I was diagnosed with PAF a couple of years ago and had a pacemaker fitted. Am on Bisoprolol and Warfarin. What has me puzzled is what triggers an epsiode. Have looked on the Internet, NHS and AFA websites, but have not been able to find anything. I drink very little alcohol now and for well over half of recent episodes I had not had a drink within the previous 36 hours. I don't smoke and don't drink a lot of tea or coffee, so can anyone suggest anything else I should avoid?

Many thanks

Chris M

32 Replies

  • AF happens Period. Don't waste time looking for triggers unless they come and bite you on the bum and say Hi I'm a a trigger. That way madness lies.


    Usual proviso personal opinion only but suggested by my EP.

  • A simple trigger for me is eating a full-sized meal. It's not a problem and I could still eat what I want, but it's uncomfortable, so I tend to eat little and often, unless it's chilli-con-carne, which I love, then I gorge on it and suffer afterwards :-) .

    Also, annoying things, not actual stress as such, will start me off. So having to queue, traffic jams, having to watch a rubbish film. I've managed to cut all those out of my life.

    As Bob says, your mind can also be a trigger in that if you look too hard you can make triggers out of nothing. Mine are real though because I wasn't looking for them.


  • I think your comment about the mind making triggers is spot on. Maybe I have got a bit locked in on it!!

  • I was diagnosed with PAF in September. I spent a lot of time trying to identify triggers from food and drink but results were very inconsistent and I no longer believe that food and drink directly contribute as trigggers. However, I strongly suspect that, over a period of time, they indirectly contribute through chemical inbalance within the body (for example, I understand that alcohol depletes magnesium levels).

    Regarding other factors, stress and exertion have definitely been triggers for me in the past and I have had to train myself to stay relaxed, avoid arguments etc and generally slow down.

    Having said all this, we are all different and AF can affect us in different ways.

  • The magnesium connection is worth following up. One of the sites I stumbled across today asserted that the majority of people with AF have a magnesium deficiency (it was American, mind!!).

    I also wondered what folks think about what to do when having an attack. Do you rest up etc or just carry on doing 'normal' stuff?

  • I have been taking a magnesium supplement (300 mg daily) for about four months (alongside other measures) and the number of my AF episodes has decreased significantly. I have also increased my consumption of bananas to improve my potassium levels.

    I take a very simple view that the human body is just one big chemistry experiment and electrical signals for the heart are generated as a result of inter action between various chemicals. OK I know things are more complicated but I like to work on the KISS principle.

    Thanks to a recent post from NanT I am currently reading a book by Lisa M. White entitled 'Conquer Your A-Fib' which has some interesting information about chemicals etc.

    You asked what people do when they are having an episode. Luckily I don't have bad symptons so I generally just get on with life but I will use it as an excuse to have a good rest when I can.

  • There appears to be choice of magnesium types (citrate or taurate - think I have the spellings right). Which do you use and where do you get it?

  • Sorry I should have said. My supplement is Magnesium Citrate which should be widely available. I get mine from Natures Best (online or catalogue).

  • Brilliant, thanks

  • Would also recommend Nature's Best. (I have no commercial interest here!)

  • For me it depends on how `bad` the episode is. If it wakes me up at 5.50 am I know its probably going to end up in A and E. I hang on as long as I can, but my heart rate is high and I am breathless after about 6 hours. Other times during the day I feel it for maybe minutes and although I am thinking of it all the time manage to carry on around the house, (Im retired a "fit and well" haha person ) Sometimes Ive found this the best way with shall I say mild attacks as when I sit waiting for it to get back in SR if feels worse.

  • I have started having more potassium in my diet after seeing I was below range on the three occasions my AF was bad enough to go to A and E Since then (last April) I haven't had any AF episodes so definitely think it's worth looking at

  • Hmm, hadn't picked up any reference to potassium. How/where do you get it, just from foods?

  • It's safer to increase potassium from food

    Jacket potatoes. Tomatoes bananas salmon Lots of fruit and veg. Coconut water

  • I think kale and spinach are good sources of potassium also nuts, I also sprinkle some sunflower and other seeds on cerial and add some to my home made bread.

  • When being reviewed because of Warfarin I was told that kale and spinach are particularly high in vitamin K (also some other green leaved produce) and that you should either eat constant amounts daily or avoid so as to stop the INR plummeting.

