do ectopic heartbeats trigger AF?

[OscarN]

I’ve been back in NSR For three weeks now following taking flecainide at 150 g. Tonight, for the first time since then, I had two or three sips of beer and noticed that I was experiencing ectopic heartbeats almost immediately after I had my first sip. I put the drink away. I went onto alcohol free. The ectopic heartbeat is quite disconcerting and worried me that I might be going into AF. Does anyone have any experience or wisdom about ectopic heartbeats? And whether they are triggered by anything such as alcohol.? do ectopic heartbeats trigger A F?

[mjames1]

Not sure if a ectopics trigger a fib ( they probably do), or if just a harbinger, but definitely a relationship with me, especially when there are a lot of ectopics.

If I'm not on daily Flecainide and start getting a lot of ectopics, sometimes I'll take a small dose of Flecainide prophylactically. That often works to calm things down. During times when I'm on daily Flecainide, I rarely get ectopics or afib.

Never had a problem with alcohol triggering ectopics, however I only have an occasional beer. Usually light beer and only one at a time and always with some food in my stomach.

Jim

[OscarN in reply to mjames1]

Thank you!!

[stoneyrosed]

For me AF nearly always followed ectopics, and yes alcohol was a massive trigger for me. I have not had a beer now for three years since I had my first ablation. One of the things I truly miss, but the AF was too symptomatic so abstinence was the sensible thing I’m afraid.

[OscarN in reply to stoneyrosed]

Very sobering. Thank you. I fear I maybe the same.

[BobD Volunteer]

That was how my AF started thirty years ago. One sip was enough.

Ectopics can be a pre cursor to AF I'm sure but not always a bad thing. Sabine Ernst (google her) once told me (this was post ablation) that they were a good sign as it showed that the heart was trying to go into AF and failing.

[Autumn_Leaves in reply to BobD]

Ectopic are the heart failing to go into AF?! Never heard that one before.

[OscarN in reply to BobD]

Wow. That’s interesting. I’m still having ecotopic beats even though no alcohol!

[AAJJTt]

Before my formal diagnosis and treatment, ectopics always appeared to be ‘the siren call’ before an Afib episode. However since the start of treatment (150mg - Flecainide - daily), my Afib has been well controlled; in fact no discernible, sustained episodesfor 3+ years. I still get ectopics and earlier on, they were problematic for me but now ‘‘Afib trigger’. I had them investigated, the burden was not high and my cardiologist wasn’t overly concerned. After a course of CBT and some work on myself, I have kind of got use to them.

I have not seen any indication that alcohol exacerbates my ectopics or my Afib. I am still enjoy the odd beer or wine but in moderation.

[secondtry]

'One sip of beer' to me suggests you have vagally mediated PAF ie the brain sends the signal to the heart that you have started drinking before the alcohol has gone anywhere.

I would also take care with non-alcoholic drinks as the ingredients or the fizz may also contribute to AF being triggered.

Not sure how much and how often you are taking Flecainide but my cardio favours daily intake rather than PIP; his reasoning being a PIP is too much of a roller coaster for the heart, which needs stability.

I have recently started getting the odd ectopic and regard it as a good early warning system to take extra care with other potential triggers and/or take my Flecainide a tad earlier.

[OscarN in reply to secondtry]

Thank you. I kinda feel that whilst the heart is doing a lot of ectopic beats I should continue to stay off the alcohol. Your point about just one sip and the vagal nerve might be true. Really interesting thought

[needlestone]

I drink only gluten removed beer. No problem with those. For me it is the wheat in beer that sets off my ectopics not the alcohol.

[OscarN in reply to needlestone]

Ah!!! But what about wine?

[needlestone in reply to OscarN]

wine doesn’t bother my heart but I limit it to 2 glasses only.

[Ppiman]

You are mixing cause and effect. Swallowing naturally stimulates peristalsis in the oesophagus, causing a wave of muscular contraction. In some people, this presses against the top of the left atrium when it can trigger a premature atrial contraction (an ectopic beat or PAC). This can set off AF in prone individuals.

This has nothing whatever to do with alcohol being a trigger, and I don't believe it is in the way people sometimes explain it. A drink of tea did it for me when I was wired up and being checked causing the nurse to comment on it as she was watching my ECG trace.

The proximity of the food pipe to the atrium is one reason why people are now given an acid inhibitor for a few weeks following their ablation to calm any oesophageal irritation from the heated ablation catheter.

Steve

[OscarN in reply to Ppiman]

Thank you. Really appreciate this.

