Paf and it's triggers

Hi, I have had paf for over 8 years, normally get two a year,(finally got one on ECG this year), and can relate 99 % of episodes to, 1: alcohol consumption(sometimes the day after) 2: change in posture,(picked a box up from floor) and 3: sudden exercise, I can walk for miles with no problems, but put my heart under a bit more strain and it's havoc.

I have been prescribed bisoprolol but do not take it on a daily basis, as I don't want to become reliant on it

I also note that digestion and sleeping on left side at night can bring heavy palpiations on

I'm 31 now, don't smoke, not overweight, and don't drink much at all.2/3 pints could set it off so I have decided I'm going to stay clear from now on

Any input/advice would be fantastic,

16 Replies

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  • Hi Rich and welcome to the forum. Many people look for triggers for AF and for sure some find things. like alcohol, MSG, chocolate. You name it somebody will claim it is their trigger but you must accept that AF is a mongrel condition where few people are the same so you could get fifteen ideas from here none of which affect you. I note that you found sleeping on left side starts you off whilst I know of people for whom the right is the trigger.See what I mean.

    To have AF you need a pre-disposition to it which can be genetic or acquired . It is almost always a progressive condition but again progression may take many years. I probably had it for at least ten or even fifteen years before mine was diagnosed as it got a lot worse. Don't suffer if things do progress but get to see a cardiologist in the first instance or maybe even an electrophysiologist since they are the specialists in heart arrhythmias. GPs seldom have the knowledge or understanding to properly treat AF and yes bisoprolol seems to be like smarties to most of them. I doubt that you would get reliant on it but it may well make you feel worse than the AF!

    Good luck

    Bob

  • Thanks for the quick response bob, it is nuisance more than anything to me.

    I have gone up to two years with no af before, so I'm pinning my hopes on that again.

    I understand that in most cases paf can get worse, I have an appointment with my cardiologist next month and my vision is to go there in search of a cure/relief. As I have read paf can be cured but a permenant form is unlikely.

    As a general rule if I have little stress then things tick along quite nicely, but I refrain from exercise to an extent, and this bothers me. I am 100% that mine is linked to digestion in some form! I also suffer from ulcerative colitis!

    I am currently experimenting with magnesium and multi vits and probiotics to see if this improves digestive tract.My doc thinks I'm mad going to cardiologist looking for the cure but in my opinion if a cure is not the docs mind too, then he's the wrong doc!!

    Would I need to ask to see a electro physiologist or do I have to be referred by my doc or cardiologist.

    Thanks again for your response

  • Hi there I have just joined this forum and really identified with the triggers you mentioned. Indigestion being the most important. I could burp for Britain it is awful as I try so hard to watch my diet and the speed that I eat Most of my episodes of PAF wake me up very very early in the morning when I am curled up and constricting my chest. It is a combination of things that is the trigger.

    I have had PAF for 20years the first 10 were about 8 episodes a year controlled by PIP then I got fed up and took Flecainide daily 100mg twice a day and for 7years no PAF then 2 years ago had to have a cardioversion after PAF. Now last week had another episode so cardioversion and an appt in 3 weeks so will see what happens.On Warfarin since Feb.other anticoagulants gave me very bad side effects.Still taking Flecainide also Ibersartan(high BP).

    I am thinking of taking Magnesium I already take omega 3 and vit.D

    Best of luck and hope things go well for you.

  • I think either the GP or cardio could refer you to an EP. I hope that the cardiologist helps to explain things better and the AFA website of course is an invaluable source of knowledge. I'm sure there are lots of triggers for AF, but every time I think I've identified mine my AF proves me wrong - though some of yours, like alcohol, overdoing it, sleeping on the left, all do it for me too. I am just trying for a healthier lifestyle now, on the grounds that it can't hurt. It sounds as if you're already pretty healthy, and there's no harm in trying to find things that help, just don't get downhearted if you get AF every now and again. It's the nature of the beast...

    Lis

  • Hi Rich, I have had paf for 6 years and until this year did not see any 'white coats' after the initial diagnosis back in 2008. However this year it kicked off significantly and since February I have been on a steep learning curve.

    I agree totally find your own triggers (those you mention are on my list) and stick to them….a pain I know. Also do your homework to fully understand AF, see a cardiologist and insist on seeing an EP;there's a lot of information to digest but you need it to take the right decision.

    Hardest thing for you (and me at 60 !) will probably be always holding back (i.e. not pushing yourself) be it exercise work or consumption.

    Good Luck!

  • with only two a year I would try to relax about it and see what happens. So much of living with AF is in the head. Try to work out what type of AF you have, I have vagal mediated which means that episodes start at night / early morning and are not accompanied by rapid heart beat and can be stopped by exercise. You could also take the pill in pocket approach using flecainide if you can tolerate it. Beta blockers no good for vagal as resting heart beat is probably low already and lowering it with beta blockers is not a good idea

  • Thanks for the responses, lis, I also take a similar outlook, and stay as happy and positive, it is difficult at times when af constantly reminds you of things.

    Orchard worker i agree and it's bloody frustrating that I can't participate with mates sometimes , like a night out and even playing a game of footsie as it's bound to kick things off, excuse the pun

    Ben, I think I have mixed af, both adrenergic and vagal although I have only ever had one episode in the night........Like you say , I.e - beta blockers, I have avoided them as I want to speak to cardiologist face to face and let him advise after he has heard about the triggers, I have heard people saying there af has got worse after taking meds.

