I am having my first face to face meeting with the cardiologist next month, but he has been working closely with my GP and advising on medication for the past few months.
Following a 24 hour ECG my Verapamil dose was increased at the end of last week and I feel so much better. My heart is calm, my Kardia has shown only Normal Sinus Rhythm, my brain is working properly, I feel energised and able to easily do the things that had become hard work. In short, I feel like the real me.
Whilst preparing dinner yesterday I was thinking of adding chilli flakes to a sauce I was making for my husband. He loves spicy food but I stick to more bland stuff because I am consciously steering clear of anything that might be a trigger so the sauce was just for him. I opened a new jar of chilli flakes and because it was new I was unsure how many to use, so I thought I'd try a small one to test the heat. Oh my goodness! It was in my mouth for a millisecond and burned the tip of my tongue and lip. I didn't swallow it, I spat it out immediately.
Within minutes my heart was dancing around, I used the Kardia and it read possible AF. I couldn't believe that one chilli flake that I hadn't actually eaten could have that effect.
We had dinner (no chilli flakes) and when we had finished eating my heart felt calm again. I took a reading and NSR was restored. I've taken several readings since and all have shown NSR.
It could be coincidence, or it could have been the chilli flake. Can my heart really be so sensitive? Has anyone else had similar experiences?
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Long before my diagnosis I found that the slightest trace of alcohol caused strange things to happen, what I eventually understood to be AF. Even a bite of a bun with chocolate sauce containing brandy set me off once. I didn't even need to swallow it so yes if something gets to you it will happen.
It's amazing isn't it? I can eat chilli (not hot) made with a small amount of chilli powder so I can't have an allergy, but I would love to know why it happened.
Thank you Bob. Unfortunately I'm a bit behind the door with terminology and I don't really understand what a chemical shock is. Would it be a reaction of the nervous system or the immune system or something? Sorry!
it is the same reason my Cardiologist prescribed a very low dose of BB Metoprolol I take approx 10mg morning and night that’s equivalent to 1mg of bisoprolol. It’s not so much for my HR which is normally around 60-65 he said it’s to help temper down that adrenaline spike I sometimes get with stress or that shock from certain things. Whether it’s true or not it seems to be working
Thank you, Bob for stating it’s so clearly. An example of chemical shock: I had a wasp sting last summer and used an epipen. Within minutes, after a year free of AF since my first ablation, I was back in AF. Again and again. Six cardioversions and a second ablation later, I’m doing fine, but it was clear to my EP and me that the adrenaline triggered by the epipen was the cause of the reversion to AF. It may have happened anyway with some other trigger some other time, but that shot of adrenaline was without doubt the trigger. Stress can up adrenaline. Foods our bodies aren’t crazy about. Emotional shock. Lack of sleep that we push through. Caffeine. For me, big restaurant-style meals late in the day that make my digestive system work overtime—bringing chemicals to the rescue. It’s tricky.
Not with chili flakes - we eat spice daily and although I now moderate the heat, neither of us react. Whiskey though did exactly that to me, just a sniff and only with whiskey - which I love - no other alcohol. Very individual.
I’m very sensitive to chilli, a mouthful of too hot chilli makes me feel as though I’m having a heart attack but once it had the opposite effect. I ordered a ‘mild’ curry at a family meal but it definitely wasn’t, however, not to spoil the atmosphere I struggled to eat some. The next day I had violent diarrhoea but went from persistent AF to NSR 😂 Not keen to try that method again though….
Careful putting that out there or EPs might start suggesting a vindaloo rather than ablation. A cheaper alternative, although with the price hikes at our local curry spot, there's probably not much difference 😁.
I wonder how many people have a sensitivity to ingredients that they don't know about if they have no symptom AF like me. I firmly believe that the coffee I drank an hour or so before having an ECG triggered the AF which was picked up. I've never had any symptoms of AF before, during or since that ECG. (Caffeine has a long half life)
I'm really annoyed with myself because I didn't know I was going to have an ECG. I could have avoided that coffee - I don't really like coffee and have given it up completely now.
I now have adrenaline free local anaesthetic at the dentists because I get a racing heart from the adrenaline which I very much can feel. Once the dentist hit a vein with adrenaline in the local anaesthetic and I literally saw stars and fireworks - quite dramatic.
This is interesting. It's years since I had a local anaesthetic and I have a dental appointment in a couple of weeks to have a replacement filling. I didn't know local anaesthetic contained adrenaline. I'm definitely going to call the practice to ask about adrenaline free.Thank you for telling us about this.
