Ectopics and Digestive Difficulties - Atrial Fibrillati...

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Ectopics and Digestive Difficulties

mcpacs profile image
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I have been dealing with diarrhea recently which I think is being causing by a Turmeric/Curcumin supplement I started taking. My ectopic heartbeats, probably mostly Premature Atrial Contractions (PACs), have started to flare up again. So I stopped taking the Turmeric/Curcumin supplement. Two years ago I had started having continuous PACs until my cardiologist put me on 100 mg Flecainide twice a day, which stopped the PAC's and kept me in Normal Sinus Rhythm (NSR). I also take 25 mg Carvedilol twice a day.

I have had several colonoscopies over the years. The intestinal clearing process with laxatives the day before the colonoscopy procedure always seems to trigger the ectopic heartbeats and during one procedure the gastroenterologist almost decided not to perform the procedure because I was in Atrial Fibrillation (Afib). I convinced him to go ahead with the procedure since I had been in Afib before. After the colonoscopy was over, they immediately sent me to the hospital emergency room to treat my Afib.

I just want to know if anyone else has noticed irregular heartbeats, whether Afib, PACs or PVCs, being triggered by these digestive/intestinal difficulties?

Thank you,

Mark

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16 Replies

Yep. This is all mine are triggered by. I am actually at the point where I’m questioning whether I actually have afib or if it’s been Roemheld syndrome this whole time.

My situation is different than yours in that for me the ectopics show up the moment I have digestive upset, but I’ve never had them as often as you describe. Whether it be gas, acid reflux, ate too much in one sitting, or constipation (after it’s been about 2 days). In the past, these ectopics and short runs of tachycardia would slowly worsen toward bedtime until I got to a point where my heart would start beating 200-280bpm. I was only taking a beta blocker, and even that did nothing to keep that peak rate lower (at 25mg atenolol- at one point I was upped to 50mg per day and episodes stayed around 160bpm - but I also had more episodes than ever while taking that dosage).

I have now been completely off atenolol for over a month, I stopped even taking it as pill in pocket, as I discovered that every single episode is prevented from worsening by taking digestive meds. Usually it seems gas is the culprit as taking simethicone seems to be what stops it. Sometimes I also have to take an antacid, but I have not had an episode that went out of control since April 4th. In March while on 50mg of atenolol I had 4 of the high HR episodes. When it’s caused by constipation it’s a bit more of a challenge as treatments for that take time, but I haven’t progressed to a bad episode even then. I think when I had the bad episodes it was always when multiple upsets came together, like having a bunch of gas while also constipated - now I am controlling it to the point that I never have all that pressure at the same time.

I also now take magnesium taurate which I believe helps prevent the ectopics most of the time, as I’m having them much less than I used to.

Another interesting difference is that for my colonoscopy I had a very happy heart, not a single ectopic because my digestive system being empty clearly was great for my condition. I also didn’t go through it the same though, as I started a liquid diet a day early - so when I took the laxatives the day before the procedure there was already only really liquid in my system, I got no cramping or anything. Not sure how it might have effected me had I taken them with a full system.

And all of this is of course caused by vagal nerve stimulation, and/or displacement of the heart from the pressure.

mcpacs profile image
mcpacs in reply to

Thank you Aoxomoxoa,

I also think it has to do with the type of foods I eat. It seems high carbohydrate foods, especially sugar, can trigger an increase in my heart rate and/or ectopic beats. If I have not eaten for awhile or fasting, my heartbeat seems to stay in more of a regular rhythm. And then when I start eating, sometimes I will notice the ectopic beats. I definitely believe I have the vagal nerve stimulation response to my heartbeat.

I never heard of Roemheld syndrome that you mentioned. I'm glad you mention that. I will do some research on that. I suffer from acid reflux and have a history and genetic link to stomach ulcers. My father almost died while experiencing a bleeding ulcer, which required surgical removal of a large portion of his stomach (gastrectomy). Not sure, but I think during the gastrectomy they also cut the branch of the Vagus Nerve that goes to the stomach (Vagotomy) to help prevent stomach acid secretion.

I take 20 mg Prilosec OTC which is a proton-pump inhibitor (PPI) daily to prevent my acid reflux. That's the only thing that seems to help keep it under control, as I have tried other things such as Mylanta and Tagamet.

Frances123 profile image
Frances123 in reply tomcpacs

I’ve just looked up Roemheld Syndrome as I suffer with GORD as well as Afib and Dr. Sanjay Gupta has even written a piece on it. drsanjayguptacardiologist.c...

mcpacs profile image
mcpacs in reply toFrances123

Thank you Frances123.

After reading your link to Dr. Sanjay Gupta, looks like I may have to consider a different way of controlling my acid reflux besides taking Prilosec OTC, which is a Proton Pump Inhibitor.

