AF Association

Vagal AF, Omeprazole and Metoprolol

A Dr.Gupta video recently appeared on this site. It suggested if you have vagal AF then treating the stomach problem may help the AF. I told my new local GP who suggested doubling my Omeprazole for the treatment of my reflux. I then started taking 2*20mg first thing in the morning but that didn't influence my AF. So I decided to take 1*20mg morning and again last thing before bed. What a dramatic change. Since then I only start an AF during the night and importantly, never during/after eating which had been my predominant trigger.

Has anyone tried something similar?

I also take Metoprolol. It has also been suggested on this site that if you're suspected of having vagal AF that Metoprolol is not the correct beta-blocker for the heart. BUT there was no suggestion what was better. HELP.

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Hi lizzle,

I've got enough drugs rattling around inside me I certainly don't or didn't want anymore. I consulted a Nutritionist and went down the change in diet route. Gluten free, wheat free and oats free - and I expanded the diet from there. Until a couple a weeks ago I have been AF free now for almost 3 years.

On 15 Feb 2018 I had an AF event arising from sleeping on my left side. Lasted 4 hours or so but the heart rate took another 20 hours or so to slow down to normal. It peaked at 149 bpm and my normal resting HR is around 65 bpm.

I've made a big effort to stop sleeping on my left side and my diet continues. nothing more since. Feel just great. I'm on 5 mg Bisoprolol daily at night for HR control.

John

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Do you still eat meat etc..

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Yes, most red meats, white meats, fish and some poultry. Much depends on the cut of the meat. The exclusions are duck and pork.

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That's very interesting, as I find that lamb doesn't agree with me as it is fatty where as pork sits much better.

By the way what change had you made to your diet that made AF appear again or was it something else that you can pinpoint or did it just happen?

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The diet didn't cause a return of AF, or contribute in any way. The cause of its return was posture related, i.e sleeping on my left side. My heart began banging away like it was trying to clamber out of my chest. This was a new experience for me, I had not had this ever before but I knew intuitively what was happening. Take that one step further and you come back to a dysfunctional Vagal nerve which involves food and diet ( and in some people hot and cold drinks, coffee, tea and/or alcohol), and also posture.

Sleeping on the left side has been reported by many to be a trigger of AF.

Anyway, as good as new now ..... until the next time.😀

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Glad to hear :)

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Out of interest do you drink any alcohol?

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Yes I do - low alcohol beer, wine and G & T. Sometimes a lager. Never English pub real ales.

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Hi again.

I've had trouble sleeping on left side , right side, raised head etc, and I'm now suspecting it depends whether I'm curled up. I know that bending over can greatly increase my HR, so a fetal position in bed would be somewhat similar.

A

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Hello again Carneuny. I remember a previous thread of yours on how successful your nutritionist consultations had been.

Obviously I've touched on something relating to my digestion to create the marked change in my triggers. I've noted my body position when I've awakened in AF but can't find a trend. There's been laying on left side, right side, flat on my back and even with raised head and torso. I'm not sure if that indicates a digestion related issue as it's flowing through the body.

I'll have to read all the responses in this thread to make any sense but appreciate your reminder of your successful diet.

Many thanks

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Hi again lizzle,

As I said to Andy, this sleeping on my left side was right out of left field for me. A new experience totally. My own personal view is that posture, food and alcohol and other beverage triggers all come back to a dysfunctional Vagal nerve. Nothing supported really by medical or scientific research, just my views based on extensive reading. There are some interesting diagrams online about how far and the extent to which the Vagal nerve wanders through the body and how it influences various functions.

Sorry to read that you are being plagued by so many conflicting symptoms and I do hope you strike lucky soon.

John

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Thanks for those thoughts. I'll keep posting updates as they develop in the next few months.

Alan L

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NO - not Omeprazole it’s a PPI!

It was never designed for long term use and will deplete the stomach of acid which is the worst thing you can do for GI health.