    I do believe it can be cured, and there is a reason for it, I have had echo, blood tests, chest X-rays , holter monitors, and they have all come back fine . So I know there is no heart disease or structural issues, so every now and then something happens to cause this arrythmia and there has to be a way of stopping it.Sorry little rant to myself.

  • Rich I think one of your biggest triggers is worry. When initially diagnosed I was placed on medication and I only had an attack when I over did things. I learned not to over do things and things went swimmingly. I didn't give my nights out or my past times a miss, I adjusted to my new condition. I started to worry less about AF and lived a perfectly normal life. I then changed my medication and after a short while I was having an attack a week, currently running at two a week. Attacks have been triggered by Cold water, over eating, during and after exercise & out walking the dogs, but the biggest trigger has got to be worrying about what my triggers are!!!!

    I have been so down, because of the attacks over the past few weeks, but I have a meeting with my Cardiologist soon and he has already stated he will refer me to an EP for possible ablation. I won't let it beat me and I will keep adjusting my lifestyle until things start to get better.

    Try to live your life as close to normal as possible. AF is a pain in the arse especially for somebody so young as you. As for the medication, If I could take a pill everyday that would let me carry on as normal, then hell yeah I'd be having it. Speak with your Cardio and if you're still not convinced ask for an EP referral.

  • There's lots of triggers for me. Eating a big meal or even a normal sized one, so I graze; lying on my left and maybe my back; alcohol; caffeine.

    But also, and possibly less obvious, are little annoyances or minor stresses. Like traffic. When we park, if I think we're going to be 2 hours, I'll buy a 3 hour ticket so I can just forget it. I arrive at meetings early. If I'm catching a train, I'll get to the station ½ hour early and have a coffee ( decaf :-) ), so I never have to rush. We try very hard to never fall out over anything, life is too short. etc etc etc

    Koll

  • Agree totally with you Koll re stress and avoiding it. I too always make sure I give myself enough time to get to appointments. Stress is definitely a trigger for me, along with consuming anything with artificial additives and not drinking enough fluids. I eat as natural as I can and since you said about wheat being sprayed to kill it before harvesting, I now try to buy organic products where I can.

    Jean

  • Hi Rich.

    I too have PAF and was told not to drink alcohol at all.

    A friend cannot eat any chocolate at all. It immediately brings on an attack for him.

    I've just been in France for two weeks , imagine how hard that was !!!!

    Good luck.

  • Welcome to our forum Rich, you will learn so much here and also receive loads of support. My advice, as always, is to avoid anything with artificial additives and make sure you don't become dehydrated.

    Jean

  • Hi Rich still working out my triggers. Flavored yogurt is one too much sugar another. Quavers which I love full of MSG. But I find I might react to something on one day and not on another day. Since my ablation no reactions but won't take a chance on some things just in case.

  • Hello Rich - I think many of the things already mentioned trigger my AF, especially Koll's post about stressing about minor things or worrying and fussing - especially about AF. Also artificial sweeteners, especially Aspartame, inhaling white spirit or any type of solvent (I paint in oils - I'm not a glue sniffer lol). Spraying insecticide or weed killer without a proper breathing mask - out of laziness.

    Keep hydrated - I carry water with me in the car when I go out.

  • Hi Rich, I'm 10 days into an AF episode at the moment. I do believe stress is a trigger. I stress about absolutely everything! But my first ever episode really was down to stress, I know that for certain.

    But i think certain medications may kick start it too. I had a sinus infection which had been ongoing to varying degrees since Christmas. I was given Nasonex for the sinuses, it worked well but I do think that could have been a trigger. But then on later returning to see another GP in the practice with a swollen nose, eye, cheek and my glands were so swollen I looked like a very greedy hamster!! She gave me antibugs for this infection. The cardiologist believes this may have been my trigger. I finished the antibugs yesterday. So who knows?

    I am presently on 10mg Bisoprolol (together with candasartan for my bp) and really don't feel great..I don't think they're for me...My heart is still erratic, I'm exhausted and the slightest exertion leaves me with an awful soreness in my chest (as if I'd run a mile).

    Now the infection has gone, I'm very hopeful that the AF will leave soon! But I stress about that too!!

    There should be a 'keep calm' slogan for AF I think

    JDB

  • Just noted my previous comment, "footsie" was definitely supposed to be footie! Lol

    Worry and stress is definitely a factor, however went for a kick about with my son earlier and after about 2 minutes, I became dizzy and could feel the palps starting which normally preceded my a.f. So had to call it a day.

    I'm pretty certain 90% of them are adrenergic a.f. As any thing more than walking will set it off!

    It's interesting that people have mentioned weed killers ect..... I am a greenkeeper and have a pesticide licence so spray large quantities on a regular basis but has never bothered me, however I do wear full PPE, so not exposed directly to the fumes.

    I have been quite lucky with food really, nothing is a def trigger, however I don't eat late t night and avoid too much caffein chocolate and alcohol.

    It's good talking to you guys, as it is giving me more insight prior to my consultation in sep.

    Thanks again

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