Lone, idiopathic, atrial fibrillation

I found this article to be of interest, particularly with respect to vagal mediated episodes - I have been led to believe by my cardiologist that the vagally mediated forms of af are much less likely to progress to persistent or permanent af - the only doubt being the ongoing question of absolute confirmation of vagal origin which according to my cardiologist is not something they can absolutely guarantee

Absence of Syncopal Episodes (Atrial Fibrillation of Vagal Origin)

Most of the syncopal events that present at the onset of an episode of AF are consistent with a vasovagal mechanism, a circumstance that identifies a group of patients with vagal primary AF in whom the likelihood of recurrence is low, possibly due to the fact that the vagal hyperactivity is a transient episodic event.


7 Replies

  • Really interesting and bears out my experience. Alcohol plays a huge part.

  • Hi netpi, thanks for that link, I read the whole thing and of course struggled with the terms. But I got the gist. Now I confess I'm a bit confused. I have been 100% convinced that I have vagally mediated af, just from info on here and my own instinctual feelings (not scientific and very subjective). The first thing that leapt out to me was the statement that vagal af typically starts with syncope (fainting). I have never passed out in 20 years of af. Been a bit close a few times, but not at the start. I don't know what to think now. Has anyone got any comments on this? JanR

  • Yes, I know what you mean. About 2 or 3 years ago I used to have faintings- for no apparent reason it would go black and I would pass out (in Debenhams cafe at one time)no palpitations etc though. I was taken to A and E once, checked over nothing strange found. The said it could be just one of those things. Now, I feel light headed always when in AF so if at home I lie down with legs higher until it passes. I remember 2 years ago mentioning it to my Practice Nurse who said it could be a drop in blood pressure, that was it with her though. Regards


  • I think I might have vagal AF but not sure. My episodes often start with a feeling that I might faint - but I haven't so far. The feeling soon passes though the AF will stay for typically at least an hour.

  • Thanks for posting. The crux is one can't be sure so I have tried to cover all bases.

  • Thank you for posting, same situation as me. And as Orchardworker says below, you have to cover your bases. My cardiologist here in the US just recommended that I get a FitBit Charge HR, which will monitor my pulse 24/7 (apparently -- I did buy one but it was too big so switching out as soon as this snowstorm passes!). So the idea is if you are lone afib and relatively young (I'm 53) then you wear this and you can know whether you are having episodes of rapid pulse. OK, so not perfect and you might get false positives, but Afib will typically make your pulse atypically rapid so at least it's one way to try to take back control (without going down the route of blood thinners, which I am tempted to do and the charts say I should do as I had a TIA after the one tracked Afib episode but there is risk with blood thinners as well). ANyway, just throwing it out there to the community ...

  • I have never felt any faintness before, during or subsequent to an attack - all my episodes without exception appear related to something in the gastric system and exclusively in spring and autumn but as we have seen, everyone is different - there is a vast constellation of symptoms associated with af and of course different forms of af have different sets of symptoms - it's an alphabet soup of issues and we can only hope that some day, someone has an aha moment and figures this all out

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