Positional changes trigger AF for me - Atrial Fibrillati...

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Positional changes trigger AF for me

Vony profile image
Vony
56 Replies

Hi. I am just wondering if anyone else experiences their arrythmias very much when they sit or lie in certain positions? When I lie back in bed or sit on a low chair, it is a very very significant trigger for me. I feel my heart begin to flutter and then go into full force AF at these times. Several doctors gave dismissed this as a trigger and try and explain it away by saying I am probably just more conscious of the palps because I am relaxing. I find this very frustrating as I have tried to explain that one cannot generally NOT be conscious of your heart galloping in your chest at a rate of knots so it is certainly not that I am 'only noticing it ' when I 'relax'. I actually began to find that bed was not a resting place for me anymore and began to sleep upright to try and reduce symptoms. I am very curious to see if anyone else has experience this or if anyone can explain it. My EP did say that it can be something to do with the venous return? ?

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Vony profile image
Vony
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56 Replies
dedeottie profile image
dedeottie

Yes. If I lie on my left side or bend down. X

Vony profile image
Vony in reply to dedeottie

Seriously? Have you ever had any explanation as to why?

rosyG profile image
rosyG

I think it's to do with pressure on the vagus nerve and/ of the heart itself

dedeottie profile image
dedeottie

Yes Rosie that is what it feels like. I feel as though those positions squash the heart and kick it into A.F. I'm not sure if that can be physically possible but it's what it feels like. I recently heard someone.else say that bending down did it for her too. X

Gtmoshi1 profile image
Gtmoshi1 in reply to dedeottie

100% its the case for me. I go into afib after waking up on my right arm being numb about 50%. I get up, sit in a chair, put my feet up, breathe deeply in n out. Now without any medication, and go back to sinus rythum. Takes me about 5-10 min of relaxed concentrated deep breathing, then immback to normal

dedeottie profile image
dedeottie

I also sleep upright and have done so for a long time. In fact I now get a decent nights sleep like that! X

GivEmkeL profile image
GivEmkeL

It doesn't happen to me all the time, but I have noticed that things like bending over to pick something up off the floor will set off an episode for me. Best wishes! -KeL :)

AnticoagulateNow profile image
AnticoagulateNow

I'm 100% the same Vony. I entirely empathise with your somewhat sad comment that "bed is no longer a resting place". I feel exactly the same. My AF episodes always begin in the horizontal position. There must be an explanation - internal organ shift or something similar - but then it doesn't affect all AF sufferers. Yet another mystery to add to this mysterious of medical conditions I guess.

They are rather expensive but I am considering one of those beds that allow you to sleep in a raised position from the waist. Simply raising the head on pillows doesn't cut the mustard with me.

Tobw profile image
Tobw in reply to AnticoagulateNow

It's similar with me, I'm best off lying on my right hand side, but, even then, I can go into AFib. When I'm going through one of my periodic spells when I slip in and out of AFib a lot, I try sleeping upright, but that even that doesn't work because I find that, at it's worst. my heart starts misbehaving once I've been sat down for around ten minutes. One other thing, I cannot once remember going into AFib when I've been stood up.

wat54 profile image
wat54

Almost all my AF episodes start around 6 to 7 a.m. when I am still asleep. Sleeping in as upright a position as possible seems to help, and when I do have an episode I often discover that I have turned onto my side whilst asleep, especially the left side.

in reply to wat54

Yes. But more like 3 or 4 am for me.

My arrhythmia is triggered by position, food and annoyance/niggles. With the position trigger, I get the wobbles if I lie on my left side and to a lesser extent on my back. I'm now on drugs which "smother" the arrhythmia, but I still feel a bit funny if I lie on my left. The same when I eat a meal unless it's very small, I can feel my ticker trying to wobble but the drugs just about stop it.

Koll

A-FIBBER333 profile image
A-FIBBER333 in reply to

May I ask what drugs do you take that smothers the A-Fib.? Is it especially for that or, one of the regular dailies that one has to take, like I do. For instance Propafenone and Toprol? I have only just started to experience the a-Fib whilst lying down. Wake up 2-3 times a night with heart racing with extra beats every now and then. Try not to give in to take yet another extra med. Thank you. Evie

frenchgoose profile image
frenchgoose

Hi all of you...I have the same problem with a position arrhythmia, food, over eating, bending, gastric bloating and the heart wobbly feeling! My family and friends look at me quite strangely when I tell them! My EP says these things happen when a nerve can be close to the heart/stomach......but I just wish there was some expert out there who would take all our experiences seriously and be able to offer suggestions to alleviate these symptoms .....but who do you book a consultation with??? I have been prescribed Diltiziam which helps slightly!!

