Atrial Fibrillation (AFib) Support Group
Atrial fibrillation (AF or afib) is an abnormal heart rhythm (cardiac arrhythmia) which involves the two small, upper heart chambers (the atria). Heart beats in a normal heart begin after electricity generated in the atria by the sinoatrial node spread through the heart and cause contraction of the heart muscle and pumping of blood.
In the past we have discussed both adrenal and vagal mediated AFIB in addition to our extensive experience with thyroid involvement. I thought I touch upon Vaso Vagal AFIB a bit since we haven't touched upon it for some time.
Every few months, I go through periods of constipation every 7-14 days that last a day or two. Frequently, these periods of being backed up, kick off an AFIB episode. The episode usually starts around 4:00 AM , with all the usual discomfort), and last until I have one or two complete bowel movements, usually between 6:00 and 9:00 am). Then after a nice hot shower, I'm fine. This morning was one of those mornings.
This is really annoying, but after 40 years of AFIB, which is now under pretty good control, I should be used to it. This morning I got motivated to do a little more research and came up with the following article:
http://www.medscape.com/viewarticle/473550_2
"For those who cannot access Medscaoe, here's a section:
Vagally mediated paroxysmal AF occurs more commonly in men than in women (ratio 4:1)] The age of onset is usually 3050 years. It hardly ever occurs in a structurally diseased heart, probably because any cardiac disease tends to shift the vagosympathetic balance towards a sympathetic predominance.[3]
The usual history is of weekly episodes. The heart rate is relatively slow during the episodes of AF and most patients complain of irregular heartbeats rather than dyspnoea, lightheadedness or syncope.[7] A typical attack usually begins at night and lasts for a few hours. Attacks do not start in the morning: on the contrary, conversion to sinus rhythm frequently occurs in the morning, when the sympathetic drive is higher. Neither physical exertion nor emotional stress triggers the arrhythmia but a period of relaxation that follows may trigger it. Cough, nausea, rest, post-prandial states and alcohol are also precipitating factors.[8] Vagally mediated AF rarely, if ever, progresses to permanent AF."
Do tis sound familiar to anyone?
Every few months, I go through periods of constipation every 7-14 days that last a day or two. Frequently, these periods of being backed up, kick off an AFIB episode. The episode usually starts around 4:00 AM , with all the usual discomfort), and last until I have one or two complete bowel movements, usually between 6:00 and 9:00 am). Then after a nice hot shower, I'm fine. This morning was one of those mornings.
This is really annoying, but after 40 years of AFIB, which is now under pretty good control, I should be used to it. This morning I got motivated to do a little more research and came up with the following article:
http://www.medscape.com/viewarticle/473550_2
"For those who cannot access Medscaoe, here's a section:
Vagally mediated paroxysmal AF occurs more commonly in men than in women (ratio 4:1)] The age of onset is usually 3050 years. It hardly ever occurs in a structurally diseased heart, probably because any cardiac disease tends to shift the vagosympathetic balance towards a sympathetic predominance.[3]
The usual history is of weekly episodes. The heart rate is relatively slow during the episodes of AF and most patients complain of irregular heartbeats rather than dyspnoea, lightheadedness or syncope.[7] A typical attack usually begins at night and lasts for a few hours. Attacks do not start in the morning: on the contrary, conversion to sinus rhythm frequently occurs in the morning, when the sympathetic drive is higher. Neither physical exertion nor emotional stress triggers the arrhythmia but a period of relaxation that follows may trigger it. Cough, nausea, rest, post-prandial states and alcohol are also precipitating factors.[8] Vagally mediated AF rarely, if ever, progresses to permanent AF."
Do tis sound familiar to anyone?
Sorry to hear it got cha again. I just got off a 12 hour binge, but hey, it could have been longer
Thanks for the information. I had never heard of vasovagal before and the article left me with more questions than answers. Maybe the 12 hours did some serious reduction to my thinking-capacity (then again, maybe not and I was just born that way). At any rate I was pretty sure that vasovagal had something to do with vagal and therefore the vagal nerve which is used like a superhighway to send messages to the brain from the stomach (digestive tract) and vice-versa - with the majority of the messages being sent from the stomach (digestive tract).
