AF returns: Unfortunately afib returned again... - AF Association

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AF returns


Unfortunately afib returned again early this morning. My last episode was in December 2018 as I’ve totally changed my diet and have gone teetotal. Last night I made a lovely spaghetti bolognese with a bottle of red wine poured in as well as a couple of herbs etc. I’ve made the exact same sauce using the same recipe for years. I’m assuming that as the red wine alcohol content boils off this couldn’t have caused my problem or could it. We had our dinner around 6pm and the afib occurred around 5am the next morning. I was sleeping on my left side though but have been sleeping on that side consistently over the last 18 months. I was prescribed pill in the pocket so took the tablets as advised by my cardiologist. Took one immediately then another one hour later and the final 100mg one hour after that. I’m pleased to say that I reverted to NSR around 10 mins after the final flecainide tablet.

I’m racking my brain to think what could have triggered it. Any views or similar experiences I’d be grateful. Thank you

45 Replies

I sleep alot on my left side with no issue. I have not had a fib for over 2 yr. my doc says it is like a dog chasing its tail trying to figure out triggers. I have noticed the times I feel like a fib might be ramping up are in the evening after I over eat a meal not too healthy. Seems like high carb high salty meals like pizza, spagetti type things. Thankfully relaxing, controlled deep breathing and drinking plenty of water seem to chase that feeling away. A fib gives us more questions than answers.

Sorry it returned but hopefully it was just a one and done event.

in reply to Hidden

Yes it really does. Thought afib was at bay but then it hits you. Been thinking about the triggers and I did have loads of ectopics but no afib the early morning before. I wonder if it’s something occurred then rather than last night. I could be clutching at straws though. Blood pressure today is fine at 106/74. Heart rate is around 75. Normally when resting my HR is mid 60’s. Guess flecainide bumps up the HR a bit.

in reply to Profound15

Just rest up, stay well hydrated and try and ease your mind... like a the morning after a storm. Prayers a fib stays in your rear view mirror

in reply to Hidden

Thank you

Yes, I know all about the diet issues, and I too have lurched into AF when sleeping on my left side. That caused my last AF event in February 2018. Nothing since, except a range of episodes of high HR, but not actually lurching into AF . I can only assume there is a tiny ingredient in the dish you made, maybe a trace of a herb, that either aggravated or inflamed your Vagus ( Vagal) Nerve.



For many people it is not the alcohol in wine but the sulphides whcih casue the problem.

Thanks Bob I wondered about that. Haven’t had the spag Bol for a fair bit of time so there might be some substance in that. What’s for sure is that I’ll not be eating it again.

If you think that is the trigger , then perhaps as a one off it would be worth trying it again .

Then you really could identify that trigger with a much higher degree of accuracy ?

I started FODMAP almost 3 weeks ago and have had no noticeable episodes since then.

However I am also taking 50/100 flecainide since then ( upped from 50/50).

So I would say it’s the flec doing its job more than anything else perhaps .

I have also increased my running almost back to where I was before ( yet I do no high heart rate fast stuff anymore and stick to 130-140 bpm ) .

Cut out beans and peas etc , bread I only have early in the day etc on FODMAP as I would have those nearly every day ...

So I’m thinking maybe I should experiment and try the beans peas again to see if they are a trigger .

But I’m so pleased to be Afib free at the moment I keep putting the experiment off !

Hi David

I’ll have a look at FODMAP. I don’t want to try and ‘create’ another episode as they are really a horrible feeling. I’m going to be extra careful now with diet

Indeed they are bloody annoying these Afib episodes .

I really don’t want to create an episode either .

I have had many false dawns after a eureka ! moment , so I need to follow my own advice and experiment on myself before ratifying a trigger.

I’m highly skeptical of myself thinking I have found a trigger.

Re FODMAP - i have noticed that I’m not as “ windy “ as I used to be .

But I miss a giant plate of beans on Seeded buttered toast with lashings if HP sauce on an evening :-(

Now that’s sounds lovely but I’d be suffering from severe indigestion and wind if I ate that. Funny enough I also suffer from a high incidence of wind depending what I eat. I wonder if there’s a link there

Hi - red wine even in cooking would do it for me! Just a sniff and my heart starts playing up. So glad PiP worked for you - maybe try the bolognaise without the wine next time?

in reply to Tako2009

Thanks Tako. If it was the wine it took a fair bit of time for my heart to trip over. I ate at 6pm and it hit me next morning at 5am. I guess it must stay in your system for a good bit of time

Can only comment based on my experience but I’d say don’t think into it too much. My AF was progressive with no consistent triggers. That length of time with no episode is pretty good going. If you cut out everything you think might have caused it you’ll be left with not much to enjoy.

Yes that’s very true. I’d rather cut something else out though than have another episode. It’s a horrible feeling

Pleased to hear the PIP did it. My reaction would be Spag bol at lunch only, use quality spelt pasta (the modern wheats are bad news) no wine and the meat should be organic and free of as many additives as possible. I am optimistic by nature and don't agree with the medics who say you will go mad looking for triggers and just take the pills/have an ablation. I do however think AF is complicated and in many cases is caused by a compound of reasons. In your case it could be as simple as stopping eating the dish/take action as above and/or that you should review further lifestyle measures to put a wider safety cushion before one small factor (like your supper) pushes you over the AF threshold. I hope something there makes sense and good luck.

