I have seen a fair number of folk here describing what to me are potential (or sometimes very probable) Vagal AF symptoms. From a paper on this, it is described as follows:
"Vagally mediated atrial fibrillation occurs more frequently in young healthy men than in women (ratio 4:1). The age of onset is usually 30–50 years. It hardly ever occurs in a structurally diseased heart, probably because any cardiac disease tends to shift the vagosympathetic balance towards a sympathetic predominance. Rather than being precipitated by emotional or physical stress, the arrhythmia more likely occurs at relaxation periods and most frequently in the evening as indicated by heart rate variability studies and by the presence of bradycardia in individuals with structurally normal hearts. Other inciting events (reflecting increased vagal tone) include cough, nausea, rest, post-prandial states and alcohol
Holter monitoring may show sinus bradycardia before the onset of atrial fibrillation and a slow ventricular response during the episode. Vagal stimulation has been shown to shorten the atrial refractory period, thereby decreasing the wavelength of atrial excitation wave fronts. The shorter the wavelength, the higher is the probability that multiple reentrant circuits can exist simultaneously in the atrial myocardium. Furthermore, vagal stimulation has also been shown to facilitate reentry, and this effect has been used to induce or maintain AF in experimental models."
"Conversely, adrenergically mediated paroxysmal atrial fibrillation occurs more commonly in patients older than 50 years, during the daytime, and during periods of increased physical or emotional stress. The diseased myocardium is more sensitive to sympathetic stimulation evoked by these stressors."
Could we do a (highly unscientific!) poll to see how prevalent this might be? Thanks
If you would therefore
(a) post your age AT ONSET of AF
(b) male or female
(c) your resting heart rate when in sinus rhythm
(d) whether you have any digestive problems
(e) your most obvious triggers
It would help not to have too much / any discussion in this thread. Thanks!
Written by
Jong1945
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Age 55 ish but had ‘palpitations’ most of my life which were ignored.
Female
Varies - when well generally 62-72 but when unwell with virus or infection or Mg flare - 85-110
Yes - always had GI problems starting in my teens with Ulcerative Colitis - now controlled with diet.
Most obvious trigger is moving just after eating; eating some foods or too large a meal; stress and emotion; worry; over exercising.
I have been aware of the significance of the ANS and ill health and specific links between AF and food, alcohol, sleep apnea.
I come to the conclusion in the mid eighties that we must look holistically at illness and treating symptoms one by one results in what is called ‘chasing the pain’. Resolve one issue and another pops up.
We need to address all the following at the same time - nutrition, sleep, breathing, exercising for general & AF good health and well being.
Feel good and you will be good - whatever conditions you may have.
It's a good point you make about early, ignored symptoms. When I was pregnant (age 20) I had an 'odd turn' while panicking about my mother's darling dog going awol while she was shopping - I'd been running around trying to find the darn thing, which she was very attached to, and my heart started behaving oddly. I had to lie down for about 20 minutes before restarting the search.
PS - 10 years ago I had what was described as ‘mixed’ AF ie: episodes starting during the night which were frequent were Vagal and were probably linked with sleep apnea - CPAP cured that and I now never have these episodes.
2 ablations cured the non Vagal AF and now all my episodes are preceded by tachycardia - so I only have Vargal AF and have warning and can take preventative measures.
So I don’t think I fit into that profile! Whoever did the the research and what study was it based upon?
(a) 44
(b) male
(c) resting heart rate 75
(d) no digestive problems
(e) alcohol, caffeine, full stomach, emotion/stress
I have digestive problems like bloating, seems to make my heart skip beats.
70ish BPM
I notice lots of skipped heart beats when just sitting around. When Im active I do not seem to get them. Im not sure if that is AF I am new to this. Oh and if I overeat I get lots of skipped beats or my heart races. Hope this helps
61years at onset
Male
48 bpm
IBS
Anxiety, following heavy exertion but never during exercise, large meals
e.Eating late afternoon, or evening, full stomach, larger meals, during resting after meals, any resting late in the afternoon or evening, never afib after a big breakfast
(d) yes, can be prone to indigestion, excess gas and feelings of bloatedness, nothing officially diagnosed.
(e) exercise, eating late, large meals, alcohol, laying on left side. Most of my attacks happen either late in the evening, just before bed, or in the middle of the night. Except exercise at anytime can sometimes bring it on. I'm convinced I have some vagal component to AF.
e. dehydration possibly. Otherwise unknown. There's certainly nothing that will definitely, or even probably, trigger AF, although I've cut out or cut back on lots of things.
OK, that's enough for my purposes; thanks everyone. Keep posting if you like but I'll not be including the answers in my summary. Unfortunately it looks like I can't paste the results in here in any presentational format. Last post included is "UScore" 's post.
Unfortunately without being able to post something pictorial it's difficult to see this but in general, there is a rough correlation between low HR, digestive problems and vagal or suspected vagal AF.
Whilst it's a complex picture, what did strike me was
- the low number of clearly adrenergic AF
- 50% are below 60 bpm, where I think the usually quoted average rates are "60-80" (?)
- 50% are vagal or possibly so (my assessment / "I am not a Doctor"!)
- digestive problems strike 2/3rds of us - that's HUGE!
I did say it was an unscientific poll; take what you want from it. There is also the point that the sample is a self-selecting group, not only in terms of people answering a poll that might interest them, but also they are taken only from those who come to a web site like this and will therefore tend to be those who have had problems and are needing support/discussion etc
Thank you John for creating this poll. It prompted me to look in to the concept of vagal and adrenergic AF. It seems that not all cardiologists as opposed to EPs believe in it.
Indeed, although it has been included in the American and European Heart Soc Guidelines for at least 5 possibly 10 years now. Albeit a bit buried away.
I have Bradycardia now post ablation x 1 + year but note if I get up, move around that helps. I also drink ice h2 0 as soon as I begin my day, about 48 oz over an hour. Really helps but if it’s an a fib day it doesn’t always respond, then it’s more like 5-6 hrs to go away. Resting rate is about 65 but with Brady will go down into high 40’s. I have IBS issues also. Hope this helps.
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