My husband has paroxysmal A fib. This started after cardiac damage from chemo 4 years ago. He has had 2 ablations, 2 cardioversion and a pharmacy of meds. He is only 62. He went 5 weeks without AFib. Was feeling good. Boom! Tachycardia. Question. We keep trying to find triggers. Only thing different was a massage the day before and had his phone in left shirt pocket day before which he never carries. Thoughts?
A fib Triggers: My husband has... - Atrial Fibrillati...
A fib Triggers
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Lenaropes
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BobDVolunteer
My EP told me looking for triggers was the way to madness. You have AF you will have AF.
Well it drives me mad. Lol
It's pretty much a pointless exercise. You know why he has it, his heart was damaged by previous treatment. It's a fact of life now. The thing to do is concentrate on how to best manage the symptoms of it for best quality life. Not to obsess on a holy grail of something to blame. It does drive you mad.
Phone in pocket would be my best guess - massage unlikely but possible - massage if it was vigorous back massage could have triggered an episode but for me it happened instantly when still being massaged and I self converted quickly as I know it’s postural so bit of cat and cow yoga fixed it.
You are advised never to put your phone near your heart but sometimes you don’t need a trigger - just happens - especially when underlying cause is known such as cardiac damage.
Hope Hubbie feels better soon.
My guess would be, did he eat anything containing artificial additives like sweeteners? I hadn't had any major episodes with my heart for almost 4 years (was in constant low rate AF 60-90 all the time though).
Last week I went for an ECG at my GP's surgery and lo and behold my heart rate was 120bpm in one ECG and 130 in another. As soon as I lay on the couch to have the procedure I could feel my heart thudding away. Now I know that artificial sweeteners are a trigger for my AF, what had I done - popped a tiny mint into my mouth about 10 minutes before. I hadn't looked at the contents before buying them as they were too small to read. I don't normally eat mints but occasionally get fits of coughing, so that's why I had decided to try them. When I arrived home I looked the contents up online and yes they contained artificial sweeteners!
Jean
very interesting. I will try to be aware of that. Thank you.
Best to avoid or control things that can cause higher BP and AF so change to decaff tea and coffee, avoid alcohol unless you know it's not a trigger and take care during exercise and don't overdo things. I have no triggers but had already changed to decaff tea and coffee before AF and never over did the alcohol and drink even less now. Never knew what my trigger was but likely exercise - it was my job for 37 years and I was of the no pain no gain school so found it hard to change.
Just be aware that although artificial sweeteners are a trigger for some people, others won't have any problem with them. Same goes for alcohol, sugar, spicy food, caffein and all the other foods people stress over. I have no triggers. I inherited my AF. No point obsessing about that so I don't.
artificial sweeteners are POISON, no two ways about it. The worst offender is ASPARTAME, which over excites the neurons in the brain and stimulate the heart causing it to go into AF for us AFibbers. I have had half a dozen AFs due to this chemical poison which countries allow to go not only in food but allow it to be there without even telling you on the label it has it. The European Union does not allow this, allowing us to easily avoid it, however in other countries, which I will not name here, they do not do this causing all sorts of grief for us. My advice? Avoid ALL processed food, especially sweet ones (sugar is not good for us anyway) and just cook at home all the time. The other big offender is Acelsufame K. I have not had issues with Sucralose or Saccharin but that does not mean they are good. There is a reason why so many people taking sports and energy drinks end up with heart problems and it is not just the caffeine they contain but the massive amount of aspartame and acelsufame K they contain.
I have Paroxysmal AF and the absolute direct trigger for me is increased HR on exercise (running is the one that gets the HR up). I hit much above 140 for more than a few seconds and BOOM - next stop 215bpm.
A couple of Flecainide and a few (5-10) hours taking it easy and back to NSR.
Occasionally I get spontaneous episodes with no specific trigger.
Previously I had Paroxysmal A Flutter and the trigger for that was either sport (generally long bike ride) the day before or a big night out the night before. Would then kick off in the morning. Always wondered if the common factor was in fact dehydration as opposed to what caused the dehydration?
Now your thoughts on dehydration makes sense. I have read of exercise induced AFib. Thank you.