I am also going to call my GP to check whether local anaesthetic is ok with Verapamil. The information leaflet says to contact your GP if you are going to have anaesthetic, but I don't know if it means local or general.
I hope it means general - I'm a bit of a wuss and can't bear the thought of a filling without anaesthetic.😕
Be reassured - Dentists NOW know all know this stuff - I’ve just been to the dentist for filling and had root canal about 4 months ago. Every dentist I’ve seen always checks your health history and the meds you are on EVERY time you visit. Dentists are very well aware that they must use adrenaline free anaesthetics for anyone with arrhythmias but know that they sometimes are not quite as affective if you need a really deep feeling. If they don’t automatically ask you for your health history and what meds you take - walk out!
Ten years ago, early days of AF I didn’t know about this stuff and I also had pass out moment as anaesthetic was going in, sent my BP into my boots so sent home in a taxi with huge apologies, didn’t see that dentist again.
I have to say I didn’t feel a thing for either of my recent treatments and am confident in the dentist I now see, I think that is most important. This is the third dentist I have seen since moving here 2 years ago and I had no confidence in the previous two, first I think was so frightened of my conditions (not just AF) they didn’t want to touch me and the second was the opposite and too blasé. Bit of a Goldilocks situation 😆
Unfortunately, adrenaline free anaesthetic loses its numbing effect quicker so I've had a couple of painful procedures. Last time, after discussion with my dentist and EP, he used an anaesthetic called Articaine, which is low adrenaline but acts in a different way to usual to do the numbing. I know it can't be used for every procedure but may be worth discussing if you are sensitive to pain.
I usually don't have anaesthesia for a straightforward filling so if you can't face a filling without it, I'd discuss whether adrenaline free or Articaine is best.
It's not without anaesthetic. They use another anaesthetic that doesn't contain adrenaline. IT doesn't last quite as long so you may need a top up. I always have it.
When I have a dental appointment - I get an online form to fill in to give details about any medications or medical problems since the last appointment. I think as the dental patient you should let the dentist know any meds or problems - hopefully the dentist will be aware of risk factors.
I was thinking of asking what resuc equipment the dental surgery carry in case of emergency!
I filled in the form when I had my checkup but the dosage has increased since so I'll inform him, thanks for flagging it up.I can see where you're coming from re the resuscitation equipment🤣 I'm very aware of the fragility of life nowadays!
We live in a small village and there is a defibrillator outside the school down the road and one outside the village hall in the other direction. I've timed the walk to both to see which is the one to use in an emergency. The school has it by half a minute 🤣.
My husband thinks I'm barmy but that's a full minute there and back, it could make all the difference.
I don't think you are barmy...I walk my dogs in the woods, hardly anyone else to be seen, and they are big woods. I started on the 'what if' scenario....so I always take my mobile and I got a medi alert rubber wrist band just with my ICE details on it. But haven't shown it to my other half - too embarrassed!!
I love walking in the woods with my dog, I rarely meet anyone and I used to leave my phone at home because I love the peace and quiet. My mother used to tell me I shouldn't go alone in case I got attacked, but I would say anyone coming to the woods looking for someone to mug would likely be disappointed - they'd give up and go home before they met anyone.
I haven't been to the woods for a while because I haven't had the energy for a proper walk but now spring has sprung I'll be heading off again - definitely with my phone fully charged. I think your idea of the medi alert band is great, I'm going to get one.
All dental surgery’s carry. A full first aid kit and nowadays have a defibrillator. The nurses are trained to know the signs of everything from anaphylactic shock to to a faint. We had training twice a year , can’t remember all of it now though!
Sorry about your mishap but it's really useful reading these responses. I'm pretty sure I'd react to chilli like that! Bob talks about chemical shock and I think we can forget that food is also chemistry. I cannot tolerate melted cheese (normal is fine) and with even a bit of alcohol it's like Russian roulette. So I avoid both. You'll probably find that the chemical make up of chilli has a strong active ingredient that your body reacted to. And being on a presumably empty stomach possibly exacerbated the effect. You may well be able to tolerate a little chilli in a cooked meal. If you'd like an alternative (I get violent hiccups with chilli) try cayenne pepper. I find it gives a kick but milder.
It's not the flake, but the muscle tension that arose from it, I feel sure. It could have been ice cold water, or a glass of coke; constipation, bloated tummy, or even hot coffee (caffeinated or otherwise); even kneeling down or stretching high. All sorts of things on the right occasion to set AF off. The context is all.
Given a certain stimulus, the oesophagus, stomach, diaphragm and intercostal muscles tense, pushing and pressing the heart. These physical effects cause ectopic beats in many people it has been shown, and in prone individuals, those PACs will set off AF.
