Are these symtoms Vagal AF

[ian16527]

Hi all, new to the forum, hoping to get a little information.

I had wrote a long post, but thought I would cut it down a bit.

I have had ectopics ever since I had surgery for Crohn’s Disease in 1986 and had a line inserted which went into my heart causing VF until they pull it out, but since 2010 I get the following:

•Ecotpics on day 1, on and off

•Day 2 – Gradual pain in my chest, mainly across the top and down my sternum. Sometimes up the back of my neck – pain in my sternum when flexing chest muscles.

•Feel off colour, short of breath. Sometimes used to get short flushed/sweats, but not lately.

Had first attack of SVT/PAF in 2012 then the above symptom’s start and then die down slowly. Been on Bisoprolol 5mg since then. To muddy the waters, I have suffered ec

I’ve not been right since then with a lot more ectopics and the other symptoms as above.

Only ever seen a cardiologist once in Nov before the last attack and was quite well for a couple of years before this so don’t see him till August, although in hospital in Dec they suggested an ablation.

Question is, are these vagal symptoms causing the PAF or is it the PAF causing the symptoms? I have had 2 attacks last year, after a late meal and lying down in bed, the last one in December.

[BobD Volunteer]

The ectopics are a normal rhythm really it is only frequency which may be abnormal. ALL people have up to 200 per day and do not notice but of course we do.

Vagal AF generally presents at night time or after a large meal but even so some specialists deny it exists as a separate entity. If it does then beta blockers may not be the best treatment as slowing down the vagal tone increases the likely hood of AF presenting.

Your current AF burden does seem very low compared to most but that does not mean that you should be complacent. I think you need to talk to your doctors about seeing somebody trained in dealing with arrhythmias to discuss your condition and likely best treatment.

[ian16527 in reply to BobD]

Thanks Bob, I haven't had time to go through many posts yet, but my level of problem seems a lot less than many other posters.

But, because I feel unwell, when this comes on, as it has done over many years, I have pestered my GP's without any real diagnosis, other than when I've had the attacks . There was a question, whether they were Svt's as one doctor said the first 2 attacks were regular but fast, but the last one wasn't and I did feel rough, although I get no pain at the time, just later the next day or so.

My GP is on about anti coagulants as they are running a program at the minute to catch everyone with AF, but as I never see the same one twice its very difficult to get some continuity. The last one I saw was going to write to the consultant this week.

I have always had an attack after a meal, and at night just as I am going to sleep.I get ectopics always when I lie down, and I wonder whether these are the triggering event.

[BobD Volunteer in reply to ian16527]

Well IF you have AF then you do need to investigate your other risk factors to see if you need anticoagulation. Try looking up CHADSVASC on AF Association website and do your own assessment.

[seasider18 in reply to BobD]

Interesting that when vagal AF " then beta blockers may not be the best treatment as slowing down the vagal tone increases the likely hood of AF presenting "

I had not heard that previously and wonder how many GP's let alone cardiologists know it.

[cuore in reply to seasider18]

My GP certainly didn't as I went from having no palpitations and symptoms to palpitations and other symptoms.

[ILowe in reply to BobD]

How do you react then BobW to the Dr Sanjay Gupta video called "Palpitations and Beta Blockers"? I am still not clear in my mind about the label 'Vagal AF' but Dr Gupta here argues that a small dose of a betablocker acts against palpitations such as ectopics and helps to treat some of the causes, such as inflammation, irritation, too much adrenaline.