Al6215 profile image
Al6215 in reply to frenchgoose

Sotalol can help too, just not at the same time as Diltiziam.

After breakfast and after dinner seems the worst for me. Also sitting in a reclining chair and leaning back seems to trigger the palpitations.

Dixiegurl profile image
Dixiegurl in reply to Al6215

Leaning back will almost always trigger an attack for me.

Kimmieblue profile image
Kimmieblue

I completely agree with Rosy, the vagus nerve, for me causes all of my AF episodes and ectopics it seems.

I don't have this from a medically trained individual but from my own experiences, I am sure when the vagus nerve seems to be under pressure my heart will start it's usual acrobatics!!

How come EPs won't even discuss this, that's what I'd like to know?

Hope you get the advice you need here.

All the best. X

Beta44 profile image
Beta44

I use a v shaped pillow designed so that you can sleep upright. Available from John Lewis and elsewhere. You get used to it!

Peter

CDreamer profile image
CDreamer

Hi yes, it is vagus nerve. If you do a search on this forum for posts regarding vagus nerve or vagal tone you will find that a high proportion of AFers are triggered by Vagas nerve. It is well known trigger and I really don't why so many people on this forum report exactly what you have, their doctors dismiss it as insignificant because it sure isn't to those of us who suffered from it.

One particular episode episode I had left me completely incapacitated and admitted to cornary care because I had the opposite reaction ie I was in Slow AF when lying down but as soon as I raised my neck to sit up I went into very fast AF and my BP dropped to 70/30. I was like that for 72 hours and as 12 of them was in ER I had doctors coming from ER and cardiology asking me to sit up just so they could watch what happened on the monitors - I was linked up to ECG. Never seen that before they all said. And that is the problem, most of them havent seen it happen to someone who is linked up to an ECG and unless they see that trace, you will not be listened to.

If you are confident it happens every time, ask to be linked up to an ECG so you can demonstrate.

Good luck

steve60 profile image
steve60

Hi there, yes agree with everyone. Lying on my left side in bed and off it triggers, when I turn to the right it stops. Yes yes I can hear the message, 'so stop lying on my left side' !!

in reply to steve60

Yes rolling on my left side triggers it. A few times I've been quick enough to react to cut it off but most often I'm in a-fib and reach for another dose of medicine to stamp it out. I wish turning to the right was all I needed to do.

makeawish profile image
makeawish

with my a/f I didn't really notice any particular"triggers"........but since my stroke in april,I do notice an increase in my heart rate laying on my left side,all the time.i did ask about this but was told I was probably worrying too much,really!!!!

Vony profile image
Vony

Makeawish... i find it very concerning when experiences that are reported to doctors are dismissed as being 'worry' or 'anxiety'. It leads me to believe they are not taking it seriously and will miss something important in their diagnosis or treatment plan. Indeed, i have had this experience myself as i have reported episodes of slow arrythmias for a long time now ( am only being treated for fast) and have been told i am 'focusing too much on every sensation in my heart' or 'it's probably ectopics' or that 'slow rhythms have never been recorded'. I also have reported about the positional trigger and that has never been discussed at length with me and indeed has been dismissed as me 'analysing it too much'. I know my own body as do you. We live in it 24 hours a day. I actually asked if the AF could be secondary to something else (eg..am i stimulating a nerve or is there an enlargement of some abdominal organ that is pushing against a valve when i lie down) as i am so sensitive to positional changes..i was laughed at. Honestly i was. I felt so demeaned and belittled.

cbsrbpm profile image
cbsrbpm

Yes I too have loads of pillows and left side sleeping is a no no. Sitting down in a low chair will also start the heart to wobble somewhat. I often wonder what response we would get from a cardio that also has AF, that would be interesting!

carriewoods profile image
carriewoods

Hi Vony, yes I'm exactly the same and now always try to sleep in elevated position. I've just ordered an adjustable bed as my pillows don't always keep me elevated.

