Nocturnal afib: I tend to go into afib... - Atrial Fibrillati...

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Nocturnal afib

Flipflopper profile image
57 Replies

I tend to go into afib between midnight and 2am. Anyone else like that? I would say it is 90% of the time. Is this normal?

I have paroxysmal afib. Finally confirmed in 2013. I can remember my heart flopping around like a fish out of water when I was a child. That would be 45 years previously. I have low bp 95/55 and pulse 50 I am on verapamil (calcium channel blocker). Digoxin has just been added as my pill in the pocket (propathenone) leaves me so sick after I take it. I was on it daily for 2 years, but had to stop. It will still be my pill in the pocket though. I have tried and failed metoprolol diltiazem and a few more. Digoxin is because I can't go on anything that would lower my pulse.

I go into violent afib. Every time. Like I don't need to take my pulse, I can feel it in my chest and back and I can hear it in my ears. Is this normal?

Sorry this is so long. I'm just not understanding how people can have this constantly?

My protocol from my Dr is to take my pill in the pocket after only an hour of afib. If it doesn't work then I am to get to the hospital.

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Flipflopper
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57 Replies
robboian profile image
robboian

Hi Flipflopper

Yep, that's how it is for me. I've had AF for about 18 years now, done various drugs, several cardioversions and three ablations including a transthoracic ablation. Since the last ablation I'm mostly controlled BUT when it come, it comes at night. I wake up with that thumping in my chest. I don't think that we are the only ones.

Good luck.

Strongheart143 profile image
Strongheart143 in reply to robboian

My AFIB episodes are caused by stress, worry, and anxiety.

Right now in America, the whole COUNTRY is having a anxiety meltdown! I eat a banana, drink Natural Calm (Magnesium citrate) mixed w hot water and a little lemon.Also I drink plain Pedialyte mixed 1/2 and 1/2 with Low Sodium V8. I put in a pinch of GOOD SALT..- Himalayan Pink and a good squeeze of lemon. This helps my electrolytes and minerals which get depleted when I am stressed. Nourishing the electrical system is key to heart rhythm balance.

I don’t know about the middle of the night stuff except that I stay up MUCH TOO LATE. Like last night, and my heart started going wonky. Early to bed seems to be the ticket.

Lastly, I am ultra sensitive to EMFS. This means limiting computer/ iPad/cell phone use and Turing off all devices preferably leaving them in a different room and NOT the bedroom. Never EVER falling asleep with devices on near my body! Which of course I have done. 😏

All the best to you.

Walking helps me to restore my natural rhythm.

Flipflopper profile image
Flipflopper in reply to Strongheart143

Thanks for the input😀. For a person who has had this for so long, I am finding I am really uneducated in the causes, the ways to help myself etc! I am really thankful for this group!

I have just read about

electronic devices and causing issues,so they will stay outside my bedroom. I am going to try watching how late I eat and I have already cut out every trigger, but wonder if I do need a push on magnesium. I am super fit and so my eating and lifestyle is fine, but the afib is increasing in intervals and strength and I want to do everything I can to stop the downward spiral.

I have been doing the lemon and a bit of salt drink for awhile now.

Flipflopper profile image
Flipflopper in reply to Flipflopper

When I am in afib I tried the walking and my heart rate went to 175 and bp was 128/107. Thought I was going to throw up or pass out So the walking doesn't work for me

Maril1 profile image
Maril1 in reply to Strongheart143

Same here . I use walking instead of flec as a pip because of the after effects. I find a good walk 15mins to 1hr brings me back to sinus rhythm heart rate is through the roof mind you but it beats sitting around with fireworks going of in my chest.

JoBrien profile image
JoBrien

Hi. Very interested to read your post. My husband says he wakes early hours gasping for breath and he can hear his beat through his ears and how the beat drops to a low thud then picks up etc.

Is this normal for you guys and gals and should GP be notified/will they do anything?

I can only begin to imagine how frightening it must feel.

Polski profile image
Polski in reply to JoBrien

See BobD's note below!

BobD profile image
BobDVolunteer

Night time AF can be casued by sleep apnoea so it may be worth having a sleep study done. Many people are unaware of this.

Flipflopper profile image
Flipflopper in reply to BobD

I was not aware! Definitely ask my Dr about that. I am starting to have increased episodes in the daytime though. I'm in an active phase right now. It's why I had to go on Digoxin. It's so interesting to see all the posts !

