A few years ago (pre covid), I took my son-in-law to the emergency room of a prominent hospital because he had been coughing for a couple of months with no answers from the local doctor. The ER was very busy, so he was put on a gurney next to the check-in desk. A physician's assistant finally talked to him briefly, suggested he try a medicine he had already tried and then told him he was good to go. On the drive home, we looked at the discharge paper. Under "diagnosis" (what we went in for) it said one word: "cough". They only charged $100 for that, though. He later found that he had bronchitis. This essay is about the diagnosis of Afib.
After dealing with Afib for several years, I came to understand that it was primarily and almost consistently triggered by trapped gas and bloating in my gut, from constipation and eating the wrong things, which moved to my chest and confused my vagus nervous system. I finally went for testing with a GI and found that I have celiac disease, and I began sorting out what foods were causing my problems and adjusting my diet.
Never were my complaints about the gas/Afib connection acknowledged by doctors, nor did they recommend any follow-up or referral for my digestive issues. They only wanted to focus on my illness called "Afib" - recommending risky meds, ablations of the heart and other treatments and responses to the episodes of arrhythmia.
I am beginning to understand that I really don't have some scary disease or aberration of the heart. I have a heart response to a disease and condition of the gut! I have dealt with the gut issues effectively and have, so far, been free from Afib for 9 months, after having episodes every 10 days to 2 weeks (12-24 hours long) before.
If I pulled a muscle in my chest, and it became too painful to breathe deeply, I would not expect to be sent to a pulmonologist for lung scans or other lung treatments; I would expect to get help treating the pulled muscle to relieve the pain and be able to breathe normally again. Certainly, the cause-and-effect relationships between our gut and heart are much more complex, varied and subtle than my simple analogy, but the principle is the same: treat the root cause of the ailment, and you will eliminate the symptoms that result from it, instead of merely dealing with the symptoms.
Identifying those of us whose Afib is a symptom of gut issues as having a serious heart condition not only merely treats the symptoms, but also creates a world of anxiety and confusion which introduces unnecessary negativity into our lives.
I feel that I don't "Have" a scary disease called "Afib". I have a digestive issue which can cause distress and confusion in my heart's electrical functioning. That can be serious, of course, and needs to be dealt with by relieving the digestive problems, but, as scans and an angiogram have shown, my heart is fine! I now, at age 79, walk, lift weights and do squats for an hour and more each day. I cannot know what might happen with my heart in the future, but for now, in my mind, I don't have a heart problem. It is a great feeling!
Each of us is different and needs different types and levels of treatment. I am only stating my experience and beliefs because testimony on this forum and elsewhere suggests to me that many people are experiencing similar gut/heart related issues, and I want to offer us a perhaps more beneficial and effective approach to dealing with and thinking about Afib.
I am not intending to be simplistic or make light of those with more complicated, difficult Afib issues. I do not suggest that my experience is typical or a model for all for dealing with Afib.
I am not a doctor of medicine; I only have a patient's own experience, knowledge and perspective.
Respectfully,
Fibnum
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fibnum
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On the other hand I had ten years of being told I had gastric issues , several endoscopies etc lots of inappropriate drugs before a change of address and new doctor diagnosed Afib.
You really can't generalise but we do try here to point people in the direcetion of life style changes, weight loss, lower meat consumption and avoidance of stress inducing things like alcohol and caffeine all of which have been shown to drastically reduce AF burden.
Oh and AF is not a disease it is a condition. Subtle but important difference.
Your last point was my point, with the addition that it is sometimes caused by something which can be identified and treated -in my case stomach gas. It is a condition related to something treatable for me. Too often, we get the impression that we have a disease of the heart and develop a fatalistic attitude towards the symptoms, instead of trying to find the root cause. That subtle distinction gets lost amid the anxieties of Afib symptoms.
I guess if you first go to a GI, you have gastric issues, if you go to a cardiologist first you have heart issues. They are still trying to describe the elephant with their limited eyesight.
I agree that solving digestive issues may not eliminate Afib for some, but I was told flatly by an EP that I could "try treating the gas and bloating, but it will not stop your Afib episodes."
That was not true.
I believe that you are perfectly right. I have written about it, in this forum, some 8-10 years ago, under a different name.
If the control system of the heart puts before a sound heart the demand which it is not able to fulfill (eg demanding to high BPM), it will get "haywire", and will not be able to respond in the right way. Whenever such abnormal demand is no longer present, the heart will obediently go back, in NSR...
Not all AFibers, but many of them, have a sound and structurally normal heart. Such hearts switch from NSR to AF, and back, very easily, not causing any problems to the patient (asymptomatic cases). The question that remains open - "What causes such abnormal demands and how to avoid them?"
I am sure there are many varied and intertwined causes, unique to each individual. I was fortunate to get some relief by focusing on treating the gas problem.
I fully understand your way of reasoning. If you ask the people in this forum, there are countless triggers/causes of AF (from drinking cold drink, to listening military march in the radio - not my words but from others, who have reported it). In your case, the trigger was bloating (gas), but the "root cause" of AF remains the same for all of us. The triggers just push you over the edge, the cause is what brings you critically close to the edge...
When you say that the "root cause" is the same, I don't quite follow. What is the difference between the root cause and the source of the trigger? Are you referring to our heart's receptibility to the trigger? I suppose that is the root as far as the heart is concerned. My doctors have offered no explanation as to why my heart, which is in generally good shape, would be more sensitive to vagus nerve irritation than someone's who does not have Afib. I can't then know whether my root cause from the heart's standpoint is the same as everyone else, because I don't know what it is. In my case the preventative efforts seem more appropriately directed to eliminating the triggers. That, I do know how to do.
Maybe I made your point, though, we all share a mystery with our heart's susceptibility...
I have found the discussions with doctors about my Afib, especially pertaining to why my heart went into Afib and what possible triggers to look for, to be unhelpful.
Those are the answers we need, not just a bandaid on the arrhythmia. My goal in posting the over-long comment was to push for more research efforts toward answering those questions and to suggest a less menacing and confusing characterization of, and perspective on, Afib for some of us. I suspect progress could come out of EPs and other physicians' study of the comments of Afib sufferers on this and other forums. It seems like a topic about which detailed patient histories could be insightful.