Deeferdi profile image
Deeferdi

Yes when I lie on my left hand side in bed I have a very curious sensation in my heart area, not pain just discomfort. It goes away if I lie on my back or on my right side. it doesn't trigger my AF but something isn't right, going to mention it to my Cardiologist next appointment.

Musetta profile image
Musetta

I've had AF for 2yrs - hospitalised twice - other AF episodes (an average of one every three months) have been managed at home - and yes, I find some episodes AF or unpleasant heart flutters are triggered by sudden movements i.e bending down,turning over in bed, and very occasionally while bearing down during defecation. All the best to you Vony.

iris1205 profile image
iris1205

100% agree. Position being compressive to the heart or vagus nerve. Posture plays a big role... any gentle stretching which opens the thoracic region is helpful. Wouldn't it be lovely if the cardiologists and EPs starting recognizing this... not much they can do, but the compassion would be lovely. As one mentioned, it isn't always anxiety or stress related!

Vony profile image
Vony

So interesting Iris...and thank you for the advice on gentle stretching. I had to stop doing pilates as lying down and rolling onto side for different exercises was just triggering me into arrythmias far too much during sessions. I will try some gentle stretching. I am staggered at how many people have replied to say they too experience this. Even on coronary care wards when i have been in hospital, some doctors have dismissed this as coincidence when i have pointed out this pattern and been on telemetry and kept a personal record of positional changes to show the correlation. Why is it not listened to?? Surely this should influence the research and treatment of AF if the main trigger comes from somewhere other than the heart? Fascinating!

iris1205 profile image
iris1205

Find someone who is more fascially oriented and doesn't teach old fashioned classical Pilates. It can help as it maintains length in the body which is what our thoracic region needs - not compression. Stay away from old fashioned crunchs, tight "roll-ups".... anything which will compress the diaphragm, viscera and of course the heart.

Or yoga, but again not old fashioned, turn yourself into a pretzel yoga! The meditative aspect can be quite helpful as well. We tend to get a bit too attentive in Pilates sometimes - something AFers excel at already!

I work with a brilliant woman in Brighton - fascial therapist and the best yoga teacher on the planet because she knows Fascia from a hands on point of view as well as having done top level research.

If you would like her name, she could also send you to someone in your area perhaps? Send me a private mail if would like her name. She does crainal-sacral work as well. She was the "ange"l who came to be with me for my first ablation. Made the pre and post procedure so easy. Hope this helps!

EricW profile image
EricW in reply to iris1205

Hi Iris,

I live near Brighton. Can you let me have the name of your Yoga teacher. Thanks. EricW

Gtmoshi1 profile image
Gtmoshi1 in reply to iris1205

Im 39 years old, ive had 3 afib occurances in the last 2 years.

I really wanted to ask someone that had an ablation procedure, did it stop the afib, or help?

Hi Vony,

As already said lying on the left side and or very flat is a vagal nerve or problem pressure on the heart. I sleep using 2 pillows (i.e. quite high but not sitting up) and do not sleep on my left side, which you get used to and I am now back to around 6-7 hrs sleep.

Re doctors, I haven't even bothered mentioning it as I know even if they don't dismiss it out of hand, they will say they can't comment as outside their remit and I have too much other stuff to squash into the limited time available.

If I may a general comment on dealing with doctors and I have seen a lot this year…….I'm an easy going, happy chappy but I have found you have to be stern verging on the stroppy with doctors to make them listen but stay on the right side to keep their support. Don't expect a holistic empathetic approach, you are just another case in their increasingly narrow specialty and consequently many have zero knowledge in surprising areas e.g. nutrition.

End of rant, have a good day!

Vony profile image
Vony

Haha orchardworker...i shall practise my stern voice for my next appt! I find if something cannot be immediately explained by the medical model, it is generally dismissed as neuroses or ' looking into things too much'. It cracks me up i work as a nurse myself and my ethos is that people know their own body best...they live in it 24/7..so NOTHING they report should ever be taken lightly. Unfortunately not all health care staff have this approach though as i have discovered.

Al6215 profile image
Al6215

Yes, I know it affects me the same way. Different positions seem to make me feel my heart start palpitating, or sometimes go into full afib.

