'Hungry heart', causing PVCs, ectopics, etc?

[DaveT81]

Hi guys,

I have AF but was - as many of us have been - successfully ablated around 2 years ago.

I've had just one episode for 2 hours of full-on AF since my ablation, that came 6 days after my ablation.

However, recently I've noticed a lot more activity and in particular I'm having a lot of positional ectopics.

But just now, I'd been taking food out to eat and I came over all 'funny' and my heart lurched bigtime. It was probably the biggest 'pause' I've felt since the last time I went into full AF. It happened a couple more times and I now feel a bit weak and feel like I have a bit of a headache coming on too.

The reason I typed 'hungry heart' in the title is because I'm wondering if hunger/not having eaten a lot for many hours can cause these ectopic beats? I ate at 6:30pm last night and all I'd eaten prior to my late lunch just now was a small crumpet about 10:30am and a piece of chocolate in like 19 hours.

Is it possible, does this hunger causing ectopics thing actually exist?

Cheers

[bantam12]

I guess we all have different triggers so it's possible, I can't blame my PVCs, PACs, ectopics on hunger as I'm constantly snacking !

[DaveT81 in reply to bantam12]

I normally can't either, bloating and gasiness definitely. Never noticed hunger but if there's a vagal connection between the stomach and heart then it makes sense I suppose.

[Kellyjelly]

Yes, My heart becomes much more sensitive when I haven’t eaten for long periods with lots of ectopics.

[DaveT81 in reply to Kellyjelly]

It's weird. I'd not experienced this, in this way before, I feel lightheaded, tired, have a slight headache and feel like I want to go to sleep.

Almost feels like I've been in afib!

[Kellyjelly in reply to DaveT81]

A little catnap might just reset things, can work wonders sometimes 😊

[Bob56]

I have suffered with ectopics for a long time, both before and since my ablation, and hunger can definitely be a trigger. We all know that there are links between the digestive system and the heart, proximity being a very obvious one! Boring as it is, adopting a fixed routine, eating regularly, avoiding very big meals, and not eating late in the evening has helped me keep ectopic activity to a minimum. That said sometimes they strike with no obvious cause, that’s the nature of the beast, and then the other techniques such as slow breathing, can help. I can’t comment on your other symptoms, but being generally unwell or feeling anxious from some unrelated issue can also trigger my ectopics and you get into these awful “Catch 22” situations wondering if the anxiety caused the ectopics, or did the ectopics make you feel anxious. Seems very unfair sometimes, but you are not alone in wondering why and how this debilitating condition comes and goes.

[DaveT81 in reply to Bob56]

Hi Bob, thanks for your reply.

It certainly is feeling very unfair at the moment. I am positive that my other health issues are exacerbating this issue greatly. I've been investigated for a lot of things but it's beginning to look as if I'm dealing with a functional nerve disorder. At the first mention of nerves at the moment, as an afibber, my mind goes straight to vagal nerve.

As some of my other symptoms have worsened, my heart has seemingly become more sensitive/irritated. What makes it worse sometimes is that I'm having really bad breathing problems 24/7 (totally unrelated to afib) that can't be explained - as yet - and a lot of really weird neurological problems, so when my heart 'kicks off' it can feel liked I'm trapped.

So far, I've managed to - mostly - hold the anxiety at bay, but the stress is really starting to kick in lately.

I'm seriously hoping that yesterday's little episode was just due to not having eaten a lot for over 20 hours. My heart gradually calmed down as the night went on and I've had few, if any, ectopics since.

Just feeling very lightheaded and a little bit 'off' today. Slight touch of what feels like vertigo or dizziness.

[Bob56 in reply to DaveT81]

When you mention dizziness/vertigo, you might want to get that specifically checked out. There can be all sorts of explanations, both heart related and not. Low blood pressure can cause dizziness, low blood sugar likewise and various vitamin deficiencies, often exacerbated by your heart condition. The anxiety which accompanies these feelings is horrible, and I speak from experience. If your doctor or whoever you consult can eliminate or confirm some of these things, that might help to ease your mind a little. It’s always good to be following some sort of regime to give you hope that things might improve, as often they do. Good luck!

[T8746 in reply to DaveT81]

I can relate to your suspicions about the vagus nerve.

I also have strong suspicions of it.

I also feel that the esophagus is suspect.

I had been complaining sometime before my first afib episode of a feeling of a swollen esophagus.

I am also struck by the common experience of ectopics or afib after eating.

One helpful trick was to take a Prilosec when I felt ectopics or afib.

It seemed to limit or stop afib episodes pretty reliably.

I also suspect that my afib has less to do with my heart, and more to do with my esophagus and possibly my vagus nerve.

I’m using my situation as a science project that I would rather not have.

On the bright side, I haven’t had an afib episode in two months, and hoping to keep it that way.

[DaveT81 in reply to T8746]

I'm actually certain that very small bits and pieces of afib have to do with my heart, and its primarily vagal.

In fact, the sensitivity I've felt in recent months is almost certainly gastrointestinal and occasionally it will be caused my learning over, bending forward and lying on my right side, some times left side. All of this points to vagal nerve, for me.

I've had a lot of neurological problems in the past 18 months too that have got worse and this seems to be nerve related, so surely it all pulls together.

Either way, I'd be very surprised if bloating, wind, reflux and hunger weren't all potential irritants of the heart. Stomach and heart being connected by the vague nerve would suggest they are/can be.

[T8746 in reply to DaveT81]

Many people have an intuitive sense about afib and the relation to their vagus nerve, and I do to.