Causes are most likely very varied. Mine turned out to be being way overmedicated for Hashimoto's autoimmune hypothyroidism. I didn't realize this until I had an afib event, but having begun a stepwise process of reducing my thyroid medication, not only have I not had afib again, my high blood pressure has returned to normal with no other intervention. I'm not on any drugs, beyond thyroid supplementation.
There isn't a generic root cause though. That's the point- if there was, there'd be a cure for AFib. We don't really know its aetiology. We know behaviours and contributory elements, but not the root cause. At least as I understand the term.
There is an interesting question; "How is it possible that the root cause remains hidden for so long, despite the high level medical science has achieved in its development?!" The cause is most probably something that the MDs have no idea about, or something that is "non existent" in material sense (say wrong set of parameters - similar to the situation where you would try to adjust idle speed of your engine to 300 rpm and it is well known that it does not work smoothly below 800 rpm). So, the demand is "out of range" and problems are encountered.
That is true. My comments are meant to point specifically to approaches for those who might have a similar gut/heart connection with their Afib, and to suggest generally that we all be actively involved in seeking to better understand our Afib issues and participate fully in decision making with regard to treatments.
I'm also celiac but didn't know. I think what happens is that if the body is stressed then it exacerbates other existing conditions. Certainly sorting out my gastric issues has led to a calming of another condition but I think it's because my body is more balanced now. I don't think one is responsible for the other.... It hasn't calmed my heart down though... So still on the meds... Lol.
So glad to hear that resolving your gastric issues has calmed your Afib right down. Brilliant news. 😊
You are so right - many important information can be found in people's posts.
In one occasion, I have posted about the problems the MDs encounter when dealing with arrhythmia of any kind - they have not sufficient knowledge to deal with this problem since they are not prepared for it during their study. In our bodies, there is a sophisticated automatic regulation of many processes, including the regulation of blood circulatory system. The knowledges and the preparation of MDs for such problems equals zero. It is impossible to deal with the problem of AF without multidisciplinary approach, so using the help of experts in technical field is a must.
As for the root cause... In this forum, million times the sentence "We are all different" was used and it is nothing but a prejudice. We are all very similar and we all develop the arrhythmia in the same/similar way. When it comes to the triggers, there really are many and some are specific for one person and others are specific for the other person, of course, with some overlapping.
It is in regard to "root causes" and ones physical heart condition that I suggest the caveat that "we are all different". If there are structural anomalies and weakness in someone's heart contributing to their Afib, they are different from others. Among my several friends who also deal with Afib, digestive problems do not seem to factor in. We are different from each other. I liked your comment; it does not have to agree with everything I say!
In some cases, AF is a consequence of structural changes in the heart or it can follow a viral illness. In my case I believe iron overload played a role in developing arrhythmias. Whereas Bob draws attention to specific lifestyle factors, I haven’t never been anywhere near overweight in my life, haven’t eaten red meat for 45 years, rarely touch alcohol, gave up caffeine long before AF happened, lifelong low cholesterol, low BP, low hbA1c. AF like many conditions is multi factorial.
Yes, I know you are right, but I am not sure why, when told repeatedly by an educated, rational patient, that his Afib was clearly always preceded by a build of gas and bloating, a doctor would not consider at least working with a GI to see whether they could help alleviate the possible trigger. Many Afib sufferers do find a connection between gut discomfort and gas and Afib. I am advocating for better awareness and responsiveness to that cohort. Knowing that we are not helpless to prevent our Afib is a very reassuring feeling and relieves some of our contributory anxiety and stress.
I think with any condition it's always a good idea to look at Co factors. Sometimes as is the case with you those cofactors once sorted have calmed yours down to the extent you are no longer aware or maybe it's gone if you are tracking your heart.I have Hypothyroidism. I was on optimal treatment (I did much research on this to get the best for me ) for me the Co factor of B12 (injections and a basic bit B complex with folate) was a miracle. Gluten free also aided absorption....& settleded my guts and my body shape compmetely changed. So yes this was all interrelated but not the cause of my thyroid failing. But the difference in my wellness is truly amazing. I often think doctors forget about Co factors. Seeing as they're not even taught vitamins or minerals in their training the absence in this area isn't surprising. They rely far too much on blood tests which often doesn't lead them to think more widely.
I think you've raised a very important point. We are not a condition or conditions but a whole body that is interrelated and reactive. Whole body medicine has largely disappeared and has become bits of body...
Some people have bad gas and not AF. For me gas triggers my arrythmia but so do other things too. Essentially I believe my problems relate to a dysregulated vagus nerve and my nervous system can be affected by many things. Identifying my triggers can help alleviate vagus nerve dysfunction and electrical misfiring in my heart as a result. My heart is structurally sound like yours, my nervous system isn’t. As the vagus nerve is key to digestion, I find working on my vagus nerve is really helpful to eliminate bloating and aid digestion. I also take probiotics and eat a varied high fibre diet to support the microbiome. I take supplements to support nerve health and magnesium. I have managed to reduce my arrythmia as a result
I agree that not enough cardiologists are aware of gastrointestinal issues and their impact on the heart. Hiatal hernia is another issue that can cause arrhythmia.
Absolutely ! Both my older brother & I have familial hiatus hernia. Both people who were fit & played sport . Both have AF , but a different ages . Our family is Celtic heritage. I wonder if our genes way back play a part ?
A marvellous and accesible article on hiatal hernia and its link to common issues, including pressure on the Vagus nerve and the left atrium.drrtannenbaum.com/applied-k....
Yes, I told my Cardiologist that my heart only goes into A/F when I'm bloated and he said it was Hiatus Hernia and I could have a small operation to fix it
I know that it will sound odd, but you are lucky in that fixing the HH will spare you from Afib. I am taking Pantoprazole and don't have HH symptoms. Good luck.
I looked over the exhaustive report on Afib and hiatal hernia. Thanks for the link.
