At the risk of driving myself round the bend looking at occurrences and triggers of my AF, I have been noticing a trend. All my attacks happen at rest, either on the sofa or in bed, at home - and weirdly the majority are on a Friday night or a Saturday day/night. I have never had one at work so far or say out and about or exercising. I’m sure ultimately it just has a mind of its own but I wondered if anyone else has noticed similar and with this in mind if I can do anything to reduce/eliminate the attacks. It’s a minefield! 🤯 I also wanted to mention that my first ever attack was when I had to hold an urgent bowel movement in to find a toilet in public (sorry!) and after ‘release’ (where I felt faint) the palps started (didn’t know it was AF then!).
Timings of AF attacks /triggers - Atrial Fibrillati...
Timings of AF attacks /triggers
I suffered from episodes exactly like you do….at rest ( an hour or so after eating on sofa) or during the night and like you, it was usually a Friday or Saturday night 😳 It’s not unusual to have Afib after eating, or during the night at all…during the nights can be caused by digestion too ( always make sure 3 hours after food before bed) ….but I have no idea why a Fri or Saturday….perhaps it’s because the body is more in a relaxed state on those days as coming towards the weekend?
I used to have alcohol on a Friday or Saturday night before I was diagnosed too, so that may have played a part? or perhaps a bigger meal is eaten on those nights?
You will indeed drive yourself mad trying to work it out!
I did have an episode which totally threw me, after a brisk power walking episode, ( only half hour walk) when I bent down to take off my trainers, as I came in the door….so that action triggered it 😳 watch out for that sort of thing…
Sounds similar to me and others have said it points to vagally-mediated AF. My triggers are rest, heavy meals, alcohol - but I can also do all those things another day and be fine!!
Hi Joey. If only we knew the answer, it would be like winning the lottery, don’t you think? Anxiety and large meals are my main triggers. Everyone has their own. Your first attack must have been an anxiety trigger, to say the least! I tend to hold my breath when l am anxious because l am so tense. Breathing properly is essential to controlling the anxiety, so l have to work very hard at that. Why your attacks happen while you are at rest is a mystery, as all AF is. It is such an individual and complex condition. You have to find answers from your own body mannerisms and listen to what it is telling you. Bad reactions to things such as food, drink, sleep and excercise etc. It took me three years to get into a routine and adapting my life to accommodate this monster. Don’t let it drive you mad by trying to reason with it. It won’t let you. Take care.
It really is a strange beast! I am trying to think that I have it in my life but it is not my life but sometimes are harder than others! Seems I may have vagal AF but who knows! Avoiding heavy meals, sugar and alcohol for now. I’ve never had one when really anxious so the bowel episode may have indeed been the gut/heart connection (again, vagal nerve). Thanks.
Could be Vagally Mediated PAF - triggered by rest rather than exercise. Have you tried exercising hard for a few moments? Works to stop an episode for some.
The bowel incident could have upset the Sympathetic/ Parasympathetic balance ??
This does seem to fit what I experience. A fast walk up a hill has stopped an episode in its tracks. Bowel issues, heavy meals, relaxing, alcohol…all triggered episodes in the past. Thanks.
It just goes to show how divisive AF is. If l excercise during an episode my already high heart rate goes through the roof. I just have to sit and curl up in a ball, doing breathing excercises to lower my pulse. An episode makes me quite ill.
if I exercise while afib my heart rate goes down fron ~140bpm to ~120bpm. After about 20-25minutes it will drop to 90, quite suddenly, at that point I’m in NSR and can stop exercising.
It’s so interesting to hear how others cope and find a way through this. Your regime sounds much better than any medication and you have such an advantage in being able to control this monster yourself. I am the complete opposite to yourself, which makes this condition so difficult to understand, not only for us but must be for the medics as well. Take care.
This is my experience, as well!
My triggers are when I’m rushing about or when I drink coffee so I now drink decaffeinated coffee instead and I make sure I’m up and ready on time. I was once rushing to get my 6 year old daughter to school and ended up in hospital with an event.
Interesting - mine is the opposite and I rush about a lot!! This beast is so different for all of us!
