WHAT ARE YOUR AFIB TRIGGERS?: Hi ALL, I would... - AF Association

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WHAT ARE YOUR AFIB TRIGGERS?

Ruza2020
Ruza2020

Hi ALL,

I would like to hear from you guys about your Atrial Fibrillation Triggers. My afib triggers are as follows:

Most (if not all) of my Afib Episodes start at rest, after meals, and/or during sleep, or very early in the morning - that is just before I get out of the bed - especially when my heart rate drops very low - at around 48 beats per minutes. The only medication I take when I am in NSR is Apixaban.

I also associate my Afib episodes with full stomach, heart burns, pain and rambling in my intestines, and the pain in the upper part of my left side of the chest.

Sometimes Afib would come on right after extremely low, but pounding heart rate. I also noticed that having cold meals, all day long tend to trigger Afib. I suspect, but not certain, that taking two Apixaban a day triggers Afib. Sleeping on left or right side tend to cause heart pounding - the heart tend to beat forcefully against my chest wall.

Cheers.

85 Replies
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BobD
BobDVolunteer

For me it is life.

Hi Ruza - what you describe sounds like vagal AF and there are quite a few posts on the subject. If you enter vagal AF into the top right search box, they’ll list.

The only triggers I ever identified were sugar, alcohol and using white spirit as a thinner in my painting. For the rest of the time, AF started just because it felt like it. Flecainide has managed to keep it away for six years.

Ruza2020
Ruza2020
in reply to Finvola

Thanks Finvola. My cardiologist suggested that I stay away from any beverages with caffeine in them, and no alcohol - not even a drop.

Have you had any Afib episodes while taking Flecainide?

Cheers

Finvola
Finvola
in reply to Ruza2020

I’ve had no AF since starting Flecainide six years ago and have learned the importance of making lifestyle changes from using this forum. I switched to decaf tea, removed all things artifical like sweeteners, colouring, flavourings and preservatives. I loved a glass of wine but was also well warned by docs to avoid alcohol.

Stress is another factor which is inherent in AF and getting to grips with it is a challenge. A healthy BMI is important too, especially with COVID-19 around.

Singwell
Singwell
in reply to Ruza2020

Hi, I'm relatively new dates n Flecainide. I did have an episode about 3 days after starting - previously on Bisoprolol - but none since. Your triggers sound very similar to mine. The pounding and chest pain can be digestive. You may have severe acid reflux or a hiatus hernia. I know that I have reflux and suspect the hernia. Look into healing your digestion and the triggers may calm down. There's an acid reflux diet I followed that's made a huge difference. Currently I'm avoiding alcohol and have just two read a day. No coffee but i can tolerate some chocolate.

That sounds very familiar...I'm early on in this journey so will look at the links.

Thanks for the reply.

Best wishes

Stress.

My triggers are caffeine, alcohol, sugar, sweeteners, decongestants, dehydration, MSG, heart rate dropping too low at night.

The trigger for my very first episode was caused by erythromycin That was prescribed by an idiot in A&E saying I had a chest infection. It turns out that I didn’t have a chest infection. I saw my GP then next day and my chest was clear. Never had erythromycin since, it is on my list of drug intolerances.

I can’t think of any more at the moment, but I am sure there is some.

Val

Ruza2020
Ruza2020
in reply to Mrsvemb

Thanks Val. Unfortunately, and sadly, doctors do make errors on daily basis.

Best wishes.

Mrsvemb
Mrsvemb
in reply to Ruza2020

Nobody is more aware of that than me. My late husband was the victim of a sequence or errors, from ignoring a lesion on a scan which eventually became aggressive and he could not be saved. During this time, other things were missed. He was on Rivaroxaban and was given Clopidogrel and aspirin in A&E, resulting in a huge bleed. Because of this his treatment had to stop. I could not believe the incompetence and did make complaints in the hope that it will not happen to someone else. This was only 2 years ago and I still feel very angry about it.

Ruza2020
Ruza2020
in reply to Mrsvemb

ThanksMrsvemb for sharing your story - it sounds awful.

