I’m in persistent AF. 80% of time it is flutter not fibrillation. HR usually 120 but rises to 140. I have been in persistent af like this for 4 months. Previously 17 years PAF. I also have bad food sensitivity problems , bloat badly after some foods and I am long term obese at 130 kg.
About 5 weeks ago I made a fermented drink and drank it young to have it without it turning alcoholic. Quickly realised it must have introduced yeast to my system , or was continuing to ferment in my system because, oh my goodness, I bloated badly.
At one point whilst bloated I was in a garden and had to walk back to my car. 50 steps and my breath just sort of stopped. I went from fine, to excessively out of breath fairly instantly. A wk later we went out for a meal which bloated me badly again. I was huge when I went to bed. Got up at 3 am went to the loo and couldn’t speak or breathe. Rushed to A and E. Told immediately oxygenation and HR fine. The took bloods and in front of the dr my bloating went down. I could speak and breathe again. Dr said it was either intestinal colic or bisoprolol.
Approx a week after that, I had another attack whilst walking about 500 m. Yesterday I couldn’t walk 70 steps to the drs surgery without it happening, and I wasn’t bloated - but I bloated after it happened.
i have been testing this. In a morning, without having eaten I can walk up and down my garden pretty much as far as normal. If I do deliberate walking ie going out for a walk things are different. I hold myself more upright and become out of breath really quickly.
otherwise, I can do the gardening, do exercises and a Zumba dvd without noticing any strange breathlessness. It is just deliberate going for a walk that gets me.
Verdict - is this AF breathlessness? drs now don’t agree.
When I go for a walk, is my obesity filling my chest cavity and stopping my diaphragm moving properly? Where as otherwise I don’t stand as tall/ walk erect?
And can I improve things ( yes I know lose weight) but in the short term?
Thank you as always.
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Rhiannonimity1
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I was recently prescribed a low dose of bisoprolol in addition to my diltiazem because I had gone into persistent AF. I am asthmatic and was a bit nervous about taking it but I tried. A few days in I had an episode of feeling as if something was stuck in my throat and had to take 5 doses of inhaler to clear it. I thought you had tried several meds but maybe thinking of someone else. In the absence of a medical diagnosis I’d ask to try a different medication - Nebivolol or better still Diltiazem. I would also try to solve the bloating issue because that may be the cause of the AF in the first place. Certainly avoid any foods you know cause bloating. The FODMAP diet is very useful for some people. I don’t need to lose weight but if I did I couldn’t eat the usual weight loss diets because they include lots of stuff I can’t eat - salad, wholemeals etc.
Thank you buffafly. Yesterday I spoke to my arrhythmia nurse and a gp. The gp said it was definitely my af causing the breathlessness. The arrhythmia nurse said it might be and he has raised my bisoprolol to 12.5 mg per day ( ok as I’m heavy)as he said it definitely won’t be caused by the bisoprolol.
Have you been tested for heart failure as I've had persistent afib for many years and constantly breathlessness an echo then right heart catheter diognosed me with H/F there are new drugs to help it.
I couldn't take bisoprolol it made me feel worse than the AF with breathelssness. The crunch came when one morning I couldn't get down the stairs. My wife phoned my cardiologists office and they said to stop the bisoprolol. After that they tried all sorts of different medications and mixtures of medications and in the end I just continued taking anticoagulants and nothing else as the rate control and beta blockers didn't help at all.
I think you need to see your GP about this. You should really rule out any gastro-intestinal conditions including your gall bladder. I’m also wondering whether you could have constipation or a slow transit problem. If you’re blocked up, you’re going to feel very full and distended after eating. Also, if you are diabetic, this can also cause gastroparesis, so perhaps you need a blood test to rule it out or find out if there’s any problem with your blood glucose levels
I know that eliminating FODMAPs has already been mentioned and I found it enormously helpful, but it needs to be done under the supervision of a registered dietitian who has had specialist training. It’s not a DIY job you can cobble together from internet searches. Before you can get a referral you’ll need to have any more serious GI problem ruled out.
