Causes of Afib

[fibnum]

I have a question:

One of the programs available at the HealthUnlocked "my hub" site from the AFA is entitled: "Atrial Fibrillation and You" It lists common causes of Afib:

High blood pressure

Coronary heart disease

Mitral valve disease (caused by rheumatic heart disease, valve problems at birth, or infection)

Congenital heart disease (abnormality of the heart present since birth)

Pneumonia

Lung cancer

Pulmonary embolism

Overactive thyroid

Obesity

Sleep apnoea

Dementia

Many of us have written that digestive issues that produce trapped gas are clearly the most frequent trigger for our Afib events. The question is:

Why do doctors and the Afib Association refuse to acknowledge that fact and to recognize it as a cause of Afib?

If I had been directed to investigate and treat my digestive problem, (celiac disease), I would have been spared several years of Afib episodes, trips to the ER and needless worry. Instead, I was offered risky medications and ablation. My frequently expressed assertions that my gut was the culprit were categorically ignored.

Is there a logical, medically sound reason for that?

Fibnum

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[mjames1]

I think if you dive a little deeper into the literature, you will see that the afib/gut connection is accepted by many medical authorities and ep's.

Jim

[fibnum in reply to mjames1]

I know there is a study and some videos which support the gut/heart connection, but it is still not widely accepted standard information. I have not found any doctor who accepted it and recommended trying to resolve my gut problems as a means to alleviate Afib.

I told my cardiologist about my gut trigger three years ago, and he rolled his eyes. Another ignored me one year later after I moved to a different city.

I told my EP two years ago that I wanted to hold off on strong meds and ablation because I wanted to see whether resolving my digestive issues would reduce or eliminate the Afib episodes.

She said: "Well, you can try it, but it won't help."

She was wrong!

[CDreamer]

Good question - I wish I knew! It seems to me that as soon as you get a specialism there is very little cross over between specialities unfortunately. Dr Gupta, York Cardiology does accept the connection and works with gastro expert - unfortunately I can’t post the link because of the ridiculous new ruling by Admin without them ‘approving’ it.

Look on YouTube and search for gastrocardiac connection, York Cardiology. I would also look for Leaky Gut Syndrone - causing inflammation which I believe was my undoing as I had developed Ulcerative Colitis by the age of 20.

Hope that helps.

[fibnum in reply to CDreamer]

I have seen Dr. Gupta's videos discussing gut-related vagal Afib. They helped me stick to my guns on refusing an ablation and meds. (I finally let them give me Tikosyn. It made my heart timing dangerously low, and I was in the hospital with a magnesium drip for 3 more days.)

I went ahead and figured out my own plan. I was tested and found to have celiac disease. I avoid gluten and other foods that cause gas and don't eat after about 7:30 p.m., eschew alcohol, excess caffeine, and sodas, exercise nightly with walking and weight lifting, and take gas relief pills as needed. I also lost 30 lbs.

I have had only 4-5 isolated events over the last 14 months, and they were all attributable to eating the wrong thing or Covid. I was having them every 10 days-two weeks before I figured out my own treatment plan.

[CDreamer in reply to fibnum]

Good work, well done!

[DiyChas in reply to fibnum]

IYO, could my GERD type symptoms (requiring Pantoprazole AM and PM) be causing my mild AF?Is there a test to confirm celiac disease?

[fibnum in reply to DiyChas]

Yes, there is a simple test for celiac. I strongly recommended it. It could help you begin to sort out your digestive problems.

[mav7]

Certainly respect your initiative and decisions including diet and exercise regiment which can alleviate afib.

Do you use a Kardia or other device regularly to monitor any possible afib episodes ? As you may be aware, afib can be silent.

Is there a logical, medically sound reason for that?

Personal opinion, I would say the doctors do not feel your celiac disease is a cause of afib, but certainly a possible trigger, hence they have offered medications and an ablation.

Wish you continued success.

[fibnum in reply to mav7]

Thanks for writing.

I check blood pressure and heart rate at least once daily. It has always been very clear when my heart rate goes out of NSR, in that I can feel the uneasy, weak feelings and both my hand pulse-taking and BP machine show arrhythmia. I may have occasional blips I am unaware of, but have not sensed any. I have worn a continuous monitoring device in three test periods, including a month-long test period and found no problems

My heart has been thoroughly checked out very recently and is healthy.

The trigger is very consistently trapped gas.

I do not see a phenomenon, apart from the "trigger" that could be described as the "cause".