Best wishes.

what you describe is almost identical to my problems, ive seen my dr quite a few times over the past 18 months he eventually and reluctantly had a monitor fitted over night, had it been the day before, or after it would have picked a lot up because i really was unwell, however that particular day I happened to be fine. The monitor did however pick up some irregularities and again reluctantly he agreed for me to see a specialist. Now i have to wait till October (due to corona virus) my heart rate goes between 48-160+ at rest, im 58 with young children so I have some concerns (im also type 2 diabetic). As of yet I have no diagnosis and am not on any meds to help control it. There is heart history in family, both mother and father and now my brother has had ablation. My brother has been much better since op, I would feel happier even if i were just on blood thinners, maybe the way forward is to ring for an ambulance when i have a particularly bad day, I am worried that upon arrival everything will go back to normal and im left feeling like its all simply fictional and im just a victim of stress (which my Dr implied) Im actually a very calm person and don't worry unneccesarily but this has gone on for so long it is beginning to cause some concern. I wonder how many others have gone through this, it seems to know when Im seeing my Dr (he has seen an irregular pulse twice, plus the few irregularities on the monitor) aside from which I was tested for one minute on a heart monitor and announced everythings fine, stop worrying (which in itself has caused some concern)...its a bit like an intermittent fault on a car...lol...stay safe. Brian

Suggest you pay for a private cardiologist appointment to reduce your stress level and also those extra few minutes in a private clinic can be valuable. The interface between private and NHS is much better and should you need tests you can go back to the NHS to save £.

Hi - when I saw my Cardiologist I asked about triggers and he said I’d drive myself mad trying to find what started it. But: he did say there are links with with being diabetic and being obese. As I have both - I lost 14lbs and so far so good. My blood sugar numbers are under better control. ( not on meds for diabetes which means being properly careful what I eat. Bought blood sugar monitor to test after meals). Not sure if this is relevant but you mentioned diabetes. Fingers crossed for you

Been there 😬💜

That’s an interesting comparison to an old car- that’s exactly what my GP said but if we were cars we would buy a newer one!!!

Hi Brian. Thanks for sharing. I am sorry to hear your doctor is not taking your heart issue more seriously - especially the fact that you have family members with heart problems.

I also wore heart monitor for forty eight hours - it didn't indicate any abnormalities - because I was not in Afib during that time. But one time my Afib episode was so bad that I decided to call an ambulance (16 months ago) - this is when a cardiologist on call diagnosed me with a paroxysmal atrial fibrillation. He offered to be my cardiologist.

Good luck Brian with your doctor, and your health.

Yes, i think it may take me calling 999 when i get the bext bad episode. Thanks for all the feedback

Sue1955
Sue1955
in reply to Respondicus

Hi you might like to get a kardia from Amazon it enables you to take a one line ecg with an app on your mobile, l know lots of people use them on here. And fore sure that’s what helped me to get a diagnosis, because it tells you if in possible AF, I kept getting episodes didn’t know what it was but went to gp rhythm ok, ended up in a&e for chest pain on cardio ward for a week nothing happened, so my husband found the kardia and we gave it a go, it also allows you to do a printout to take to gp, anyway I was able to record these episodes took printouts to gp the rest is history Paroxysm AF diagnosis, gp and cardiologist were impressed with the kardia. Good luck for the future

Hmm. That's not very good of you're Ur GP. Can you afford a Kardiamobile? That way, together with a phone App that you just download, you can track your heart rate and its readings any time you suspect arrythmia. You can print them up and send to your doctor or show from your phone itself.

Mine always comes between 0100-0230. I have narrowed mine down to being very tired, dehydration and alcohol. I’ve been symptom free for several years until last year when my brother was taken from us in a random attack. I was stressed and threw myself into training as a coping mechanism. However this kicked the AFib off again (it was also the original cause) and I’ve had several episodes since. I’ve now stopped training and only do light exercise, I drink 4+litres of water a day and limit myself to a glass of wine up to a couple of times a week. I am also back practicing mindfulness to try and reduce stress.