I had concerns about my esophagus in relation to Afib. I was often feeling tightness and a "bubble" of gas under the sternum. I had an endoscopy which showed nothing, and my reduction in stomach gas seems to have alleviated the esophageal discomfort and Afib.
Sorting out the possible interactive factors in dealing with the heart, digestive system, lungs, et al. is a challenge for medicine. There is an urgent need for physicians who can look at the whole picture.
Please see this link I think you will find it very informative and prove your thinking. He has also done one on the link between the stomach and Af youtube.com/live/zt4Cw-VKIl...
Thanks, I have seen this and other enlightened videos from Dr. Gupta. (not the Dr. Sanjay Gupta on American TV) It helped me stick to my plan of working on my gut issues to resolve my Afib.
My AF was triggered by heartburn episodes which was mainly bought on by overeating and of course spicy foods and chocolate. During my treatment I was seen by many cardiac consultants nurses etc - only one advised me on my diet and what specific foods to avoid. I know it's common sense but when I made or mentioned this link it fell on death ears and it wasn't taken seriously.
That sounds helpful for those in a similar position to you. Sadly, that doesn’t apply to me. Mine is persistent. I guess it could have been triggered by Covid.
It would be good if a forum like this ( health unlocked as well as this AFib group) could direct people with a condition to a useful place to report their experience that is regularly reviewed to see if there are pointers for new research. Posting here is helpful, but I hope there are other places such experiences could be usefully shared and help inform more research.
The distinction between causes and triggers is helpful.
Looking around, this article looked fairly helpful.
Because Afib triggers are so nuanced, Ghannam recommends his patients be vigilant about their symptoms.
"We tell our patient's that it's up to them to identify what triggers their atrial fibrillation. We encourage them to keep a symptom log to help them keep track." There's also wearable technology that helps monitor triggers with more accuracy as patients may forget exactly what caused a recent heart rhythm issue, he says.
However, for people like me with persistent AFib, that is not so helpful, sadly. I hope using a smartwatch etc with PPG monitoring and some ECG could help if more research focused on persistent asymptomatic AFib and how that varies.
Very thoughtful and thought provoking essay. But it's more complicated than that. Most of us here would recognise that many foods and gastric reactions DO result in attacks of AF but so do other things. It is difficult to argue with a cardiologist whose ECG clearly shows the arrhythmia in your trace, and what often starts as a paroxysmal series of events in many/most progresses to a more enduring condition and permanent AF.
But your main point is correct that practitioners should take their patients more seriously. In the end, almost all of our medications (including ablations and other treatments) are related to symptom reduction and what can be better than just taking more care of our diet or realising what food stuffs can provoke problems, rather than becoming dependent on strong pharmaceuticals to 'sort out' the problem. But the number of people for whom that would prove to be a 'solution' is probably extremely small. Those that do permanently benefit are extremely lucky.
Yes, gas and bloating is a trigger for many. But only a small minority of 40-70 year-old folks with severe reflux end up with AF just like only a few similar aged heavy alcohol drinkers end up with AF.
That's because to get AF (at least before age 70) IMO one needs to have the predisposition - genetic and/or epigenetic - to having AF. That we can't significantly change IMO. But we definitely can try to identify and avoid our triggers in so far as we can to mitigate or even for some totally prevent (at least for a good while) reoccurrence of AF. But the predisposition remains so we need to remain forever vigilant as best we can.
I wonder if this is true for everyone, did they identified the gene that causes the Afib?
I was diagnosed persistent at 37, I'm not aware of people in my family with Afib of any age. I was considered a lost case, cardiologist prepared me for cardioversion saying he was skeptical because of the long standing persistence... and it worked (so far 🤞). No doctor tried to investigate possible causes, I'm sure there is a cause. They almost seem disappointed to see someone in shape and non-drinker with this, and honestly I start to think that it has very little to do with drinking and being overweight, and these other small factors. A big percentage of the population in UK drinks way too much lol but they don't have afib. At the same time I'm not totally convinced by the genetic "defect", if it's that it should be treaceble as for other genetic problems.
It's probably (once excluded heart structural issues) related to deeper causes such as inflammation, autoimmune deseases, anxiety...
Since I discovered the afib, I realised to suffer of sleep paralysis (I thought it was normal and everyone had it lol), my sleep is not quiet and my heart some days is more active while I sleep than during the day (thanks Apple watch).
I just can't believe that doctors din't even try (except blood test for tyroid) in my case to find a cause, the cause could be easy to sort instead of going on heavy meds and surgery straight away.
Hopefully research will focus more on the orgin of afib.
Very worthwhile discussion. The thing you need to consider, aside from whatever is the causal problem, is that it's the AF end of things that will increase your risk of stroke, not the gut problems.
Decades before I developed atrial flutter, and now, with that cured by ablation, occasional AF, I, similarly, was told by a local cardiologist, who had X-rayed me, that stomach and intestinal distension caused by trapped gas and food was pushing against my diaphragm, and that that was pressing against the base of my heart to spark off ectopic beats and palpitations. I was told that it was harmless and that unless I was unlucky in older age, all would be well.
Skip forwards from my mid 20s to my late 60s and my luck ran out and the ectopic beats started to set off arrhythmias and a fast heart rate which led to the need for an ablation. In the intervening years I had continued to have ectopic beats and palpitations. The old diagnosis of the stomach distension causing ectopic beats was never again accepted, even though it was agreed that ectopic beats can lead to arrhythmias (AF, at least, if not AFl). The whole focus was on my heart and not my stomach (in the intervening years I found that I had a sliding hiatus hernia and bad reflux). I was assured that vagal irritation was largely a myth and not involved, and where it did occur it caused major issues of bradycardia followed by swings of fast tachycardia.
There is very little online about stomach distension causing topic beats, although there are a few mentions and a Wikipedia page on this.
In the end, I concluded that while whilst the distended stomach can trigger ectopic beats, and they can set off AFl and AF, that for this to happen, further changes in the heart are needed to allow this to occur, i.e. the heart itself must become prone to more serious arrhythmias (AF and AFl). I found that I had also developed a wide QRS and left bundle branch block (LBBB), too, but that my heart was structurally sound.