It could be coffee not caffeine. Before I went into persistent, now permanent, though asymptomatic, AF, coffee always appeared to be a trigger, but caffeinated tea wasn't. Decaf coffee also gave me AF. I've not had coffee now for 16 years.
hi Joey. Over the last 14 years I’ve getting to know my monster I have noticed the same pattern as you. 90% of the time I get attack when I’m asleep which wake me up.. I think this is triggered by changes in the heart rate during the normal stages of sleep. The other triggers are alcohol and caffeine and anxiety. Reading the replies there seem to be a lot of commonality and I wonder if there’s been any research on this. I agree with the connection to vagal nerve disturbance. I have been suffering from long Covid which also affects the vagal nerve and my last AF attack was after a Covid vaccine. I do a lot of breathing exercises And yoga. Fortunately, I haven’t had an attack for many months since being on amiodarone and now dronedarone. I’m interested that some people stop and attack by indulging in vigourous exercise. If an attack is caused by changes in the heart rate then forcing a change in the heart rate might well reverse it.. worth bearing in mind. Good luck
My AF started the same way. Then gradually got worse over 6 months. Happening at work lasting longer etc. Increase in drugs was no use.
Only ablation corrected it 3 years ago.
My AF comes on, like with many other people, with alcohol, heavy meals, indigestion, anxiety and rest. It almost always happens in the evening, most commonly around 10pm. Also possibly it's triggered by the body overheating.I kept a record for many years with a note of the circumstances and the most common trigger was the upset stomach. When I reported this to doctors years ago, they rejected the idea.
AF is a strange condition - some years ago I was in the Soviet Union and had an attack which ended abruptly when I walked into a bathroom and the light bulb exploded.
I like that! I’ll try to find an exploding light bulb if I slip out of rhythm. (-:
hi joey, 99% of my AFIB episodes are when I’m resting too. either in the early hours or late evening !! I have had the odd episode at work but it’s extremely rare.!
Iv never been able to find a trigger and nearly sent myself insane trying to find it?🤪
All the best mate
Ron
My AF started 2 years ago and I could predict it like clockwork - every Saturday morning on a golf course. So I traced it back - so I thought - to the McD coffee, which I had been having for several years before playing without issue. I even spoke the manager and asked if the source of the coffee had changed, but he said no. I stopped the coffee, but the AF continued every Saturday, I was going crazy trying to work it out. Did tons of research on Dr Google, came across POTS via Dr Sanjay Gupta videos, made a lot of sense. I spoke to the GP about the hear fluttering (before I knew it was AF), and about the possible POTS trigger, she basically marched me out of her surgery and told me learn to stand up properly!!!
Then I had a trigger a few months later after bending down gardening and was convinced it was something to do with bending and possible pressure between the stomach/liver/heart but the episode was bad enough to warrant trip to A&E.
Tests followed, cardiologist said unlikely to be POTS blah blah, gave me bisoprolol as a PIP (my choice) but since then the occurrence is less predictable as I hardly get it following bending, but once every 2-3 months for about an hour. I take magnesium, zinc, vit D, etc that are heart healthy supplements and the episodes are infrequent thankfully.
But in answer to your question, mine was predictable like yours for a while but now the AF giant had been triggered it is with me less predictably and I hope I keep it at bay with AF friendly supplements.
True. Those supplements have kept me Afib free since my last episode in 2021.
Bending down and doing garden work after a meal triggered an atrial tachycardia event post-ablation. I don’t do that anymore. After I eat, I rest and digest.
Thank you for posting this issue and do keep trying to fathom it out.
I have had and still am having similar experiences and and I believe the main culprit (other issues also contribute in most cases) is the Vagus Nerve not working competently due to often a long historic period of too much stress/ poor lifestyle choices.
I resort to an old car engine analogy to try to explain. If you remember the choke, it's like a choke getting stuck out and not returning slowly and normally ie stress is OK if short term and the VN will adjust slowly back to normal. However, too much stress and for too long and the VN stays transmitting 'full alert' and then when resting suddenly drops too quickly triggering AF as the heart is affected. I don't think I explained that very clearly but hope you got it!!
The solution I am pursuing is long term normalising stress levels not eliminating them completely. I hope then the body will take over and the VN will return to competency. Patience will be required 😁.
hi
I’ve had AF for only 4 years now but mine is triggered by dehydration mainly and I have to drink at least 2-3 litres of water a day or bam it comes. Whether it’s because I have the added complication of when I get AF I get Left ventricular obstruction as well which gives me bad chest pain and I have to go into to hospital each time because of it
Most of the time I’m really good Atr remembering to hydrate but with the added hot weather it’s got me quite a few times this year
Would be interesting to know if the same for others
I have just decided one of my triggers is the coating flavour on crisps. Have always snacked on them but now changing snacks habit
There's not much evidence of "triggers" even though many seem set on finding them. However, the weekend is, I gather, well known for bringing health changes - or at least I was once told that by a doctor. After the stress of the working week, Friday night onwards brings a different emotional response and this can, I was told, lead to various health issues emerging. Your own response seems to be to develop AF.