AIW58 profile image
AIW58

Also look into vagal AF. IThere are threads on this forum. I used to get woken about that time with it too. You seem to be on a lot of meds and I didn’t know Dig was used as a PIP. Have you tried Flecainide? Have you been referred to a EP?

Flipflopper profile image
Flipflopper in reply to AIW58

Digoxin is a daily now , along with verapamil. My PIP is still propafenone which I think is the same drug line as flecainide. I do have an EP. It's great to know there are others as I have been told by emergency staff that I am abnormal 😀

ILowe profile image
ILowe

I wonder. I have not looked into it. I read somewhere that in a normal healthy person, the heart does a workout during the night. Could what you think is AF, be a heavy workout? Too heavy?

I started looking. Googled: sleep heart activity.

Incbi.nlm.nih.gov/pmc/articl...

... the rapid eye movement (REM) stage is characterized by a likely sympathetic predominance associated with a vagal withdrawal, while the opposite trend is observed during non-REM sleep.

Flipflopper profile image
Flipflopper in reply to ILowe

We documented it as afib. As a kid it was always in the daytime. I was told I had a heart murmur and I just assumed that was what a heart murmur did 😀. Interestingly, after a full cardiac workup 5 years ago,the murmur is barely audible. My brother has afib as well. He had two ablations

Strongheart143 profile image
Strongheart143 in reply to ILowe

If you’re asleep, you won’t notice it!

Jamila123 profile image
Jamila123

Hi

Yes I was diagnosed the same no cardiac problems just I use to get monthly bouts of Afib

Normally started post evening meal

I went on a detox and completely stopped all so called triggers

The health professionals in many cases are not sure what causes afib so therefore it stands to reason we not sure whether there is a cure or not

And it certainly does not always progress

All I can say is that many poeple genetics can predispose us to certain illness for example Asians are predisposed to diabetes however how they choose to live there lifestyle means they might not get it

I know I am slightly going off tract but basically

Change your lifestyle it’s all about the inflammation and oxidative stress

Put in good stuff keep away from the bad

Begore I detox I realised the night time afib was related to my gut

Do your research

Dr Gupta talks a lot on utube about the gut heart link

I realised everytime I got heartburn or bloating

Yep my heart would start up

So I treated my gut by stopping foods that caused this and started on repairing my gut

This treatment and herbal medicine the one not seeped in alcohol as this is toxic to the body

But dried herbs from Baldwin’s

And the key part was putting back nutrients into my body

Since over a year not afib and 6 months prior as I was treating myself the symptoms were reducing by amazing short time

I don’t take any orthodox medicine and never had an ablation nor will I

June 😀

Flipflopper profile image
Flipflopper in reply to Jamila123

That's cool if it works for you 😀. I'm documented and diagnosed by a cardiologist and electrophysiologist using all the modern medical technology and happy for it . Lifestyle change isn't necessary. I'm fit, lead a very healthy lifestyle, know and avoid my triggers. Just haven't found anyone else that does the nocturnal afib, so it's nice to be here

Jamila123 profile image
Jamila123 in reply to Flipflopper

That’s great

However I gave another view point on nocturnal afib Which could be the gut

Of which u did not acknowledge

Which I had

Flipflopper profile image
Flipflopper in reply to Jamila123

Oh truly sorry! Wasn't disregarding it at all. We are very gut friendly and enjoy putting only non processed foods onto our body. I eat a very gut friendly diet and i make everything from scratch.

I just meant it isn't my problem obviously I didn't type my response out right.

Jamila123 profile image
Jamila123 in reply to Flipflopper

😃

in reply to Flipflopper

I've had six episodes of very fast horrible afib lasting about 7 hours always blue lights in to A&E every single one of them started at 1am i have no idea what the triggers were. I don't sleep very well so possibly apnea.

Flipflopper profile image
Flipflopper in reply to

I find it comforting that there are others out there who have the same experiences. I was hard to explain the violence of it all. Are you exhausted for a day or two after?

in reply to Flipflopper

Very much so I'm usually sick with it and upset tummy and it lasted about 7 hours and reverted back into sinus with the help of bisoprolol then I'm 2 or 3 days of resting in bed or sofa. But to be honest I'm very debilitated all the time, i can't work or even manage very well around the house some days. But I think it's the drugs for me I can't tollerant them. I have other heart problems too.