You can’t self-diagnose by guesswork and internet searches, so if this is affecting your quality of life then you need medical attention. I know it’s not easy the way things are now but you deserve proper care.
Thank you Mav. The arrhythmia nurse said that anyone not working in cardiology thinks it’s a big deal - anyone working in cardiology thinks it isn’t. He has significantly upped my bisoprolol to 10 mg a day this week, 12.5 next week. And said that my only other options are digoxin and Amiodorone, both of which I have had allergic reactions to. Or it’s pace and ablate which they won’t do because I am too young. He also said that my problem was not my AF it was my weight and any drug would have to be short term whilst I lost weight. ( another recent post was about being denied weight loss surgery at the 11 th hour) - there is no help available to me to lose weight. The nhs dieticians refuse me because I am too complex in that I am highly sensitive to sulphites, preservatives and pesticides ( this is why I have problems with medicines) so we run our house as a homestead and grow/ forage or trade for our food. I am trying to upmy exercise daily - I have done my 10000 steps today and have to dig some spuds soon, then blackberrying tonight. Life is not sedentary, it’s damn hard work.
I had tachycardia heart rate in the 150s I have been told that was the cause of my heart failure. Since my pace and ablate, I am happy to say my heart failure is actually improving. Ejection rate is now 76% and no blockages. Your heart cannot continue to pound like that and not be damaged.
Thank you for such a detailed reply Autumn. As an overweight person I have spent years trying to get a dr to take my stomach issues, food sensitivities, probable hernia seriously. No avail. I am not diabetic or pre diabetic because I am sensitive to most carbs, but when I asked the dr in hospital what ‘ intestinal colic’ was. He said it wasn’t wind as such but was a blockage maybe caused by wind or inflammation. Because of food sensitivity problems I have done a fodmap withdrawal twice in my life and am fairly sure where I am, I am sensitive to chemicals, even the chemicals in packaging - so it is very easy for me to be caught out. I have been speaking to drs about my stomach problems for 25 years. I have paid to see 3 gastroenterologists - all the same - you have IBS and severe food intolerance. You are fat so you probably have a hernia. . They wouldn’t do an endoscopy because of the AF.
Yes, it is a very complex situation and food sensitivities can be very difficult at times and sometimes symptoms will occur no matter how careful you are. I don’t think you’ve been treated very well at all. If specialists blame your weight (or use it as an excuse) then they should be supporting you to find an effective way that’s going to help you, not just as a way to pass the buck. If you’re an active person then you’re already doing your best as far as physical activity is concerned so they really ought to respect your needs a bit more. I hope the increased bisoprolol helps to bring you HR down in the meantime. As mav7 says, 120-140 for a prolonged period isn’t good. Keep persevering. You shouldn’t be written off like this.
Thankyou Autumn. You have spelt out what I think so perceptively. I am used to living a life for others really, even though my kids are 23 and 18, they are at home and I see my role as keeping the home fires burning, without much thought to myself. I think at least in the short term that has to change and I have to prioritise my well-being. Re my last post, I am so devastated that after years waiting for bariatric surgery it didn’t go ahead. There is nothing I can do except pull myself up by the boot straps and change what is in my gift to change. I was surprisingly quite heartened when the arrhythmia nurse said it was my weight not the AF that was the problem. Because my weight is something I have to take responsibility for.
Hi , have you looked at the ZOE system. For an outlay they will test your reaction to various foods so you can better plan your diet. Based on your stomach biome.
Zoe is not specifically for weight loss. It’s also expensive and not everyone has the spare cash to drop on such a programme.
The issue I have with Zoe is that people with normal blood glucose and blood lipid control don’t need to attach themselves to a continuous glucose monitor and micromanage their numbers, and some people end up cutting out food groups unnecessarily and become anxious about eating. Dr Nicola Guess, who is a diabetes researcher at Oxford, describes the issues with this approach on her Substack pages. If someone has a normal hbA1c and normal cholesterol levels, they don’t need this programme.