I do know, also, that gastric disturbances, such as a hiatus hernia and reflux acid, can mimic heart pain as a neighbour was hospitalised several times for this reason.
My Afib was always manifest as erratic timing of the heartbeats (arrhythmia). Every time I thought I had Afib, I did. I am lucky that thus far relieving gas issues has eliminated Afib. I know it is not that simple for most people, but the bottom line is that we need better understanding of the causes and potential preventatives or alleviators of Afib and more individual-specific, fine-tuned treatments for it.
Edit:
I am adding this to agree with your statement about distended abdomen. My condition prior to the onset of Afib almost always included a day or more of bloated stomach. That tended to be the most significant warning for me to take action to relieve it and avoid Afib. I was not always able to until I made many adjustments in diet and found helpful ways (including nightly exercise!) to relieve gas.
I want to keep stating that I am not a medical doctor, so I do not want to be perceived as offering professional advice.
My untrained sense is that it would be more likely that stomach issues would be messing with the heart rather than the other way around, but I don't know that. It appears to be the case with me, since treating the digestive problems has been key to preventing Afib episodes. I wish GIs could figure out how to sort out why, how and where, from the esophagus to the large intestine, our problems occur and be more effective in treating them. If they already can, they sure haven't shared it with me when I went to them.
I would love to sit down in a room with a cardiologist, an EP and a GI and ask them questions. I would like to see how they interacted among themselves. I wonder whether the medical associations have these types of sessions at conventions or in big hospitals? I have not seen that much combined/shared research online.
Well, I’ve thought the same as you in that respect. I don’t really know what it is that separates the medical specialities in this way but, whatever it is, it seems to be to our detriment at times.
I personally was grateful for the diagnosis of AF, in my case it is familial . My version is asymptotic, so whereas I should be up in arms, I am happy a locum doctor prescribed a penicillin containing anti-biotic for an injury to my leg. This drug caused not only the usual Urticaria but persistent vomiting . This prompted me to phone the surgery, be told to go back, have an ECG and show a pulse of 140bpm. I was at once sent to a Cardiologist, kept in hospital for a couple of nights, tested and observed and prescribed Biso, and most importantly an anticoagulant. Had this non-life-threatening error not occurred, I would never have known I had inherited this family condition, until I had had a Stroke !
There is no definitive answer. I believe that my episode was caused by low potassium, and I reverted on my own with a shot of that into my tummy. Reading more about the whole thing, the sinus rhythm-which orginates from the sinus node at the top of the heart muscle - triggers the heartbeat-which is in turn set off by a sequence of tiny shots of several minerals, we call electrolyres, firing in the sinus node-in the right anounts in the right order. If something happens-poor diet-illness, general poor health-then that sequence of events can be disrupted, and the result is AF.
I mentioned my theory to the cardiologist I saw a few weeks ago, and he agreed, but because a test needs to be 'live' while the heart is working and beating, it is impossible to determine exactly what is going on with the electrolytes. Probably down the line there will be a test some sort available to find the answer, but at the moment, I carry on, take the blood thinner happily as my Dad suffered several strokes before a big one took him off (1980) as he had "Good rich thick British blood!" Our gut and brain and everything else is closely linked, just like a premium car! Some people feed their body with cheap fuel, with additives, which causes the 'backfiring' when if we fed it just what was needed, it would work as intended!
Additionally, new doctors specialise far too soon, so know very little about anything other than their chosen option! Vets on the other hand have to be specialists in every aspect of the body of many animals, and might then go on to specialise later. If I could I'd see a vet!!
Could you say more about how you believe your episode was caused by low potassium as I think this was the cause of my AF episodes (4) last year Jan to Oct 2022. Around the time I was diagnosed with AF thanks to my Kardia I had my annual blood tests done Nov 2022 and this showed low potassium - 3.2 when supposed to be 3.5 to 5 - did not seem a lot lower than normal to me but doctor insisted on testing again and then taking me off the diuretic that I had taken for 20 years for bp and onto losartan and suddenly my potassium level went up to 4.5. This was the same as the level showing in November 2021. I found it all very strange as I had taken the diuretic for years with no problem and no variation of potassium levels and then it suddenly changed. I would be interested to know what happened with your low potassium and how it was diagnosed and did you make any changes and do you still have episodes of AF.
Well, only that I went to A&E at 2.30am with a pulse of 155-it woke me up! A blood test was done, I had the shot and after about 20-30 minutes I reverted back to normal. I now take a potassium sparing diuretic (spironolactone) and I also take electrolytes each day, one morning, one at night, to make sure I have sufficient-I have a very slow metabolism, treated for hypothyroidism, and I take a beta blocker, and anti hormone tab as I had breast cancer in 21. So all in all I eat hardly anything, but continue to struggle with my weight. I figured the electrolyte would help make sure I was getting the optimum.
I, too, have British blood, through my ancestry, but it has been corrupted by decades of American cheeseburgers!
Your point about specialization is critical. Doctors and researchers need to have both high expertise in a specific area and a broader overview which affords more awareness of interactive symptoms and connections. In addition to its intimate interaction with the digestive organs, the heart is highly influenced by our breathing. I have had the experience on several occasions that my heart was in an excited, jumpy, "pre-Afib" situation, and I have used a few (4-5?) deep breaths in through the nose and relaxed exhalations through the mouth to calm it. I cannot assert that it would have gone into Afib, but it felt that way.
It can happen when I wake up in bed or when dozing off in a chair, so seems to be a sleep-apnea-induced situation. Deep breathing periodically is good. I used to like to see if I could get the pulse-ox up to 99 or 100 when I was in the hospital so the nurse would be impressed!
I wrote and posted the same beliefs that most of us suffer from Vagel Afib. I know mine is a direct problem with my Vagus nerve. It's not a Heart problem but an electrical issue that the heart responds too. My heart is healthy but my Vagus nerve as is causing my heart to go into afib. Ablations usually don't work because they are working on the wrong part of the body. I had 2 and did get some short term relief. Going to Dr. Wolf in Huston, Texas. Will this work? Well, it's alot better than burning my heart up..