Ppiman profile image
Ppiman in reply to

I feel it is stomach > diaphragm > heart displacement rather than nerve irritation in my own mind. You have a much worse case than I do, but even certain movements can set mine off: lifting high, bending low, walking up steps, and, of course, the blight of my life, constipation (I have a 'redundant' sluggish colon with diverticulae, so need to take Sunsweet Prune Juice and 6 large prunes each day to keep things moving). The doctor I saw was sure it wasn't irritation of the vagus as, he said, that is unusual and would also bring on severe bradycardia with swings to tachycardia. which I don't have.

It's a life!

Steve

Auriculaire profile image
Auriculaire in reply toPpiman

Get those diverticulae removed and shorten your colon and I promise you you can throw out the prune juice!

Ppiman profile image
Ppiman in reply toAuriculaire

I think you have it in one there, but when I mentioned this the idea was not even considered as a possibility.

Steve

in reply toPpiman

Yeah I’m unsure if my vagal nerve is involved which is why the and/or about displacement. I used to have swings to bradycardia prior to an episode, but that was while still on atenolol. I would have resting HR in the 60s normally while on it - then I would start to feel unwell and notice I was dropping into the 40s and 50s. I have not noticed this since coming off the atenolol though.

meadfoot profile image
meadfoot

Oh yes, thats the story of my life. If my gastric issues were gone my heart would be so much better. Gastroenterologist and Cardiac consultants accept my position on this and dont disagree. What to do about is the challenge.

Happy days, not.

Hiya mcpacs .... and others,

Look, I wonder if I could chuck a curved ball into the discussion ...... have you or any of you and your medical team consider what a dysfunctional Vagal Nerve can do .... is capable of doing ..... have you or your medical team ever heard of it ?

Back in the day, mid to early 2010/2011 I realised that food was a main trigger to lurch me into an AF event. My diet along with food ingredients were the problem.

What got me thinking along the lines of Vagal Nerve (VN) were my symptoms, diahorrea, loud ( antisocial ) intestinal gurgling, massive, massive and painful bloating and constant burping. The bloating was the worst and most likely to tip me ionto AF. My GP at the time had bloods done for Coealiac Disease but came back clear. I then consulted a Nutrionist. She advised me over a long period of time to modify my diet and food intake plan. Essentially this involved going Gluten Free, Wheat free, Oats free .......... however by keep a food diary noting all the wider range of 'offensive' foods I have over the years now now managed to get my AF events down to 3 to 5 a year, most minor, some so bad as to wipe me out for a weekend. I've also had medication too.

So, from anecdotal experience I have realised that most GP's/Cardiologists/ EP's may not entertain the concept of a VN issue. I would have thought that a Gasteroenterologist most certainly would have.

The VN is a nerve, part of the central nervous system that acts like a communication superhighway between the brain and the heart and the digestive system. Google it ............. but make a special point of googling " Schematic diagram of the Vagal Nerve". Basically it has the where with all to link/interact with the heart and guts!

Hope this may give you a few clues. There are quite a few on this forum who have experiences like mine and hopefully they may toss in their views too. Meanwhile I apologise if i'm teaching you how to suck eggs. Sorry.

John

mcpacs profile image
mcpacs in reply to

Hi carneuny,

Thank you. I'm wondering if there would be something they could do to the Vagus Nerve to control the Afib. As I mentioned in my previous comment when my father had a bleeding ulcer caused by acid secretion in his stomach, they cut the Vagus Nerve connection to the stomach to prevent the excess acid secretion and help prevent further ulcers. Not sure how much good it did though because to this day, he still takes Omeprazole to control the stomach acid.

AussieHeart profile image
AussieHeart

So interesting… I began with high constipation and now afib. Interestingly post ablation, this is the advice: It is also important to take a reflux medication (which reduces stomach acid) at 40mg a day for six weeks following an AF ablation (nexium, pantoprazole, omeprazole or rhabeprazole), since this will reduce the risk of injury or irritation to the oesophagus which sits right behind the heart.

dunestar profile image
dunestar

For me definitely a strong relationship between digestion issues and Afib. I eat only a light snack in the early evening and nothing after say 7pm. If my digestion is calm so is my heart.

in reply todunestar

Hi, yep thats my mantra .......... calm the VN, calm the heart.

Karendeena profile image
Karendeena

Hi Mark, yes me! My afib always kicks off after a bout of diarrhoea! I too had a CT colonoscopy in January and the 'clearing out' process started my afib the night before the scan. I was in afib with a heart rate of around 150bpm but they still did the colonoscopy as I would just have to go through it again. My afib lasted 36 hours following that one, it was awful, but I eventually reverted to NSR naturally.

You are not alone with this one!

mcpacs profile image
mcpacs in reply toKarendeena

Thank you Karendeena. Nice to know I'm not alone.

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