I have always thought that for a specific food to cause a "chemical" effect (i.e. something in it - which would be a chemical to the body), well, it would be delayed for a start for it to enter the blood stream. There are people with specific allergies or other things, of course. I am meaning more generally. The physical explanation of the heart being pulled and pushed is well accepted by bloating, kneeling, constipation, etc.. In a major study in the Netherlands (if I recall) on "triggers", few people could be sure that they had a specific thing that started off their AF.
I was going to say similar. More likely that it was something that made us jump and tense up, which could be like sticking your hand in cold water or tasting something bitter. I eat sugar but if anyone puts it in my tea or coffee, I ho into tense, spit it out mode.
I agree with what you say. I spoke to two cardiologists/ Ep's about 'triggers', i asked them about my first episode when I unknowingly had Shingles and h pylori- they were adamantly, of the opinion that they were basically a coincidence and electrical fault can develop as we age that's all. Nothing as such to do with triggers, (fault is there already)although I can understand Steve's explanation.
I guess what they were saying was ,the underlying fault is there otherwise the 'trigger' wouldn't have any effect . Chicken or egg.....
That’s it! I have AF because of my genes and leaky mitral valve but I have a little list of things likely to trigger an episode, one I might get away with but a combo is too much 😬
Yes - that is how I understand it. The age-related issue (or whatever: genetics, obesity, apnoea, blood pressure, thyroid, other diseases…), is the “root cause” that increases the likelihood of things being set off electrically.
It’s hard to imagine a specific ingredient causing the heart’s electrical disturbance.
I have none of the above and have (as far as I'm aware) always been healthy. My only operation was a tonsillectomy in my teens. And I take care of myself through diet etc.But all my mother's family going back as far as we know died from stroke or heart failure.
Ah - I just listed the things known in general to be associated. I am similar. My mother was never diagnosed but always I recall her having "palpitations".
With cardiovascular disease also in our family I take statins, too.
Yes I get that. Like my husband had to go for an ECG last Wednesday and I was telling him to sit quietly, no caffeine etc. but he said he wants to find out if there is a problem linked to any triggers so he was just going to do everything he normally does. As it happens his ECG was fine - he had omron readings showing irregular heartbeat before, but he'd been very ill with organising pneumonia which GP said was the probable cause.
Hey Steve is it correct that the Vagal nerve travels along the areas you mentioned and if so could that be the likely culprit that kicks off our ectopics and AF given the right stimulus
It does and I questioned the cardiologist about this. He replied that it was an unlikely explanation for heart problems and in his view, very unusual. He felt it was an internet myth in general (he’s referring not to vagal AF, by the way, which is not the same thing at all). Pressure on the vagal trunk, he said, first causes severe bradycardia followed by swings of fast tachycardia. He said it would affect diverse systems, too, as the nerve innervates so many other organs.
He explained that any physical pressure on the heart can stretch its cells and this is known to set off ectopic beats and those can trigger AF.
This is what often kicks off my tachycardia. Bending over, trying to do too many things too quickly, which tenses up muscles, gulping down cold water too fast, etc. And these can also be the same things that resolve the tachycardia. All very “vagal”.
Fascinating. Muscle tension has much to answer for, I reckon, that and squashing the stomach, too. The specialist I spoke to about vagal AF told me that pressure on the vagal trunk (the nerve that runs through the diaphragm with the oesophagus) would cause severe bradycardia.
Indeed, but what you are describing is more vagal induced AF, rather than from a stimulant. I have found that taking any type of stimulants sets me off either immediately or within half an hour, it is insane. And when I have tried to diet and cut down on my carbs, I have also entered AF. Every single damn time. Asked dozens of cardiologists (worked and lived in many countries and places around the globe, so got to see a lot of them haha) and they never, EVER had an answer for me. Their obsessive focus on ONLY THE HEART is frankly, rather stupid and shortsighted. They will give you drugs and/or surgery. But never once has any of them ever offered to LOOK BEYOND and see just WTF is giving you the AFs to begin with. Maybe one day Western Medicine can move beyond just treating symptoms and curing actual root causes... one day...
You make a very good point, and the frustration is something many must feel at times. I often feel that our medics over-specialise to the point of ignoring the bigger picture but, to be fair, as my son used to tell me when I tried to help him revise for his exams at medical school, the body is vastly more complex than most people could ever imagine and the closer it is observed the more there is still to uncover.