I suggest you look at Dr Chaterjees videos on gut health and nutrition advice and leaky gut if you want to help heal Autonomic Dysfunction (vagal is part of that). His recent book The 4 Pillar Plan is an excellent beginners guide with easy to read explanations and recommendations. The 4 pillars of good health are- sleep, nutrition, exercise & relaxation. Get those right and you may not need any meds.

If you do have vagal AF then try calcium Chanel blockers as HR control drugs.

Best wishes CD

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hi CD reamer'

just reading your comment and wondered if I should be taking Omeprazole daily as I am. This was prescribed as a 'preventative' as some of the heart meds I am taking can cause stomach problems. I take Perindipril, Bisoprolol and Flecainide. On top of that I also take Exemastane ( cancer medication )Thyroxine, Gabapentin & Tramadol both for pain, vitamin D3, Glucosamin Sulphate with vitC....quite a cocktail I know. Some days I just want to bin them all and see how I do!!!

stay well

Blue :-)

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Omeprazole Is almost automatically prescribed for any meds that cause GI symptoms - mainly acid reflux prevention. Many meds do cause this symptom Dabigatran one NOAC which is famous for it as well as Pyridostigamine- a drug I take for Neuro muscular condition. Omeprazole coats the stomach with a protective layer which does several things - inhibits absorption if the med is designed to be absorbed in the stomach and depletes stomach acid. Dabigatran has a gel coating which requires stomach acid to break down the gel in order for the active ingredient to be absorbed.

If you read back through my early threads - circa 2013-14 you will see I wrote quite a bit about this and I stopped take Omeprazole accordingly - learned how the drugs were absorbed, what time was best to take them and with or without foods and what type of foods. Eg - Pradaxa & Rivaroxaban need to be taken with food - preferably acid producing foods to be adequately absorbed - if you eat with carbs at breakfast for instance - which require alkaline environment to break down fibre - the stomach reacts because it cannot empty fast enough into the small intestine - which is an alkaline environment and where carbs and fibre are digested - so pushes excess acid upwards into the oesophagus = acid reflux.

Knowing how, when and with what to take your meds can alleviate most GI side effects.

Hope that helps.

I take something like 14 essential tablets and 6 supplements a day! I was speaking to a researcher who told me that all these drugs could be ineffective - you can lose something like 80% of the biological availability evidently - if not sufficiently absobed. I have one med which needs to be taken with a FULL glass of water whilst another 15-30 mins before food.

Taking them at different times can also help - but can also be a real nuisance.

I found that following this method I have all but eliminated GI symptoms induced by meds, on the few occasions when I do get acid reflux now Liquid Gaviscon and a glass of water works very well and only take when I have the symptom.

Hope that helps.

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hi,

interesting and will read up about things a bit better. I take 12 tablets in the morning and 7 at evening and am beginning to realise that perhaps swallowing them all at once isn't good after all! I've been lucky so far in that I actually haven't had any acid reflux issues but think I need to learn a bit more about all that I'm taking.

thanks for the reply,

stay well

Blue :-)

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Hi CDreamer. I always like your well thought out answers. Thank you.

I've found a youtube video of Dr Chaterjee's, all 1hour18minutes of it. I'll look at it later.

Regarding Omeprazole, I went on it about 20 years ago and since then I've had 5 different Dr's plus 3 heart specialists, all of whom readily accept my continued use. However going back to the original stomach issues, these were related to a lifetime of stress at work and home. The body could only take so much and eventually was damaged. Having said that I would expect an improvement with diet changes (although my diet is pretty good already) so I'll re-examine that issue particularly regarding cereals.

I also note your comments later in this thread concerning the bodies digestive acidity/alkalinity pattern. It all sounds very complicated. Thankfully my meds are not as extensive as yours. Perhaps I should seek out a nutritionist to help.

Some time starting Omeprazole my AF developed to a stage where medication was required to help. The point I'm trying to make is the Omeprazole was not a countermeasure to AF meds.