The trigger might be that the working week tilts the central nervous system balance towards a more adrenergic / sympathetic response (i.e. more "flight and fight" prepared), while the end of the week brings the balance in favour of relaxed cholinergic / parasympathetic nervous system activity. Some doctors have theorised that there might be two "basic" types of AF, each triggered by the two different CNS states of balance.
Steve
Thanks for that. It ties in with what I’ve read. Interesting what you say about lack of evidence re triggers - my episodes always came on after red wine (never beer) and heavy/sugary meals. But then I could do all of that 100 times and not get an episode. So maybe they’re not triggers at all! Baffling!
Indeed. It’s a strange condition. I get so many palpitations that aren’t AF, too, which complicates it all.
Yesterday was like that and then, when I was in bed at 11pm reading peacefully, I noticed that my throat felt somehow hot and eventually it dawned on me to check my Apple Watch. Sure enough, AF had started and continued till around 4.30am. Thankfully I had some sleeping tablets to get me off as I otherwise just can’t sleep when it’s on.
Steve
Iam retired so every day is the same for me ; yet my episodes always start at the weekend.. So on the odd occasion when l have had to go into hospital, the consultaltant is never there.
Yes - don’t be ill at night or at a weekend in the UK, eh?
Steve
Too true, or bank holidays.Shirley.
That’s very true Steve. I know a friend who used to get a migraine at weekends, or when in relax mode. I also know a school teacher who used to get a very bad cold every time the school holiday began. Again relaxing mode. The human body is a mystery.
hi there - I too was looking for some reason (mainly so I could avoid) and mine too are at rest on the sofa usually mid afternoon absolutely no idea why. When I asked the cardiologist this question his answer was not helpful ‘if I knew that I could retire and live in the Caribbean’! So it seems looking for answers is really difficult and can end up with you restricting your activities to try and avoid an episode. My first one was after a bath and so I only took showers for months afterwards but then ‘braved’ a bath with no ill effects. It is I think as others say, sometimes it happens and sometimes it doesn’t! You are not alone
Yes, it is a minefield!
This is a great question ... I feel it's good to understand as much as possible and ideally figure out the triggers - it gives me a feeling (illusion?) of control which lessens my anxiety.
Night time PAF is what my cardio calls 'the vagal type' when the low resting heart rate allows extra space between beats for ectopics to kick in and disturb the rhythm ... Sanjay Gupta (York Cardiology videos) defines two categories of AF: one is predominently 9pm to 9am the vagal type, the other is daytime ...
It's also important to try and pinpoint the triggers. Not easy - for me PAF happens in the night after very active days (over doing things and feeling good at the time). It's a glimmer of hope in the general confusion and anxiety - fingers crossed I'm on the right track!
Actually your BM experience fits with the vagal connection. A well known (but doesn't work for me) 'remedy' for PAF is to 'bear down' as if you're going to the loo.
For me deep slow yogic breathing quite often restores normal rhythm, then I can then avoid resorting to PIP Flecainide. I practice a lot when in normal rhythm so when PAF kicks in it's second nature. I breathe in to a count of 10 and breathe out 12 ... my understanding is that its the outbreath the connects with the vagus nerve and helps to control heart rhythm.
I've said this before but Michael Moseley's BBC series on Calm is relevant - in the first episode on Breath, he and a scientist from California talk about the vagus nerve.
bbc.co.uk/sounds/play/m001z66y
Thanks again for your post .. good questions to ask oneself! Take care ..
Thank you too! That is really interesting and, like you say, calms the anxiety a bit which is for me is probably one of the worst things about this pesky condition. I watch the Michael Moseley link - thanks for that! Such a shame what happened to him as he did so much for health. One thing I am a bit confused about is that my urgent bowel movement brought on the AF but bearing down as if having a bowel movement can stop it?? Weird that doing something that triggers it can cure it! I may be misunderstanding though…!
Drinking icy cold water can trigger afib. It can also stop it. I think it is the shock to the system.
Yes, I read somewhere that Flecainide has 'a narrow theraputic window' I think it can sometimes cause arrhythmias as well as stop them ..
