I have been diagnosed recently with Paroxysmal A/F. Episodes are usually infrequent- around 1 every 4-6 weeks. Onset is invariably at night and when lying down to sleep or actually asleep. The time spent out of rhythm varies from 30 minutes to as much as 8 hours, usually going back into normal sinus rhythm when the bloating has abated. ECG and Echo tests normal.
But have been prescribed a blood-thinner of course (not warfarin), which I have to start soon it seems.
Two things concern me:
ONE that neither the specialist or my GP seemed to accept that there was any connection between A/F and bloating/IBS yet the internet is crowded with people with the same symptoms as me. Only two (eminent) USA sites mention this as a reality.
TWO I do wish my GP would take seriously a need to review and change my medication routine (I have been on 25mg Atenolol for ectopic beats for 9 years now), especially since I have read in several notable cardiological sites that atenolol can not only contribute to A/F but also that in any event, 25mg is too low a dose.
Would others with A/F AND these IBS-type symptoms please share their experiences/outcomes/view please?
Many thanks!!
Hiya Edward,
Yes, absolutely there is a connection. The connection is the Vagal or some people call it the Vagus Nerve. It is a main nerve in the central nervous system and it controls both the heart and the digestive system. I suggest you 'Google' this and any other terms I use for clarification.I'll try and give you a brief outline of my situation. I was diagnosed with paroxysmal AF in Jan 2010, aged 65. By April 2010 I began to associate the onset of an AF event with food/digestive issues. Specifically these were Bloating, burping, diahorrea and lower intestinal gurgling - and very loud at that too I might say. My symptoms appeared to represent Coeliac Disease and / or IBS. My GP organised blood tests for both and they came back clear, but, he felt I was probably marginal IBS. He offered more tests - I declined. What I did do was (at my own expense) consult a Nutritionist. She was not in the least surprised and put me on a diet of Probiotic powder 490 billion bacteria per satchet, going gluten free, and the FODMAPS diet. FODMAPS IS SEVERE so I just pick the eyes out of it. Improvement was very very gradual but now some 4 years plus down the track I now cannot remember an AF event. My diet now is so different from what it was I can't believe it. No digestive issues like before and Bloating was the worst, and so bloody painful. At times I could feel the bloat hitting my heart. Awful. I do still get the occasional palpitation, I would never claim to be cured of AF, and for the record my drugs are - Simvastatin (40 mg) and Ramipril (10mg) were on my meds list prior to AF being diagnosed. Following AF I had the additional meds of Bisoprolol (5mg) and Warfarin (averaging 5.1 mgs per day).
I'm now coming up for 70, still working part time and enjoying life. BUT, I do have to pace myself and be ever vigilant with food.
Hope this helps you, get back in touch if you have any questions.
John
Edward,
I forgot to say, in Britain at least, you will seldom get a Cardiac Consultant recognise this connection we both experience BUT a Gastro consultant almost certainly will.
John
Hello John,
And many thanks for your swift and timely response (I was up most of the night with sever bloating AND A/F...the latter for around 4 hours this time). Yes I'm very much aware of the structure and function of the Vagus nerve- I'm an inveterate researcher like you it seems!), and I did mention it to the one visit I had with a cardiologist in February, who nodded his head only...but perhaps in an indulgent way!!
I have also started to investigate diet as an issue and feel that fatty foods (lasagne and spaghetti being to prime suspects) and greens ate in the evenings...are to be watched and left-out of an evening meal.
IN two years since starting A/F, 90% have been starting between 2400 and 0200,
The sequence of events for these episodes is identical. First mild ectopics with SOME discomfort in the tummy- then whilst lying down, full A/F sets in and the gut becomes very distended with aches all over the mid abdominal region with (I assume) referred back pain too.
For the 24 hours or so after one of these, My abdominal region feels as though its been kicked by a donkey though I can't say that my guts ever feel entirely normal these days.
Lastly, the list of classic symptoms for IBS are there in full for me including needing a pee every 20 minutes during the attack.
I will certainly look into the natural remedies you mention and have a friend who is a professional in alternative medicine.
Research into both A/F and IBS has often brought 'Hawthorn' into the debate...haven't tried it yet...have you?
All the best,
Edward
PS I'm 71.....tall, slimmish, seemingly remarkably physically and mentally fit- and am a professional composer, so will never retire!!!
In response to your first point, I also believe their is a link with IBS. When I first had symptons I explored the route of getting my digestive system checked out. I have had practically everything done including camera down the throat, all to no avail everything was clear. In my own mind I still think there is a link!