I don’t think Zoe are unethical. I know they have many happy customers who feel their system has helped them make healthy changes, and that’s a good thing. They also provide a lot of reliable, evidence based dietary advice on their podcast and YouTube channel. It is possible to alter one’s diet to influence the gut microbiome for the better, but the information is available for free. It’s basically plant fibre, polyphenols and fermented foods. Simple.
Thanks for the Nicola Guess info, I have subscribed, though I wish academics didn't feel the need to cherry pick info from others to make what is already probably a valid point.
I have never been a Barbie doll. In fact close to 100 pounds overweight at least in my eyes. I’m not looking to be thin just better. Since my pace and ablate although I don’t know what it was that changed something has changed in my body and I have dropped almost 50 pounds since the end of February when I had my pace and ablate. It wasn’t rapid, but it has been steady. I no longer have the appetite that I did prior. I have tried everything in the books over the years. I like to think this is a gift for dealing with a fib. LOL I also am happy to say my doctor has never said one word about my weight. Neither did my other in Florida. When I was swimming every day, I was in much better shape unfortunately right now we don’t have a pool since I moved. I think the doctors realize dealing with a fib/flutter is hard enough. My doctor is very big about the mind-body connection as well as the soul. A doctor that jumps right on you about your weight when you were dealing with what you are might not have other answers for you, so he blames you. We don’t want to be heavy. There are reasons for things and with you. It sounds more gastric than it does heart related. Another thing strange since my pay son of late is that I no longer get heartburn which I’ve lived with for a very long time. I don’t have any reason to make this up. Lol.
I’m not aware whether there is a link or not. with AF. I was replying in the context of the OP’s gastro-intestinal symptoms which seem to be causing her considerable discomfort. It’s something that might need to be ruled out, regardless of AF.
What I can’t get my head around (and I don’t mean this as a criticism in any way) is how you can be fat if you have so many food sensitivities and ibs. I ‘officially’ have IBS - since found to have diverticular disease as well and struggle with keeping my weight up - I am too thin now and would like to put on weight but struggling because I can’t eat much. So I’d be interested to know what you do eat - the homestead idea sounds wonderful but I know it’s hard work because we grew food in our garden and on our allotment. You are doing the right things so it seems as though your body is super efficient at using nutrients.
I think that shows there’s more going on. I just wrote mentioning the weight. I have dropped since my pace and ablate. They did not sew my lips together, but something changed. I have never been a big eater. I am also very picky. I never knew why I was so big either. Oh I could sit down and eat a package of cookies, which is why I don’t keep them in the house. I’ve learned through life how to keep things controlled. I always end up back at the same exact week. I don’t go higher. It was almost as though my body decided this is what you need to wait, which was ridiculous. We all need to remember most of us are probably not very active with a fib. It was difficult for me to walk down the hall to the bath. Only the person knows what they are eating that is not helping. It makes no sense for me to fib because I am the one that pays the price. I do have one large gallstone. I’m beginning to think after all these years, it wants to come out, but I can’t bear the thought of one more surgery for anything at this point. Unless it is an emergency, I am not to have anything done until after the first of the year anyway. My doctor said my body needs to rest.
it is ok Buffafly , I know you are lovely from previous posts. Firstly I have lipoedema, which is a type of rogue fat cells that increase at certain points in your life like pregnancy , menopause. You may have seen ladies with unnaturally fat legs and bottoms, particularly noticeable on the lower leg where you get fat shins making a sort of cuff at the ankle. That’s me. I don’t really know how much lipoedema fat is on me. Nor is it known whether you can actually lose all of it. There is a special sort of liposuction which removes it like cancer cells, they have to take a margin around it. But this is very expensive. This said, at least 5 stone of me is obesity - gained as a young woman , who didn’t know about lipoedema and was always on diets to get rid of her big legs from being a teenager, and then somewhere late 20s gave up trying to attain something unattainable so the fat piled on. It’s a common story for people with lipoedema. Realistically I have maintained roughly the same weight since then , so whatever my body takes to run, is what I have been eating. For the last ten years when I was in PAF my heart rate was 50-60 bpm, held down by bisoprolol and flecainide, which didn’t help my metabolism. When I became persistent, earlier this year with a rate of 120-140 - I thought, I will lose weight now, tbh, even though I still do all my homesteading jobs,growing and preserving, I’m going slower because of the HR.