I wasnt sure if the vasovagal a-fib was a sub-class of vagal a-fib or the other way around. I found this explaination:
Two Major Afib Types
Vagal Afib is caused by vasovagal stimulation, meaning stimulation of the vagus nerve, a large nerve which controls both digestion and heart beat. Because of the connection between the vagus nerve and the stomach, vagal afib can often follow stomach symptoms such as gas or stomach pains. Also, vagal afib often develops in the presence of a low, resting pulse rate. For this reason, athletes and other very fit individuals with low pulse rates are often susceptible to afib.
Adrenergic Afb is caused mainly by stress, both physical and mental. Stress that may trigger afib includes anxiety, fear, grief, or sudden upset. Physical stress of excessive exercise may cause afib in some susceptible individuals.
Some individuals may be vulnerable to both types of afib, but many experience one exclusively or one type more frequently than the other.
I also read that depending on which type of a-fib you have some medications work better or worse.
Paul, if I knew that constipation were a trigger for me I would get into some major magnesium and make sure that doesnt happen again.
Carpe diem,
atp
ATP, you make an interesting point: "I also read that depending on which type of a-fib you have some medications work better or worse."
Out of all the heart doctors I've seen (and I've seen some of the best), never have any of them asked me about stomach conditions, or even so much as mention the vagus nerve connection, and certainly none have taken the tact of treating me with different medications depending on whether my afib was triggered more by gastric symptoms or stress.
If you have kidney disease (renal failure), you must not take any magnesium supplements without your physicians monitoring!
Im not sure why that is, but I have read that on several occasions.
duder, don't be disappointed or disillusioned because your doctor didnt ask about your stomach conditions. It may very well have been obvious to him/her depending on how you described your symptoms which drug would or would not be appropriate for you. There are other factors that they have to take into consideration too when prescribing: your overall heart condition, your age, your fitness and what you have already tried among other things.
Stay well,
carpe diem,
atp
BTW, my stomach is fine, no indigestion, no acid reflux (ever since I quit that really stressful job 5 years ago (which I had for 5 years which came after the really stressful job for the 7 years before that - gee, that's twelve years of mega stress, no wonder I'm screwed up -g-).
Anyhow, as I was saying, the stomach is fine, I get some cramps, lower down like gas pain on occasion, so my issues are intestinal, not stomach, well, its all digestive.
Im glad someone brings this vagal nerve issue up every now and then. I one of those who strongly believe that the vagal nerve has something to do with it. I have seen that article before and made some research on it and it seems that although it almost never turns into persistent afib, there seems to be no cure for it either.
For my part, in the past 5 years I actually had 5 afib episodes and all between Mid-July to Mid-September 2015. I know it seems little for some of you guys but still I believe that once an afiber always an afiber. They all lasted only 1 to 5 hours and were gone by the time I got up the next morning. I guess I will never really know what precipitated those attacks in the first place because afib is such of two faced disease that every time you think you actually have it figured out and under control, it seems like it hits you anyways and then your back to the drawing board.
IS it the Vagas nerve? I have been on Sotalol since 2008 and had an ablation in 2011 for an atrial flutter but even after my flutter ablation I had my first bout of afib so they kept me on Sotalol. Is the Sotalol not doing its job anymore? In July we had a big heat wave and I bike to work, walk a lot in the weekend and ant lunch time.did I overdo it? Was it the heat?
I guess I never know. What I do know however is since that period in July to September, I have developed huge bouts of PACs and PVCs every night. I go to bed feeling tired and without any PACs or PVCs and wake up about 2 hours later with mega PACs and PVCs and I tell you, if I dont sit up in my bed it turns from every minute to every 10 seconds to every other beat and finally to afib.
If I sit up, it all settles within minutes. Sometimes I have PVCs and PACs bouts for about 10 more minutes but it always go away. That is what I find so puzzling! why only when I lay down? I also remarked that when I have the bouts my heart always beat a little faster than normal. If my HR is a bit faster and I sit up I have no PVSs or PACs (or almost none) but as soon as I lay back down it stars again. Until my HR is back to normal, I cannot lay down or it starts again. That little game sometimes persist for hours but is always gone by morning. I should also inform you guys that generally those bouts always come along with bloating, gas and abdominal discomforts.
