A few days ago, on turning onto my right side to go to sleep, after about 30 minutes I noticed palpitations (rather “heavy”ectopics and a slower than usual heartbeat which was “stuttering”) This lasted for several hours until I fell asleep. Last night this pattern repeated again, but this time when I sat up I went into AF at about 128 bpm. This lasted for about 45 minutes (much shorter than usual- the usual duration is at least 6 hours). However, when I turned to my right side again to go to sleep , the palpitations, heavy ectopics and slower heart rate etc. started again. I turned onto my back and the symptoms seemed to improve. This has never happened before- once an episode of PAF is over the heart settles down. I’m worried that I could go back into AF again. What might be causing this unusual new pattern?
Unusual positional ectopics and PAF - Atrial Fibrillati...
Unusual positional ectopics and PAF
You said it - postural. Probably irritation of the vagal nerve. I have an electric bed so it’s easy for me to lift the head of the bed just a fraction and this seems to stop this happening for me. Was suggested to put strong bricks under the legs but my old bed didn’t like that and broke its’ supports!
Or just don’t lie on your right side. For many people it happens when you sleep on the left side.
Problem is I get lots of ectopics when I sleep on the left left (since a bypass)! The vagal nerve explanation sounds quite credible- but I’m not sure why this would suddenly start. I’m also wondering if the medication I take (10 mg of Bisoprolol) is becoming less effective.
You are prone to arrhythmias so this sort of thing happens. As soon as I got rid of one type. another would kreep along and move in.
I have a wedge which elevates me enough not to have issues.
What you're describing also happens to me either being on my right or left side. Though not all the time -- probably two times a week with a few ectopics going on when on my side. I then will also go into afib but it's not 45 min only around 30 seconds. Never happens when I'm upright and in the day. It is completely different from when I am in a full flutter/afib episode... that I know for certain. I will get the ectopics and sometimes short 30 second afib when on my side, but they do not go into my usual full blown flutter/afib episodes that can last 4 to 5 hours. And I take a calcium channel blocker for my afib/flutter not a beta blocker. I assume it's the calcium channel blocker (rate control and lowering blood pressure) that keeps the big episode at this point at bay. But since I'm paroxysmal this could change who knows when in the future. Fingers crossed.
I can only speak to my experience since everyone is different in how and why it develops, but for me it acts vagal. When lying on my side it increases sensitivity on my vagus nerve to heart position. And depending on that day's stress, lack of sleep or just plain overdoing anything makes it worse and my heart positioning doesn't like it.
Only after being diagnosed with my first afib/flutter episode have I also developed alongside it a vagal heart that's sensitive to pressure and blood flow when positioning.
Yes, lack of sleep and stress do seem to be factors. Thanks for the reply.
Listen to your body and just sleep on your back for a while.
Why it has suddenly started could be for a number of contributory reasons including as BobD says prone to arrythmias. If you can't think what leave it a month and try the right side again.
I have found Left Side definitely a No No and right side or on my stomach usually a short time only before, if it doesn't feel comfortable, I listen to my body and turn onto my back.
Unfortunately , -I find it difficult to sleep on my back. I suppose it get easier with practice.
The slower heart rate could be said to result from an increase in vagal tone, and the AF from an increase in adrenergic tone caused by heightened stress levels or even from sitting up. Vagal tone increases naturally as we relax towards sleep; this seems more likely than pressure on the vagal nerve itself but I suppose some kind of postural change might have caused that. Another explanation is that the heart was pulled and pushed a little, something that a bloated stomach can bring on, or even a gulp, or movement, since the stomach and oesophagus can both press against the heart. Ectopic beats are the result of such disturbances and are known to be able to bring on AF.
These things will always remain a mystery, wouldn't you say?. Explanations such as mine above is just a guess and not much use in practice, let alone helpful. At the root of it all, I suppose, is what we all have: a more than usually fragile cardiac conduction system, one whose sensitivity waxes and wanes for reasons that must forever remain mysterious.
Mine is pretty fragile at present and as bad as it's been since the difficulties I had during blanking period following my ablation in 2019. Palpitations are as hard to deal with at times as my much more occasional AF. What a life it can be!
Steve
Palpitations do seem to wax and wane, but are very annoying and can often lead into AF. I think stress levels are definitely a factor in my case. I’m hoping things will settle down eventually.
I hope you find the reason Sam. But this AFIB of ours is definitely a weird animal.? Iv tried all sorts over the years to try pinpoint a cause for AFIB and troublesome ectopics but to no avail unfortunately.!!!
Best wishes mate.👍
Ron.
I’ll try breathing exercises before bed and see if they help. I was ok ( as far as I know) yesterday as I fell asleep immediately.
I couldn’t slow breathe for the rapid anxious breathing interfering with it at one time.!! I’m not too bad these days thankfully.👍
Thankyou though Sam, much appreciated.👍
Afib, palpitations and ectopics
My AF story (well part of it anyway)
Ectopics / unusual sensation 