I grow our veg, and eat or preserve for winter. We have our own eggs and buy a small amount of organic meat from a local farm, and we still use the fish man ( feels guilty taking our business away) . I trade about 50 eggs a week for olive oil fortnightly, a pack of butter, 2 packs of cheddar and organic lemons. Once a year I buy organic flour, chickpeas, rice and sugar ( and a bit of chocolate). That’s us. I can’t eat the flour or sugar, but I occasionally have some rice.
My husband says I graze, so I eat too much. I eat a lot of potatoes and our diet is very fruit heavy, especially at the moment, we have grapes, apples, plums, pears, strawberries and raspberries.
I’m sticking to a strict two meal a day plan,no snacks or seconds. Larger lunch, small tea, 1-2 portions of fruit. No more than 4 oz potato per meal. Max 70 gm protein per day. - and forcing myself to try to do things faster. I hope I can keep to it and I desperately hope that is enough.
I am going through similar at the moment with bloating but also feeling sick, get indigestion and can't eat, just generally uncomfortable and breathless but also in pain just beneath the middle of my breastbone.....Hiatus Henia. I too have a weight problem, not excessive but as I am only 4foot 11 and a bit (that bit means a lot lol) I am like a dumpling with legs! I know you have been to the hospital and I also know you were preparing for surgery but in the light of this I do feel you should return to your GP and ask for a full check up bearing these symptoms in mind. You know as well as I do that there is no quick fix to weight loss, I find it hard to do on my own in fact when I went to Slimming World 2 years ago I went with my husband and we both had good weight loss then came Covid and we put 2 stone back on! Is there any chance that you could perhaps do the same and someone maybe who would join you, just an idea. Failing that you could have a look at some form of exercise, your doctor can give you access to a leisure centre under the G.P. Referral Scheme where you can take appropriate exercise under guidance. You could also try swimming sessions (water aerobics) where you are in a group and together perform exercises in the water, the water takes the strain. The plus side of this is of course that you are amongst others with similar problems so that in itself gives support. I am an ex leisure centre manager so I know that most leisure centres provide these sessions and amenities. I would suggest that you still continue with your walking, slow but sure and the Zumba if you can manage it too, remember any exercise is better than non at all. Last but not least, watch what you are eating, keep a record of what upsets you and also your overall intake, cutting back but getting enough of the right foods to further enable weight loss. As for the Bisoporal, I had to have my dosage increased from 2.5 mg slowly up to 10mg and feel better for it however if there is any chance that this is in fact the cause, ask for an alternative. Good luck x
Thank you for taking the time to reply Opal. The, I have now booked my EP privately for another opinion. I have been really shocked that since covid the yearly check ups with your heart consultants have been scrapped. I was thoroughly checked in AAnd E about 5 weeks ago and my bloods have been taken twice in the last month. My blood pressure is normal, everything is normal except my Rhythm and HR. For the last 17 years my PAF has been Lone. I asked about the GP referral scheme. It is too far from where I live and the gp said I wasn’t eligible because of fitness levels. I tend to think that because my blood sugar levels have always been low - I’m not even pre diabetic - I get no help. If I was diabetic or pre diabetic I would have health professionals breathing down my neck constantly. The dr once referred me to the practice nurse because the hospital dieticians refused my referral. The nurse refused me because I wasn’t diabetic. I absolutely agree about keeping a log of what you eat. It is a good idea. Thank you
It sounds to me as if you have fallen through a crack and I don't like the fact that you are being refused when you obviously need advice and support. You are being told 'because of your fitness levels' however how can you improve this if not given the best possible chance to do so. An alternative is to find appropriate videos to exercise with at home, possibly You Tube, to do as well as your Zumba when you are feeling well enough, any amount of gentle exercise you can do should help, split it into two sessions a day, one when getting up before breakfast and the other in the early afternoon thereby increasing your overall amount. It certainly is not easy to lose weight but if you can manage a little extra and keep your food diary it might help. Please only weigh yourself once a week, keeping a log of your weight, probably what you were or are doing on the NHS scheme. Good idea to see your EP and to get a second opinion, write everything down that you want to bring to their attention so you don't leave anything out. Again I wish you the best of luck x
ps the drugs we take for our condition does not help with weight loss because they slow the heart rate down, keeps metabolism slow so we burn less calories as a consequence but that in turn means we need less calories in our diets.......a vicious circle.