I am not getting the distinction between a trigger and a cause. To me, gas attacking my vagal nervous system is the cause of the distress that triggers the heart response and is functionally the source or cause of my Afib episode. The other indicator for me is that when my gut is free of bloating and gas that precedes my Afib, I do not get Afib. The AFA article and many other articles apply the term "causes" to things such as obesity and sleep apnea. I'm not sure why trapped gas would not be in the same category, i.e. a non-heart-function source.

Why would a doctor find that air deprivation from sleep apnea may be a cause of my Afib, but not the pressure of trapped gas? Since relieving the gas eliminated the Afib, why would that not be an important, logical first line of treatment for patients who report gut involvement, rather than higher-risk meds and invasive procedures?

Those are still the questions for me. I repeat them here rhetorically, not as rebuttal of your comments. I appreciate the opportunity to discuss the issue further.

Best wishes,

Fibnum

[mav7 in reply to fibnum]

Good points above about “trigger vs cause”.

It can become a matter of semantics. I don’t have the knowledge to discuss in detail. Would encourage you to continue to discuss with your medical professionals.

[bean_counter27]

Is it a case of "digestive issues" being more widely recognised as a trigger than a cause?

[fibnum in reply to bean_counter27]

If we apply the psychological application of the two terms,( i.e. a "trigger" is external and a "cause" is internal), to primarily physically manifested examples, I suppose that a digestive issue would be considered external from the heart and therefore labeled a trigger, whereas a cause would be an issue within the heart itself.

If that is the distinction, I have never heard it expressed by a doctor, nor is it clear in discussions of Afib causes in articles and journals that I have seen. No matter what label is assigned to the gut in the gut/heart connection, if treating the gut resolves all or most of the Afib problem, doctors should address that, just as they would suggest avoiding alcohol, losing weight or taking measures to avoid sleep apnea. Why are they so disinterested (in my experience with doctors and as evidenced in publications) in dealing with the gut?

[Buzby62 in reply to fibnum]

I have similar thoughts as mav7 and bean_counter27 , I prefer to think that something has caused my predisposition to AF and a way to manage the predisposition is to avoid triggers. Many claim to have great successes avoiding triggers but it can lead to madness for some. If a treatment can remove the predisposition then I feel for me that would be more successful than removing a trigger or triggers. Another trigger could be waiting in the wings to take advantage of the predisposition.

Just an opinion, I don’t have the knowledge to discuss the definitions in detail but we all learn our own ways to manage the mongrel condition and if something works or helps then great.

[fibnum in reply to Buzby62]

I accept your point in that should my Afib events return to being more frequent, I would consider other treatment options. If avoiding the trigger at this point works, I will not have ablations or take high risk meds. The only time I was in serious, Afib-related danger was when I agreed to take Tikosyn after being urged to by my EP for months. It caused a life-threatening time lag between chambers of my heart, and I had 3 days of magnesium drip in the ER to correct it. I don't want that kind of help!

I know not all can identify and avoid a trigger, but for those who can, more cooperation from Doctors could expedite the process.

Thanks for writing!

[secondtry]

Many heart medics historically did not include the Vagus Nerve and therefore did not see a connection with the digestive system that they felt confident in discussing. Possibly staying in their own silos and not wanting to tread on another colleagues specialty.

[Ppiman]

That list on the forum are not "causes" but associations, despite what they say. I find this all over the internet. Yet, as you rightly point out, a link with hiatus hernia and digestive issues is also clear enough from both anecdotal reports and from some studies. I suspect, however, that the prevalence of digestive issues is so wide and general that any causal connection with AF or arrhythmias is far less easy to make.

The actual cause of AF is likely, from what I have read, to be a genetic predisposition, but having high blood pressure, something that is also linked to so much ill health, would be my number one focus for treatment if I had it. A cardiologist I saw when I had atrial flutter (and, later, AF), prescribed 100mg daily losartan even though I had normal BP at the time for just this reason as he said there was good evidence of its long term protective effect on the left ventricle.

Steve

[fibnum in reply to Ppiman]

If one gets a sharp pain in the toe after, and only after, stubbing one's toe, it is not hard to discern that the cause of the pains is the toe stubbing, not a nerve problem within the toe. I see the toe stubbing as the "cause" which clearly precedes and initiates the pain.

If the toe aches without any external stimulus, one can see a neurologist.

Since with every Afib event, I have bloating and trapped gas build up over several days, which I can feel moving into my chest and eliciting heart palpitations, especially when I lie down, I have little doubt that it is the source of my Afib, especially because relieving that gas build up through change of diet, exercise and using gas pills has eliminated Afib almost entirely.

I went from Afib episodes every two weeks-ten days to 4-5 over the past 14 months. I still eat the wrong thing occasionally. I think the gut/heart connection is very well documented by my experience.

