Any fellow violinists with paroxysmal AF?

I've been suspecting for a while that playing my violin may be a trigger - episodes often started when I came out of an orchestra rehearsal and logic said that sticking an instrument into the side of your neck for 2 hours at a time may cause problems with the vagus nerve. I'd originally ruled it out as a trigger because episodes still occurred during a 6 month break from playing. However a change of drugs broke the weekly pattern and I got to 4 weeks before I had my first rehearsal with an episode the day after. Last week we had a rehearsal on Thursday, followed by a concert on Friday - I had warning signs on the Thursday, and went into full AF just before the interval of the concert, so played the 2nd half in AF.

There was one particular piece that we were playing, both when I had the warning on Thursday and the full episode started on Friday. It was one that I was not familiar with (having missed a few rehearsals) and I know I was apprehensive about playing it so probably more tense and maybe not breathing properly.

Rather than give up playing completely, I'm looking for other options. So far, I'm planning to try Alexander Technique lessons for posture while playing and also to increase the level of practice that I do during the week. Hopefully that will mean I am less tense while playing because I'll be more familiar with the music.

Has anyone found anything else that helps, because I really don't want to give up playing?



18 Replies

  • Hi CTG99 I am new here but am post 6 weeks AF Ablation....for PAF might like to look into the procedure and read some of the experiences of others on the forums and talk to BobD who is a wealth of knowledge on fact everyone is wonderful.....

    I hope you find what's right for you as you shouldn't have to give up playing your violin that would be a great loss for you....

    Good luck with it all and as I have been told by many on here ask lots of questions and do lots of research.... and get a good EP cardiologist too...



  • Hi Caroline and weclome to the forum.

    I don't play the violin, or at least I tried when I was about 6 or 7 and managed only to get all the neighbourhood cats wailing which was the only thing in tune with my scratchings.

    And I hope you find someone on the forum who does, we certainly have some accomplished musicians on here, so you never know.

    I think your analysis of your own AF is very insightful, so many of us never really manage to find the triggers, but what you have said seems to all make sense.

    Are you being treated?, and have you seen an EP (electrophysiologist) because you are right that the management of triggers is important, but so is the treatments itself, and it may be (NOTE the may I am not medically qualified) that something like the "pill in the pocket" treatment of something like flecanaide might help to control the AF and allow you to continue with your music.

    Either way we are here to help all fellow sufferers, and good luck


  • Thanks Ian,

    I've actually been following discussions on the forum for some time now, but only recently plucked up the courage to post something myself after meeting people at the Patients' Day. (It was my therapist who was asking the questions about links between the body structure and AF at the conference.)

    I was on the pill in the pocket approach for a year from first diagnosis (age 42), then saw an EP in August who changed the drugs so I take Flecainide and a calcium channel blocker daily. Immediately I went from weekly episodes to four weeks, but each long gap seems to end with an orchestra rehearsal! (I've missed a few due to holiday and a cold, which is why there have been some longer periods without a rehearsal.) I'm still working with the EP on the medication route - he won't consider ablation until the medication route is exhausted due to the increased risk of stroke. In the meantime I'm trying to find some more practical ways of avoiding the trigger points occurring.

    The experiment continues...!!


  • Hi Caroline and I do remember you and your friend. She has my card if you need to chat off forum. My only thought is that it is more likely to be stress,-- for example feeling unrehearsed--- that has caused your events but since we are all different there is no way of knowing fully. AF is a very mongrel condition with little or no commonality.


  • Hi Caroline

    I play guitar and if you heard me, it would put you or anyone into AF :-) :-) .

    Seriously though, and this may be a long-shot, but I have heard it said that emotion, in the widest sense of the word, can start AF. I love music and recently went to see my favourite band at the Royal Albert Hall, and when they played my favourite song I went immediately into a quite severe arrhythmia bout, just like at the flick of a switch.

    I guess it can't be this as you must be very used to playing, but thought I'd mention it just in case!

    Hope you get it sorted.


  • Hi Caroline, sorry to hear of your struggles.... you've come to the right place.

    I don't play an instrument but I know that if I am in a rehearsal for an orchestra or a ballet production and the music is too loud it can set me off. The intensity of the vibrations in the music? Brass section very strong? Unless you were particulary worried about a piece I wouldn't think it would be emotional. i work with violinists (and oddly dentists) who have a left rotation of their spines due to their work and it is possible that postural work may help you - at least lighten the episodes for a bit.

    Look for an osteopath who works gently- deep fascial work as opposed to "cracking". Of a Structural integrationist (rolfing), again deep tissue work. Get a recommendation though if possible, you'll want a skilled therapist considering the Afib.

    Best wishes!

  • Thanks Iris. I agree re the soft tissue work - I've actually been using Amatsu for some time (a form of Japanese osteopathy) and we find that whenever I have an episode my T1 or T2 vertebrae go out of alignment (and it's the AF that puts it out because I went into one episode while putting my shoes on just after I'd been fixed!). It's very much a focus on soft tissue - no "cracking" whatsoever!


  • Thanks bigleg,

    Unfortunately magnesium and I didn't get on - if anything, I had more episodes while using it! I saw a naturopath quite a while back who recommended it so I gave it a go. However, I felt better when I stopped and my blood tests showed magnesium at normal levels. Rather than use a supplement, I'm going the salmon / spinach route.