Lizty
Lizty
in reply to sdgb

Those are also my triggers! So I have to explain to people that I can have a drink with them if 1] I have slept well the night before; 2] am not under any extra stress; 3] the humidity levels are low; 4] there is no risk of getting dehydrated or over tired. Actually, I don't say all that ...I just keep it as my own set of rules. My friends who really enjoy a lunchtime tipple, never really 'get it' unfortunately.... so I have to arrange to be careful when and where I arrange to meet them! Does anybody else feel pressure to drink in these circumstances? Afib is definitely a hidden disability.....

Ruza2020
Ruza2020
in reply to Lizty

Thanks Lizty for sharing. You are absolutely right, Afib forces us to change our life - big time. In my case no pressure from family or friends to drink... Try to educate your friends about this difficult ailment we have acquired.

Best wishes

Ruza2020
Ruza2020
in reply to sdgb

Thanks SDGB. Oh my God - I'm so sorry to hear about your brother.

As for drinking alcohol, my cardiologist, as well as EP strongly recommended that I stay away from alcohol and any stimulants - they said: "not even a drop of it".

Best wishes.

All of above in the past, AF is chameleon like and triggers change with the seasons. Virus of any type is the only trigger for me.

Lizty
Lizty
in reply to CDreamer

Yes, the 7 day monitor eventually discovered the afib and flutter, on day three, when I was suffering from a mild virus. That is why I am being extremely careful with this latest threat and staying very close to home.

Ruza2020
Ruza2020
in reply to CDreamer

Thanks CDreamer.

Best wishes.

Hi ruza2020,

Mine I feel was stress, which I avoid totally now. But my cardio tells me I get small episodes of af in the night so I don’t know what starts them.

getting Over tired traveling has caused one attack. And I feel early on tonic water was a trigger as I drank that instead of white wine....and had episodes constantly....

Stress was definitely the trigger for my 2 episodes 3 years apart. I wondered about over tiredness as I am often up into the early hours but on both occasions I had had 8+ hours sleep

Auriculaire
Auriculaire
in reply to Morzine

Tonic water has small quantities of quinine I think. This is toxic.

Morzine
Morzine
in reply to Auriculaire

Yes it definitely affected me.

Ruza2020
Ruza2020
in reply to Morzine

Thanks Morzine for sharing.

Best wishes

Janith
Janith
in reply to Morzine

Tonic water is a no no ... no more g & ts for me.

Singwell
Singwell
in reply to Morzine

Tonic water contains quinine which stimulates the heart. I nearly fell into that trap too!

No problems during the last three months. No alcohol, lost 1.5stones weight by having low carbs. Take 1.25mgs bisoprolol. Fingers crossed this continues.

I have now lost 1/2 a stone and am treating some days fasting as a realistic alternative to drugs

Good luck with your approach - change in lifestyle is always better alternative to medications, as long it works, and you consult your doctor...

Cheers

Ruza2020
Ruza2020
in reply to RedOaks

Thanks RedOaks for your reply. Glad to hear you have lost some weight (if you needed to lose - not sure what stone is:)).

Changing lifestyle - losing weight, eating well, staying away from alcohol works very well for many people.

Best wishes

I collapsed on Saturday morning, and have episodes now and again. I started a tooth abscess Saturday and pretty sure that was the trigger. Feeling drained generally and in pain with my tooth. Apparently the NHS 111 doctor told me that any sort of infection can set if off.

Ruza2020
Ruza2020
in reply to Chilbolton

Thanks Chilbolton for sharing. Are you able to see your dentist during COVID-19?

All the best.

Cheers

Chilbolton
Chilbolton
in reply to Ruza2020

I rang this morning, they are not seeing patients yet. Told me as I have antibiotics,mot ring when I’ve finished the course. To be honest, I’m not in fit state anyway to see him. Easing slightly after 7 tablets. Feeling very drained

Ruza2020
Ruza2020
in reply to Chilbolton

I totally understand.

Take care.