Dehydration will cause both potassium and sodium to go down, especially potassium. I have had many documented AFs with low potassium. Solution? Very simple, take hydration formulas if you are in the UK (dioralyte is awesome!) but avoid outside of the European Union as they stuff these things with Aspartame which WILL give you AF guaranteed. (I just bought a packet of KCl - Potassium Chloride, and take a tiny pinch with some water two or three times a day and that makes me feel pretty good).
What color socks did he wear that day 
Sorry, not trying to make fun, but as has been suggested, you can sometimes go crazy looking for triggers and sometimes there may not be any.
As to massage, just be careful of anything too heavy and especially around the neck area where the carotid and vagus nerve lie. I once went into afib after using one of those shower massage devices on my neck.
Jim
That is interesting because usual carotid massage lowers heart rate. But like you said, who knows. They do so much for the heart now would think they could figure this out. Lol
The vagus nerve runs from brain through the spinal cord and exits for heart control in the thorax region. The only thing you can say about PAF is that there are SO many variables and everyone reacts very differently to just about every variable so there just are no consistencies.
A few years ago I had been in AF for about 72 hours and we were travelling home when the car hit a hidden, very deep pothole and broke the wheel and damaged the axle. It wasn’t until about 2 hours later, after we had the breakdown truck and got some food that my husband remarked I looked a lot better and I realised that the shock of the impact had converted me to NSR - not recommending it though!😁
Many years ago I had one of these mini exercise trampolines. It put me into Afib so stopped using it. Some weeks later I woke in middle of the night in Afib, eyed the trampoline in corner of bedroom and thought what prompted Afib might stop it. 6 jumps later and sure enough, NSR ! Likewise, not recommending it though 😉.
I also believe what causes often cures! Same goes for all the pharmaceuticals and homeopathic and herbal remedies.
🤣
I would suspect that phone, especially if it was put on vibration. Also if there was certain vibrating kind of music during that massage?
He did have the theragun. The hammering massager .
Theragun works through percussion and vibration. It is not recommended on chest for people with pacemakers. I'm pretty sure that my AF would be triggered by that. However, certainly not all people would react like that. It may also depend on which body parts it was used. The further away from the heart the better.
You could possibly find out by another try, but it doesn't have to happen all the time. I would consider that a risk and turn back to old fashioned manual massage.
Agree
Hi
I have PAF...am 48 and have had it 11 years 
My triggers are nothing like that...they are...
Chocolate
Alcohol (i don't drink much but 3-4 pints now and again can kick it off)
Pushing myself exercise wise (mountains..cycling)
Gassy stomach from certain foods...(different beans etc)
Good luck
JT
My only trigger is sleep. My EP told me not everyone has triggers.
My main trigger is alcohol - but fatigue, lack of sleep and dehydration are contributing factors
For me triggers are: alcohol, serious over exertion, dehydration, stress/distress.For me usually a combo of any 2 or 3 of these to be avoided or alcohol in excess (more than 2 glasses)on its own with large meal.
Online a search will reveal a report of a clinical study in which researchers looked for triggers in a large group and found that the vast majority of sufferers were not able to attribute any specific event to causing their AF, but with the most common causes in those that could, being eating a meal (not a specific food) and lying down to sleep.
Despite that, there are people on social media forums who do seem able to attribute their AF to "triggers". Coffee and alcohol are perhaps the two most commonly cited causes. This is despite plenty of work that shows caffeine, in normal doses, is safe. Alcohol can affect the heart adversely in the long term, but whether there is a short term, immediate "trigger" effect, I haven't found evidence for. My own AF and ectopic beats are as random as can be and my moderate intake of coffee and alcohol have no impact at all, and perhaps even help in terms of relaxation
What is known is that the heart's conduction system can become prone to "misfiring" and arrhythmia through various means, including ageing, obesity, high blood pressure, being tall, sleep apnoea, thyroid disease, genetic causes, and other direct heart diseases such as valve weaknesses, enlarged heart and heart attacks.