I'm up at st georges next week so hoping they have some answers for me. Take care.

Flipflopper profile image
Flipflopper in reply to

I hope they have answers for you as well. Thank you for making me feel better 😀.

in reply to Flipflopper

Thank you 😊

Potter22 profile image
Potter22 in reply to Flipflopper

Dealing with afib for over 10 years now. 95% of the episodes were 3:30 am and would wake me. Had a sleep test and they said I had very mild apnea. Never got a mask. Had an freezing ablation a month ago but they froze my phrenic nerve so that is another story.

Strongheart143 profile image
Strongheart143 in reply to Jamila123

Love Dr Gupta! His You Tubes are SO lovely informative and helpful.

I agree with what you say here. Glad it’s working for you.

I’ve had 3 cardioverisons since 2014. Last one only three weeks ago w 5 days in hospital. My AFIB is stress and anxiety related. A medical intuitive recently told me I have a valve that prolapses when I am stressed. This has not been confirmed medically but I was surprised.

Doctors in America are completely CLUELESS as to what causes AFIB.

I find this unacceptable.

Dr. John Bergman and Dr Peter Glidden are maverick naturopathic chiropractors who have ALOT to say about AFIB! And how the cardiologists in this country are in the dark as to what causes AFIB and yet treating with drugs and procedures that don’t necessarily work and actually can harm the body and make things worse.

Glad your way is working out. I do notice my heart goes wonky sometimes after eating though I haven’t figured out what triggers it specifically.

All the best Everybody! This is a terrible thing to live with. It makes me even. More anxious than I already am.

Finally I am addressing the anxiety. Just started on some medicine that I hope will help. It’s needed as my system can no longer cope.

Jamila123 profile image
Jamila123 in reply to Strongheart143

Great we are on the same page 😃

RichMert profile image
RichMert

Just curious, is it fast or slow AFIB when it kicks off?

Flipflopper profile image
Flipflopper in reply to RichMert

Fast and violent. Pulse 130-175. My normal pulse is 55

Dodie117 profile image
Dodie117

Mine always came late at night and I too was diagnosed in 2013. I had ablation in November 2013 and after 5 months healing period I have had no more AF.

Also, I agree with Jamila123 about looking at any gut problems, losing weight and a healthy lifestyle.

Good luck 🍀

Strongheart143 profile image
Strongheart143 in reply to Dodie117

Agree w Jamila as well!

Flipflopper profile image
Flipflopper in reply to Dodie117

My brother has had two ablations and now is afib free. My EP doesn't recommend it for me. I don't know why. My brother had afib that was not violent like mine but his would last 3 days. That's when I realized afib is varied in its presentation

Dodie117 profile image
Dodie117 in reply to Flipflopper

Hi. I do not know why your EP does not recommend ablation. Maybe you can ask them and/or get a second opinion. Maybe related to hole in heart?

My EP gave me a choice on day one - ablation or meds route and I chose ablation. So with the exception of a few months on bisoprolol whilst on waiting list I have no experience of other meds. I am on apixaban for life.

I make my own yogurt and kefir and finding an improvement in gut health since starting kefir.

Good luck 🍀

valg59 profile image
valg59

Hi same problem for many years. In February this year had a two lead pacemaker in Barts. The results are brilliant, definitely much better. Ifs it’s offered go for it .good luck .

Flipflopper profile image
Flipflopper in reply to valg59

Yeah, my family Dr had a discussion on pacemakers. Sometimes, when my pulse and bp are in the danger zone, I think it may be easier. I was just told that the concern is not just a stroke but heart attack.

valg59 profile image
valg59 in reply to Flipflopper

My BP was also low at times, but the main concern was my heart rate was down to 30 at times when asleep , so the A F could creep in .

Flipflopper profile image
Flipflopper in reply to valg59

Very interesting. My latest holter showed my bp is in the bradycardia range all the time. Lowest only 40 bpm. I've always known that but it's nice it's documented 😀.

Maril1 profile image
Maril1

Yes my AF comes on late evening or I awake during the night with it. It never comes on when I am active only at rest. After 12 years of it I have almost given up looking for a reason but still willing to try any suggestions.

barabas profile image
barabas

Check out sleep apnea. US docs are really focusing on this now... Not sure about Europe. I was stunned by sleep study results.. Wasn't breathing 15 minutes per hour. CPAP has nearly eliminated issue after several months. Not breathing and absence of oxygen would seem likely to put lot of stress on heart at night.