I have had similar issues before AF became a rare occurrence. Suggest you implement all of the following: reduce activity/stress so you are not as tired when you rest. Particularly in the evening and try some meditation one hour before bed. Eat lighter meals and the last one of the day early say 6pm. Avoid all cold drinks and food straight from the fridge. Look into your diet and gastric issues (that can agitate the Vagus Nerve which then carries on that nerve system to the heart). Sleep with an extra pillow under your head and two on your left side to stop you turning onto it. Possible sleep study to check for sleep apnea or just start by using nasal strips in bed.

I believe it is important to take all possible actions at once as AF is such an individual mongrel condition that selective action may mean the remedy for you is not covered resulting in no benefit. Good luck.

Ruza2020
Ruza2020
in reply to secondtry

Thank you Secondtry for such great suggestion. I have already implemented many of those ideas - but will try to be more disciplined about them.

I was supposed to go to a sleep clinic few months ago - but this COVID is standing in the way(:

Cheers

My first attack came on at work during lunchtime ( a light salad so cant blame that) although I had been getting ectopics for 2 years previously combined with a mild chest ache.

I was admitted to CCU when this first appeared as my ecg was not normal, something to do with a line under the midline trace when it should be on or above it. Wish I had taken more notice

They said I had costochroditus and sent me for a stress test which was normal.

Any physical stressing of my chest muscles, i.e lifting heavy bags of compost or strenuous pulling makes me feel off colour and increases the chest ache. This usually finished with an AF attack either that evening or the next day.

Previously the other attacks come on just as I am faling assleep. My HR was going down to 35 when asleep on 5mg Bisprolol so this was reduced slowly to 1.25mg and it still gets down to low 40's.

At the moment I have a fairly pain in my chest, sternum and neck which rises up in to the base of my skull and is peaking. I also feel sickly and weak but my blood results are perfect, cholesterol of 4. GP doesnt know what it is. This has been like this for 4 years.

I think the AF is connected and a symptom.

Interesting you mention chest “ ache”. I’m sure my left side chest ache is from my heart because if not it would be bi-lateral? Also it’s nothing like MI chest pain which starts centrally. The ache does sometimes go down my left arm too, but this is when I am at rest after a day of lots of arrhythmias.

john6
john6
in reply to ian16527

I had the same thing with Bisoprolol 5mg, night after night Afib kicked in due to my HR going too low. Swapped to Nebivolol 5mg which took my resting HR from 44 bpm to around 56/58 bpm, it cut my nighttime episodes down by around 95%.

Ruza2020
Ruza2020
in reply to john6

Thanks John6 for sharing. Sounds very promising...

Cheers

Ruza2020
Ruza2020
in reply to ian16527

Thanks Ian for sharing. That sounds very frustrating... I hope your doctor sends you to some specialists?

All the best

Light salad my have contained mayonnaise? I have to be careful with fat... or maybe you got up and walked around before digesting the salad. Your symptoms do sound very like afib.

john6
john6
in reply to Lizty

I think anything that stimulates the system, even the hidden fats in quiches, scones, pies , gravys etc can start mine off. Another is the volume/weight of a meal/drink that can set it off.

Virus/infection, raising arms above head to work - includes swimming! - upset stomach, raising heart rate suddenly. There’s a history of AF in my family so I think I inherited a twitchy heart 🙄

Ruza2020
Ruza2020
in reply to Buffafly

Thanks Buffafly for sharing. "twitchy heart" - haven't heard that expression before:).

Cheers

Sounds like 'Roemheld Syndrome'. Google it .. there is alot about the subject .. on YouTube too. Might help and relax you to know it's very common. myacare.com/en/mya-blog/wha...

secondtry
secondtry
in reply to Rhea11

Thank you!

Ruza2020
Ruza2020
in reply to Rhea11

Thank you Rhea11. I have done so much research on the topic of Afib, but have never came across 'Roemheld Syndrome'. I briefly checked the article you forwarded - it sounds very familiar to my digestion problem. I will do more reading on this subject and will discuss it with my doctor next time I see him.

