Positional changes trigger AF for me

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? ?

38 Replies

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

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

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

  • 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

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

  • 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 :)

  • 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.

  • 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.

  • 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.

  • 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.


  • 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!!

  • 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.

  • Leaning back will almost always trigger an attack for me.

  • 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

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


  • 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

  • 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' !!

  • 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.

  • 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!!!!

  • 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.

  • 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!

  • 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.

  • 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.

  • 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.

  • 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!

  • 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!

  • 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!

  • Hi Iris,

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

  • 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!

  • 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.

  • 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.

  • 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.

  • 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.

  • 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....

  • 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!!!

  • 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

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