  • Yes, I have seen a reference to vitK content of green leaf veg affecting INR. It suggested that if you are already eating them it's OK to continue and increase slightly but be careful if starting to eat them. Same applies to chard and pine nuts.

  • The NHS web site has some really good stuff on AF and 'good' foods. also has some interesting stuff on foods.

  • Just as a matter of interest - how do you know if you have too much/too little magnesium, potassium etc. without blood analysis and how do you know what the optimum levels are for you? Or is it a case of assuming that there might be a surplus/deficiency and seeing if changing diet/taking supplements reduces symptoms?

  • Good point Pat. My Naturopath advised a blood test for Mg which was at the bottom end of the acceptable scale so gave me a supplement to boost it to mid range.

    The snag is I don't know whether a simple blood test tells the whole story as I think I read the body can rob Mg from elsewhere to keep it up in the blood.

    Every day's a school day!

  • Correct to be sceptical, a blood test will only show serum level of magnesium, not cell. The body will do everything to maintain blood serum magnesium at the expense of cell magnesium. Oral magnesium is notoriously hard to absorb so most of what you buy goes down the drain.

    In extreme heart failure in hospital, an anaethetist will administer magnesium via a drip, but even that will only boost magnesium levels enough to enable heart function for 20 minutes, it is very short lived.

    I researched this thoroughly and came to the conclusion that it wasn't advisable to take magnesium supplements, and definately not potassium which can be very dangerous for kidney function, unless prescribed.

    But it was a good idea to eat well and ensure you eat foods with enough trace minerals in such as organic fruit and veg.

    Also consider taking a bath with Epsom Salts. Relaxing, cheap and effective for absorption through the skin of essential minerals withn he added benefit that your body will only absorb what you need - osmosis.

  • Thanks CDreamer that's timely info as I see my Naturopath next week.

    I have actually stopped the Mg supplement as after a few months I got a metallic taste in my mouth. I am however considering rubbing a small amount of Ancient Minerals Magnesium Oil ultra into the chest shoulder area - this product was recommended for my circumstances by Robert Redfern of Naturally Healthy, who I think is good but the doubt is his firm sells a lot of product.

  • Too much magnesium gives you loose stools. Beancounter felt that was an understatement when I mentioned it a year or so back.


  • Thank you! Without the benefit of a blood test, this description suggests that I already have sufficient magnesium in my diet!

    After I had my heart operation, I was given a magnesium infusion as they said my BP was too low. It felt as though I was on fire.

  • Spicy food or anything tomato based can set me off, but not always. I do have the vagotonic strain of AF and a history of gastric issues so no surprises that some of my episodes are set off with food. Alcohol was another but I rarely drink nowadays.

    Having said all that just when I think I have this whole af sussed it comes and bites me on my arse when I've had nothing spicy, no alcohol etc.

    So as others have said trying to second guess what triggers AF is pretty much impossible but you can do a few things to help yourself which may help in managing your episodes.


  • I think that's what I found so frustrating, no matter where I looked I couldn't (can't) find a definitive answer!!!

  • That's because there isn't one!

  • Sugar, in all its forms should be avoided completely.

    A recent video presentation by dr bogle observed that success rates of ablation were doubled when accompanied by lifestyle and diet changes. The diet changes were based on a low glycemic index .

    If sugar distresses the heart post ablation perhaps we should all give the heart an easier time prior to ablation.

  • Agree about lifestyle changes, but even when you do all of that it can still happen!

    Also if you have sleep apnea, so worth being tested. I was found to have mild sleep apnea, am being treated with CPAP machine and feel SO much better. My EP says undiagnosed sleep apnea is one of the main causes of AF returning after successful ablation. It is so easily treated and so often ignored!

  • I'm no expert but I am slowly coming to the conclusion that you have to change your lifestyle including diet and relaxation techniques. The success will depend on the degree of sleep apnea, anxiety and AF.

    Of course loving tennis, skiing, running and working flat out I was not over the moon about walking, table tennis and yoga/qigong, less work/income was the easier bit. Although, I do miss the past, I am positive about the new alternatives.

  • Good for you Orchardworker! I'm also somewhere along that path and the only way I think it will succeed is if I stop comparing it to the past.

  • Agreed Marilyn, it's a shame Flecainide (my drug) does not cause amnesia!

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