I have come to believe that, once prone, that the most likely "trigger" will be a physical pulling and pushing of the heart caused through natural body movements. These are known to be able to create ectopic beats, and those misfiring beats are an accepted trigger of AF. The heart can become naturally pulled in various scenarios such as stretching or crouching, and, neatly fitting in with what the study found, even eating, drinking, bloating and constipation can push the diaphragm upwards against the heart to set of misfiring.
There's some strong evidence, I have read, that there's a group of sufferers whose hearts become more "misconducting" when exposed to adrenaline, say during exercise, emotional upset, anxiety and similar. This is called adrenergic AF. Another group get their AF during periods of rest when the adrenergic system calms and another hormone called acetylcholine dominates, such as after a meal or during sleep. This is called vagal AF. (This latter is not the same as what some claim to experience which is "vagal irritation" caused by gastric acid reflux or hiatus hernia. There seems no evidence for this as a common cause of AF, but it is a somewhat popular explanation found online).
Steve
I just have to smell coffee and have my heart start skipping beats lol. Caffeine is not safe in any dose, despite what they may say (was that study funded by the coffee lobby or something? lol)
Oh cynicism, the beast that social media always awakens! 😉😉 I am joking.
But no, it wasn’t - it not so far as I know and there have been several studies, now. Each has a caveat, if I recall, that there are a very few people who are unusually sensitive to caffeine thanks to their slightly different metabolic liver processes. Something similar happens with other alkaloids, for example, codeine, where some people metabolise that alkaloid differently and, very rarely, dangerously, I gather.
Also, the psychology of food sensitivity comes into play with powerful results in many people apparently. There was a fairly good BBC R4 programme on this yesterday afternoon discussing cough and cold relief medicines which , scientifically at least, have been proven to be pretty much ineffective. The placebo response works for 30-40% of people to mask the drug’s ineffectiveness. It’s much the same with homeopathic and many (not all) herbal medicines.
Steve
I am very interested in what you wrote. Do you know what is happening when I get AF the moment I lie down to sleep (especially if I lie down too suddenly)?
Thanks in advance!
I get what you describe, too, or, at least, most often runs of ectopic beats that feel much like “slow” AF. I think several people here do, too, from past posts.
My belief is that when we first lie down, the stomach area pushes upwards against the diaphragm and this presses against the base of the heart. This happened to me first in my late twenties, forty or so years ago, when I also had a frightening audible “clicking“ sound come from my chest. On investigation (which had my GP call of his colleagues in for a listen and to send me straight off to hospital…), an X-ray showed that air in my stomach, or simply my posture and anatomy on laying down, pushed the stomach against the diaphragm, then pressed that against my heart and caused mild racing and ectopic beats. When it was caused by swallowed air or stomach gas, the stomach then also acted like an echo chamber to amplify the heart beat as a clicking sound.
This happening when first getting into bed is quite different from the “relaxation” or “vagal“ AF caused when the adrenergic system is suppressed by the parasympathetic nervous system which happens later, during sleep.
Steve
Lots of good info. They believe my husband's original beginnings was due to Left lower lung removed and pulmonary vein ligation. It is so hard for me being a retired RN and a person who "fixes" things. And I can't this time.
Well, having the desire and willingness to help, whether we can actually do much or not, is a fine characteristic! And your training couldn't be better. AF is an unpleasant thing to have but feels worse than it is, sometimes much worse. And yet a friend has it full time and hardly knows about it!
You sound like you're a great pair and in a good marriage, much as we two here are here after fifty years. I hope for the best for your hubby who has clearly been through a lot.
Steve
I cAn stimulate the vagus nerve in my neck with turning my head to right or chin to chest. Does not always cause an episode. I do a valsavor action which usually stops it. This is only cause of my long tachycardia episodes
I liked this web page when I read it a while back:
mcgill.ca/oss/article/criti...
Steve
Thanks for link Steve. I just wish my vagus nerve would calm down. I find Magnesium Taurate helpful as well
I could do with mine being a bit more to the fore and my adrenergic system taking a back seat! 😳😉
Steve
Yes but my vagus nerve speeds my heart up which I can’t understand as supposed to be part of the parasympathetic nerve system..it’s a mystery
I asked a cardiologist who I was seeing a while back about vagal causes of AF. He told me that they were very unusual and more an internet myth than a reality (this was AF caused by vagal irritation, not the theorised "vagal AF", i.e. parasympathetic-induced AF). He said that vagal irritation would cause swings of severe brady- and tachycardia as well as other systemic effects since the nerve innervates so many systems. That might explain your findings - but what could be causing this irritation, I wonder?
