Afib or palpitations?: Once in a while... - Atrial Fibrillati...

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Afib or palpitations?

hearthealth2022 profile image
13 Replies

Once in a while I get very irregular heartbeats after I go to bed at night. My Dr. said they are palpitations and not afib and did not occur during the 24 hour holter monitor, but I noticed a pattern as to when they occur: always after a very salty and probably MSG restaurant meal and a few drinks with said meal. I've had an echocardiogram (all was good) and as mentioned a 24 hr holter monitor.

Narrative

· Predominant rhythm was sinus rhythm.

· Palpitations occurred.

· No atrial arrhythmias noted.

· No atrioventricular block noted.

· Rare premature ventricular contractions

· Frequent premature atrial contractions

· Normal sinus rhythm noted.

· No malignant arrhythmias present.

· Multifocal atrial tachycardia nonsustained supraventricular tachycardia.

Last night after having one of these restaurant meals, my Fitbit signaled irregular heartbeat several times over a 2 hour period, and I could feel them. I got up and drank a lot of water and they stopped. My question is, how long can you have undiagnosed afib before blood clots form? I have a follow up with my GP and cardio in a few months, but doing some research on my own because these irregular heartbeats did not happen while I was 24 hr holter monitored and I think I figured out what causes them. Thanks for any info.

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13 Replies
BobD profile image
BobDVolunteer

OK firstly palpitations merely means that a person is aware of their heart beating. The term has no specific meaning regarding what or not that might be.

Secondly msg is a known trigger for such matters and best avoided as of course is alcohol.

Unless you can capture any of these odities on kardia or during a holter monitor I doubt you will have much joy regarding discovering what they are. Your last holter captured no AF, some tachycardias and some ectopics beats none of which are particularly nasty.

I would try to avoid worrying about soemthing that may not happen. Unless you are over a certain age or have other co-morbidities (Googel and check CHADSVASC score) then anticoagulants would not necessarily be recommended even if you did have AF.

hearthealth2022 profile image
hearthealth2022 in reply to BobD

Thanks for the reply and sorry about the incorrect verbiage. I'm not really worried and I trust my cardiologist, but what concerned me was he only did a 24 hour holter, and I get this very sporadically. My Fitbit called it afib last night. I wondered if it knows the difference between irregular and true afib, and also wondered how long it would take to form a blood clot if this was undiagnosed afib.

BobD profile image
BobDVolunteer in reply to hearthealth2022

Must make it clear I was not critising you at all. Merely pointing out that your doctor was talking nonsense. Its like they treat us as idiots!

Ppiman profile image
Ppiman in reply to BobD

I can't see on the thread the nonsense from the doctor. I'm intrigued - where is that?

I suppose that a Fitbit could mistake ectopic beats as AF, since my Kardia has done this twice (although not my trusty Apple Watch). These devices look for an irregular beat (i.e. AF or multiple palpitations) but shouldn't call this AF unless there is no P wave on the ECG, signifying the lack of an atrial beat.

I can understand your anxiety over the stroke risk as AF can easily be "silent" or occur very briefly. Could you ask for a two week Zio monitor, maybe?

The connection with food is possibly a mechanical one, rather than salt or MSG related. When the stomach swells from food or gas the diaphragm is naturally lifted higher and can press against the heart. This can set of mild tachycardia or ectopic beats, which, I should think, in prone individuals, can trigger AF.

Steve

BobD profile image
BobDVolunteer in reply to Ppiman

Steve the point is that the term "palpitations" defines nothing. It merely says that a patient is aware of their heart beating. To say "it isn't AF its palpitations" is akin to saying " it isn't an apple its a fruit" so not helpful at all. AF, SVT, A tach. Ectopics are all palpitations if the person is aware of them.

Ppiman profile image
Ppiman in reply to BobD

Aha - I see. I've always thought of palpitations as "missed" beats, i.e. ectopic beats such as PVCs. My doctor calls them ectopic beats, now I think of it, not palpitations.

Steve

secondtry profile image
secondtry

'..also wondered how long it would take to form a blood clot if this was undiagnosed afib.'

I am afraid the answer is probably how long is a piece of string. As your individual circumstances & beliefs are the basis of when a clot will form, whether it is something your body can bust naturally, what you do post episode and your comfortable risk level. All that said, those few of us here who are not on ACs have to make that decision if an episode does not terminate very quickly.

From cardiologist discussions & what I have read, in my circumstances, I would probably reach for that box of pills after 2 hrs into an AF episode. I STRESS that is not advice to others, who may want to take ACs much earlier. I would then continue taking ACs for 2 weeks assuming no more episodes and consider stopping after that if I had confidently identified the episode trigger to be avoided.

RoyMacDonald profile image
RoyMacDonald

MSG is known to interfere with even a healthy hearts rhythm in people who have an MSG intolerance.

From the NHS..... What causes a food intolerance?

It is often unclear why a person is sensitive to certain foods.

