AF triggers

[GardenLover2]

My AF mostly starts in the early hours of the morning, picked up on my Fitbit. I am unaware of it until I wake in the morning and notice the fluttering sensation in my chest. Does anyone else have this and what do you think are the most likely triggers. I generally have low blood pressure, often below 90/60, so wonder if it drops low in the night and that triggers the AF. I also often have nightmares so I wonder if that causes it. What do others think and experience?

[BenHall1]

Perhaps you may find it useful to investigate the Vagal Nerve - a comunications superhighway between brain, heart and gut ! Then perhaps you may wish to consider food you eat, particularly the night before an event.

Basically if you eat food which causes some inflammation/ some dysfunction of the vagal nerve and it kicks off then it will trigger the fairly well known heart/gut relationship. I solved these problems back in the day by consulting a Nutritionist who advised a diet in various shapes and forms.

One of the first things the Nutritionist recommended was to go gluten, wheat and oats free.

Also consider times you have your last meal of the day, earlier the better (within reason ). Also look seriously at your overall diet and sizes of meals.

Doesn't work for every AF'er but for me most certainly it has. That said, it is not a quick process either, but well worth looking at.

John

[GardenLover2 in reply to BenHall1]

Thank you John, I will look into this.

[LouBrig in reply to GardenLover2]

I was exactly the same! I read an article on inflammation and its associated impact on AF then decided to cut red meat out of my diet. I have not had an episode for over 15-months. I was getting 3 or 4 a month prior.

[Pommerania78 in reply to LouBrig]

Why do you think red meat is a problem, and what other changes have you made? Thanks.

[LouBrig in reply to Pommerania78]

I am not entirely sure. The journal I read suggested red meat/saturated fat contributes to inflammation. Inflammation and higher cholesterol can trigger AF. So, after removing caffeine, dark chocolate and alcohol but still experiencing middle of the night episodes I thought I’d try to removing that too. I’ve not had an episode for 16-months and I was having them 4/5 times a week. This was against the backdrop of a failed Ablation 3-years prior. I haven’t changed anything else. I eat chicken and fish now.

[GardenLover2 in reply to LouBrig]

That’s very interesting about cutting out red meat. Thank you- worth a try.

[Pommerania78 in reply to BenHall1]

How long were you on a gluten-free diet before you had a discernable difference in your body? Thanks.

[mjames1]

Not familiar with Fitbit, but does it generate an ekg that confirms afib, or are you just thinking it's afib based on heart rate? If it's truly afib, early morning episodes are sometimes linked to sleep apnea, so a sleep study might be something you want to look into.

Jim

[GardenLover2 in reply to mjames1]

Hi Jim, the Fitbit - Inspire2, can detect AF, I then confirm it with a Kardia device before I take my pill in the pocket - Flecainide. I did not know that AF is linked with sleeping apnea, thank you for the information.

[secondtry in reply to GardenLover2]

Yes sleep apnoea one possibility, suggest you start simply be trying a nasal strip at night, I always use BreatheRight small/medium. I have had a couple of sleep tests and only have mild SA.

[GardenLover2 in reply to secondtry]

I will definitely give Breatheright a try. Thank you.

[opal11uk]

Mine too was at night, just as I was going to bed.......not a lot of fun and not a lot of sleep for me. My trigger I believe was and is stress, stressful job, heavy workload, 140 staff and so on, I loved my job and believe it or not I thrived on the stress however my heart did not, the P/A/F led to a stroke and I was then forced to give up the stress.....I retired at 56.

[secondtry in reply to opal11uk]

Yes loving your job is a stress trap and following the news/politics and other shenanigans affected me (sleep & AF) so now no news and no computer after 5pm.

[GardenLover2 in reply to opal11uk]

I am so sorry to hear about your stroke. I use to work with people who had strokes and I so wish to try and avoid having one, which in itself makes me feel stressed. What I have noticed also, my AF seem more frequent when I am not only stress but sad and stress, caused by things that have no obvious solutions.

[opal11uk in reply to GardenLover2]

If you take an anticoagulant this should prevent you having a stroke, at first my cardiologist just prescribed 375 mg soluble Aspirin a day, it wasn't until after the stroke that I went on to Warfarin. I am convinced the Aspirin saved me from having a more severe stroke, I fully recovered from mine after approx. 2 years.

