Vagal afib?

[Andyt36]

How does one know if one has Vagal afib?

[rosyG]

It often starts at night when the nervous systems changes when asleep. Also, vague nerve stimulation through large meals etc can start AF

If you do have vagal AF you shouldn't have beat blockers or digoxin as they can make it worse

[Andyt36 in reply to rosyG]

Hi rosyg thanks I was just wondering how it would be diagnosed?

[BobD Volunteer in reply to Andyt36]

Unfortunately there is no concrete diagnosis of vagal AF and in fact some cardiologists do not accept that it exists. As Rosy mentions if food is a factor or if AF is worse at night when the vagal tone is low then it could be. The reality is that AF is AF is AF and what may set it off is the conundrum. Since we are all different there is no one size fits all answer Andy.

[Andyt36 in reply to BobD]

Thanks Bobd,

[Hidden]

Hi Andy,

For me it was the gradual realisation that food triggered an AF event. It took me some 4 months post diagnosis to understand this. My symptoms were massive and painful bloating including a feeling of pressure and heaviness in the chest around the heart - and/or intestinal gurgling (socially unacceptably loud) - and/or diahorrea - and/or burping. So, nowadays, so long as my chest remains 'light and free' I know I'm Ok.

The worst and most significant of these was bloating. They all occurred at random with no way of predicting which of the 4 would occur after a meal. Time frame was anything from 90 minutes to 5 hours after eating - depending on the food.

From tests done in hospital when I was diagnosed with AF I knew there was nothing structurally wrong with the heart or cardiac system.

When bloating occurred my blood pressure increased - normally it was around 126/70 ish but when bloating occurred it could rise to anything up to 160/90 in hours, but would take about 5 days to return to normal, and I'd feel crap in the meantime.

I ignored the heart, stayed on my meds, consulted a Nutritionist changed my diet but continued experimenting with food along the way and now I have been AF free since April 2015.

Now, all that said if you research in detail the Vagal nerve, it can also be linked to, stress, anxiety, food, dodgy gall bladder, alcohol and caffeine to name a few. If you haven't already done so 'Google' vagal nerve schematic/diagram and you can see where this nerve spreads to (the wandering nerve). I don't think the medical world really understands this nerve properly yet. Cardiologists rarely accept it much less understand it. A Gastroenterologist is much more likely to know about it and have an understanding of it.

John

[Andyt36]

Thank you, when I had my first bout if AF I was in a bad place, mentally, very highly stress, suffered from anxiety and was trying to figure out whether they were contrbuting factors. My head says yes, as when I am calm, happy etc my whole body feels it.

[CDreamer in reply to Andyt36]

The vagal nerve is just part of the ANS - autonomic nervous system so if you are under a lot of stress, this can also trigger AF episodes. I think it was only last week that the link between ANs and blocked arteries was announced. There is a lot we still don't understand about the complexity of how are bodies work, until recently, western medicine has had telescopic vision to such an extent that we failed to view at the bigger picture.

bbc.co.uk/news/health-38584975

The ANS can also go awry and cause lots of different dysfunctions in digestion, controlling body temperature, BP and heart rhythms.

Managing stress in our lives is crucial for good health, we all cope with it very differently.

[Hidden]

I go into a pronounced arrhthymia if I eat even a normal-sized meal. I have to eat small meals (almost child-size) and graze during the day instead, the key being to never fill myself up or anywhere near it. But knowing this, if I do get an arrhthymia after eating something I can't resist, it doesn't bother me because I know it'll just go away after a hour or two. I'll just sit it out. Very uncomfortable though.

Is that vagal aFib? I guess so.