I have had IBS for 20ish years. It did not worry me enormously. 3 years ago I had a STEMI. I ended up with the usual set of meds (BB, clopidogrel, low dose of anticoagulant)
6 months ago I started feeling unwell, and was diagnosed with AFIB, well the Kardiamobile did the diagnosis. The device was recommended by my cardiologist when a Holter did not pick anything up apart from a low burden of ectopics (3%).
3 cardiologists disagreed about the AFIB diagnosis, but decided to put me on 5mg of apixaban Bd anyway, (since my CHA2DS2 VASc score is 3 and I'm 78). A month after I started the apixaban, I started to get dreadful GI symptoms resulting in me getting 3 hours sleep a night.
H had a 1 week Holter done, and it showed an ectopic burden of 16% with periods of 40%. But no AFIB.
I generally feel pretty awful.
I got a second opinion from a cardiologist at one of the main heart hospitals in the UK. He looked at several Kardia printouts I had done which showed AFIB and said it really was not afib but SVEs.
He also looked at the 1 week Holter. The patient (me) can input the TOD when I felt ill into an app and the app transfers the data to the holter. The holter collects enough data for an electrophysiologist to match up the TOD to the data collected so it can do deeper analysis for that time period. To determine if AFIB was present (i.e. a short run of it).
So still no AFIB although on several of the occasions my Kardiamobile showed AFIB.
The Holter was done when my IBS was very bad and I am getting little sleep and showed up as a greatly increased ectopic burden from a holter done a year ago
The lack of sleep is the result of increased GI pain at night
This happened a month after I started taking anticoagulants
The cardiologist is making the assumption that the increased GI problem is the result of taking anticoagulants ( apixaban was the second one the first was Rivaroxaban)
So by stopping the anticoagulant the GI problem will be lessened and I will get some sleep. In turn this might lessen the ectopic burden if indeed that's caused by my level of stress as a result of lack of sleep.
The arrhythmia itself is causing me symptoms, so reducing it can only help
So my question is "is the the anticoagulation causing the gastric pain leading to stress leading to arrhythmia? Or is the arrhythmia the source of the other problems?
Unsyre if you're on PPI omaprazole - which I was put on as a matter of 'one size fits all' even though I'd never had an acid problem- caused me terrible abdominal pain every time I ate. Has eased now, more luck than judgement , as I had to stop it 2 weeks prior to an endoscopy and felt better , won't touch them again. Thinners? Another story in progress, side effects yes. But nothing like omaprazole
I was on omeprazole for a while before having any Afib. It was to relieve chest gas. I don't like side effects, and I stopped it on my own and started taking a probiotic, which I have done for 10 year now. It worked better for a time. Later, I developed celiac disease, and I use some over the counter antacids along with a major diet change.
It is that! I find a problem with labels in medicine. What is Afib vs something else? Labels tend to narrow the focus, stereotype and compartmentalize medical phenomena which are actually fluid, interactive, host specific and complex. Our bodies do not recognize the labels and decide to sign on for a specific set of symptoms or treatments. Afib seems especially difficult to put a name tag on.
One of the silliest labels in medicine is the "disease" IBS. I don't know how they got the initials IBS from: "We don't have a clue!"
Anticoagulants gave me severe GI syptoms, gas pain, constant burping, and GERD. The suggestion was to take yet another drug, a PPI. Nope. Everyone's situation is different, I have had no afib after reducing my too-high thyroid meds, am not on any medication (other than for low thyroid) except the anticoagulant, my heart is healthy on echo, and I elected to stop taking that. But that's not a good answer for everyone or probably even for most.
Makes sense to me. My afib ( first and only to date...touching wood)was caused by a nasty virus shingles, time will tell if it happens again I guess. Curious..are you on any blood thinners /medicine now .
Yes, although I have, as of now, been free of Afib for 9 months, I will not take myself off until a doctor okays it. There is some history of strokes in my family, also.
I just told my husband last night that I WILL find the cause of his AFib before before I die. He had a hx of lung cancer with left lower lobectomy and chemo. Then AFib started. Like you Ablations meds, cardioversions, meds. and still AFib. I swear he gets bloated before the episodes. His BP spikes during an episode rather than the norm of being low during AFib. I am going to keep pressing for GI or endocrinologist. I think his may be phrenic or vagal nerves. Thank you for this timely post that will spur me forward. BTW I am a RN , retired now except for volunteering. Stephanie
I want to be clear that I eschewed ablations, cardioversions and risky meds from the beginning, except for being bullied into trying Tikosyn, which almost killed me, because it produced an overlong pause in the signals between the heart chambers. During the ensuing 3 days of magnesium drips, I vowed to trust my own judgment!
This is my exact situation. Look up Roemheld Syndrome. I have had off and on AFib issues for years and I was put on several medications. Although they kept the heart in sinus rhythm, I still suffered other issues every time I ate - shaking, bladder control issues, and odd anxiety feelings.
I read articles on Roemheld Syndrome and Gastritis. I changed my diet and lost 60 pounds. The shaking and other symptoms disappeared. I slowly titrated off of the medications to see if I needed them.
AFib never reappeared.
So, I decided to try eating foods I had eaten before. Initially, it was not an issue, but after a couple of weeks I began experiencing palpitations, which eventually led to AFib. I could stop the AFib simply by standing up or loosening my pants! I documented these events on my Kardi in order to show my EP.
I began journaling the foods that caused problems. Gas was the biggest culprit and eating my food without thoroughly chewing it was another. Gas-X worked, but the best medicine was small meals, no eating after 5pm, and stay away from any foods or beverages that cause symptoms.
My EP reviewed all of the information I had documented and concluded that my AFib was indeed caused by gastric issues. I was removed from the medications. My situationis a lifestyle change. I cannot eat the same foods I used to. I was a fast-food junkie, and I loved spicy foods.
Today, I eat more vegetables and limit my red meat intake. I have a list of "safe foods" that keep me AFib free as long as I follow the rules.