Daddy45 profile image
Daddy45

I have found rubbing just under my rib cage or between my left hip and left side of my rib cage can stop the afib and bring back normal beating.

Yes, most definitely it is a positional thing for me too. The only time I ever get a-fib is when I am lying in bed. I have caught the exact mechanism a number of times, with the most recent one just last night, at 4 am. I try always to sleep on my right side. I guess there is a mechanism that wants you to roll over -- I do this while asleep. As soon as I did roll over onto my left side the a-fib triggered. Have experienced this many, many times. I am now starting to think of countermeasures I could put in place to wake me up before I roll onto my left side. Has anyone come up with a solution? Sew something to the back of my undershirt? Use that spikey plastic covering that discourages dogs from jumping up on the furniture? Help! I feel like my a-fib episodes would be gone if I could just control my sleeping position. Comments? BTW, I am new to this forum, but I am a regular on the prostate cancer forum. I am doing fine now with that situation but now a-fib episodes are coming with greater frequency. I am age 67.

scottlayton35 profile image
scottlayton35

Wow this is so relevant at the moment. My doc said all my symptomss are down to anxiety yet im not convinced. I get the increase in HR when i turn over in bed and then heart palps continue rest of night. I wee alot at night, i have restless legs, i have heart flutters. I think ill give sleeping on my right side see if it makes a difference.

Vony profile image
Vony in reply to scottlayton35

You know your own body. Do not allow anyone to tell you you are Neurotic when you point out a symptom. I was told in the past by one know-all condescending doctor that sensations I reported as though my heart would 'stop' for a few seconds or go to slow were 'in my imagination'... I am now getting a pacemaker....

li17 profile image
li17

I'm experiencing exactly the same thing. So frustrated. Sleeping is not relaxing anymore but anxious. I can only lay on my back, and whenever I wake up at night, I can't fall asleep any more, resulting I getting out from bed at 3am or 4am. I'm only 36 years old, long way to suffer. Sigh!!!

Vony profile image
Vony in reply to li17

So sorry to hear this. My EP said my AF is vagally mediated and this is a sign of that. If it's any consolation, I have got used to it now and can sleep through it most nights. Be wishes and I understand exactly how you feel xx

Haydnoneill profile image
Haydnoneill

I have just developed this over the past year and I can also confirm that when I lay flat on my back I start to get skipped beats. I had to sleep on my left side to stop or I went for a little walk.

Gtmoshi1 profile image
Gtmoshi1

I also am 1000% sure for me, i trigger my afib when sleeping on my left side. I wake up with my left arm 50% numb.

Always seems to be around 6-7am.. weird..

So i get up, sut in a chair, put my feet up, and begun to take slow deep breaths, in and out. I really focus on a regular heart rate sound. I close my eyes, sitting there for 5-10 min, and i go back into sinus rythum.

Ive done this now without any medication. The mind is a very powerful thing.

Vandalbragg profile image
Vandalbragg

Before being on Flecainide laying down or reclining would trigger palpitations. Didn’t matter which position.

SkippyTicker profile image
SkippyTicker in reply to Vandalbragg

Are you on flecanide daily? I have it as a "pill in pocket" but seem to be going into AF more regularly now at 330 am especially if I'm on my left hand side.

Doris2010 profile image
Doris2010

This subject is so interesting as a sufferer of SVT not AF I always worried about positional triggers and was advised the vagus manoeuvre to halt episodes so there is a definite connection further research led me to discover that if you have any spinal “issues” undiagnosed they are triggers of Arrythmias! Fascinating check out Dr John Bergman on You Tube “hidden causes of Arrythmia” will make so much sense.😀

Jklmn profile image
Jklmn

I have the same experience. It's not our imagination, etc!! I often sleep in a chair. Annoying!!!

navaho profile image
navaho

I became frustrated with my GP dismissing my AF episodes as ‘acute awareness’ or ‘anxiety’ after I had a heart attack back in 2015. 75% of my AF episodes are most definitely attributed to sleeping on my left hand side, I also experience flutters when on the sofa with my feet raised (this was the position I was in when I had the heart attack)...I am 100% certain that my AF is triggered through positional, mainly left hand side sleeping.