Steve
Thanks for reply… I think doctors just give us any old answer as my consultant told me my episodes definitely vagal. But i do find the magnesium shortens length of them
I think they do and maybe GPs especially these days as they seem too busy to give a very personal consultation. I was lucky that the specialist I saw was a professor at a teaching hospital and it was a rare, deep conversation as it turned out was an area of his interest.
I wonder whether your doctor was not referring to the two basic “types” of AF, “adrenergic” and “vagal”? That’s a reasonably widely accepted idea.
I think a few here take magnesium salts and report some usefulness. They did nothing for me, sadly.
Steve
Hi lenaropes, unless you notice a definite guaranteed trigger( which I cannot)! You will end up spending alot of time and energy searching.? I kept tabs on everything from food, exercise, sleep, alcohol, stress, you name it I was monitoring it. I kept note books and graphs, even logged my pulse and BP daily, but after A year and nearly losing my sanity I realised that I was on wasted task unfortunately.!!! I remember shovelling rubble into a skip( summertime ) when we were renovating our house. It was 2 days of hard work to clear bricks and concrete up and I never got a missed beat. 👍
but whilst relaxing reading a book I have started with missed beats for no reason which has started a AFIB episode.!!😡 this is why I know I will never understand this condition.??
I wish you well in your search 👍
Best wishes. Ron.
Sorry his AF is back again. I read somewhere that people with AF shouldn't be massaged around the neck area, as it can be a trigger. Looking it up now I can only find this BHF article saying massage could move clots around the body, or raise blood pressure. It also says "During a massage, pressure moves fluid around your body, which can affect your heart and circulatory system, especially your blood pressure." bhf.org.uk/informationsuppo...
I guess we all have different triggers. I have paroxysmal AF and worked hard to find my triggers, keeping off them I feel much better. For me eating a large meal will do it, having alcohol or anything containing ethanol ( includes some cough medications), adrenalin eg in the local anaesthetic at the dentist. Flouride, ( cleaning my teeth in the evening and I would have afib about 2 hours later), I now use charcoal fluoride free which contains a natural fluoride. Lying on my left side when I first get into bed, this is a very common trigger, I will now lie on my right side for a few minutes then I can turn over. Hyperventilating is another common trigger, if you get out of breath, breathe deeper and slower so as not to cause a trigger. Hope some of these are a help, finding your triggers is worth doing .
My experiences are similar. A large, late meal certainly, I feel, was an important component of my heart suddenly jumping to 140bpm as I lay in bed 2 hours later, in full A-Fib. Alcohol is completely out for me; it is a definite trigger— plus I love being alcohol free, sleep better, feel better. One of my last big triggers was using an epipen for a wasp sting. I’m 99% sure that adrenaline rush triggered A-Flutter and tachycardia, leading to another CV. The two events—epipen followed by A-Flutter—were too close to simply be coincidental. I, too, do not lie on my left side when I go to bed—simply because it feels like my heart doesn’t like it and is telling me so with bumps and thumps.
I hadn’t thought about anesthetic at the dentist’s. I resist it, and thanks to your sharing, will continue to do so.
I think it is clear there are A-Fib/Flutter triggers and agree it is worth paying attention. I know sometimes we all feel like we’re stabbing in the dark, but I’d bet some of our suppositions are on the mark.
The dentist has an adrenalin free anaesthetic so ask for that. Another definite for me is dehydration, just a glass of water will make all the difference, even during the night if I wake with my heart out of rhythm.
Thanks!
My triggers initially was nothingIt came on when i was having a salad for lunch at work.
After that nothing for 4 years then it would come on after i pulled something or stressed my chest with lifting or caravaning but always the next day Eventually it came on for nothing.
