I am certain that my AF is vagal by nature as I notice PVCs particularly when I have indigestion and bloating. Has anyone with a similar profile found ways to calm the excited vagal nerve and thereby reduced symptoms? It's well over a year since I had an episode of full on AF lasting about 30 minutes which stopped once I had done a lot of belching and got rid of abdominal gas.
vagal AF: I am certain that my AF is... - Atrial Fibrillati...
vagal AF
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DIB69
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Hi,
I have no idea TBH ....it was all so long ago. However that food or food ingredients directly tipped me into full blown AF is beyond doubt.
Got checked out for IBS and Coeliac Disease and once they were eliminated I went off on my own and consulted a Nutritionist re food and diet. Followed her advice and gradually over the years ( since 2011) I have reduced AF to one or two events a year. I am still on my original medication - Bisoprolol and Warfarin too.
DIB69 in reply to
This is of particular interest carneuny and has prompted me to consider consulting a nutritionist.
hello yeah I've had the same. my afib which I have not had for ages now was vagal I'm certain. being bloated/indigestion + sleeping on my left side were causes. So i try to avoid those siuations, I take calcium channel blocker rather than beta blocker+ 5mg flecainide each day .
on the odd occasion I had a breakthrough I took one more flecainide and that's converted back to sinus quickly. think you would need to see cardiologist to get flecainide prescribed as they're are possible complications
I have gastric problems and a hiatus hernia, but was told that AF caused by actual irritation of the vagus nerve (as your post implies) is very unusual and would be accompanied by a range of other significant symptoms, including severe bradycardia with swings of tachycardia. The vagus innervates many organs, after all.
Vagal AF is a different thing. It’s a theory to explain why some people get AF when the vagal nervous system “dominates”, such as during sleep or after a meal.
What might be happening in both our cases is that the heart is being physically pressed against by the diaphragm, itself pushed up by the stomach and intestines. That is a cause of ectopic beats and those can trigger AF.
Steve
Ah, this definitely makes sense to me as it's ectopic beats that I suffer from mostly, especially when I lay down to sleep at night. It's as if my organs are sort of rearranging themselves as I change position!
I have developed a better sense of my 'inner workings' since first being diagnosed with AF and what you say chimes with my own experience. The cryo ablation I had in 2013 has helped well with episodes of AF but has seemingly never really conquered those pesky ectopics which in the main don't bother me. I'm trying to identify foods and drinks that seem to set them off.
I suspect whenever the stomach swells from food or air, or from bloating from wind or constipation, the heart can become slightly compressed by the diaphragm. I once was shown this on a chest X-Ray, so it is a reality in my case at least (or was once).
That was many years ago. Now ectopics are an everyday occurrence and AF occasional - and I feel due the two are linked. I’ve never really been entirely convinced by “triggers” in the sense of this or that specific food, more by the effect of food on the stomach - but it would be nice to know.
Steve
I know some relationship.I had bloating for years..like pregnant.never knew what it came from..but read could be heart.have it rarely now..vagus nerve seems possible now that I know more..but how to deal with erve I don't know
add some digestive enzymes with your meals, that is what I do. Eat less, I’ve read only eat to 80% full. I had some refried beans the other night it was horrible and tore me up. Stay away from Lectin containing foods. You will need to do a search to get a list. MSG is another trigger for me even the tiniest little bit.
Thank you Peacefulneedshelp, I have already added some digestive enzymes and avoid MSG but will now also shall look at Lectin free foods.
We need the vagus nerve to 'rest and digest' so- according to my understanding- you need to stimulate the vagus nerve in this case, not the opposite. I identify with Steve's response as I have a hiatus hernia (undiagnosed). My advice is to eat slowly and thoughtfully- maybe not too much talking whilst eating, and not reading or watching TV. Mb Phones are bad news in this respect! After you've finished, sit down for between 5-10 minutes and breathe slowly. Sit upright so you don't collapse over your stomach. Then get up and move around a bit - clear away, maybe go for a short easy walk. This seems to work in my case, plus avoiding multiple courses and overly large portions.
Thank you, some really sound advice here and it makes me conscious that I do sometimes eat in a 'stressed state' and possibly swallow a lot of air whilst eating.
That seems excellent advice to me, SW.
Steve
I think we need a HH thread don't you? Maybe I'll start one over the weekend.