My AF increased in intensity and frequency just 6 months after the heart attack, after repeated failures by my GP to take it seriously I paid private health care to see a coronary GP, this was 2 visits, 1 of which was to have anECG for 24 hours...what a waste of time that you as, anyone who suffers from AF will tell you that 24 hours on ECG will rarely show typical results, a waste of time and £1250.

However, when I went to take the ECG back to the nurse, I complained about the 24 hour home monitoring period and told her that I would need it for at least a week to capture a couple of episodes properly. She recommended ‘off the record’ that I invested in a device called ‘Kardia’ which connects to an iPhone and allows you to record AF as it happens. She also said that many GP’s and specialists refuse to acknowledge apps but Kardia captured every detail of heart activity through AF and it was gradually being accepted.

I bought Kardia on Amazon in the UK for £99 and I started to record ALL of my AF episodes, within a month I had 60 five minute recordings of AF which demonstrated a heart rate range of 120-210 over prolonged periods (up to 8 hours for me) these were almost all experiences after falling asleep.

Once I had the reports, I took them to the GP and he immediately referred me back to the Cardiologist who treated my original heart attack. The Cardiologist was astounded at the quality of the Kardia recordings and asked me to email more reports to him when they happened. He was initially sceptical when I said I was recording my AF, ‘Fitbit’ he asked? ‘No, Kardia’ I replied and then presented the 60 printed reports to him.

The Cardiologist then explained with concern that AF is serious and should be taken seriously, due to the increased risk of stroke and heart attack. He immediately referred me to a cryo-ablation specialist and I am waiting for a procedure to freeze the faulty area of my heart which is responsible for the AF.

Experience tells me not to ignore what your body is telling you, don’t let your GP dismiss your AF as ‘anxiety’ or ‘acute awareness’ whe you know that something is seriously not right. My advice is to invest in Kardia and take your results to your GP, hand it to them, mail it to them or email it to them, they cannot ignore a written record from you with so much evidence of coronary irregularities.

Arion52 profile image
Arion52

Two attacks of AFib both time lying on my side...When I sleep in a recliner have never gotten an attack...Have more fluttering also when I lie on my side, no doubt about it!

Cher17 profile image
Cher17

I am in permanent AF but I have to sleep on my right side and sit propped upright or I feel worse

Jellybelly2016 profile image
Jellybelly2016

I get this when my heart is feeling irritable. I say irritable because there are definitely times when my heart feels more ‘electric’ and sensitive. During these times if I lie on my left or right side, particularly after a meal, it sets of my palpitations and funny rhythms. It’s horrible. Like you I’ve just been told it’s because I’m more aware of it. I say that’s rubbish and there must be s better explanation! X

My Afib is faster when I lay down, especially if I am asleep; dreaming seems to be connected. I've had episodes where my rate was over 200 for two hours before I woke up. So the idea of "just being nervous and being aware of your heartbeat is ludicrous! People know more about their bodies and how they react since they live in them every day. You see your doctor every few months and there is no textbook case of reactions and triggers to afib. I have two cardiologists, I call them my plumber and my electrician. They each have their function. In the last 5 years when I started with Afib, I have had a pericardial stripping, multiple cardioversions, a seven hour ablation, and after that time my ejection fraction has gone down from 60 to 30%. I"m wearing a portable defibrillator. Just diagnosed with dilated cardiomyopathy. I'm not young, but PLEASE stick with the medicines, keep all MD appointments. I have done everything that was prescribed, meds, tests and procedures. Please don't go down the same path.

JoWilmer65 profile image
JoWilmer65

I have same symptoms.

Can be vagal related.

Hiatal hernia.

paulymac profile image
paulymac

Exactly. Both of my episodes were when I sat on my bed and laid down quickly.

paulymac profile image
paulymac

Yep. I’ve had two episodes when I sat on my bed and then lied down quickly

vosenbox profile image
vosenbox

I am glad I found this thread. My symptoms too are common when sat or reclining in a chair. I go into the 'heart wobble' that a few have described on here, and also leads to full AF. I had a cryo cardio ablation on 6/3/24 and haven't really seen much difference tbh. I know I'm still in the 'blanking period' but things honestly feel the same. If anything the symptoms from sitting & reclining seem worse. So I definitely am thinking Vagal Nerve is a culprit after reading this thread, something I've thought for a good few years.Thanks all for sharing your symptoms

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