansoprazole and they do help. I was put on them when I first started with PAF. My Consultant prescribed them. I had undergone a endoscopy in the weeks before my first huge PAF episode and had been very stressed about it and work issues too. Think that together that contributed to my first perfect AF storm.

I take a rate control drug - Atenolol 25mg twice a day (I was taking one a day until my last big episode when the Cardiologist then doubled the dose). It is meant to help keep my BP in check also which, largely, it does do.

I have been prescribed Rivaoxyban also since Feb as my CHADS score had increased - its one of the new anticoagulants as an alternative to Warfarin which I have never been prescribed.

My consultant has said he will put me on Flecanide 'Pill in the Pocket' when I next have an episode and will consider referring me to an Electro Physiologist. He is not a big fan of Ablation but thinks we will look at it and discuss with one of his EP colleagues. At this point an ablation is not required (I have spoken to a couple of EP's personally at heart conferences and they agree it is not appropriate for me at the moment). I feel comforted having had several opinions from experts who concur.

Best of luck.




Acute stress seems to be my "trigger". In fact I was only diagnosed after the tragic loss of my younger brother last year.


It's strange really as I've had some very stressful moments recently when my heart does race but not into AF , then when I least expect it ,sometime even days later AF strikes I think the stressful times 'prime' my hearts resistance to dealing with AF when I'm trying so hard to get back on track , a mystery to me at times.


Interesting hearing about the stress links with you. Stress also interferes with sleep, may trigger stress eating of fatty or salty foods, and can raise BP, all of which can trigger AF. So the way we react to the stress can really be the trigger.

A large meal and leaning forward will start my AF. I take meds to avoid the acid reflux and there is a strong link between the AF and acid reflux.

After reading all these posts...if we didn't know better, one would think that we are all a mess! :-)


Stress without a doubt can make AF worse. I am now in permanent AF but can still have a turn especially after eating chocolate so now avoid it . I looked after my husband for 15 years ( he had cancer) and the last year of his life was grim and my heart went into permanent AF ; I'm sure without that stress my heart ..maybe.. would still be flitting from sinus to AF. Eating smaller meals helps ; but am pleased to see that some of you are taking tablets for acid reflux.... shall ask cardiologist to put mine back on my ever growing list of tablets !

hope you get it sorted ..try any type of relaxation ....worth a go.



Hi Trilby. I was once told by my EP that chasing triggers was counterproductive. In order for you to have AF your heart must have a predisposition i e some electrical pathways which are breaking down or incorrectly wired. Without that you won't get AF whatever triggers you might experience.

Having said that, and also must mention that the more you have it the more you will get it as the pathways re-establish themselves and multiply, it is important to understand that in SOME people AF is vagal related. Since the vagus nerve which is rooted in the brain extends to both stomach and heart, it follows that things which affect one CAN but not always affect the other. Doctors talk about AF being more likely when the vagal tone is low , for example when we are asleep which is why many people get woken with AF attacks.. Others find some foods, often those containing large amounts of MSG like Chinese foods, will make an attack more likely. Alcohol especially binge drinking is about the only scientifically proven trigger but caffeine is not good as it speeds up the heart anyway. Stress is an odd one. Zero stress is just as bad for the human animal than too much. I always found I was worse when the stress was over and having been in motorsport for 50 odd years, that was most Sunday evenings!

Coming back to the digestive side again, although post three ablations I don;t get AF any longer I do get lots of ectopic beats, those "missed beat" moments and find that these are less likely if my stomach is in good order. If I get into a pattern of these I start taking lanzaprazole to stop the gurgling and this usually cancels out the related ectopics.

AF is a mongrel condition and there are few common links between patients as we are all different. IT can be a long journey and few of us ever really finish that journey so it is important not to let it become all obsessing as is all too easy. Let AF be in your life but not your whole life.



Thankyou so much BonbD for that information and the advice so true it can become all consuming especially when like myself already having difficulty trying to get back to full health mentally & physically - looking into Mindfulness with relaxation as well as counselling for anxiety- thanks again


Reading these responses every day is so very helpful and fills in much of the detail that explains how to deal with AF. Presumably it usually gets more challenging as time goes on? I have only recently been diagnosed and the cardioversion failed, so am on betablockers and Warfarin - but I don't understand the paroxysm bit - as I have not experienced anything different, simply the irregular heartbeat, tiredness and feeling very cold. Any additional advice would be most welcome.



Ruuth, paroxysmal means it comes and goes whilst some people are in permanent AF which is usually easier to cope with. For many people it is the sudden attacks which are most distressing. The human animal is very adaptable and when something is there all the time , finds a way of dealing with it and putting it into the background whilst occasional attacks cause panic and anxiety. When I was on a BHF committee dealing with AF matters as a patient rep it was the anxiety and psychological side of the condition which I felt was most neglected. Things are improving but sadly Many GPs and cardiologists still do not really understand and consider this side of the problem.



