Many people here have written that big meals can be their triggers for afib.
I have three questions:
1. What is the time lag that you experience? That is, the time between the last swallow and the beginning of your episode?
2. Is a big meal a reliable, consistent trigger, so much so that you almost never have a qualifying big meal?
3. Is there a particular component of the big meal -- such as pasta or steak?
For me it's not the size of the meal, rather how close it is to bedtime, I like to give it at least 3 hours for the stomach to digest the food. I find a quick 15 minute walk after dinner helps speed up the process. Also I have a few foods that give me bloating, which I eat in very limited quantity or avoid.
So do you believe that food in some quantity can trigger afib?
Some foods yes can trigger AF with me, particularly very processed foods with additives, preservatives. I'm trying to eat more natural foods, but do slip up often. For me the bloating or meal too close to bedtime seems to put pressure on my heart when lying down. If I am bloated or full but still standing or moving about I don't find it's a trigger. Also sitting slouched on couch watching TV, with a full stomach I feel my heart under pressure, stressed. Maybe it's a vagal nerve issue, or a physical limitation, I'm not sure. Someone else may be more knowledgeable to answer that.
Thank you. I think I have a couple of triggers. I'm wondering if others suspect that they have a trigger of a big meal plus 10 hours.
*Ten hours* -- e.g., dinner done at 7:00 p.m., AF at 5:00 a.m. -- seems like too long a time. But I know very little about "transit time" -- that is, for food to come in and travel and exit.
You probably have vagally mediated PAF ie the Vagus Nerve is sensitive to digestion issues.
I am and I have my evening meal as early as possible around 5pm usually, lighter and little if any meat, certainly not steak. Then agree with KiwiBlakes advice re bedtime.
I would work on maybe eating slower and avoiding processed food as far as possible. Also no accompanying cold fizzy drinks or alcohol.
Thank you. I do eat slowly and never have steak but often have chicken. Nonalcoholic beer every night.
Usually I am lying flat, in bed, within four hours of finishing a meal, say around 10:30 p.m. AF episodes occasionally begin in wee hours (3:00 a.m. to 5:00 a.m.). Those do seem to be vagus-nerve-related.
But I have many more episodes that seem not related to food.
Mmmm...maybe check for sleep apnoea (ie a sleep monitor) and/or if comfortable with the drug ask your cardiologist to increase your flecainide to 200mgs/day ie a medium dose. That worked for me for 10yrs, whereas 100mgs/day still resulted in 2 episodes a week.
That was when I was 60yo with Lone PAF, active and no comorbidities.
Thank you again. I do not have sleep apnea.
The flecainide idea is worth pursuing. I now take 50 twice a day, and have for 2.5 months. I occasionally take 100 at a time instead of 50, if I'm actually in afib. That seems to help.
I'm still thinking that I might be able to identify at least one of my triggers. Maybe that's a fool's errand.
I would suggest you keep working on your diet (eg reducing gluten) and other lifestyle choices rather than trying to identify one trigger. That said, I found out that a cold fizzy drink gulped down was one of my triggers and surprisingly a cold drink gulped down has also stopped an episode.
Overall my personal theory is AF is triggered (for most of us) by an accumulation of many adverse factors, anyone of which could appear to be the culprit when in fact it was just the last one to the party. Hence the reason why many here think looking for triggers will drive you mad.
I also use this theory to incentivise me to improve my lifestyle and thereby avoid possible other future chronic issues ie I may not be able to beat AF but I can use it to derive other benefits I would otherwise not have achieved. For me one of the most important examples of this has been spiritual growth 🙏🏻, which has reduced my anxiety.
In the last 14 months I have TOTALLY given up gluten. Doing so has helped me to lose 30 percent of my original body weight. And I have not had Afib in seven months, or ectopics that I know of. I think giving up gluten has contributed mightily to that improvement. You have studied more than I have, so why do you think giving up gluten might be so beneficial? Thanks.
Thanks for the incentive to avoid my complacency over gluten, which I have allowed to creep into my diet again, just maybe the cause of my increased AF.
Totally non-scientific answer but my guess is the gluten in most products including most breads upsets the gut, then the Vagus Nerve and then the heart.
Do you only have episodes at night, if so could it be caused by sleep apnoea.