BobD profile image
BobDVolunteer in reply to barabas

see my reply earlier

barabas profile image
barabas in reply to BobD

Bob:

Sorry, missed your earlier post. Looks like you live in England and have a banking background..great country always enjoy visiting, were there this summer. I am retired US public company CFO/Treasurer so used to spend lot of times with the banks...we had a lot of activity in Europe at times and issued US debt securities in Europe, on occasion.

Had two ablations earlier this year (one Fib, one Flutter), which now suspect may have been caused by sleep apnea. I ignored my wife telling me for 15 years I didn't breathe at times at night, since was in reasonably good shape, didn't snore, etc so assumed no problem. When my Cardiologist heard my wife's comment about not breathing, he sent me out for sleep study.

Cardiologist told me less than 50% chance ablations would be effective long term if don't address sleep apnea....EP said less than 10% chance if didn't address.

They got my attention.

Have noticed that the Cardiology/EP offices in the States now often have CPAP mask displays, the Internists and Ear, Nose and Throat docs are talking about sleep apnea...suddenly has become a big focus....and probably an increase to their practices' bottom line.

BobD profile image
BobDVolunteer in reply to barabas

Retired at age 52 because the industry had changed so much I didn't recognise what I joined for. Spent the last ten years there investigating fraud and teaching prevention but since I wasn't selling anything they said i was vulnerable! Called their bluff and told them to make me an offer and i would go. They did so I did. Best thing I ever did as I have been playing with race cars ever since. Ten years after I left all their chickens came home to roost viv a vis payment protection insurance scandal which has cost them billions . No I'm not smug really. lol 😂

barabas profile image
barabas in reply to BobD

Good timing...yes, it was out of control in so many ways. Before the implosion, we tried to get US SEC and/or Justice Dept. or New York State AG to investigate a Goldman salesman and a large hedge fund....it was quite apparent, after the fact, that the hedge fund had sold short into a secondary equity offering during the road show, and been promised by Goldman account rep to cover his short on the allocation. We were doing the roadshow for foreign investors, and they didn't oversee the allocation closely...but we found out about it later. No one would investigate....today every agency would be fighting over who got to do the investigation....although still seems the boundaries are being tested by some.

Race cars sound great. Never spent any time around them, and then in last year bought a low end AMG. Didn't realize when I bought it, that included a day at Formula One Track in Austin, TX (Circuit of the Americas). What an experience following the pro drivers around the track in high end AMG's provided by Mercedes...amazed they actually do this as seems pretty risky...we were hitting as much as 150 mph in backstretch, then braking down to 20 for turns, and basically no classroom or advance instruction...just follow the leader. Watched every minute of the F-1 race here a month or so ago....addicting sport!

BobD profile image
BobDVolunteer in reply to barabas

Never raced myself . Always engineering side and now still building engines for historic race cars. I discovered I was about 5% too slow compared with my regular driver and I only play to win. Now my boys run a team of three drift cars, (two BMWs and Nissan Skyline) and one does stage rallies in a Ford Fiesta so plenty to do.

Flipflopper profile image
Flipflopper in reply to barabas

Wow! Absolutely would put stress on the heart.

I'm actually Canadian so I'm not sure what they think about the sleep apnea connection. I feel like I have enough information to start asking and requesting more testing.

Flipflopper profile image
Flipflopper

Thanks! I stop eating and drinking water ( my drink of choice) around 7 pm

Flipflopper profile image
Flipflopper

😊 thanks for the information. I may try to widen the fasting window

Interesting comments below suggesting many cardiologists don’t recognise Vagal AF, and may not consider whether some medications might be unhelpful.

richardbogle.com/blog/vagal...

afibbers.org/atrial_fibrill...

Strongheart143 profile image
Strongheart143 in reply to

Most of them, at least in America, are CLUELESS.

When I asked my cardiologist (who is head of the cardiology team, Columbia Presbyterian/Cornell, Harvard/ MASS GENERAL trained), when I was first hospitalized for AFIB why he thought I had gotten AFIB, he said, “Why is the sky blue?”

