Back for a bit

[Andyt36]

Hi all hope you are well. Managed to go afib free for a few years, but after a successful run it has popped up again, very stressful last few months so run down as well. I notice it only comes around when I eat generally in the evening. Lasts less than an hour or an hour.

Am on 200mg of flecanide in the evening only.

I think it is vagal, just trying to figure out how to do a hard reset. Diet wise any advice in what my be the least stimulating 😁.

Thanks all

Andy

[mjames1]

I was getting my afib episodes very early in the morning so I upped my Flecainde at bedtime so there would be more in my system by morning.

In your case, if you're getting episodes in the evening, maybe change the time of dosing to three or four hours before you eat. Right now, by the time you eat, your Flec levels are near their day's low, you want them near their high. You can also try splitting the dosage 100 at night and 100 morning. See what works better.

As to diet, try making bkfast or lunch the larger meal and dinner the smallest. I found the FODMAP diet helpful as well.

Jim

[Andyt36 in reply to mjames1]

Thank you for the sensible input

[jeanjeannie50]

Andy, I would reduce the size of your meals in the evening. Always stop eating when you know that you're full - no matter how lovely the food tastes! Also drink a glass of water half an hour before you eat. Perhaps have a banana a few hours before your meal and eat your last meal of the day as early as you can.

If you are overweight (are you) and have a big meal in the evening - well that's a sure recipe for AF. That full stomach could well be pressing against your vagal nerve.

Jean

[Andyt36 in reply to jeanjeannie50]

Thanks Jean, yeh could do with losing around 10kg to be honest. Generally have been good with my diet except after Xmas this year. Maybe it all culminated in this but we have to get back on the horse again.

[Andyt36]

Maybe a silly question how does the water before the meal help?

[jeanjeannie50 in reply to Andyt36]

Water fills you up so that you don't need to eat so much.

[Andyt36 in reply to jeanjeannie50]

Thanks 😁

[Singwell]

I agree timing of Flecainide might make a difference. Flecainide also needs water to be absorbed so that fits with Jeanie's advice too. Try eating smaller amounts and not late in the day. Sit up straight while eating (no TV meals) and sit quietly for a few minutes afterwards to signal to your body that you know it's digesting. I usually do some light household tasks or amble round the garden in the summer for a few minutes after that 'rest' so that I don't slump down on the full stomach. As for weight loss if needed - Michael Moseley Blod fast diet is good. Maybe check him put. He's on Instagram and has a short podcast too called 'Just One Thing' I think.

[Andyt36 in reply to Singwell]

Thank you

[Ppiman]

My cardiologist was sure mine was not "vagal" in the sense of an irritation of the vagus nerve and told me very few are despite the popularity of the term on the internet. What seems to be the case is that some AF is set off by the adrenergic / sympathetic system (activity / stress) and some by the "vagal" cholinergic / parasympathetic system (rest and digestion).

Mine tends to be worse after eating, but I've come to think that the cause is physical rather than internal. Food pushes the stomach higher against the diaphragm and that presses against the heart causing ectopic beats and mild tachycardia. That can be enough to set of AF in some, it seems.

Steve

[Andyt36 in reply to Ppiman]

Very interesting as bloating seems to be a part of this

[Ppiman in reply to Andyt36]

Before my arrhythmia troubles began properly with atrial flutter in 2019 my GP was convinced my hiatus hernia and general reflux issues caused me a lot of vague problems and even first blamed the atrial flutter on that. Since then, I just don't know whether it's chicken or egg. Does the gastric problem cause the heart problem or vice versa? They seem interlinked to me quite often.

But the issue of the heart being physically disturbed by a bloated stomach is real and well documented, even that it can cause ectopic beats or mild tachycardia, both of which can set off AF. That's not the same as vagal AF, of course, and it would also be very hard to prove that the bloating is the trigger of any AF episode, but I feel sure it can be.

Steve

[secondtry]

Breakfast like a king, lunch like a prince and supper like a pauper ie no meat at night, very light and very early (5-6pm). No caffeine after 1pm. All stress in your face and on your subconscious must be cut. Also not sure about 200 mgs Flec at one hit in the evening; maybe discuss with your medics a more even approach of 100 am & 100pm.

[Andyt36 in reply to secondtry]

They had me on a 100 in the morning and 200 in the evening

[secondtry in reply to Andyt36]

Whoa..that's a lot, definitely step up your lifestyle changes.

[Andyt36]

Funnily was stable on that dose, but think I slacked on the lifestyle and stress management. Even though I run etc , could do better so figure this is about a reset on all fronts thank you 😃

[JOY2THEWORLD49]

Hi

In reading others have a light tea low fat with no alcohol.

Do not exercise hard after. Rest up to bed time.

cheers JOY 73 NZ