I recently read fascinating studies that theorised from animal work that the root cause of arrhythmia was from some kind of "stretching" of the heart cells, perhaps from the effects of the arrhythmia enlarging the heart, wear and tear from old age, obesity, blood pressure, arteriosclerosis, "extreme sport", inflammation, genetics, and other causes. Once the cause is removed, the cells seem to recover well, but forever remain prone. The trigger could, I suppose, then be a whole range of things that stretch the cells just that bit too far.
One thing that seems to be the case is that keeping weight, blood pressure and glucose levels low, avoiding sleep apnoea and lethargy, from early childhood through to old age, seems to be the way to a healthy heart. Oh and... good genes.
I’m sure the mind can trigger an episode that you might not have had otherwise, just thinking “oh I shouldn’t have done that” can trigger an adrenaline rush. As us AFers are all sensitive to something upsetting our hearts we can overreact. I’m sure I’ve done this a few times myself but I have no control over it.
Similarly distraction from thinking about it can revert you to NSR in my experience.
I had a wisdom tooth that had a root that curled under some of my other teeth and was starting to cause a problem. I was on anticoagulants so my dentist refused to have anything to do with it and referred me to my local hospital. The dental surgeon there was scathing in his opinion of 'cosmetic dentists chasing the easy money'. I tod him of my AF history, (at that point, two years AF free after minimaze) and asked for adrenaline free. He said that in AF cases he generally used normal anaesthetic unless the patient had a history of post treatment AF. He explanied that the adrenaline kept the anaesthetic at the site of the injection. In his opinion, the extra injections required for adrenalin-free and the higher likelihood of pain was more likely to cause AF. It went ahead with no problems.
I recently had a crown at my 'cosmetic dentist' using ordinary anaesthetic, and everything was fine. I think the bill was more likely to tip me into AF than the procedure.
It looks like a bit of a minefield now after reading your post. I suppose my best course is to ask the dentist about adrenaline free, Articaine and ordinary anaesthetic and take his guidance. I'll ask my husband to drive me to the practice so I won't be alone.
I've never liked going to the dentist since Butcher Latham (as he was known) used to use gas to knock me out, but I didn't expect it to be so worrying nowadays.
Hi, my wife is allergic to chilli and it is irritating the way so many chefs and so much supermkt food add it to everything without telling people. Seems impossible to have tuna in a restaurant without chilli. I suppose now you know just check everything and read the small print.
I got caught like that, didn’t register ‘spicy tomato sauce’ as having powerful chilli in it. I made a terrible fuss, one mouthful made me hyperventilate and they had to give me a different meal free! There is one Italian restaurant chain (Ask, since you ask!) that hardly seems to be able to provide a dish without chilli 🤯
For me its also a question of how your mind/stress and worrying about things can govern your body. If I do something I think could possibly be a trigger (over ambitious gym work-out for example) I worry & stress out about it so much that then I worry that the worrying could cause an attack! Perhaps what set you off was worrying about the chili flakes and not necessarily the flakes!
Based on my own experience and many other reported reactions such as yours, I believe that there is a condition I would call a hyper-gut-sensitive heart response which can trigger Afib from even small amounts of an irritant ingested.
Figuring out what the irritants are and religiously eschewing them can relieve many of us of Afib episodes. There should be intensive research focused on the gut/heart relationship, but the medical community seems slow to take any interest.
Capsaicin, found in Chile, is a cardiac stimulant, so that very well may be the cause.
But don't rush to judgment that it was afib, just because the Kardia said so. It could also be a run of ectopic beats that can fool the Kardia. Unless you're confident reading the ekg yourself, send a copy of it to your ep for confirmation. Alternatively, if you subscribe to their premium service, you can have one of Kardia's cardiologists read the ekg.
Thank you Jim.I have printed off a copy of the ECG to take to the cardiologist and made a note of exactly what happened.
It's interesting to see what can affect your heart rate. To be honest I think things that don't affect it would make a shorter list than things that do! It seems almost all of every day life can affect it.
Cardiologists normally, NEVER give a damn about the food or drink you consume every day. In my humble NON-MEDICAL opinion, big effing mistake. Black pepper, aspartame, msg, etc. all have caused me to go into AF. No ifs, or buts. Food does and will make your heart go into AF. Don't let any doctor tell you otherwise. In fact, I read a study that found 40% of AFibbers also suffered from gastro-intestinal issues so there is a huge connect between gut health and heart health as well as being affected by what we eat. I had a huge breathing and heart problem back in 2007 after a single tablespoon of a mildly spicy Thai curry soup. It was delicious but after that one single tablespoon, I had to go to the hospital.
Try to keep a diary, that way you can start seeing trends and connections.
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Return of the AF
very early days