For me, it's usually wakening up in AFib at 2 or 3 in the morning. Sometimes I can predict one as it's preceeded by a lengthy bout of burping, I mean the type where you can make yourself do it at will, and hugely. Normally I can't make myself burp at all. We like to cruise, used to eat at 7:30, have three courses, finish at 9:00, go to bed at usual time of 11-11:30. Used to often feel uncomfortable and anxious. Now, we eat at our usual time of 5:30 and I think that's much better for me. If, socially, I have to eat later, I'm very careful to choose the "blandest" and/or smallest of the choices, maybe the soup (which you can leave a lot more of without people commenting). Not pasta (which I love) as I feel it "sit" there, also because I like it with the creamy sauces like carbonara. And I avoid anything with melted cheese, my GP once told me that the common snack of cheese on toast is the hardest thing to digest. I'd choose either fish, or chicken, occasionally steak, but without adds like pepper sauce. If I really want dessert, I'd choose berries, otherwise I'd go for ice cream - I have a spoonful, then pass it over to my husband, and nobody comments, and I don't feel I'm a party pooper. I don't have cake-style/creamy/ or chocolate desserts. I don't drink alcohol hardly at all, and never drink wine or fizz as even the first mouthful gives me instant heartburn, which I believe is a trigger for me.
I do normally eat all of those things, just never later in the day. It's therefore hard to give you an answer as to how much "weight" each factor carries for me. I think it's the combo. I could eat a steak at 9pm, I'm sure, and feel fine, so long as not along with a baked potato with butter, sauce, etc. But I'd be fine eating all of that at 5pm. I'd say I don't have any "rich" food after 6pm. I aim to never have that regretful feeling of "oh I've eaten far too much and/or too sickly" If I overeat and/or eat too much rich stuff, if it's early enough I feel like I can get away with it, a couple of hours before bedtime and I feel like I've bought myself trouble. Hope that helps.
Yes, very helpful. I will come back tomorrow and digest your comments more thoroughly.
But another question until then: Have you ever suspected a link between vivid, complex dreams (and nightmares) and afib? As in, can dreams cause afib, or does afib cause dreams?
It’s after I started on Edoxaban I have vivid dreams, mostly harmless but quite entertaining of those that I remember afterwards. For example, chased by elephants when me and my son were playing golf at our local course…
Best wishes.
I've been taking Flecainide, Bisoprolol and Apixaban for about 7 years. Before I did have quite vivid, adventuresome dreams, rarely nightmares. Since taking meds, I have a lot of disturbing nightmares, the kind you waken yourself up with, as you can't bear them. I've never thought of the dreams causing the Afib though, as I dont recall ever being in Afib when awakening from one of the nightmares. Come to think of it, I do feel like my heart is pounding when I awaken from a nightmare, but I'm not out of rhythm. Think the pounding heart is what "normal" people feel after a nightmare? I guess I don't think about it too much, I try to not think too much about AFib at all!
The times I have woken up I the early hours in afib have usually been preceded by a nightmare or unsettling dream. I’m not sure if is the afib that wakes me up or the dream but my watch shows the spike in heart rate at that exact time and ecg confirms afib.
Definitely. I do all I can to avoid vivid dreams and nightmares. They wake me up with a start. If I'm lucky it will just be a bit of tachycardia. If I'm not so lucky I will be in Afib and then I'll have to get up and do my deep breathing routines and try to stay calm. It usually reverts to NSR in an hour or so. I'm assuming it's the dreams which flip me into Afib rather than the other way round. I will do a sleep study as soon as I'm able to see if they can pinpoint what's going on. Of course it may be sleep apnea or something else.
With me it's not a big meal as such that's the problem. I can get away with it if I sit still for some time. But if I try to move around too much it's likely to trigger an episode. It's as if I don't have enough blood/oxygen to cope with digesting a meal and exercise at the same time. But like others I wouldn't eat a big meal after say 7pm.
I believe this is to do with the Vegas nerve
I held my Vegas nerve and gambled it all on black and now I no longer have to work!
lol didnt happen for me in Las Vegas, perhaps I should go back and try again!!!
l not so sure it’s the components of the meal, but more the size of the meal and how fast you eat. A large meal makes the heart work harder to aid digestion. A large meal pushes the intestines and oesophagus up into the diaphragm, which in turn can press up against the heart as they are all in close proximity. I never eat for at least 3 hours before bed. The metabolism slows down with sleep and this can lead to food being undigested. I find if my stomach is happy, my heart is too.
my triggers are:
Overeating (too big a meal), but particularly in the evening. As a result of cutting back I’ve (deliberately) lost and kept off 2.5 stone
Eating too much ultra processed food. Generally meals are meat / fish with veg. Takeaways are an infrequent treat.