If your symptoms happen after eating dairy products, it's possible you may have lactose intolerance. This means your body cannot digest lactose, a natural sugar found in milk, yoghurt and soft cheeses. A GP can usually diagnose lactose intolerance by looking at your symptoms and medical history.

Some people have trouble digesting wheat and experience bloating, wind, diarrhoea, being sick and stomach pain after eating bread. Read more about wheat intolerance (also known as wheat sensitivity).

Otherwise, the culprit may be a food additive, chemical or contaminant, such as:

monosodium glutamate (MSG)

caffeine

alcohol

artificial sweeteners

histamine (found in Quorn, mushrooms, pickled and cured foods, and alcoholic drinks)

toxins, viruses, bacteria or parasites that have contaminated food

artificial food colours, preservatives or flavour enhancers,

From the originator of a letter that is much quoted.....Monosodium glutamate’s notoriety took off in 1968 when a Dr Robert Ho Man Kwok wrote a letter to the New England Journal of Medicine musing about the possible causes of a syndrome he experienced whenever he ate at Chinese restaurants in the US. In particular, he described a feeling of numbness at the back of his neck that then spread to his arms and back, as well as general weakness and heart palpitations.

As food-related health theories are wont to do, his suggestion went viral

Kwok speculated the cause could be soy sauce – but dismissed this as he used it in home cooking without the same effects – or the more liberal use of Chinese cooking wine in commercial establishments. Then came the clanger: perhaps it was the monosodium glutamate used as a common seasoning in Chinese restaurants. As food-related health theories are wont to do, his suggestion went viral, spawning a huge number of scientific studies, books exposing ‘the truth’ about MSG, anti-MSG cookbooks, and even prompting Chinese restaurants to advertise that they didn’t use MSG in their cooking.

All the best.

Roy

RG72 profile image
RG72

I agree that the doc comments aren’t overly helpful. The other area I noticed was

· Rare premature ventricular contractions

· Frequent premature atrial contractions

What is ‘rare’ and ‘frequent’ quantified as? On my holter readings, my doc always gives the total quantity over 24 hours and the % of overall beats. A ‘frequent’ 8000 pac’s in 24 hrs would give more concern than a ‘frequent 800 for example. Same with the pvc’s. Unless they are quantified ‘rare’ and ‘frequent’ are meaningless.

Dodie117 profile image
Dodie117

I would suggest getting a Kardia machine. That would identify AF (and other arrhythmias) as you can use it when you feel the palpitation. You can print out the trace and show your doctor. As you are 66 you probably would be advised to take anticoagulant if you have af. My Holter monitor missed mine as did ecg when seeing doctor. This was the best way to identify what I had.

Finally it would give you peace of mind.

Teresa156 profile image
Teresa156

Some excellent advice here for you from others. I was like you and had palpitations at night, after some foods and alcohol but I didn’t know it was Afib for many years. If you are paroxysmal afib (perhaps and hopefully not), 24 hour monitors never picked up mine and they’re not likely to, unless you have an episode while wearing one. I had about 4 monitors over a ten year period. The only way I finally got a diagnosis was when they became more frequent last year and I got an ‘official’ ECG done at A&E, in the UK.

For me, I’ve had episodes which have lasted over 8 hours ( longest 12 hours, only once), with HR of over 180. Even in hospital they let me go on for 8 hours attached to a monitor, before they gave me anything. I’m not anti-coagulated yet, due to my CHADS VASC score of 0 and I am 56 but we are all different. A Kardia, as others have suggested would be good as cardiologists and EPs tend to like them.

I wish you luck.

ktf2022 profile image
ktf2022

I had to avoid MSG starting years ago, well before my AFIB started. I would get ocular aneurysm episodes (basically migraines in the eyes without the resulting headache). Very scary. I was only in my late 30's at that time. I was able to pin it down to MSG in Asian restaurants which I ate frequently at the time. It's not a good food additive in general. I always wonder if I might have been having (silent) AFIB episodes at the same time as I would occasionally get palpitations during those years. Might want to try and avoid MSG. It's in so many prepackaged foods as a flavor enhancer (I was shocked honestly). Many Asian restaurants will say "No MSG" on their menus.

tunybgur profile image
tunybgur

If you're worried about Afib and blood clots I would invest in a monitor and record any event as it happens. You will then have something to show your GP who can refer you to a cardiologist. If Afib is suspected you will normally be put straight on an anti-coagulant as a precaution.

I use a HealForce PC80B to record heart rhythm. I simply wet the contacts and hold it firmly against my chest and it gives an excellent 30s heart rhythm trace which clearly shows if the P wave is missing.

The absence of a P wave is a clear indication of Afib.

A lot of people use a Kardia but I have no experience of these, the PC80B certainly works very effectively. I don't bother with electrodes, I find just holding it against my chest gives the best results.

They can be bought online for about £90, cheap for peace of mind.

Also a lot of people are wandering around with undiagnosed Afib and I'm sure blood clots are the exception rather than the rule, I was undiagnosed for at least several weeks to my knowledge.

Good luck

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