Yesterday I discussed with my GP an alternative to Metoprolol as I'd heard it was incorrect for vagal AF. He didn't know of this issue and we agreed to both investigate it further. So, do you have some reference or link to say calcium chanel blockers are the way to go for vagal AF?

Thanks once again for your input

Alan L

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PPIs reduce stomach acid. Problem is that the stomach needs acid and the lower sphincter only reacts to an acid environment so if you stop that acid it doesn't open to allow passage into the gut and food is retained in the stomach for longer increasing the chances of reflux. As CD states not a great idea long term.

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I am sceptical about taking Omeprazole long term too. I have been taking it for the last six months to protect my stomach from pain meds for arthritis (Naproxen and Zapain). I don't have AF, I have SVT. Over the six months my SVT episodes have become more frequent and hectic, also BP has risen. I take Bisoprolol PIP but it doesn't seem as effective now. I suspect it's the Naproxen possibly causing this increase in SVT episodes and BP, but I can't take it without Omeprazole and I suspect the Omeprazole was reducing absorption of the Bisoprolol? So a week ago I dropped all pain meds and Omeprazole. It's quite difficult stopping Omeprazole, I am suffering from rebound acid indigestion, which I believe is common when stopping, and I am suffering with the arthritis without the meds, but I am just glad the SVT and BP have improved.

I've heard that Omeprazole isn't meant to be taken long term, you don't get all the nutrients from your food and as has been mentioned by others here, it can possibly interfere with heart meds.

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Interesting post, apart from my AF and I am a great believer in AF and the link between digestion, stomach health etc...just not sure what the next steps should be.

Oh yes and omeprazole ...my father who is now 85 has been on it for as long as I can remember, GPs appear to dish it out but never review it afterwards. It is getting me thingking that might be one of the culprits for his occasional diarrhea....which for some reason peppermint oil tablets seem to help.

Thought I'd post the above just in case it helped.

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Thanks for your input Andy.

I rarely have any diarrhea even though I take Omeprazole. It is one of the stated side effects, but so is constipation.

I've never heard of peppermint oil tablets. Presumably you get them at a health shop.

Alan L

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Hi Alan, I believe the peppermint oil tablets I got from Holland and Barrett

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I have afib 2 years now and take metoprolol and also omeprazole for the past 15 years with GERD and doctor advises to stay on it due to Barrett's esophagus which is precancerous,,,,have tried to wean off the omeprazole but acid in my throat and pain stop me cold! Also have a huge hiatal hernia for which surgery not a great idea due to age and general health,,,it's a problem,for sure,,,,when one thing affects another,,,,weighing the cancer risk of Barrett's against the side effects of long term omeprazole use,,,I am thankful my afib has only occurred twice in the two years,,,,!

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My understanding is that NO beta blocker should be used for vagal AF.

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Interesting comment.

I discussed with my GP an alternative to Metoprolol as I'd heard it was incorrect for vagal AF. He didn't know of this issue and we agreed to both investigate it further. So, do you have some reference or link to say no beta-blocker should be the way to go for vagal AF?

Your help is much appreciated.

Alan L

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My consultant never diagnosed me with Vagal AF. He diagnosed me with paroxysmal AF! It was many many months later that I made the connection with the Vagal nerve. I consulted a Nutritionist and through diet I have concentrated on calming it and therefore calming the heart. Either way I have been on Bisoprolol for over 8 years now with no side effects, apart from occasional weariness.

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Does your consultant now say you have vagal AF and if so does he confirm Bisoprolol is the correct medication rather than the standard beta-blocker of Metoprolol?

A

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Hi Alan,

Apart from follow up consultations after I was originally diagnosed way back in the first half of 2010 I have never felt the need to return to my consultant - ever. Thing is, when AF first hit I lived in eastern Surrey, I now live in Cornwall so it would be very much a case of starting again. Once I accurately identified food as the trigger for AF and consulted a Nutritionist and overtime calmed the vagal nerve it was nonsense to rake over old ground. This simply worked. I doubt any consultant will say that one has vagal AF - most cardiologists don't have a clue about the relationship between food, drink, vagal nerve and AF. My official diagnosis was paroxysmal AF with the tendency at times to be asymptomatic.