Your experience is quite parallel to mine! I am glad that we are all able to compare notes and point toward some realities that doctors have been slow to accept. I had read about Roemheld Syndrome. It helped me stick to my guns when risky heart meds were being pushed on me. I finally acquiesced to taking Tikosyn and suffered life-threatening lapses in response time between the two heart chambers. During my ensuing 3 days and nights of magnesium drips, I resolved to trust my gut (by not trusting my gut!) and make my own decisions.
Wow! I'm glad to hear you recovered from that nightmare!
"I resolve to trust my gut (by not trusting my gut!) "
This is great! This needs to be a tag line for people who have Gastro-Cardiac issues! 😀
It is a simple solution but not easily followed. It is a lifestyle change. It's either that or fighting with palps and possibly Afib after every meal - and worse at night!
I will say that I keep Xarelto on hand per my EP's request just in case I fall off the wagon and start overeating. It has happened a couple of times - mostly holidays. My gut doesn't mind a weekend of mild excess, but if I extend it into the week, then the palps start returning. That is the warning sign that tells me I better stop or Afib is next. Once Afib hits, I fast for 24 hours - drinking only water. That shuts down the AFib, then I spend the next couple of weeks fixing the mess I created. Palps finally go away and I'm back to NSR.
I have enjoyed this discussion. I have heard for years that our health is in our gut. so I agree with everything you stated. our bodies work as a whole, therefore holistic medicine makes sense to me. specialized medicine focuses only on individual issues when "one thing leads to another", they don't look for root causes they only prescribe medications to cover up the symptoms which in my opinion is no help at all, but a necessary evil.
Someone on here commented that veterinarians are much better at treating the whole body of their patients. I once banged my head on the edge of the car door while trying to grab our escaping, veterinarian-bound cat. When I arrived at the vet's office, she said, "lets take care of your bleeding head first!" She put something I had never heard of on the cut, which healed quickly and beautifully in a shorter time than I had expected. In her vet work, she made her own herbal compounds, used pressure points and tuning forks, etc. (one of those weirdo docs who also studied Chinese medicine!)
We had a cat that was pronounced terminal due to kidney issues by the weekend emergency vet clinic at the mall. On the next Monday, our regular vet took the cat home for a couple of days, prepared herbs and instructed me how to care for her. She lived another 15 years!
Despite the advances in technology and increased knowledge in the medical field, we could still all use a doctor like that, buggy wagon and all!
I totally agree with you. I have several close contacts with chiropractors that practice just as you say. I start there and if I don't get relief then I go to a regular doctor. usually I don't need regular dr. My last annual check up with my GP I asked if while they were taking blood could they run a homeostasis test. The doctor said no, that was functional medicine. I thought to myself so what is this? Dysfunctional?
I can totally understand what you're saying. I was diagnosed with afib by coincidence during a routine physical and just prior to a stress test in 2020, and I do believe it was the wrong diagnosis. My thinking - and I know I am not qualified - is that the PA that did my stress test was clueless on hooking up the cables to my chest. Numerous times, because of my hairy chest, my PCP and others would get erroneous readings until they shaved my chest. Since 2020, I have never had one episode of afib. I have talked to my cardiologist (a different one that originally found the so-called afib) and showed him thousands of afib checks that are all negative on my Kadia and Apple Watch. Not once, has afib ever shown. So, I'm basically labeled with afib. I even asked my cardiologist if he would consider a "pill in the pocket" type of treatment- to my so-called afib and at first, he said, let's see what happens in 6 months.. Then 6 months came around and still no afib ever showing and still reluctant to do anything but eliquis which changed me. So, I'm wondering how many inaccurate afib diagnosis there is out there and how many people are put on that expensive, awful blood thinner, Eliquis. No sense in getting any more opinions. One erroneous diagnosis by someone that was incompetent and I'm labeled. Show me the afib and I would be happy to continue with a blood thinner. The fact is, I don't have afib and never have. One erroneous reading in 2020 and nothing ever again. 😔
you are absolutely correct, in my opinion about the vagal implications that cause AFib. I have a chronic tick borne Illness called Babesiosis which is blood borne and wreaks havoc with the vagus nerve. I have been treating it for years. It caused my AFib. I can’t seem to get rid of it so suffered with AFib for three years because of it. There is a thoracic surgeon that I’m sure most have heard about in Texas who believes lone AFib is vagal related. I couldn’t get the AFib under control because I can’t get rid of the chronic Illness. So I had the MiniMaze surgical ablation which ablates part of the vagus nerves on the outside of the heart that he believes causes the problem. True it was treating the symptoms but in my case, that is what I had to do. I have been AFib free ever since the surgery which is over a year and as a bonus my gut issues went away. For me that was the answer due to the complicated nature of my core illness.
One outcome from the array of comments on this forum and the wide-ranging, complicated medical issues that are reported is that we get a better sense of what doctors are up against in trying to resolve pain and suffering in their patients. I am not making excuses for them, but it is clear that one-size fits all, formulaic medical practice is not sufficient, and that doctors need to be, and should be, open to the participation of informed, self-aware patients as co-managers of their health. I have several doctors who are great listeners. I find that the more capable they are, the less threatened they are by patients' questions and desire to participate in their own decisions.
It is why I so against some lawmakers in my country wanting to put into law certain protocols and make them mandatory. It is not one size fits all, they should know that but it seems they don't. Real good doctors are loosing their licenses because they are actually trying to help their patients. very disturbing.
Hey well done! I am treating my gi stomach issues the last 2 months after Dr told me ibs and the tablets she gave me were not helping I’ve taken my health into my own hands like you have done, fir 2 months all I can manage is a small bowl of porridge in morning and soup at night lost a stone but my Dr isn’t concerned- so there you go that’s we’re in at and your post has encouraged me to continue my health plan to heal my gut.
I have celiac disease and avoid all gluten. I also avoid gas producing vegetables and fruits, and eat smaller meals with often a midday snack. I do not eat after 7:30 p.m., and I try to make the last meal a lighter one. Those changes caused me to lose 35 pounds, which in turn helped me to do a consistent exercise routine every evening. I use Pepcid 10 mg before lunch and dinner often and take a gas-X and a dose of Pepto-bismol at bed time. I am not sure how necessary that is now, but it seems to work. My goal is to not go to bed with gas and bloating which tended to creep up on me when lying down and trigger Afib.