Thank you so very much - I have a lot to learn and want to do what I can to improve things so I read everything I can and find that some things relate to my own situation, others don't. I suppose that's inevitable, we are all different beings.

I shall continue to read the comments every day, and find it very helpful.

Many thanks Bob,



Hi ruuth

I am like you in persistent or permament A Fib I use both descriptions as there are arguments over which term to use. Permament probably.

There is no real reason for it to get challenging, I am fairly sure I have had it for at least 5 years with almost no symptoms whatsoever, until last November when I had an attack (my only one ever) and was hospitalised and they diagnosed it. There is no real evidence that it will continue getting worse, or better one simply does not know, you may just have to learnt to live with it.

The tiredness by the way is a sort of sympton of AF but more probably from the beta blockers, I changed from Bisoprolol to a calcium channel blocker and the tiredness was much reduced. Ask your Cardio about potentially changing meds it might help.

Like you too a failed cardioversion, and now waiting six months until I see the cardio again, there is very little rush involved now and I am being left to manage my AF through lifestyle changes mainly.

I would be interested to know what the cardio has suggested next for you, any statins?

Take care



BobD you talk sense again - I have PAF and was diagnosed almost a year ago - I've mentioned on here before that the Vagal Nerve - aligning the brain, stomach and heart can have an impact - I don't know for sure but my EP in Leeds thinks there could be a link - when i get a gurgling or upset stomach the ectopics start.

This condition, or similar, are becoming so common - I know of 5-6 people, all under 45, who have or will probably be told they have it in some form - all of them are FIT - runners, cyclists etc etc

Certainly a direct correlation between a high level of fitnessa and AF/PAF.

Stay positive (not easy but you need understanding friends and family)


Thanks Parco, Prof John Camm told me years ago that the vagus nerve could affect both. I take lanzaprazole to combat stomach problems and reduce ectopics.

The question of athletes and AF is not new either, especially endurance athletes as the training tends to enlarge the left atria which can upset the normal pathways ad allow AF to propagate. You may be surprised to know that another group who suffer this way are fast jet (fighter) pilots, presumably because the work they do fighting G forces loads up the heart.



Google 'Lone Atrial fibrillation' by Hans R Larsen for more info. Heart rate is controlled by both the Sympathetic Nervous Sytem and the Parasympathetic Nervous System. LAF can by caused by dysfunction of the first, by exercise and the second by other triggers including loads on the digestive system.

The article suggests nutritional deficiencies may be an underlying cause. If you enjoy massive amounts of physical exertion you might well be short of some of the nutrients that are suggested.



I am glad I found this forum I have had AF since early 1992 a number of attempts to get back on track with 3rd ablation very soon. I have never linked food with AF I seem to get it from over execise a sudden shock. I do suffer from reflux and was put on Sotalol 80 mg 3) times a day which did after 10 days get me back down to a 60ish bpm, But my breathing was so bad, my fingers went blue (I have lung disease) and was moved down to 2) 80mg Sotalol a day with 1) Digoxin.


Thank you all for sharing your information, hopes and fears! I have been diagnosed with Af since 1994, but so irregularly to be [almost] forgettable. Since September 2012 though it has really been a great bother to me, and it has made me quite scared. Am now on Digoxin, Warfarin and Verapamil, and my heart rate seems to be much slower and heavier, with occasional flurries for the last week. I am concerned about travelling next week from Cambridge area to Brighton by coach and train in case anything happens. Does anyone else

have this sort of fear, and is it irrational?


GranJan - no fear is irrational in my book. It may seem irrational to others but to you (and me!) it makes sense. AF does seem to sap one's confidence a bit. I think it's because one's body can't accept the flurries as normal and reacts by sending stress messages to the brain

Does it help to think through the worst case scenario? I mean think it through not just panic about it. When you are not at your best at home what do you do? if it's rest and wait for things to settle - you can do that on a train. The flurries are perhaps because you are worrying about the trip. The likelihood of something happening in those few hours in transit is unlikely. You can book help through rail services to help if you have platform changes to negotiate or problems coping with luggage


I agree with that Bagrat. Why let this mongrel condition ruin your life. I was once driving to Stanstead airport to catch a flight to France to see my Sister's new house there when an attack came on. I thought sod it I'm going anyway.I might as well feel rough in France as in England! The only problem I had was that I was running out of pills so had to see their local GP who freaked out and wanted to send me to a specialist heart hospital in Tours. I was able to show her an e mail from Brompton Hospital relating to my drugs and she relented and gave me a prescription so I could continue my holiday.

Granjan, accept AF into your life but do NOT let it rule your life. Who is in charge anyway?



Maybe this is just me, who knows, but recently I've been getting a 'jolt' or 'shock' type of zap when over tired (i think) or when in bed and trying to drop off (which takes ages) - I'm sure it's linked to my heart but it is very unnerving and when my wife and i are, say for example just reading in bed and she turns around and asks me something, it can make me really jump and that 'jolt' symptom happens.

Thought or experiences anyone?