I saw today that there’s a Facebook group called something like “AF and Hiatus Hernia”!
Steve
Nah can't be doing with FB groups. Have to be in them for work and definitely don't need more! Thanks for mentioning it though. I'm.currently on a mission with my HH.
I too am celebrating a year since an AF incident that required a stay in the hospital. I was anxious and not sure why my heart was fluttering. I was told I had Vagal AF and that pointed me in the right direction. My AF was paroxysmal and went away within minutes, but Roemheld Syndrome described my situation much better.
I could sit at my desk running my Kardia, bend forward on a bloated stomach, and trigger an AF reading. I could sit back up and I was right back in NSR. I could repeat this process several times in one sitting with the same results. I did this “experiment” on different days and at different times of the day after eating and feeling bloated. The results were the same. I recorded them for the EP to see.
I started taking Gas-X when the bloating episodes would appear and that helped a lot. Lowering my weight, reducing the size of my meals, cutting back on carbs, and staying away from caffeine has been the best medicine for me. If I overeat every now and then, I may trigger a PVC or sometimes an SVT, but no AF events occur. And even these events are dissipating. I try not to eat after 6pm since my episodes always occurred in the evening before bed – the “rest and digest” time.
There are times I overindulge too much – especially around the holidays - and that is when I find myself drifting back in the other direction. Gas-X may not help in this situation. When this occurs, I have found that massaging the stomach right below the sternum in an up and down motion helps stimulate the mobility of the digestion process. If that doesn’t help, I will take a walk to get the body moving, which also aids in digestion. Once the food and gas have been reduced, the symptoms will go away.
If I am experiencing any pain in the stomach – specifically just to the left below the sternum and under the ribcage, I will help myself to an 8oz cup of Bluebird Chicken Bone Broth. Persistent pain in my stomach is a warning sign for me. It is telling me that I need to get my regimen back in order or else I will find myself back where I started. The bone broth is amazing and works very similar to Prevacid or Prilosec. It relieves my stomach pain, and the warm broth has a calming effect, which also helps aid in digestion.
We are all different and have different needs, so I only present this information as an example of what has worked for me. I have gathered much of this information from the great people on this board and others who are gracious enough to share their stories.
Thank you TechGuy62, a very interesting read and one that reflects some of my own attempts at a better understanding of our 'condition', its triggers and its varigies. Coincidentally, today I decided to avoid coffee altogether, even though for a while I've been drinking decaf. You're absolutely right in saying that, despite having the same problem we all respond to different approaches. I guess this is why there's no 'silver bullet' and why we become our own best detectives.
That was a useful post - thank you. You seem to have worked your way around your issues rather well. That’s what I try to do but the other evening, after nine months of no AF (but masses of ectopics and palpitations), it returned for several hours. Luckily at a lowish rate so not troublesome.
Steve
Did you notice anything different in your lifestyle that may have changed? Stress, something you ate/drank, sleep pattern, etc.? What about when the palps and ectopics occurred? Was it right after eating, doing strenuous activity?
Occasionally, I will get a cluster of palps and ectopics that occur well before any AF events. It's like a warning beacon that tells me I better watch what I'm doing. If I ignore them, then my AF will return. I try to look at what I might have changed in my diet, if I'm working too much, my sleep pattern, stress, etc.
Hi TG - I tried to think of a connection at the time but there was nothing unusual and I was just sitting watching TV some time after eating. I get ectopic beats so regularly that I just noticed they felt more prominent and then my Apple Watch showed AF. It tends to happen around the same time - but not always.
Steve
Hi Steve, I could get palps while I was sitting at the computer doing work. I found that by loosening my belt they would go away. I ended up buying "stretch" jeans and went without a belt afterwards. After losing the weight, that issue has gone away. That light amount of pressure on the stomach seemed to be enough to aggravate it.
It took some time tracking my meals, how long I sat in my work chair before getting up, what time I went to bed, how long I slept, etc. before I began to notice patterns in the palps and ectopics - when they occurred, what I had eaten prior to the event, how long before the event took place after eating, etc.
My AF is so infrequent (single bouts last February, June and now this week) that I'd struggle to make any connections but, like you, a loose belt is far more comfortable, and if I do anything while kneeling low, like say checking the tyre pressures, then I feel uncomfortable and slightly unwell and get lots of ectopics (but not AF).