[GardenLover2 in reply to opal11uk]

I am really pleased you recovered from your stroke. I am on Edoxaban.

[secondtry]

I have the same issue now often waking 2am with what I believe is 'Flutter' (need to confirm with cardiologist next month), I then take one of my daily Flecainide 100mgs doses and go back to sleep and usually fine when getting up.

As for causes and solutions; I would say low BP & Oxygen are contributory factors. As mentioned nasal strip, going to be not too tired and maybe try eating a pice of toast or something just before bed...I'm afraid it is trial and error as we are all different. I have also found 3 pillows and not sleeping on my left side helps.

[Pommerania78 in reply to secondtry]

I read different things about sleeping on both sides. Why do you think avoiding the left side is important? Thanks.

[secondtry in reply to Pommerania78]

Comments here suggest more pressure on the Vagus Nerve on the left side.

[AustinElliot]

All but a few of my episodes were when I wake up. I got an Apple watch and I can now look back to see when the episode started. The last few have been around 4 or 5 in the morning, my HR jumps up to around 90-100 vs the normal sleeping 42-55 or so.

I don't think I have nightmares, but when I have to go for the 2 am pee, I try real hard not to wake up fully, that might help, but who knows.

I have not tried the gluten free diet, but I am watching my salt intake. I am pretty sure that between Parmesan cheese and salt in Powerade it brought on at least 3 episodes. My last episode was 2.5 months ago, prior was 4 months. (before that it was getting worrisome at once a month)

Hope that helps.

[Kendalghost]

My episodes happened during the night and the EP, after the second ablation which failed said I needed a pacemaker. This is due to having a very slow heart rate of around 40/41 and he thought that during the night this dropped even more to 30. The heart realised this and tried to speed up and flipped me into AF. During the ablation my blood pressure dropped to low and I had to be medicated and my heart rate to 30. Does your fitbit record your heart rate?

[JOY2THEWORLD49]

Hi

It is normal to have your BP including H/Rate rise early morning.

That's why BP medication is taken at PM.

Most strokes, heart attacks happen early hours of morning.

My H/Rate always goes down to average 47bpm. Never changes except Metroprolol gave me pauses at night. Did not control my H/Rate Day avg 186 making me at rest most of day, exertion, stairs, and steepness out of the ?

Changed by a H/Specialist to Bisoprolol not much better at 156 but no pauses.

Private H/Specialist introduced CCB Diltiazem 120mg only. I've never looked back. My regime continues now 2 years 5 months ...

Diltiazem 120mg AM for control of H/Rate Day to 60s Night stays at 47avg bpm.

Bisoprolol 2.5mg PM for control of BP.

cheri JOY.

[108cat]

My AF episodes are also always at night early or morning, and my cardiologist says I have 'the vagal type' AF .. I have low blood pressure like you 90/60 (which is fine as long as you don't feel faint breathless etc.) and I have low resting HR (in mid 40s).

My cardiologist said when the resting HR is low at night, then the ectopic beats have more chance to slip in and trigger AF ...

Like you I'm on Edoxaban, with PIP Flecainide. I have monthly AF episodes and try to deal with it through practicing deep breathing and diet etc. prefer not to take the Flecainide unless it goes on longer than say 20mins.

It's possible your nightmares are a side effect of Edoxaban, I've heard it can cause nightmares, vivid dreams etc. I did have them for a while.

I'm also a Garden Lover .. and just yesterday (Friday) forgot the time in hours of strenuous gardening, completely exhausted myself, probably dehydrated, but felt good to be doing a normal amount of work .. then hey presto at midnight an AF episode, it resolved in an hour with Flecainide, thank goodness.

Have you seen Dr Sanjay Gupta you tube video where he talks of the vagal type of AF between 9pm and 9am.

The good news from my cardiologist was that the vagal type of Paroxysmal AF tends not to be progressive. There's no guarantee of course but it gives me hope ..

Today exhausted, I'll just go and look at the garden ...!

best wishes ...

[Madscientist16]

Have you been tested for Sleep Apnea? Many nighttime episodes are linked to this condition. See your medical professional for a sleep test. Many of these tests can now be done at home.