Koll

[Jomama]

I'm pretty positive I suffer from vagal afib. I would say 99% of the time I go into afib in the evening, after I have eaten my dinner and am settling in on the couch to rest. If I don't eat too much and am upright and active, I can avoid the afib. For instance, if I go to a restaurant and then get up and walk a bit and get home a while later and sit down, I may not go into afib. The vagus nerve runs right by the heart, and regulates, or slows down heart rhythm. It's the nerve that will slow down the heart when you are running and stop. My understanding is if you have a vagal type afib, when you are resting, your heart might slow down too much, so other cells trigger in the heart to speed the rate up and this triggers afib from too many signals. The vagus nerve then kicks in to slow down the irrational fast heart rate and then actually promotes more afib becaause it's actually in a sense competing with the other triggers and you get a merry go round type scenario going. Contributing to this is a full belly from eating which might put pressure on the vagus nerve and stimulate it to slow the heart rate as well, and then this causes the afib to act up when the other cells fire in the heart to slow it down. There's a great explanation of this by Dr. Gupta that might help explain better than I can youtu.be/yvJ7KNIgGQ4(Not working as expected?) Like another post said, I think eating smaller meals is a good idea if you suffer from vagal afib, as well as making sure you don't sit down and relax immediately after eating for the evening.

[Andyt36 in reply to Jomama]

That's very interesting thank u

[timince]

Vagal nerve AF virtually always gives rise to paroxysmal (ie non-persistent) AF and is usually associated with a trigger of some kind, usually food or drink but also stress and/or exercise. My first recollection of AF was after drinking a couple of very light, gassy lagers when I experienced very strong palpitations (I now know as ectopics) which felt like my heart was bouncing around in my chest. This was accompanied by a feeling of trapped wind and a strong need of a good belch! I didn't go into full, rapid AF on this occasion and the palpitations stopped after about an hour. I went to my GP the next day, and although this was over 35 years ago, she immediately told me about the vagus nerve which passes very close to the stomach on its way to the heart and when distended, can 'stimulate' the nerve which in turn can set off palpitations. Well, over the next 30 or so years I had many more similar episodes and had to stop drinking lager and switch to bitter! About 5 years ago I started going into full blown AF, always preceded by ectopics and associated with indigestion and wind. I am now on Pradaxa (dabigatran) for anticoagulant and Flecainide/Bisoprolol as a PIP and otherwise am a very fit and healthy 70yr old.

Hope this is of some help Andy, but there is a lot of info about AF & Vagus nerve connection online.

Good luck with your AF.

Tim

[Andyt36 in reply to timince]

Tim thank u very much. I am on a journey right now trying to ensure that I compartmentalise. I think I am slowly accepting I have paf doesn't stop me searching for a hopeful solution.

[Hidden]

Hi Andy, I diagnosed I have Vagal PAF from reading postings here and from a quite old article I think I found googling.

For what it's worth I believe, like AF, the Vagal Nerve has its own triggers (e.g. heavy meal, stressful life, pressure - lying on the left side in bed) not just one, they all potentially contribute some which when sufficient result in a reaction strong enough to cause AF.

If you are still with me, I will take it one step further. I think I have identified the key factor in my case was stress. My understanding is that if you have continued stress your para-sympathetic system expands to calm the Vagus Nerve; take the stress away like in the evening or at night and the para-sympathetic system having become stiff at a high level due to continual stress does not ratchet down quickly enough...result heart is calmed down too much when it no longer needs to be, allowing AF to start up.

What did I do.....initially I avoided collapsing into chairs or bed at the end of the day but wind down slowly and when ever I felt AF coming on I would take some deep breaths or get up and do a light household chore. Then I accepted I need a few years of low stress on everything - work, relationship, social, exercise etc and I now do 1 hour a day Mindfulness, Yoga and prayer - all 3 a great comfort and just walking daily when I would prefer running, tennis and skiing.

All conjecture but you have to back your own theories that work for you. Good luck.

[Andyt36]

Thank you orchard worker, my episodes went like this very stressful few years, mind dark etc lot of changes

None the less after a stressful year cold hands feet, fight or flight, anxiety IBS. I started feeling things were improving did some yoga in hotel room and bam, first episode of AF. Anxiety then sky rocketed but I was determined to beat it, wrong attitude as I should have worked on acceptance.

Second episode 3 months later after a very heavy boxing training session. Bisoprosol reverted in 45 mins.

Third after 7 months after a tiring few months, stress and relatives being hospitalised etc... That was on Xmas day.

I am beginning to think that the stress and anxiety for a prolonged period has not helped and could be he trigger. In fact the latest episode I was asleep and felt it go into AF as I woke in the morning Christmas day.

Thanks again I find all your responses V helpful.