[kkatz]

36 hrs ago I had 1/2 glass of wine & 2cl brandy with a meal and virtually instant ectopics.both my EMG(Kardia) & fibricheck.Lasted about 2 hours.quite upset by this as 9 months NSR.I think it was the brandy not the wine.

Had a repeat 30 mins or so yesterday even though I avoided the beautiful mulled wine at our Christmas bowling match & meal.

I was told in no uncertain terms.If you don't want undoing the hard work so far to avoid alcohol.

[OscarN in reply to kkatz]

Uff. That’s really interesting. I have been drinking wine and beer quite heavily with no problems at all before my last FAF episode. But the night that I think pushed it over was when i drank a large glass of sweet rum and the next day I was in FAF. I fear I’ve trained my heart or vagal nerve to trigger FAF now with any drink.

[Ppiman in reply to OscarN]

I was told that drinking in moderation is entirely okay after my ablation. I drink maybe a glass of wine four days a week.

Steve

[OscarN in reply to Ppiman]

Thank you. Good to know.

[Jetcat]

iv always been led to believe that afib usually follows ectopics. But having said that, I can get up to 2 weeks of ectopics daily and not get afib, then I can be ectopic free but get an episode of afib.!!! So I don’t know what to make of it to be honest.??

[OscarN in reply to Jetcat]

Thank you. Yeah it’s confusing.

[Jetcat in reply to OscarN]

I tolerate alcohol well too which is usually a NO NO with afib. it’s all a mystery sometimes isn’t it.?

[ian16527]

I have had ectopics for nearly 40 years, and they come and go. Never gone into AF but had SVT's go into AF.

I am now 7 months post ablation and still am getting ectopics every week regardless of any alcohol intake. The EP said take some magnesium supplements

[OscarN in reply to ian16527]

Magnesium - I will try this.

[Rhiannonimity1]

hi Oscar. Once your heart becomes excited, which might include tachycardia, ectopics or runs of palpitations, I tend to think AF is a strong possibility. Alcohol is a known trigger of an excitable heart and is best avoided - particularly fizzy alcohol. Also caffeine, msg, any stimulants, foods that give you wind - it is very individual what triggers you. There is some research that ectopics can be tamed a little by deep slow breathing exercises. For me, i once had ectopics for 8 weeks which never turned into AF but mostly I would get them in the evening and wouldget afwhen I lay down for the night. Ithelped to sleep sitting up, or go for a walk before bed.

[OscarN in reply to Rhiannonimity1]

Yes I found breathing calm and slow really helps. Thanks

[Aegean56]

I posted a few weeks ago about having runs of ectopic beats after indulging in a week of new black teas and chocolates .UPDATE: These led to an episode of tachycardia up to150s but was totally asymptomatic otherwise with normal pulse ox. A couple of Kardia checks did NOT capture Afib only sinus tachycardia. Took an extra 1/2 dose of my beta blockers but didn't kick in so headed to ED....still no A fib on EKG. After an hour rate was down to 70s with occasional PACs. Was discharged home on my regular meds. In my case, I believe the ectopic beats were precursors to this episode of whatever. I have had similar with these beats leading to asymptomatic "flutters" . So no more caffeine for me and will hold off on the alcohol as well as I know that's also a trigger me

I will miss the dark chocolate the most . Especially my daughter's homemade peppermint bark.

I would listen to the messages your body sends out.....the same was you woukd any other alert.

Happy Holidays

[OscarN in reply to Aegean56]

Thank you. Really great advice.

[marcyh]

I asked my electrophysiologist a quetion like this a few years ago. He said ectopics precede AF 100% of the time. But it doesn't mean ectopics will always result in AF.

[OscarN in reply to marcyh]

Wow. Thank you.

[Cos56]

the one thing that triggered my episodes AF was complete relaxation on the couch. No kidding. When the episodes started to come closer together, I started Flecainide 50mg twice a day, along with Eliquis 5 and metoprolol succinate 25. Since then, I can relax without worry. I get an occasional blip after I eat sometimes, but have not been in AF since starting Flec. I love it. I like preventing it, rather than waiting for an episode. Not sure why one would only take it if they go into AF. I don’t want to ever feel that again!

[OscarN in reply to Cos56]

Good thoughts. Thank you.

[Spoiler]

sorry, I am not much help in regard to alcohol, I have had such a long roller coaster with afib… I simply do not touch it anymore at all, never had much other than wine or a mixed drink here and there. BUT it did trigger the afib at the time before treatment with meds and finally surgery. I just do not chance it anymore. I currently take a small dose of Flecainide, but hopefully maybe be off of it next June. I have been on anywhere from 50-300 mg a day.

[OscarN in reply to Spoiler]

Thank you.