Actually, my first afib episode came with a strange feeling in my left shoulder blade. At this point my guess is that it’s a condition known as “Notalgia Paresthetica”, which is a nerve condition.

The odd thing is that this condition has the same triggers as the afib.

I have an appointment with a neurologist on May 1st.

We’ll see what she thinks.

It’s all sort of interesting, but I’d rather do without afib.

In the meantime, I’ll keep trying to learn what I can.

[T8746 in reply to T8746]

My sense is that we have an awful lot to learn about afib.

[DaveT81 in reply to T8746]

Would you say that many of your triggers are some how nerve related?

[T8746 in reply to DaveT81]

Well, the main triggers for me seem to be eating, exercise, and stress.

As you mentioned, things like bending down, lying down in different positions, and others can affect things.

The fact that the Notalgia Paresthetica (NP) has the same triggers as afib convinces me that they both have the same root cause.

When I eat, the NP will often start activating and ectopics may start as well.

So, I do think that the triggers are nerve related.

My esophagus figures in as well.

Also, the esophagus and the pulmonary vein are in very close proximity at a point. This could be an issue as well.

It’s all very complicated, and I do get tired of my new role of a researcher, but I keep on.

[DaveT81 in reply to T8746]

Yeah, I'm beginning to feel like I can pinpoint a lot of my sensitivity and irritation too. Having said that, I do sometimes get little episodes of ectopics, or for instance last night before I replied I had come to bed and I was putting a glass of water at the side of the bed and my heart gave one of those scary, very insistent runs of ectopics, the sort that feel like it will almost certainly convert but then it went back to normal.

I'm convinced that my current health issues are somehow due to nerve disorder or damage and I'm planning to ask to be referred to a neurologist too, along with the chronic fatigue and dietician referrals I'm already having.

If only these things didn't take so damned long.

[T8746 in reply to DaveT81]

I have shingles twice, and I wonder if I have some nerve damage that might figure in.

I have had chronic fatigue for most of my life.

One of the best successes that I’ve had with chronic fatigue has been using a low dose of tricyclic antidepressants. It’s not a silver bullet, but has been helpful at times.

[Westsidestory]

Hi Dave, I’m always wondering the same , did the ectopics make me anxious or this anxiety bring on the ectopics? Don’t know , but one perpetuates the other! And then I worry about going into svt ! Hiddious condition , seeing EP In Cheshire next week to arrange an ablation , as cant go on with this hanging over you all the time , used to be a lot better at recovery a few years ago , now things a lot worse after retiring ! Fingers crossed ,

[DaveT81 in reply to Westsidestory]

I feel your pain my friend, I had a period of around 5 months early last year when I was about 4-5 months post-ablation and my heart activity had reduced to next to nothing. It was glorious and I really felt like I was getting somewhere.

But then all of my current health problems began and my heart has been slightly irritated more-or-less most of that time. Well, to varying degrees.

I'd definitely recommend getting something done about it but ask a lot of question first.

[Westsidestory in reply to DaveT81]

Will do Dave , got a long list already prepared! Thankyou for the advice on ablation , I think only way forward, no point waiting now ,

[Bob56 in reply to Westsidestory]

Funny that. When I retired, I fell out of my holding pattern, heart wise, and within six months I had an ablation. It’s mostly been successful, and AF episodes drastically reduced. Still on medication, and still ectopics now and again, but much less fraught and QOL seriously better. There is a recovery period post ablation to cope with which affects some more than others, but I have no regrets in having the procedure.

[Tako2009]

I would say yes - I can’t do any type of fasting diet without setting off ectopics so maybe this is a trigger for you too?

[DaveT81 in reply to Tako2009]

I'm definitely leaning towards 'yes' on that count. I have ectopics when I'm badly bloated or gassy so it makes sense that an empty stomach and bad hunger would set it off too.

[CDreamer]

I’m much, much better with fasting. Unfortunately I have to have food to take my meds so tend to only do 14-16 hours in any 24 hours & at least 4 hours between meals. It’s eating too much, too often which causes difficulties.

[Madscientist16]

Yes. I get an up tick in ectopics when I am hungry or if I eat too large of a meal.

[Ohdea]

I think so and Dave and this may sound daft but be careful of the Crumpets ...I love those things but I had to stop eating them because they always seemed to bring on the Flip- flops. They are a bit dense and don’t go down very easy - so even now after a successful AV Node ablation, I will not eat them. I really do believe indigestion or wind triggered a lot of my attacks.

[DaveT81 in reply to Ohdea]

Wow, so even my beloved crumpets are now working against me?

The world is ridiculous. I cant imagine many other animal species have as many unnecessary and quite debilitating diseases/disorders as we do.

I'm supposedly being referred to a dietician by my doc, along with chronic fatigue fatigue. I'm hoping the dietician has some awareness of afib and the link with the gut, but I doubt it. I know many Drs roll their eyes when patients mention it. How do you manage wind and bloating these days?

[Ohdea]

Aww Dave, don't deprive yourself of them completely, just chew them well

I know what you mean, I mentioned it one time to a Dr who didnt even bother to offer me a ‘yea or nay’ - just ignored what I said Lol!! But I’m sure we cannot all be imagining the connection?

A friend told me when she felt the start of an AF attack she took a couple of Tums ...and that helped ward it off...so I very often carried a couple of Rennies or the likes in my pocket- probably have a few still lurking in a coat pocket or two

Actually I do get bouts of it digestive trouble it sometimes depends on what I eat - I have a looong list what I should try to avoid but life would be miserable if we couldnt have a treat now and then. Shame it is usually food we like the taste of that is the culprit.

Hope you get some answers from the Dietician