The reason being, my last episode, a very bad episode which caused very low blood pressure, started after I had ate and I think I ate too much.
My episodes can be 3 months between or a couple of days but not that many.
You have a supporter in your thoughts, look after yourself.
Hello Peter,
Thanks for this. I have great sympathy for GPs who don't seem able to make the connections, but none for specialists who ought to keep their research up to date.
For the record, I've spoken this morning with a professional naturapath friend, who suggests the following strategies:
1]eat peppermint sweets regularly provided that they have peppermint oil in them:
2} Use daily and regular doses of broad spectrum pro-biotics.
3] Start with a worming treatement (something that clears the gut of any alien and unfriendly bacteria or parasites)...but make sure its a homeopathic or naturapathic one)
I'll keep you and any others posted on the progress of these therapies, and intend to take a firm hand with treating the IBS/bloating issues to see if it reduces the AFib.
Greetings to you too!
Edward
Hi Peter,
Your post to Edward touched on an interesting thought which I omitted from my discussion with Edward. Blood pressure ! I have to assume you have read our discussion but when I inadvertantly eat something which upsets me, it makes me Bloat - could be thick gravy - I just bloat, like someone puts a garage air line in my gut and blows me up. I can see my shape change, then I feel rubbish - then I feel ill and my blood pressure takes off. Normally my BP is around 127/73 within 2 hours it can increase up to around 165/90, and it will take up to 5 days to get back to normal. In the early days this process used to trip me into AF. I am so, so diet conscious nowadays that I think the only thing that stops me going into AF is my overall diet is now so much healthier. So, like you and Edward I remain convinced that food/digestive/vagal issues are major culprits in my AF.
Good luck,
John
The blood pressure aspect is interesting John. Have you tried taking you blood pressure when lying flat? Do this after around 10 minutes after resting. I haven't tried this yet ut evidently some of us might be prone to low blood pressure in a supine position- something that can add to A/F problems.
What I DO find useful for bringing down any elevation in blood pressure (mine's usually also in the 115 over 75 bracket), is to take a stiff 30 minutes walk. Blood pressure always responds to walking like that
Hope all this helps.....and thanks to you both for the feedback and ideas...let' hope more join us in the coming weeks...I know we are far from being alone!!!!
Edward
Hello Edward,
I do appreciate the comments you and Peter have made - confirms in my mind that we are on the right track. No I haven't tried the 'Hawthorn' approach yet, nor have I gone down the track of alternative medicine. I have tried Homeopathy and Acupuncture but with very little success. I must say the sleep issue you mention is interesting. I do have sleep issues. Basically I can drop off to sleep, around bedtime, say 10.30 pm, in less than 10 minutes. I sleep through until around 2.30 am to 3.30am and then wake up wanting to pee. Go back to bed but can't get back to sleep, lie in bed so mentally switched on I could redesign Concorde ! As I lie there I get massive gurgling under left hand ribs. I get up, have a cup of tea, read for a while and then drop off to sleep for another 4 hours or so. Nothing else though. The only times I sleep right through is on those evenings when I've worked during the day, usually sleep right through for 7 or 8 hours. I've decided to try Hypnotherapy and see what happens. I used Hypnotherapy in 1985 to stop smoking - I've never smoked since. But, deep down I still keep coming back to a dysfunctional vagal/vagus nerve as the root cause of all this.
Incidently, your build profile given in your PS seems identical to mine - except the composing bit.
Good researching.
John
Hi John,
With myself you have hit the nail on its head, GRAVY, THICK !!! As yoe can guess it does affect me also as Edward says during the night, any time from 02:00 - 04:00.
What I cannot understand, when it does happen during the night is the fact that the digestive system should have worked it's wonders within 4 hours. I am here talking about 6 - 8 hours later.
I have an appointment at the end of this month, questions regarding the points that we have discussed, will be asked.
Keep thinking positive and thanks for the input.
Peter.
Any particular type of gravy??
With BP I can imagine that the high salt content in gravy would increase BP readings but why bloating?