So is it the Vagas nerve? I have no gastric issues when I go to bed! Why or when does it start? When I sleep I guess. So I cannot help but wonder what comes first? The PVCs and PACs which causes the gastric issues or the other way around? The gastric issues which trigger the PVCs and PACs. And here the curve ball for you! I have stayed up until 2 or 3 in the morning playing games and watching TV and I do not get any of this on an empty stomach but palpitation galore if I have a heavy supper or snacks in the evening. (That makes me lean toward the gastric triggers.
Anyways I dont want to overdo it with the questions but I will continue to try to figure this thing out. I have gone through a few tests since last summer and have a few more to go:
Done
Thyroid OK
Blood OK
EKG OK
Echo Normal
Mag supplement 2x a day
Sleep Apnea Negative
To do
I want a stomach test done to see if things are out of place in there (hernia).
I have a 24 hours monitor test coming up in Feb.
I have to get my anxiety under control since that has all started.
All I know is that this has been going on for over 6 months now and I sincerely hope that these things will settle down.
Well I would so much more to say but people will get tired or reading. So any feedback is welcome and appreciated.
Thanks guys.
Scooby
Of course that doesn't stop me from getting PISSED OFF at it all, and using the forum to vent a little -g-.
http://www.stopafib.org/newsitem.cfm/NEWSID/565/afib-risk-factors-panel-videos/atrial-fibrillation-patient-conference
"Vagally-mediated afib tends to be occurring at night, you don't get it during the day and it's shortly after you go to sleep or go to bed that the afib begins. Often typically when you wake up in the morning, after an hour or two, the afib will disappear. So again, one of the common types of afib we see in athletes."
Hmmm... now what?
Based on the latest crop of videos that have been posted on our blog, and my latest increased bouts of AFIB, I've decided to modify my workout a little by cutting down on some of the weight of my bench press (I suspect it's becoming too much strain on my heart), and losing ten pounds (maybe I can do as well as the sheep in the study). That will get me to 220 and 6' 2 1/2". Overweight based on the charts, but I carry a bit more muscle that the average Joe.
.
Hospital wanted adenosine stress test, I refused. Discharged on rate control and anti-coagulation in place.
Saw my Family Doctor, he felt stress test was unwarranted at this time. Wasn't surprised about the onset, he leans towards living with it. Next day saw my Cardiologist, no mention of stress test, said Echo, with the exclusion of the addition of afib, was identical to echo 1 year ago. He suggests a one time, out patient, electric shock cardioversion attempt, after I'm at therapeutic levels of coumadin, and being placed on Sotalol.
Life long benign arrhythmia sufferer, PVCs, PSVT (Limited), PACs, some fairly frequent (5 PVCs a minute for a few months). Yet this afib scares the heck out of me, but not the doctors. I can't stand the feeling of it jumping around constantly, sometimes pretty bad, sometimes not at all.
OK, finally to your point. I periodically experience months long intestinal hypermotility, and I was, and still am, in the throws of it as my afib first started. This is not the effect of afib sensation perceived as bowel movements, this is bowel sounds that attract moose to my area, and they aren't in my state. They're attended by other effects that need not be mentioned here, one can easily imagine.
Not only have I figured that this hypermotility was involved in other benign arrhythmias, but have had success, and read, that Protonix (a PPI Proton Pump Inhibitor for stomach acid) is believed to have relieved symptoms for some with nuisance arrhythmias. No one should self medicate, and I'm not suggesting the medication will work and should only be given under the advice of a doctor). I'm not trying it now either, this afib is pre-occupying my attention.
But doctors don't want to hear it. I have seizures, chronic urticaria for 2 years so far, I've experienced loss of vision in one eye twice (briefly). But no one seems to consider other medications and conditions people have, not sufficiently. But to go way back, I've had seizures and hypermotility for many more years than I've had the other things.
Trust me, vagally mediated events are constant, though I'm not sure about the afib you correlated it to. My dog, as she was laying on the floor, taking deep, slow breaths, I noticed her heart would speed up and slow down. In healthy individuals, it's a sign of good vagal tone.
Look up Respiratory sinus arrhythmia, a natural thing, my dog had it pronounced when she was young.
Sorry for the long comment. I'm a new member, the information is meant for all as well.