Cheers

I had 9 months of persistent AF shortly after steroid injections in both knees, and have since read research that AF is much more common in people who have started on steroids. I was also taking ibuprofen for knee pain, and found that that too is associated with more AF, so now take paracetamol instead if I need it.

After my successful cardioversion in January, I had a few ectopics on about 4 occasions after trying no nitrate bacon, sausage and parma ham. I was also aware that hard cheese (was fond of mature cheddar) made my heart thump when I was in persistent Af, so dropped that too. I've discovered that all these foods are high in tyramine, which can be a trigger for AF for some people - it can act like adrenaline it seems, raise BP . As this article says "any foods that have been pickled, fermented, aged, smoked or marinated - this includes alcohol"

dailymail.co.uk/health/arti...

Happily, I've had no attacks since my cardioversion, and no ectopics since cutting these foods out shortly afterwards.

Ruza2020
Ruza2020
in reply to Belle11

Thanks Belle11 for sharing and for the link - "tyramine" -- interesting - I will look into it.

Cheers.

Belle11
Belle11
in reply to Ruza2020

Might not be your trigger but another thing to observe perhaps. I've just been recalling that I used to get migraines with MSG, which is one of the high tyramine foods (tyramine is associated with migraine too.)

I thought I'd put a reply here about my triggers, which seem to be related to tyramine containing foods - hard cheese, preserved meats and fish and others, but I can't have pressed the reply button. I've had no recurrence over 5 months since cutting these out. Lay article here dailymail.co.uk/health/arti...

and medical study here ncbi.nlm.nih.gov/pmc/articl...

Hope you find answers to yours.

Obesity, gluten, shellfish.

Time it seems is now the trigger for me although I think for many people after initially episode there is no trigger .

Since December my episodes have been happening ever 10-12 days and usually last 10 hours.They start at different times of the day and with no discernable common factor.

I was supposed to be going to the clinic to be prescribed Flecanide to try to break this pattern till C19 cancelled all appointments.

Now I just get on with life within the limits of my capabilities on episode days. There are many jobs I can still do while breathless like sitting on the path in the garden weeding unless I feel to ill than I lay on the floor breath slowly and hope for sleep .

I am happy to settle for this way of life, I don't want to do anything that will make my situation worse.

Ruza2020
Ruza2020
in reply to doodle68

Thanks doodle68 for sharing.

Best wishes

Hi Ruza2020 - here's my story....

I had many AF triggers, with most if not all of them being of the "vagal" variety. As my PAF situation worsened over the years the list of triggers grew as did the frequency and duration of AF episodes. I was always very symptomatic while in AF, and I endured many stressful, desperate visits to Emerg. I also experienced an ischemic stroke in 2016 as a direct result of AF. I grew tired of trying to understand/avoid the many triggers of AF. I decided something had to be done, as did my EP/cardiologist. So, after many months/years an ablation was finally scheduled for me. Upon having my PVI cryo-ablation some 2 years ago (Aug. 2018), my PAF situation was magically resolved (at least for the time being) and I've been in total blissful NSR ever since. My QoL has finally been restored.

I highly recommend PVI ablation to anyone who experiences PAF (with frequent symptomatic AF attacks) in the manner in which I did. It's such a mongrel condition.

Best wishes,

Richard

Ruza2020
Ruza2020
in reply to Breezera

Thanks Breezera. My Afib episodes are viciously symptomatic as well. I am sorry to hear you had ischemic stroke. Hope you have fully recovered. I too am considering ablation.

Cheers.

I endet 2 times in ICU and had cardioversion bc of Atrial Flutter and in both cases was cold during, or ice cream.I had kind of brain fizzing and then my flutter never stopped till the electroshock.

Ruza2020
Ruza2020
in reply to Kleasmile

Thanks Kleasmile for sharing.

Cheers

My identifiable triggers are fatigue and stress. Before I was diagnosed with sleep apnea and started using a CPAP, I would frequently wake up with AFib, so I guess sleep apnea could be on that list as well.

Since having an ablation last June, and being put on Sotalol this past May, I have not had an episode of AFib despite having knee replacement surgery 4 weeks ago.