When I was 1 st diagnosed with PAF in 2017 , I joined this wonderful helpful group. Someone posted a link from Dr Sanjay Gupta, York Cardiology about the Vagal nerve and AF . It helped me understand more about how AF & digestion interact via the Vagal nerve . He posts helpful videos on YouTube & has a Facebook page . I only wish that I had the link about the Vagal nerve for you , as it helped me understand issues so well. I have familial hiatus hernia & colonoscopy screening for familial bowel cancer . I’m lucky that it was all checked . Digestion or eating the wrong stuff at the wrong time certainly aggravated my AF . I ended up having a successful ablation in 2020 lockdown . I was very lucky & I’ve had to be careful .
Sounds like you’re working so hard , I hope that you can get the answers & the help that you need for a complex problem 🙏❤️🩹🙏
Thank you Alexa. I tried to get a private apointment with Sanjay Gupta,but there are none until Feb next year. According to his videos my Af is vagal. I have taken a lot of advice from him which is why I think I managed to keep in PAF for 17 years.
I was lucky & booked a phone consult with him before my Ablation in 2020 lockdown , as I just needed a different pair of eyes . I trusted my own long term EP tremendously, but a friend ( similar age to me ) had died during same surgery the year earlier . I just needed to talk it all through .
I learnt a lot about the vagal nerve through his videos & how best to take care not inflame vagal . Very interesting .
Af caused breathlessness for me. Especially at higher heart rate...over 115/ 120 worse. But bisoprolol caused worse breathlessness. Could not tolerate at all. Even very low dose.Sounds like you may have a few things going on. Might not be one route cause but getting on top of one of the contributors might positively impact others.
Thank you. Yes I think so too. I just don’t understand, yesterday I walked around my house at 90 steps per minute ( yes I carried a metronome) and walked 1000 steps no problem barefoot. Then I have a rest,put on my shoes,go outside, same metronome beat and I can’t manage 120 steps, without my breathing stopping me dead. Inside I tried to walk erect and hip bones forward. I can’t think why this happens.
If you are in persistent atrial flutter with a fast rate, then you might well be struggling with various feelings. I had this in 2019 and only an ablation eventually resolved. I wouldn't want that experience again.
But there might be another explanation? It does sound from what you tell as if there's upward pressure on your diaphragm muscle from gassy intestines. This large sheet of muscle sits above the intestines and stomach. It's one of the main breathing muscles and also causes hiccups, in spasm it causes chest pain called stitch and, if you fall on your back, it causes severe winding. Any diaphragm issues also cause nigh on instant anxiety, which adds to the physical effects happening. The yeast you drank would be highly unlikely to continue to ferment as the stomach acid and enzymes would likely kill it off but the gassiness would push the stomach up against the diaphragm.
This would be my guess at what has happened. Bad luck - it must have been frightening.
thank you ppiman. I have had stomach problems since I was 16. My daughter is a pro singer who knows a lot about diaphragmatic movement. She thinks I am either having a diaphragmatic spasm or my gas levels move when I walk on a solid floor causing something to press on my diaphragm. Maybe I bloatslightly when I walk 9n a hard surface. When I have one of the ‘brought up short with no breath moments’ my upper abdomen is always swollen, but I don’t know whether that is the cause or an effect.
Re the elderflower champagne - because it did make me bloat excessively and when I get this bloating my breathing is impaired, but never used to suddenly stop - I think it maybe made me more aware of what is happening. Ihavearthritis in my knee so don’t normally go for walks.. Maybe this is also that I have got out of the habit of deliberate ‘ going for a walk’.
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