UNACCEPTABLE!!

jbrucej profile image
jbrucej

Like others, I agree that it may be sleep apnea. Folks with heart issues like AFib and congestive heart failure may also have central sleep apnea or complex sleep apnea. That means that in addition to obstructive sleep apnea, there is some interaction between heart and brain that is not well understood that causes us to stop breathing at night. "Central sleep apnea" as in central nervous system is more serious... and will often kick us into Afib.

One thing you might do is buy one of those finger oxygen sensors. When you first awake at night and feeling 'fibby' as I like to say, then check your blood oxygen with the sensor. Generally (I'm not a doctor so take this as my opinion from reading on this stuff), you shouldn't get concerned if your pulse Oxygen is over 90%. However, if it's lower than 88% you will want to report it to your cardio. If it's much lower than 88%, you will want to report it to your cardio and your PCP. Note that it will come up quickly after you are awake and so no matter what you read - it was probably lower when you were trying to sleep. Your doctor(s) will likely want to put one of the pulse oxygen devices on you for overnight testing - which will tell them what your oxygen is doing even when you are asleep.

One final point, I read recently that there is a new consumer device that's available for a minor investment that we can wear at night on our forehead that "talks" to our smartphone. It will monitor our blood oxygen, "stop breathing events" like sleep apnea, etc. I haven't tried it but it too may provide some empirical data to help you and your care team fix the nocturnal afib.

Good luck and good sleeping

barabas profile image
barabas

jbrucej makes an excellent point. My blood oxygen level is normally 95% or above during the day. When I got my sleep study results, it was as low as 83% during apnea events.

Flipflopper profile image
Flipflopper in reply to barabas

I just went out and got my finger pulse oximeter. Is it wrong to be excited about a new device? 😀.

Flipflopper profile image
Flipflopper in reply to Flipflopper

As a follow up. Since posting this I have found my voice! I am still being told it is odd that I have afib primarily at night, but I know it is common, thanks to this forum. I do believe I have some form of vagal af but it doesn't seem to be acknowledged in 🇨🇦 . I have now gone off of Digoxin as my pulse was dipping into the 40s. I also suggested that maybe my already low heart rate dips while I sleep and that may be a /trigger for my afib. Then suggested if maybe I should get a sleep study. That was met with a positive response and now I am set for a sleep study.

I am now not scared to go into the hospital when I can't control my Afib. It's a hard thing to be told you are abnormal or as one nurse said,"well we don't usually even treat patients with afib if they are over 65". I'm in my 50's

I've sat outside a hospital with my husband watching me cry because I don't want to go in because I have been treated like I am a bother. My brother has also been told in another hospital that they won't help him.

Anyways, I have a voice now. Thanks everyone for all your help

Flipflopper profile image
Flipflopper

Wow! You guys are amazing!!! So I took your advice and suggested I get a sleep study done to my Dr.... Sleep clinic just called and I have sleep apnea! Woot! I know, I know, I shouldn’t be so excited but I have struggled to get heard here in Canada. That I am not different or have an odd manifestation of Afib (nocturnal).

Incidentally, when I asked for the test, I was told that don’t really fit the part for apnea. I was told I’m not a 65 yr old, overweight trucker 😀. I am 5’2”, thin and fit 58 year old woman! Ha!

So thank you all! One question... after being fitted with CPAP, did any of my nocturnal Afibbers notice a decrease in incidents? It’s my hope that if I can keep my 02 saturation in a normal level at night, I may see less Afib

fibber-me profile image
fibber-me in reply to Flipflopper

Well, welcome to the apnea club.....just know that I love my sleep machine. I have a full face mask and I set the humidity and temperature as I wish. It is a comfort to have and I have A-Fib diagnosis but never while sleeping. I sleep so soundly knowing it’s providing me with clear air pathways. Looks intimidating but is comforting to me. Sorry that I did not answer your question but just wanted to share that.

MikeyF profile image
MikeyF

Glad you’re off digoxin - some usefulness in heart failure but not at all good for vagal AF. Flecainide would be the PiP of choice IMO (best first tried in monitored hospital setting).

Sleep apnoea needs addressing as increases chance of AF 5-fold owing to atrial stretch from negative pressure in chest.

Flipflopper profile image
Flipflopper in reply to MikeyF

I asked for a sleep study and low and behold, I have sleep apnea 🙂. Just getting used to it, but after a week I felt better! No bags under my eyes, no headaches when I wake and the amount of apnea events per night are greatly decreased. Of note, I haven’t had a fib since I started. Time will tell

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