I think it was started by a central line inserted to far in theatre during am operation which caused vf at the time
Afib doesn't care.....Like BobD says....you can go insane looking for triggers. I went into Afib yesterday. All I did was "walk" down the hallway and then sit down and Boom. There it was and for the next 12 hours. You just don't know. It doesn't seem to matter what I do with my lifestyle it's always there waiting, lurking. But don't despair, one never knows. You said your husband had 2 ablations. Maybe he needs a third one and that just might stop it. But there is no guarantee. Believe me I know....it's a horrible condition. Wishing you the best.😀
Thank you
Hello. My advice is to ignore the nay sayers on here who don’t believe it’s worth looking. Just because they can’t find a cause for themselves doesn’t mean you and your husband can’t improve his life by looking. Just don’t take it to extremes.
Anxiety can be a huge cause as well. But let’s say you believe that it’s the mobile phone in your husbands breast pocket. Then don’t do that again, and be positive about it, don’t let anxiety creep in ( ok not so easy to do as say).
For what it’s worth I think the massage could also be a trigger. A lot of my problems developed after I hurt my back in 2018 and saw various osteopaths.
I’m too far gone now to simply go back into NSR by not doing something but I’ve improved my life dramatically by changing the way I live while looking for the things that make my AF symptoms worse.
Good luck
Well I wish healing for you.
I also have suspected massage as a trigger. Massage moves a lot of fluids and can have a strong healing effect. But…. Here’s my experience: I had a catheter ablation for A-fib on a Thursday. I had a massage on Friday (thinking it would help my recovery). I went into A-Flutter on Saturday. I had an electrocardioversion on Sunday. Who knows what actually went on, but now I wait at least ten days after a cardioversion to have a massage. If I have another ablation (possible), I will not include massage in my immediate recovery program.
I have also learned, having just had my third electrocardioversion, that at 81 it is not a good idea to follow the advice “just go back to your regular activities right away.” I did that after CV#2 — regular exercise, food, family distress, busyness, and fully engaging in a stressful legal situation. A month later, with my resting HR 130bpm and heart in both A-Fib and A-Flutter, I had CV#3.
After #3, I stayed in the total slow lane for five days. My Watch readings and heart rate were bouncing around—but then after five days became steady with NSR and a regular, normal HR. It seems to me a CV is quite a shock, and not just literally, to the heart, which wants some quiet TLC afterwards as it begins to heal from the stress it experienced. And no immediate massages.
Good thoughts. I agree. Thank you.
Was his massage with aromatherapy or just massage.Presumably if with oils it was with someone who knows what there doing.Oils are potent & need knowledgeable use.
Now she is very versed in oils but that is worth looking at. Thank you.
I have used Aromatherapy for around 40 years and did qualify about 15 - 20 years ago . Don't practice .I use mainly for everyday ailments ,to fight off infections & for painkillers.I rechecked all possible contradictions when I developed AF.Lots of people have given ideas but AFib is unpredictable and likes to let us know it is there.
I have an image of a little stick figure waving his knickers in the air & shouting "I am here" .
Good luck .
I can understand people believing that there are no triggers, but as many others on here discuss what theirs are, I thought I'd share mine. The first one is emotional stress. We have a family member who is ill from time to time and when things are bad for them, I can get overly stressed and AF kicks in. Another is alcohol to a certain extent. Artificial sweeteners, and MSG (a flavour enhancer) are others. I stay away from Pringles and Doritos due to that. I figure if you have AF then some things will make it worse or aggravate it. Not sure about the phone issue.
I have had AF for 17 years now and As a few people have mentioned, you can look for triggers and never find the answers. Other than the obvious like too much caffeine or alcohol intake, or eating a heavy meal before retiring, or stress. It seems to sometimes happen without any obvious reasons. I had a physiotherapist session one time and that set it off. But other than that it just happens.
Agree with BobD in many ways, but maybe noticing is more relaxed than pursuing. Each person's triggers are different as we often say I've been on Amiodarone for 4 years and now only have episodes every few months (as opposed to 4+ times a week). Triggers over the years that I've noticed have included: rolling over onto left side in bed; lack of sleep for a few nights, stress/super-busyness; monosodium glutamate (dips or bought sandwiches with eg coronation dressing; and NORW - No Obvious Reason Whatsoever! It's that pesky vague nerve that is so easily unsettled....Hope things improve for your husband .
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