Isn't it all about money? Which is more lucrative, treating an uneasy gut or a long drawn out afib treatment? I too have afib when my diet is askew, and when I get very little sleep or when I'm stressed out I go into afib, like clockwork. I have recently had a couple of death's that was unexpected, my two cat's and I was very much shaken but to tell you the truth since a lot of stress is gone instead of going into afib every 3 days, which I have done so for year's I went ten ten days with no afib at all and since it just recently just happened I'm on a six day afib free run now. I agree with you fibnum but try telling it to an EP or cardiologist. Stress is a killer I know that but when you love something and you worry about them along comes afib. Great observation, Thank You for sharing , by the way I am 77 years young. Have a Blessed Day
Every night, sit down and breathe and relax. Make a mental waste basket in your mind. Go through each thing that you can think of that is worrying you. Put all of those that are no longer a problem or non-essential in the trash can. Make a mental file and put those that you can do nothing about at the moment in the file. Look at anything that needs to be addressed and acted on and do so or make a plan of attack for the next day. For the really tough ones, most of us pray, as I am sure you know!
A lot of the stress we feel is from leftover outdated or unimportant worries that are like the clutter or junk box with your email. Don't carry worries around all of the time.
I used to have my daughter write the worries down and wad up the paper and throw it in the hospital room waste can while she was 11 and getting really tough chemo for 10 months. In that situation, you really learn the meaning of "one day at a time".
(She is okay now, with an incredible 12-year-old daughter who loves to spend time with Granddad.)
Definitely appreciate this post. Whatever sends us into the remodelling of heart behaviour that's known as AF is multifactorial and the balance of these elements is going to be individual. I'm sure your story will help others.
l am positive that my PAF is caused directly by gut issues as well. I am eating smaller portions …. Zero alcohol … using flaxseed and prune juice each morning … hence going potty on a daily basis … watching carbs … zero caffeine … etc. l rarely have afib attacks since l began this cautionary routine and when l do, it lasts an hour or so. Best, Jan
On the advice from someone on this forum, I took prune juice with a combined tablespoon of flax and chia seed for a while. It got me into good regularity, and I have not needed itoften in recent weeks.
I am glad you have had success with keeping Afib at bay and hope that it continues for you.
Yes yes. I had a lot going on in the summer of 2017 and had a super super anxiety attack as I was dealing with the death of literally several family members and I felt like I just couldn't take anymore. I let out a rather gut-wrenching and guttural scream that had the words I want my daddy back in it and thought I had popped an eardrum but apparently I put myself into a fib. It is the one and only time that I had the incident but I was put in the hospital in a cardiac intensive care unit for 6 days and given a test where they go through your groin to check your heart function. I had no blockage no damage and no heart disease. I am heavy and I do have some digestive issues but I have done sleep studies I have worn the monitor three times with no issues EKGs or eegs whatever they're called come back normal but they put me on all these medications that frankly I don't dare to get off from because I don't know if it's the medication that's keeping me going okay or if I am okay. I did stop taking the anticoagulant because I had a huge incident from that but my frustration is my doctor my cardiologist rather is pretty glib when I asked him questions about why I'm still on all these medications one time he actually said to me well it's my job to keep you alive till something else kills you great bedside manner huh. I'm sorry there's not a lot of proper grammar in this I'm talking into my phone but I absolutely agree that a lot of people that have one incident of afib it could be due to something unusual that happened in their life and I know that your brain reaches a point where it says I can't handle anymore of this pain this anxiety this hurt and it does its own thing which I think is exactly what happened to me. I was 2 days from having to fly from the west coast to the east coast of the US to attend my parents' service and that was only part of the family that I had lost in the first 6 months of the year so I absolutely agree that we need to be more self I don't know what the word is we need to take care of ourselves and ask the questions and do the research because Papa pill do this do that just isn't always the right thing and I said pop a pill
I am sorry for your loss. I am taking the liberty of sending you my recent, old-fashioned, rhyming poem. I hope it is not upsetting to you, but I think it is about what your parents want for you. I hope you can get to a good place in your mind and body and enjoy life again.
Weep for Me Once (A Parent’s Wish) Albert Moore
Weep for me once with tears of sorrow.
Then turn your heart to a bright tomorrow.
Know that my soul cannot truly rest
Lest I know yours is richly blessed.
Tis’ my greatest wish and heavenly prayer
That the love you gave me, new hearts will share.
Weep for me once and release your pain
Then set me free as God’s peace you gain.
My spirit be joyful if above I can know
That your life is filled with happiness below.
Although I am gone, I will always be near,
And this final wish I need you to hear.
Weep for me once with tears of sorrow
but soon turn your heart toward that bright tomorrow!
I read about Roemheld syndrome last year, so why can't our doctors read about it?
I can't even get a cardiologist or EP to acknowledge it's existence. I did have one physician's assistant say "Oh yes there can be a connection". To which I should have replied, "Hello, is there some reason then why we are not discussing my seeing a GI or someone qualified to figure out how to relieve the gas? Luckily, I was able to do it on my own, but why can't I discuss it with the heart people?
I was diagnosed with Afib, four months ago after an ER visit with a heart rate of 240 which took about three hours to bring down with meds to about 120 and then i got progressively better. Saw the electrophysiologist who has me on Flecainide lowest dose, digitlazm (sp) and Eliquis. Just had the nuclear stress test and everything normal. Wore the Holter monitor for ten days and no episodes. No episodes by checking weekly Iwatch info and occasionally checking on my own.
Prior to the ER visit I was about 20lbs overweight, eating a lot of salt items and not watching what I was eating . I have never been a drinker but would have an occasional soda drink with caffeine. I have lost 15lbs, watch what I eat daily. at a banana a day and walk a minimum of 9,500 steps a day.
I'm wondering if I really do have Afib or if you can just have one episode and still have the diagnosis of Afib. I see my doctor next week so will ask him that question. Could I possibly go off the meds or is that too risky at this point. Any thoughts would be greatly appreciated.