One odd thing that happens is when I don't register an ectopic, but still feel the beating noticeably (i.e. palpitations). I always wonder just what is happening to allow me to feel uncomfortable and aware of my heart, even though there is nothing on the Kardia or watch.
It's a strange old condition but I also have left-bundle branch block and, I think, a slightly long QT (well, when pre-ablation for Afl, my EP told me I wasn't suitable for flecainaide or sotalol, only amiodarone without explicitly saying why).
Steve
That would be difficult to determine any pattern since it is so infrequent. When I first started having issues, the anxiety got the best of me. I could feel my heart all the time. The more I learned about what was going on the less stressful I felt, and it eventually was off my mind. The Kardia has also helped in that regard as well. What did your EP say about the uncomfortable feeling you have when you're kneeling low?
The usual shrug! 
No - he’s a great doctor but I think he’s right when he says there are so many things that might lead to “feelings”.
Anxiety can increase symptoms a great deal but that’s not what I’m feeling at all. It’s often said that we notice palpitations more as if they were just the same as everyone gets, but I don’t agree at all. What they are though, I have no idea.
Steve
Yep. I agree with your statement. Considering all of the variables, I wouldn't want to be in the shoes of the physician. I think it is in our own best interest to provide as much information as we can to them in order to help guide them towards a proper solution - but we live in our bodies and only we can determine whether what is being prescribed is working for each one of us uniquely.
I'd not heard of this syndrome till you mentioned it though I knew there were links between HH and AF. Although I've been AF free since May 22 the HH is causing palpitations after meals and some fleeting chest pains if I get into the wrong position - bending my.chest principally. I'm hoping the hernia will slide back again. It's done it before and I had no problems for quite a few months.
Very happy to hear you are AF Free, Singwell! My daughter was diagnosed with HH and she has similar problems - palpitations and a sharp chest pain every now and then in the same region as I have. She overindulges from time to time and the HH lets her know it. She is still young - mid 20's. Fasting has been her preferred method of sliding her stomach back out of the diaphragm.
OK. Thank you useful to know. I could try overnight fasting, which I've been considering anyway. Not for weight loss but to help cholesterol levels. My challenge is having had abdominal surgery due to a stomach perforation aged 19 when they tied my vagus nerve 'just in case' I developed an ulcer. I didn't have an ulcer - suspect it was too many aspirin - but they did it anyway. Needless to say, as I got older my digestion has got steadily worse because I don't produce HCL like normal people. So I have to manage the challenge somehow.
Have you heard that some therapists can massage the HH back into place? I have been considering this.
I have seen examples of massaging the HH back into place. My daughter has tried it herself, but it didn't work for her. She tried drinking a warm glass of water first thing in the morning, then going up on her tip toes and dropping her heels to the ground on the basement floor to create a "thud". It didn't work for her either. Fasting seemed to be the solution that worked for her, but all options are always worth trying if any of them can bring relief.
The only people who don't understand the direct connection between gastric distress and Afib for many of us are the doctors. Instead of sending us to the the GI for testing and consulting about diet, they roll their eyes and ignore our assertions or tell us, as did my EP, that trying to avoid Afib by controlling gas will not work. After seeking out a GI, finding that I have celiac disease and changing my diet accordingly, taking gas pills and indigestion meds as needed daily, being careful about getting constipated, and staying alert as to when I need to breath better or get up and walk around, I have gone from Afib every two weeks or so (lasting 12-40 hrs) to no Afib for the last 13 weeks. I am not claiming a cure; it requires daily awareness and discipline. Time will tell.
Thanks, my wife showed me his video and several others a month ago. It was very affirming to hear him support my homegrown contentions. It seems as though the "ounce of prevention is worth a pound of cure" adage would apply well to those of us whose Afib seems to be triggered by or connected with digestive issues.
Like others here I’ve found overnight fasting with last meal 4-5 hours before going to bed very helpful. I also avoid overeating.
Weight management also helpful. I’ve found that I personally need to keep my weight below BMI 27.5 to avoid awareness of AF - but I’m in permanent AF albeit mainly asymptomatic.
Sleeping on right side is helpful for me, but I sometimes wake up with palpitations having moved in my sleep onto left side. I can stop these with slow deep breathing and/ or a change of position.
Plan to also try magnesium.
All suggestions welcome if anyone has further tips…
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