[Ppiman in reply to fibnum]

It must be wonderful to have found a link, and to have stemmed the AF as a result. I can't find anything that causes mine, and I have never found any effects from food or drink. I can't find that any link is scientifically documented, either; but, yes, anecdotally, at least, there's a connection. Equally, it must be said that AF varies enormously, waxing and waning for reasons no one understands. I went for nearly a year without any, then, back it comes.

What is also true is that most people get a bloated stomach quite commonly, many have hiatus hernias and very many millions have acid reflux, all without a trace of cardiac involvement.

I can't be sure whether my arrhythmias result from my stomach; or my stomach discomfort is caused by my arrhythmias. I used to think the former, but I am now just as inclined to think the latter.

Steve

[fibnum in reply to Ppiman]

I do not question that my heart is responding to the gas more sensitively and extremely than normal.

Because dealing with the gas also drastically relieved the frequency of Afib, I assume the gas was the trigger, (the Chicken from "Chicken or the Egg"?)

Al

[Chinkoflight]

Hi Fibnum, I see you are writing from the USA, my comments come from UK. The connectedness of the vagal nervous system is amazing in that so many key functions are controlled by this nerve pathway.In comments you have referred to self assessment using pulse and BP data. You seem to be describing ectopic irregularities and cannot be certain it's Afib from those measures.

I wonder what your access is in the States to having a LINQ ECG implant to monitor your heart 24/7/365?

While many people are afflicted with symptoms from Afib as I understand it, the significant problems arise from the consequences of an Afib event or continuous events.

I had a severe stroke out of the blue. Holter ECG monitors failed to record anything except Bradycardia NSR and ectopic beats. All other heart indicators okay and I'm not aware of my heart beating.(!) However a health initiative in the UK to reduce strokes is investing in wide spread use of LINQ implants. They have a working life of around 3-5 years, size of an AA battery. After 3 months a paroxysmal AFib event was detected. I was unaware of this, the hospital phoned me up to ask me what I was doing at a precise time .....! The importance of this was to change my medication from stroke antiplatelet to DOAC (anticoagulant) in order to statistically reduce the likelihood of a further stroke. Because of the Bradycardia I'm not on any Afib medication or treatments at this time.

The greater risks are Stroke and Heart issues, just reducing Afib, however welcome, does not mitigate against these risks as far as I am aware.

So understanding and finding your Afib is as important as reducing it.

Since my stroke I have engaged in a more active responsibility for my health and lifestyle with positive benefits for my cardiovascular and respiratory systems. But I still have an increased risk of another stroke and the best protection is the anticoagulant.

[fibnum in reply to Chinkoflight]

I have been told, each of the half-dozen times I went to the hospital with arrhythmia, that it was Afib. I feel very good and exercise fairly vigorously each night except when I have (rarely n ow) symptoms of Afib. I have had my heart scanned and had month-long monitoring with no problems found. I don't know what kind of monitor it was, but I will ask my cardiologist.

I regularly take eliquis, which is an anticoagulant.

Thank you for your detailed information, especially about avoiding stroke.

[Chinkoflight in reply to fibnum]

Hi, here is the US link to the device I have fitted. medtronic.com/us-en/healthc...

If they have already detected Afib and understood what form it takes repeated monitoring may be unnecessary and you are on the appropriate treatment it seems. Along with exercise etc hopefully all will be well.

I was stressed immediately before my stroke regarding some impending DIY jobs! Not more stressed than any other time in my life. It was out of the blue. Afterwards I was very anxious not least because it was unexplained.

22 months on I'm not anxious, as I'm doing as much as possible to improve my life! It's very therapeutic. Always look on the bright side of life #chinkoflight yesterday's sunset here in the UK

Scenery

[fibnum in reply to Chinkoflight]

I can imagine that a stroke of any strength is scary, dangerous and emotionally unnerving. I hope you remain free of it.

Fibnum

[Peacefulneedshelp]

Traditional medicine does not treat the whole person only the symptom of the one organ system. I firmly believe you and I have to be our own advocate and I have been told that by other doctors as well.

[FancyPants54]

They cite "hyperthyroidism" too. Not seemingly understanding that it's too high T3 hormone that causes Afib, and also too low T3 hormone. They never acknowledge the too low bit.

[2learn]

Hi, its just medical arrogance, my impression is the medical profession do not work holistically, they specialise too much. So v few medics look at anything outside their own specialism and often play one-upmanship games with other specialities, so heart docs regard themselves as more skilled and knowledgeable than gut docs.