Eating too late and not allowing g enough time between meal and going to bed. I now ensure minimum 3 and generally at least 4 hours and try and eat no later than 18:30.
All forms of caffeine including fizzy drinks I now only drink the odd cup of decaffeinated coffee
Alcohol - I now only drink 0-0 versions
Not enough water - I drink minimum 2 litres a day made up of water, sometimes sugar free cordial mixed with water, and berry tea (caffeine free).
Habits I have found very beneficial are:
Meditation - I use the Calm app every day twice a day
Drastically easing back at work to reduce my stress levels. Hahahaha genuinely no one has noticed!
Exercise - no more HIIT for me but I do 300 mins per week of 4 x 9km power walks and get HR up to 95-105. Hard to get highervthan that because of beta blockers.
Take medication as prescribed and same time every day. I set alarms on my phone and track it in Apple Health.
Hope this helps.
Jezza
I wonder whether there can be any consistency regarding when eating can trigger AF? For example, it seems that the atrial sensitivity varies widely so what will trigger ectopic beats or AF one day won't on another. Alos, the "trigger" from food is likely a direct, physical disturbance of the atrium itself, prone as it is to being stretched and responding to that sometimes with ectopic beats (which can then trigger AF). The heart can lie close to, or even press against, both the oesophagus and is linked to the diaphragm; it can be prone to being pushed and pulled when we eat or drink, or just gulp, as well as when the stomach and intestines move, or are bloated by gas or constipation. There are so many variables.
Steve
The atrium can be in contact with the diaphragm?
Hi - I have edited the post to say "heart" rather than atrium as I cannot be sure of that since I gather the heart lies somewhat differently in each of us depending on anatomy. It is anchored to the diaphragm and moves when we breathe.
In my case, I was once shown this on an X-ray, which my diaphragm pressing against my heart, having been forced upwards by air in my stomach. I was told that this could have been the cause of the ectopic beats I was having. Those (as PACs) can trigger AF in sensitised individuals.
Steve
With me it's quick eating of a large meal especially on an empty stomach. Plus near to bedtime. When in bed try going to sleep on your right side.
Adding to my food regime, I definitely have a link to stress. We travel a lot, so I have strategies. I used to fly, so had years of experience with standby staff travel, waiting in airports until at the last minute to see if we were going to board, sprinting through enormous airports to get to departure gates. Maybe that's why I have Afib😌? Now I never do close connecting flights, post covid even more so. UK to Europe I go the day before I need to, longhaul two days. I never fly without some clothes and bits on carry on wheelies in case our luggage goes awol. If my ticket doesn't buy it, I have lounge access with my credit card to get away from the "stir" of airports, also a haven if you have a long connection/delay. I arrive at airports in plenty of time, anything that helps with keeping calm. Changed days indeed! I have a typical type A personality, so trying to keep calm at everyday irritations is also a key for me. I have an Apple watch with ECG, heartbeat and the Health app, which I don't consult much, but I like to know it's there. I keep negative people out of my life, and I've realised that my Afib is 95% up to me to manage, and be my own advocate for. I also don't listen much to medics who don't know other than the tiniest bit about AFib, the best freely admit they know next to nothing, the worst believe they know more. An emergency doctor once spoke to me of "Proximal" Afib after I'd told him I have Paroxysmal, and that I'd never be sinus....The best thing I have ever done, health-wise, maybe ever, is to get an Electrophysiologist in my life. Every day I feel like I've won the lotto for having one!
The other thing I'd say is back to the food thing. At home I sleep with head end of my bed elevated, I used to have a sponge wedge thing under the mattress, and away I use a few pillows or improvise. Now I have an adjustable bed at home which I love, it's also taught me to be able to sleep on my back, and right side as much as possible, with head higher than stomach. I try to never sleep on my left, as I think the weight of the body presses on the pesky left Atrium. Funnily enough, if I have a nightmare, I always awaken on my left side, without fail.
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