The bearing down could trigger the vagus nerve in some way, but I can't explain it - I just saw a connection .. I may be entirely wrong.
My attacks occur when I’m recovering from excessive exercise. Always when I’m relaxing after sprinting too hard. I’ve now managed to avoid any episodes by moderating the extent to which I raise my bpm. Look to what you’re doing before you relax as the potential trigger. My theory is that it breaks out when you abruptly remove the stressor (relaxing after a hard week). Maybe go for a not-too-brisk Friday evening walk before you collapse on the sofa?
It does sound like a reaction to something you’re eating or drinking on a Friday. Most of my symptoms are triggered by food and drink. Do you take a medication/vitamin supplement on a Friday? Or, if it’s more anxiety driven, it could be caused by emotions connected to someone who you spend more time with at the weekend.
are you exposed to any chemical/fragrance on a Thursday or Friday. Cleaning the car, going to hairdressers, mowing the lawn, bleaching the loo?! Chemicals/perfumes/plants can trigger reactions.
There are certainly various triggers but I occasionally drive myself round the bend when I slip into a state of constant vigilance anticipating them. We are pattern-seeking, narrative-driven creatures, part of being human.
Unfortunately with our (sigh) "totally manageable" condition, AF and anxiety are frequently interchangeable as well as contributing to one another.
That said, AF is sometimes linked to digestion for me, sometimes if I am hungry, sometimes if I have eaten a big meal and am sitting afterward. Evenings tend to be worse than daytime for me.
As for easing an episode, breath control works for me, as does exercise -- pushing my heart rate closer to where my heart's faulty electrical system is taking it.
The caveat is that for my two major episodes there was nothing that I could do personally to calm the squirrel disco in my chest so I headed to hospital.
Squirrel disco says it all ...!
breath control often works for me too but I've never tried exercise ..... "pushing the heart rate closer to where my hearts faulty electrical system is taking it" .. I'm not sure I have the courage to do that.
what do you do?
I tend to rely on breath control more because most of my episodes occur in the late day. Sometimes I breathe myself to sleep this way.
If I have a daytime episode -- brisk walking, treadmill, exercise bike. I don't push myself to Olympic level, just enough to feel like I am working. It's all individual, of course -- I don't push beyond my ability or means but I do push a little bit.
Oddly, light weightlifting also works for me -- during this my HR ranges in the 60s and low 70s, totally counter intuitive! The way I frame it is that, if my body is going to lie to me, maybe In can fool it right back.
I can't say what will work for you, of course, but it's fairly agreed that exercise works for what we have.
Heavy meals are a definite trigger for me. Sometimes even just medium-sized meals. Sometimes, it seems, just about anything I put in my mouth and down the gullet can trigger palpitations.
A few months ago, a large (but not excessively so) meal followed by vigorous exertion kickstarted me into an episode of atrial tachycardia post-ablation. I just wrote about that in reply to jeaniejeanie and what I feel are he responsibilities of providers to educate patients about triggers.
My providers are totally mum unless I bring it up, and totally mum not only about triggers (except alcohol) but about anything to do with diet and lifestyle. It’s like the EP folks do their electrical rewiring then brush their palms together and say, “There, all done!”
Well, we patients are far from “done” post-ablation.
EP providers, in my experience, have a long way to go in providing their patients with crucial information, information like that we get on this forum regarding triggers, CV’s, common post-ablation events and whether to worry about them or not, etc.
I feel that I was left on my own to figure out how to get the information I needed, even enough to ask the right questions. I know providers are busy and specialized, but I think EP teams need to up their game for their patients’ welfare as whole human beings dealing with a difficult and complicated health issue.
If you eat larger, richer meals on the weekend and/or do not walk around after eating, stomach gas and bloating can lie in wait for you to lie down. It then moves up and irritates the vagus nervous system.
Eat smaller meals without gas producing food no later than three hours before bedtime. Cut out alcohol
In the half-hour following the meal, drink a glass of warm water and walk normally around or otherwise be on your feet and active.
Be tested for any food intolerances.
These help me; that is the extent of my expertise.
An aside: I learned about the warm water relief for bloating and gas by watching a video on line recently. I have consulted with cardiologists, EPs and GEs over the past 4 years, explaining the connection between my gut and heart. Could not ONE of them have mentioned this simple treatment?