For me at least Derek, no particular type of gravy, watery gravy and thick gravy will do it. Why bloating - dunno, thats the short answer. All tied up with my general food intolerance. The most calming stuff I can eat are anything with peppermint in and also ginger, i.e. a supermarket brand of ginger nut biscuits. Most calming. My can't eat list goes on ........ porridge and anything with wheat/oats and to a degree barley in it. The best bread I can eat is French sour dough. No Raspberries, Grapes are out, Nuts, Peas, long green beans, baked beans - are all out. In fact if I stuck to the health gurus mantra of 5 or 7 fruit and veg a day my guts would give me real grief. With the help of a professional Nutritionist and by a process of trial and error over 4 years I have evolved a diet which keeps me both healthy and enables me to maintain my INR within the range I've been told. Clearly though there are many elements of food that are at play, ingrediants, preservatives etc. one only just have to read the labels on food to see what a minefield it is. And it seems all have an impact in one way or another on the vagal nerve which causes me to bloat (and other things) and kick off my AF.
John
Do you ever make an infuson of grated ginger root or liquidise ginger.
My digestion does not like porridge, pumpkin, broad beans or peas.
Hi Derek,
Apologies for late reply - just flat out at work ..... no I haven't gone down that track. Until you mentioned it didn't think of it. Maybe time for me to have a look at it. Many thanks.
John
Hi Edward, I am certain it is to do with bowel problems. I have a rectocele problem and my AF started 7 years ago, same time as this happened. I did used to get the odd missed beat and7 years ago I woke up with a beat of 150 per minute, ended up having to go to hospital and they were deciding whether to give me a tablet to slow it down and keep me in or sedate and shock me to get it back to normal rythym. As they got blood out of my arm it went back to normal and I asked if it had anything to do with constipation or loose bowel movement and they said very unlikely. I had another bout last November, again woke up with a perculiar fast beat that was doing all sorts of rythyms and the doctor gave me a beta blocker and after an hour it went back to normal but I get more odd beats when I also have bowel problems but the doctors said they had not heard of it but I am convinced there is a link.
Hiya Mazieboo,
I made some comments to Edward about 11 days ago - if you search back you should find them. if you can't find it let me know and I'll repeat it. I remain ABSOLUTELY, TOTALLY convinced there is a link between my AF and my guts. I was diagnosed with AF (heart rate was 160 bpm) in Jan 2010. In April 2010 I linked the onset of an AF event with food and digestive issues. I have treated only the digestive issues and now cannot recall my last AF event. I am now only taking medication. I was tested for IBS and Coeliac Disease but tests were clear ... I was offerred further tests but declined. Instead I went to a Nutritionist. In my experience its no good asking a GP, A & E Dept or a nurse about the link between AF and digestive disorders - they haven't got a bloody clue. Nor has a Cardiac Consultant or an EP.
BUT - if you go to a Gastroenterologist, a Consultant in the digestive system/the gut you will get more sense. Also a Nutrionist. The Daily Mail of yesterday ran an interesting article on the digestive system - if you can get it, its worth reading.
John
Thank you John, I am convinced the victoza pen I use for my diabetes by increasing the length of time to 4 hours for digestion has something to do with this. I wasn't suffering too bad at all until a year ago when I started using this drug and all of a sudden it has flared up again and the digestion takes ages, causes all sorts of pains and noises, so much so that I had a scan for Gall Stones as the GP was convinced I had them but that came back clear. The Vagas Nerve certainly links them and the fact I have to take acid reducing medication make the Vagas Nerve seem even more linked to this as it mentions the esophagus being linked too which is damaged by acid reflux so all connected. Thank you John.
Interesting Mazie,
In my mid 30's I was diagnosed with both gall bladder issues and acid reflux ( something about a valve not properly closing off thus causing bile to come back up). Can't remember all the details now - but no action was taken except to suggest I watched my diet. Then 35 years later AF and controlling it with diet.
John
I may be a little late for this discussion but....
Yes there is certainly a close connection between the Vagus Nerve and afib. To control, and maybe stop a vagal afib episode, 1. try if possible to stay away from alcohol, including that "healthy red wine" and 2., take a formulation called "CALM" one hour before going to bed.
Its all about magnesium and how it is radically depleted in and during afib episodes.
Alcohol makes you pee out magnesium, which is probably already low for several reasons. The "CALM" is simply a soluble form of magnesium that is immediately absorbed near the misbehaving vagus and it keeps the vagus under control and happy.
You take CALM in a warm solution for rapid absorption.
I and others have stopped vagal afib in its tracks by taking CALM with an onset but now I just take it every night before bed, and I sleep well, and everything goes great.
Comments?
Frank (from the USA)
There is a definite connection with the vagus nerve. I have twice gone into AF when it was stimulated once when having a colonoscopy and the other after a DRE (digital rectal examination)