[Interested your PIP worked, must investigate getting one]

I thought alcohol triggered my A-fib - so I gave up all booze. (easy)

I asked what else can I do to give myself the best chance of keeping in NSR? For me the answer was to lose weight, I went down from BMI 26 to BMI 22. (very hard). If you try this route I recommend reducing weight slowly, and making it a diet regime for life.

I think the lesson for me is to never take my eye off the ball. I’ll adjust my diet a bit now, try and lose some weight (BMI 27) and hope I can last another 18 months again

I think Bob has probably nailed it, I doubt there would have been any alcohol left after cooking unless you poured it in just before serving. Was it the same wine you have used previously? if it was not you could try going back to one that did not cause an issue. I am sure I read somewhere that a lot of wine no longer uses sulphites, so that may be worth investigating.

I feel your pain, I decided to camp in the garden with the kids the other night and boom woken up at 4am with it! Had to come inside and curled myself up in the prayer position on the sofa and it reverted. Trying to avoid using flec if I can!

But I think the cold air triggered mine, I seem to get blips when it’s cool out there.

Out of interest, what side do most of you sleep on? I seem to be better on my right side than left.

So so sorry you had this blip, hopefully it won’t happen again. I definitely don’t sleep on my left. I also don’t drink alcohol but I also don’t drink tea or coffee as these were my triggers, I had my ablation 17 months ago but still daren't drink tea or coffee, just in case. Good luck

How has your ablation results been during the last 17 months. I was thinking ultimately that might be a course of action for me.

Omg it’s the best thing I have ever done. I had svts for 18 years and had been told to have an ablation but was worried about having a stroke. My husband had three heart attacks three days in the trot and the stress caused me to be ill and we ended up in opposite beds on the cardiac ward. ☹️😢This pushed me to make the decision and although I was really scared it went great. Had it done in Leeds private. The specialist was so nice and kind. I am touching wood as I speak and saying no blips. Oh I can’t believe I was in and out of hospital via 999 sometimes three times a week. I am so pleased now that this nasty virus has hit the world that I sorted it out beforehand, x

Hi MydogBrandy

Meant to ask, did you have ectopics/palpitations before the ablation please? Do you get any now if you did. Thanks

Palpitations, used to go into 180 heart rate, sometimes for 10 minutes, or could be an hour, usually an hour but did happen a few times for 7 hours, draining. Don’t get them now, touching wood again.i seemed to get them for weird reasons sometimes. Like looking up on the top shelf in the supermarket or looking up at a plane, could be just getting up quickly off a chair! Used to be so annoying but I found out when I was taken into an Austrian Hospital one year the medics there told me to drink ice water quickly and yes it worked so I used to always carry a flask of ice water round with me.

Hope you get sorted

The ablation seems to have worked for you so that’s great. Thanks for the info

You are most welcome. I found this site lovely when I found it before my ablation.

Yes I agree this site is excellent and a great source of information

I now tend to sleep on my right. Every time I’ve had afib it has triggered when I’m on my left side. It used to be alcohol that triggered it, then caffeine tied in with severe bouts of acid reflux. Thanks for all your messages they’re really appreciated and help.

Hi Profound15

Glad to hear you are back to normal. I wouldn't read too much into having an af episode. Af is progressive and even after a long period of inactivity it can suddenly rear its ugly head. Sorry to be pessimistic but we have to face facts. I had an ablation on November 5th Last year and have been af free for about 6 months now. I am however still waiting for it to return some time in the future. The only good thing is I will know what it is now, not like in 2017 when I did not know what had hit me.

Stay safe and hope things go better in the future.

Best regards, Flyer.

Thanks Flyer. Stay safe and well

People will no doubt shoot me down but I can only go from experience, listening to others thoughts and my EP's advice but I think that sometimes there are no triggers, sometimes the food you have eaten for years is suddenly a trigger. Sometimes worrying about the food you eat can be a trigger. Unless you have suddenly done something stupid like binge drinking after being tee total, then your biggest enemy and trigger is stressing over looking for triggers!

in reply to Barb1

Yes I totally agree about the stress. In my case I firmly believe that my digestive system is the culprit and being constipated is a real no no for me. If my stomach isn’t right then I get ectopics. My stomach didn’t feel great the other night so maybe that’s what I should concentrate on now.

Hi Profound 15 , would you please tell me exactly what this AF episode felt like . Regards Gladys xx

in reply to Gladaven

It started with a fluttering feeling in my heart then immediately went in to an irregular beat. My heart rate fluctuated from 80 odd to 130. It’s not the highest HR I’ve had with this disorder, with previous events it’s topped 150. After the first flec tablet nothing much changed. Took the second one hour later and seemed to be easing slightly although still a horrible feeling. Was shivery as well. Took my third flec 100 mg and10 minutes later back to NSR. in total it took 2 hours and10 minutes which is shorter than I’ve experienced a couple of years ago.