Good tips. Flopping on the sofa with a full or even semi-full stomach seems to bring negative effects. I will walk round the block after dinner when I can. My diagnosis took 4 years - kept getting told it was runs of ectopic beats. I believed them. When I look back in my blissful ignorance, I did all sorts with no repercussions. It seems to need a ‘perfect storm’ of things to happen. At least I’m on anti-coags now!
goodness me 4 years of AF without diagnosis .. I was 8 months and I thought that was difficult.
Now looking back I realise the risk of 8 months with no anticoag .... and thank my lucky stars ..
Great post Joeyy06 and interesting comments. Like many here, identifying my triggers has been maddeningly futile so far and I'm starting to wonder if there are any for me. In the last 18 months since my first paroxysmal (occasional) AF began, 74% of the 35 episodes to date began while I was asleep and usually within the first few hours. When it happens it immediately wakes me up. My Cardiologist naturally thinks sleep apnea is my trigger, as was confirmed by sleep study that I have a mild case.
I have since become an expert user of my CPAP which reports excellent scores, with my events per hour now averaging <.5/hour (ie- no longer an apnea problem!). However still having episodes, so my Electrophysiologist puts me on Verapamil (calcium channel blocker) to help control rhythm but since I've been on it a month I've had 2 more episodes in the last few weeks. Maybe they will reduce after more time on the medication? I don't take any other medications.
I've long ago ruled out commonly recognized triggers such as alcohol & caffeine. I retired a few years ago and have FAR less stress now - no day of the week triggers for me. My BMI index is 22 (same weight as I was 40 years ago) and I do flow yoga daily for 30-45 minutes. I've also focused on breathwork, especially just before going to sleep. I take magnesium supplements, Vit B, D, fish oil and eat far healthier than the average person (per my wife, who does much of the cooking 😉). Drink 120 - 145 oz filtered water daily. I have researched this thing to death and still hope to find that elusive trigger for me.
Have you tried Valsalva Maneuvers when an episode starts? Look through my posts on my observations of Vagal AF, I did a lot of Vagal research and personal testing to try and work out the beast.
Oh one more thing that has helped me to at least shorten AF episode, I take an extra Mg Taurate tablet and put my feet up higher than the heart, this brings the blood pressure back up faster to normal - my blood pressure drops remarkably during AF events.
It’s been intriguing reading people’s experiences/theories of what may be the triggers.
Prior to my ablation my AF attacks were always at night late night of early morning. 1 trigger I definitely noted was often on a Thursday which I testified as my gardening day when I had not had as much to drink as usual. Once I corrected this the attacks were random. My very first serious attack was after a challenging day. I had 12 year before the Ablation, in the last couple of year the AF became more frequent. Over time I decided that keeping hydrated was helpful, stress or worry wasn't good neith was rich food especially late at night. Changing one's diet dramatically brought in a couple of bad attacks. A routine helps and avoiding leaving things to do till the last minute. I wish I had seen a specialist AF Consultant sooner. Last year Ibtook part in a Research project to see if Qi Gong/ Tai Chi might be beneficial to us with AF I have found that this has changed my life for the better. Whether the movements would have help at the start I don't know. Lastly but hugely important for me was reducing my weight and exercising more. Although it hard worrying about the AF attacks makes it worse. I found unplanned side tracking helped enormously eg during a particularly bad attack In hospital when after 5 hours it was looking as if intervention other than tabs was necessary when a student nurse came to check on me which developed into an interesting conversation that required me to engage almost instantly the jumping around of my chest stopped and the HR came down. Some times taking a shower can have that effect too as can concentrating on some thing tricky. These have worked for me at different time. All the best
Hi Joeyy06. I have paroxysmal AFib and believe it to be linked to the presence of a hiatal hernia that is, a bulge (slight I believe in my case) in the tube between the oesophagus and the stomach. So big, heavy meals, alcohol, sugar, anything that disagrees with your digestion would affect it. So would the timing of 4h after a meal and lying down. I don't lie on my side to sleep anymore as I think this squishes my hernia, maybe against my heart of vagus nerve. There is quite a thread on this site on AFib and hiatal hernia.
I am now waiting for a scope of my upper GI tract and hoping that treating the hiatal hernia will lessen (eliminate?) the frequency and length of my AFib episodes.
My symptoms (which have escalated, some people have none) include bloating after eating, deep burping even hours after eating and now pain/discomfort in and around my stomach, including around left shoulder blade. Good luck!
Increased Attacks of AF
Attacks of AF
AF Triggers
AF sessions
AF triggers