So officially, after I let diet take over part of my life my last AF event was April 2015 - until 15 Feb 2018 when as a result of sleeping on my left side I lurched back into AF and the event certainly wasn't asymptomatic I can tell you :-)

Even then I never bothered with my GP much less see a cardiologist - why would I - try get an urgent appointment with a GP much less a cardio - its easier to pull hens teeth ! I have a BP monitor (which records AF) and I have a handheld portable ECG device, a Heal Force PC-80B. No ! I don't do Kardia ...... they are no bloody good unless you have an iPhone or a Samsung (although they do support some other Android phones - useless - my phone is a Moto Z2Play, a Nov 2017 model and they told me in writing they did not support that phone. ( even though they do support ONE other, down market Moto phone). So ...... on yer bike Kardia.

The PC-80B worked fine and recorded very, very chaotic electrical stuff, which I downloaded to my laptop and have printed off hardcopies. In about 4 hrs the AF had subsided but the HR took about another 20 hrs to return to normal. No sweat. Had the AF behaved differently, more randomly, more chaotically in the hours that were to follow this first hit I may well have called the paramedics.

Sure the PC-80B isn't hospital quality - but nor is Kardia - but it produces enough data as a start point for the medics to get their brains around what is happening.

I have digressed ....... sorry ....... Bisoprolol was originally prescribed by the diagnosing consultant in Surrey. It was prescribed as a (heart) rate control medication. It was not prescribed for blood pressure or anything else. It was originally prescribed to be taken in the morning. This gave me some unwelcome side effects, so my GP, at the time, checked it out and told me to take it at night. I've done so ever since (8 years) with absolutely no problems. It and warfarin are my best mates ....... ever ! So, if it ain't broke, don't fix it.

However, it needs to be said that I do care for my gut by not eating foods which are likely to destabilise it, occasionally, I eat something with an ingredient or an interaction of different ingredients which cause me to bloat, sometimes bloat like crazy and I just work through it, and eliminate that product from my diet in future. By the way this approach has no side effects on my INR blood readings. In fact If my INR is too high or too low I self adjust by varying my intake of greens. Always works.

John

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Really like your answer. Many thanks.

I'll put Bisoprolol for vagal AF on my list of possibilities to discuss with my GP.

Alan L

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Just a thought but anyone suffering with stomach problems should get theirselves tested for that nasty little stomach bug Helicobactor Pilori.......Antibiotics are normally prescribed and there are also a number of natural remedies to help control it.....Manuka honey Etc.

There is also a condition called Candida Albican ....it’s not really recognised by the medical profession but if you google it there is quite a lot of information.

Questions that arose quite recently in a coaches seminar I was attending regarding nutrition was in this modern day of eating on the run ....how well do we chew our food, what is our posture like when eating and how quickly do we rush our food.

All small points I know but they can all add up to a bigger picture. I remember as a child always being told to sit up straight and chew my food properly, when I was excused from the table I was told to take my time and not go running around until my food had gone down.

I have been involved in sports nutrition for a number of years completing many courses and listening to many experts from the medical and homeopathic backgrounds the food we eat plays a huge role in our health and well being.

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Yes, I have been checked for H.Pilori and all OK.

Reading between your lines I think a nutritionist visit may be the way to go.

Cheers

Alan L

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Absolutely my advice also - be sure H.Pylori is investigated for ( a simple blood test at your GPs)

I badgered my GP to have this test and much to her surprise and my relief it was positive - I had treatment to eliminate it with a big improvement in my gastric / Vagal AF symptoms. Cathy.

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Hi I was unhappily on omeprazol sp? Which controlled my reflux. However by having smaller meals and sitting upright after, and reducing my alcohol intake, I have successfully treated myself and no longer need it. If I feel I may be getting an attack a quick dose of gaviston works for me.

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