I appreciate your response. I am not qualified to advise you about meds. In relating my own experiences, I am only offering information about what worked for me, in hopes that it might encourage you to be involved with participating in finding keys to alleviating or avoiding Afib for yourself. It sounds as though you have taken some beneficial steps.
As far as wondering if you really do have Afib, take it one day at a time. If something seems to working, be disciplined about sticking to it. If you have an isolated Afib episode over a several-month period, don't panic, just try to stay positive and carry on. If you have more, I recommend exploring other possible factors that might be contributing, and of course, consulting your doctor.
I would recommend not being too quick to take high-risk meds or have an ablation, unless your Afib becomes a clear threat to your health. That is one layperson's opinion and should not outweigh advice from a trusted doctor.
I hope you can find a good health regimen for avoiding Afib. For me, the experience with Afib caused me to: seek testing from a GI and learn that I have celiac disease and must avoid gluten and other hard-to-digest foods, stop all alcohol, lose 35 pounds, exercise regularly, and be more aware of my heart and body needs. Perhaps it has been a fortuitous wake-up call!
I have to control gas build up through staying regular, strict diet and exercise, in addition to avoiding sleep apnea with my sleeping position. I also was able to cut out most of my BP meds safely. So far that has worked. Tomorrow, I will try to stay the course for another day!
I agree with you 100%, I have exactly the same, my heart only goes into A/F when I have gas and bloating, and I also have celiac disease. Another reason is if you have Hiatus Hernia, again to do with the gut...
Your diagnosis came from a different way than mine ended, and it still took eight months to be diagnosed because a fib does not show on an EKG. I ended up with a monitor implanted and two weeks later they found out just how bad because I had had over 300 episodes. it sounds as though they jumped to a conclusion with you. Learning about the nerve here on this site from all of you I have become very aware of what could trigger my events prior to my pacemaker. Another medication constipates me I’m dealing with that would trigger by a fib. It became less scary once I realized what was going on. It sounds very ignorant the way that they throw the diagnosis around like that for something else as a friend. It is good that you pass them. It is sad that we have had to become our own doctors in someways a specialist is just that and it seems like regardless of all the testing they do on us all they look at is theirpoint of interest. I I just had a medication changed. It was an anti-depressant. What I did not know was that it is also used for chronic pain which I have from a bad accident. Evidently it works well because when I was taken off of it Oh my goodness the pain also my GP did not wean me like he should have. very upsetting. I have been going through withdrawal and finally took things into my own hands. I am very angry, especially the fact that he is aware of my heart condition and withdrawal cannot be good for that either besides a fib and flutter atypical, I have heart failure.
I think of how my mom was with her doctors and their word was law. They were gods on a pedestal. We need to respect them when they deserve it but we also need to keep our eyes open.
I believe that we can be, and need to be, valuable partners and co-managers of our health with our doctors. It is not often that I would simply say, "no thanks" to an MD and go my own way, but that is exactly what I did with dealing with Afib, and thus far, it has proven to be a good decision. I did not do that lightly, but followed what my own reasoning told me made sense.
that is how I am now reacting to my GP. He is a wonderful person not a good doctor in my head. He has let me down a couple of times. He also does other doctor work on the beauty line of things, not plastic surgery, but other things that gox people up a bit. No doubt it is lucrative more so than being a GP with the way, our insurance treats, doctors and patients and it’s all about money for the insurance companies. I am sure if you continue to have what appeared to be a fib you would’ve followed further. We know our body better than anyone even the doctors that have been inside. Having a doctor said teaches us about it is a godsend. Luckily, I have one now for my EP. He is so passionate about his work and it shows and he is happy to share and educate that is part of his role at the Heart Institute, where I go. He is young and still hungry for knowledge, and he loves to share that knowledge. He recently presented my case. At some thing he attended in Dallas Texas. I live in Houston pretty much a medical capital of the world. He is outside the city in a small town you would never find such a doctor. They asked him after the presentation to return and teach the EPS his method of saving me. They want to be able to save others. I love hearing that about doctors because sadly they can also be about money. I don’t think it’s ethical, but who can control anything these days
I say, bravo for what you did. We have brains in the beginning I used to get nervous about everything when it came to a fib. That was my anxiety. Now I think things through inform my question for the doctor if I need to. I see people on here still in the panic stage like I was at least they ask questions, but we all need to learn not to pick every tiny feeling apart. The same with devices for our heart rate, etc. I’m glad I listened and put my oximeter toy away. As they say no, it’s can be a dangerous thing. I was a medic when I worked law enforcement, perhaps that helps me decide what is important. We are all human now. My first event when I woke up facedown on concrete I tried putting myself to bed. I fell a second time in blacked out. Yes I put myself to bed. Turned out the first time I never got there. I actually landed in the bathroom. Even when you think you know what you’re doing, you can do foolish things I am blessed I woke up again
Probably the best analysis of a lot of people’s condition that I have ever read, I’m certainly of the same mind and have always been convinced that my Afib is triggered by gut issue’s, thank you. John in the UK
Thank you, I hope you can get help to resolve your gut issues and be free of Afib.
If you have not done so, I recommend getting tested for celiac and other food intolerances.
I have found avoiding gluten and other gas-producing foods, eating smaller meals, avoiding eating after 7:30 p.m. or so, moving around after eating, drinking plenty of water, staying regular, using a gas pill before lunch and dinner, exercising some before bed and taking an antacid at bedtime to be a successful regimen for reducing gas and preventing Afib.
I am sure you have tried some or all of the above.
Perfectly said!!!! My own story is very long but I resonated highly with your post. But I will tell you after settling on the third Electrophysiologists, not one of them wanted or cared to discuss the possible root cause. Not one of them suggested a better diet, exercise etc. Thank you for sharing!
It is very telling that so many of us have had such similar experiences with "gut-triggered" Afib. I think we need to draft an open letter to electrophysiologists through their professional associations urging them to listen to their patients and take steps to work closely with gastroenterologists to provide intervention which may well provide the key to eliminating their patient's heart issues. I would recommend that they create a "take a gastroenterologist to lunch" day!
It is time to develop treatments that fit the patient, after too many years of trying to make the patient fit their treatments!
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