T hank you very much for your kind reply Profound15 I have asked many people what an AF Episode is like as I don't know what to expect, many have asked the same question. About 7yrs ago after a chest infection I had a funny turn, strange heartbeat, sweat pouring off me, doctor sent me for chest XRay. Result I was told I had fluid on my lungs and heartfailure I was put on Bisoprolol. Two years ago after an ECG I was told have AF and put on Warfarin. Now and then especially after sleeping on my left side or eating artificial sweetner. I get palpatations and a horrible feeling of great sadness or anxiety in my tummy. Can this be an AF Episode ? Glad. xx.

in reply to Gladaven

Not sure Gladaven. As I’m not medically trained it’s difficult to advise. If I go in to afib I regularly check my pulse on my right wrist. This definitely tells me if I’m in sinus rhythm or not. Perhaps that might help you by checking your pulse. It’s very easy to do. I also have a blood pressure machine that also gives a read out if you’re in afib. I bought it from boots a while back. Hope that helps

I think that Hoski’s doctor is correct; trying to figure this all out is like a dog chasing it’s tail.

I haven’t had an afib episode in maybe a couple of years.

On thing that I discovered early on was that I could cut an episode short by taking Prilosec.

I actually found a study that found that people were being taken off their anti arrhythmic meds after Prilosec stopped their afib.

On the other hand, I have seen posts from people saying that Prilosec made their arrhythmias worse - and that they had to stop taking it.

Over time, I found that eating smaller, lighter meals helped stem the arrhythmias.

I didn’t continue with Prilosec for long, and my problem seemed really improved.

Lately, I’ve been eating larger meals, drinking stronger coffee, and I have noticed that I started having PACs and fortunately, no afib yet. The PACs seem to be happening regularly now, and it’s disconcerting.

I have quit coffee and have gone back to smaller meals.

Another thing that I noticed recently is that my esophagus has felt sensitive and possibly swollen, something that I had felt when I was having my afib episodes.

The esophagus is in very close proximity to the pulmonary vein at one point, and I feel that this may have something to do with my situation.

For now, I am experimenting with diet to see if I can correct this problem.

I wish that this was better understood.

Maybe it will be at some point.

If i have a day with a lot of ectopics i am more likely to have an AF episode. But there are so many triggers, caffeine, turning your head, bending down, sometimes when i feel realy happy and the list goes on. If i was only to take them in my house i could live ok with that but its the thought of meeting somebody outside for lunch or whatever and wham AF strikes. And yes as somebldy else said, Extreme cold weather can bring one on but i think that is all down to the vagus nerve as if i tense throat it can start one which you tend to do when cold. Hope they disappear for another couple of years for you.

in reply to Lbeat796

Thank you Lbeat and T8746.

I must admit I did have loads of ectopics the day before but they cleared. Perhaps it was the start then. I did have a large meal at dinner time around 12 hours before my episode. It’s definitely stomach/vagal nerve related though. I will now try and eat smaller portions and cut out the chocolate. I don’t drink caffeine as I have rooibos tea which is caffeine free. Stay safe and well in these crazy times

I only drink decaf but am totally addicted to chocolate and I know it's the number one trigger for palpitations!

in reply to Lbeat796

Yes I agree. Since giving up alcohol chocolate has been my little pleasure. Funnily enough I did have chocolate the night before my afib event but I’ve also had it on other nights with no issue other than ectopics.

Got in touch with my cardiologist today. He said that afib is a progressive disorder but keep on doing what I’m doing as it does seem to be reducing the incidence.

Oh my goodness - spag bol - exactly what put me in A & E 3 weeks ago!

I am new on here but am so heartened that the link between gastric and cardiac is recognised and seems to be a common theme. I have had AF for over 6 years, and am utterly convinced that food and a hiatus hernia are linked to my AF, however, this is generally dismissed by my cardiologist. He suggested caffeine and alcohol as triggers, but I have next to no caffeine and very little alcohol (off it completely at the mo) - so he thinks I have an 'excitable heart'. I think it's excited by food!

Had a complete going over by a gastroenterologist 18 months ago - nothing untoward. Heart is fine apart from AF.

Is the AF affecting my digestion or vice versa?

in reply to ibuputih

I can only tell you what my experience is. My afib is deffo caused by the vagal nerve link between stomach and heart. It’s what I ingest that causes my problem. It started off through too much caffeine and alcohol but has progressed to now seemingly include my spag bol recipe which contains a bottle of red wine. I think it could be the sulphites in the red wine. The alcohol boils off it of course but the sulphites remain. I have been teetotal for nearly two years as imbibing definitely caused my afib to begin with.

Cardiologists will tell you that it’s a progressive disorder but you can do things that can reduce the frequency of events. For me it’s all about triggers and avoiding them. The list will expand over time I would guess.

Hope this helps

Thank you for your reply and apologies for the delay in reply - catastrophic laptop issues!

I can only agree and moving forward I will be using a trial and error approach with my diet. I am hoping that this will help to avoid triggered outbursts. Fingers X'd.

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