Ruza2020
Ruza2020
in reply to CookieinAL

Thanks CookieinAL for sharing your story.

Cheers

Nothing I can fathom.

Alcohol, heavy meal.

Ruza2020
Ruza2020
in reply to Janith

Thanks.

Cheers

My triggers have been BP meds, which lower my heart rate, gassy foods that swells my abdomen so that it pushes on my heart and vagal nerve and carbs, carbs and more carbs.

I have been fine since I ditched all three of my triggers. No attacks in 18 months and no meds, just Fish Oil, Magnesium Citrate and Vitamins D and E.

I still carry my PIP, Flecainide, incase my will power fails me and I eat the wrong foods.

Thanks Mollybear for sharing.

Wow, 18 months with no Afib episodes - that is amazing, and wonderful. So good to hear a such a promising story.

When you say you have removed carbs from your diet, are you referring to simple carbs, or both simple and complex? My Afib episodes are symptomatic - truly brutal - so I'm willing to try almost anything.

Cheers

Stress and dehydration.

Hi licorice made mine so bad and after reading about it can even cause heart failure. I ate a lot of it and AF began after being free from it for a year after cardioversion.

Ruza2020
Ruza2020
in reply to Maz38

Thanks Maz38. Licorice? That is one I haven't heard before.

I just did a quick search on it and came across an article titled: FDA: Don't OD on Black Licorice This Halloween

"For people 40 and older, eating 2 ounces of black licorice a day for at least two weeks could trigger an irregular heart rhythm (arrhythmia) and other troubles, ..."

Cheers.

afternoon Ruza2020 . A fib exacerbated by Mitral valve replacement 3 years ago (aged 61) and since then has reared its head approximately once annually. I take fleicanide and metropolol daily. I have good BMI drink wine almost daily eat well (aside from occasional chocolate binges)and planning for an ablation when it becomes more problematic. too much alcohol and dehydration plus very high temperatures during virus have been discernible triggers for me. I do serious Pilates and walk stairs regularly and so far everything in stasis. having said that I am not convinced that it is possible to totally control Afib beyond a certain point as it generally alters physiology.

what I am convinced of is that the capacity to alter my response to Afib improves QOL. good luck.

Do not touch liquorice. I love it and ate a large amount and being diabetic it was so stupid. It lowers your potassium level dangerously. A banana will put the potassium back up so always keep one handy to alleviate it.

I started having Afib over 20 years ago, no obvious factors that I could put my finger on, but they would last hours and left me feeling like I’d run a marathon. I then had an ablation which didn’t work straight away but after approx a year they just stopped and I hadn’t had any episodes for around 11 years until a couple of months ago and just shortly after I lost my husband, so I’m thinking it’s got to be stress related and not helped by the fact that I’ve been comfort eating and put on around 10lbs during lockdown. I’m now trying to take better care of myself and have been feeling slightly better, and I’m hoping I’ll be able to get back to where I was. This group has been an enormous source of help and reassurance and it goes without saying that thinking positively will really help you.

The goal posts keep on moving for me! This year I am finding for the first time in my life, that the sun heat seems to be affecting me. I guess it is warming up my insides and causing my HR to increase which causes everything else to speed up = two bad episodes among many other minor happenings.

It also shows how much the medics are in disagreeance! I have yet to see or hear any GP or Cardiologist who oversees me, who has said "don't drink alcohol", however, that have said - "have a drink in moderation". Incidentally although we ran pubs/clubs for 25 years I have only had two halves of beer in 3 months.

I find that drinking moderate (normal strength) beer on a near empty stomach allows me to get away with it 70% to 80% of the time. My only reason for doing it is to live as much as I can normal life ie seeing friends and having a smile.

Stress, dehydration , stress and stress

Ruza2020
Ruza2020
in reply to Mikee69

Thanks for sharing Mike. I hope you have found good strategies to keep your stress under control.

Too much and long lasting stress is a killer...

Cheers

have you ever noticed spasms causing ectopic beats? I have noticed my neck spasms/tightens up when I get a fast surge of beats in my neck(spasm may be triggered by caffeine etc)

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