    Appreciate the suggestion, though!


  • Interesting Caroline, I agree with various points made below plus I suggest you keep a diary and accept it will take time to track the triggers.

    Most people are low in Magnesium and a trusted Alternative Practitioner can help you there, say for 6 months, taking out one issue. Next I watch the experience that Koll had when 'in the zone' listening to a band - if I think I am going into a situation of total relaxation (including when I get into bed at night) I take the precaution of taking some big breaths to shoot a bit of adrenaline into the system and then decrease it slowly - sounds complicated but it's easy to get into the habit.

    Lastly, your neck when playing - I think you are right that the vagus nerve is relevant and some classes Alexander Technique or Quigong may help. I say this because my AF is vagally triggered I believe and when I sit down to read I have for some time felt more comfortable with lots of cushions behind my head so my neck had no work to do - your post has got me thinking that the Vagal nerve may be the reason.

    Don't give up on the playing, I think a lot can be achieved by careful monitoring, changing lifestyles and working as part of the team with your Cardio, EP and in my case Naturopath….and you've only just begun!

  • I know that this is offcentre to this posting but I thought it was interesting enough...


    The former Guns N’ Roses guitarist from Stoke-on-Trent faced a medical crisis of his own while appearing at Jackson’s 40th birthday concert at Madison Square Garden.

    Slash – real name Saul Hudson – reveals that it was his first gig after having a major heart operation.

    “Years of drinking had swollen my heart to the point of bursting,” he recalls. “It reached the point where the doctors gave me between six days and six weeks to live.

    “They installed a defibrillator to keep my heart from stopping and keep it beating at a steady rate. After the operation I began therapy and miraculously my heart started to heal.

    “I was out of circulation for four months before I picked up a guitar. It was the darkest period of my life – but in 2001 I agreed to play at Michael’s birthday celebration.

    “This was my first gig since the operation so I was looking forward to it. It certainly turned out to be memorable.”

    Slash did two days’ rehearsal for the September show, which boasted a bill including the reunited Jacksons, Marlon Brando, Liza Minnelli, Gloria Estefan and a host of Jacko’s celebrity chums.

    “On the day it was a great show,” he recalls. “Everyone in the Michael Jackson entourage was rocking out, and I was doing the best I could to stay away from alcohol.

    “After all, I now had a pacemaker.

    “When the doctors put the defibrillator in me, it was for maintaining a normal heart rate. For most people this isn’t a problem, but it was for me.

    “Once I get up onstage my heart rate sky-rockets. When I took the stage with Michael and got into it, I was suddenly hit in the chest by a shock and my vision flooded with electric blue light.

    “This happened about four times during each song, and I had no idea what was going on.

    “I thought I had a short-circuit in a guitar cable or a photographer’s flash had popped in my eyes.

    “Each time it happened I had to stand there and make it look as if everything was normal. I saw it later on TV and you couldn’t tell, so I guess I pulled it off.

    “It was extremely disconcerting until I figured out what was what.”

  • Practise will certainly help. If you know the music inside out, you should be able to cruise on auto pilot, therefore less tension and stress. Just enjoy your performances etc

    Happy playing :-)

  • Interesting discussion. I used to play the violin but that was when I was much younger and as fit as the proverbial butcher's dog. Now it is the guitar that provides my musical aspirations. Interestingly, sound waves through stringed instruments are particularly strong and are capable of changing the molecular structure of the wood that forms the instrument. Hence the advice that they should be played regularly and often. It does raise the question as to what effect these 'vibrations' might have on our body when the instrument is tucked under our chin or held close to the chest. Most of us have experienced the vibration within our chest that very loud music or bass responses can bring on. Certainly worth investigating, I would think. It's a bit worrying, Caroline........can you play the piano ....... or harmonica?!


  • FAscinating, never heard the aspect of molecular structural changes in the wood - Thanks!

  • I've got a couple of 40+ year old guitars David and like you say, they resonate. Also I think they used better wood back then as it was more available.


  • You're right, Koll, you have to pay a premium nowadays to get top quality tone woods. A lot of guitars come with what they term 'laminated' but really means plywood. It works to some extent for the sides but will never improve with playing if used on the top and back. Two of mine get better and better with playing - one has English walnut back and sides with a cedar top. The other a solid rosewood back and sides and cedar top. The tone and sustain on both is superb! Hey.......sorry folks! This is an AF forum not a guitar workshop! But you know where we're coming from.........

  • Thanks everyone,

    Many interesting comments. The next programme of film music starts next Friday, so it will be interesting to see what happens with some more practice. I'm also seeing my EP again on Thursday - I suspect we may be about to try a different drug.


  • How did things go? Hope you are feeling better!

  • Hi Iris,

    Thanks for asking. I was really surprised - apparently 3 months is long enough to find out that the medication route isn't going to work so he's going to put me on the list for ablation (about 6 months to wait apparently, so the Amatsu may make progress before then). In the meantime, no episodes since the concert and I've got the music for the next programme so have started working on it to ensure I'm comfortable with the music for the concert. The EP has confirmed that I won't do any damage if I continue to play in AF so that's good news.


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