AF only in wee hours of the morning

Hi all, I had my first afib episode in 2003 woke up to it at 5:45am, went to the ER had all the normal tests done
No abnormalities found, I read Hans’ information on this site when I left ER after they told me what I had was lone
AF...so I changed my lifestyle and started to supplement with mag and K, I did not have another episode until 2013
And again woke up to it at around 5am, both these episodes lasted about 3-4 hours and converted with ace inhibitor
Stil lhad the whole run of tests and again all was normal, so this brings me to 2017 woke up around 5am again this
Past November with AF and this episode lasted 7 hours...after this I had spoke to the cardiologist and said this happens
Only between 4-6am everytime it happens so he suggested a sleep study and after completing that was found
I had OSA but mild only 14.8 episodes of breathing pauses and hour but stil lwas given a cpap, the last 7 months have been a struggle
I can’t get used to the mask but I try....my most recent episode was this pay Friday morning only lasted 2 hours I took 100mg of metoprolol
If sleep apnea was causing this wouldn’t it happen more frequently? I am very lucky to only have had 4 episodes in a 15 year period but my question is
Do you think that it is sleep apnea induced? It would seem if I have OSA I have had it since 2003?.....I haven’t really seen an EP because the episodes
Are so infrequent but having 2 in the past 6 months idk if it’s a fluke or what?....the day before my last one I was doing heavy
Outside work and became overheated and I’m pretty sure dehydrated, I felt wiped out that night and didn’t get my usual water intake in. I have changed my lifestyle
Bigtime since 2013 I eat only Whole Foods, no sugar, low carbs, no alcohol, etc etc.....sorry for being long winded just a frustrating condition but I’m not complying ,
I know many have it far worse

For those like me who didn't know what an ACE Inhibitor was;

[www.mayoclinic.org]

OSA increases the workload on the heart at night when it is supposed to resting. So in the long term that can enlarge it, contributing to the atrial “stretch” that is well known to be fertile ground for AF. Nighttime episodes are correlated with increased vagal tone and are a common symptom of vagally-mediated AF.

I wouldn’t say definitely that a hypoxic episode at night isn’t a trigger, but really OSA is more of a second-order effect. Every afibber should get tested for it, in my opinion,as it definitely belongs to the risk factor management side of the AF equation.

They had mentioned vagal as well, how would you go about trying to Avoid that trigger?...
Seeing as my episodes are infrequent I’m wondering if it’s just a position I get in at night?
I was reading an article that said back problems and sympathetic nerve system can also
Be a cause......and my lower back is bad.....I guess it’s grasping at straws

Quote
joey1974
They had mentioned vagal as well, how would you go about trying to Avoid that trigger?...

You don’t. You could try not sleeping at all but I’ve heard that’s fatal after about 3 weeks!

I had (have) vagal-AF as well. It would start just because the sun went down. I’d be sitting on the sofa or lying in bed not doing anything at all. Nothing to be done about that!

The good news is vagal AF usually responds to a basic PVI ablation. Still choose the best practitioner that you can if that’s the route you’re going to choose, but take heart (pun intended) that the vagal genie goes back in the bottle more often with less kicking and screaming.

Hahaha yes I think not sleeping for 3 weeks maybe be fatal!...that’s good to hear
The vagal type manages easier...maybe that’s the reason it’s so infrequent. How
Frequent were your episodes before you had your PVI?...I don’t think I’m there yet
But it’s good to hear from someone with similar after dark episodes...crazy thing is
I don’t have a pvc or pac during the day, I go to the gym 5 days a week and my HR
Exceeds 145 and I feel fine.....I guess the Vagal genie comes out at night ?

Yes, it does.

Mine were happennig every night like clockwork.

How are things now?

I was AF free for 2.5 years post ablation. I just had a breakthrough two weeks ago, which was disappointing to say the least,

If it comes back in force, I'm going to Texas. That's it.

Sorry to hear that......prominent EP in TX?

That would be Dr Natale, who is often mentioned around here. I’ll be making an appointment when the time comes.



Edited 1 time(s). Last edit at 05/06/2018 08:46PM by wolfpack.

Ah yes I thought he was in NY.....he seems to be a master at his craft, his partner is Dibiase?

Joey,

One contributor to vagal afib, and early morning episodes are commonly vagal, is chronic fitness. This was certainly true in my case (long duration, high heart rate, endurance activities). In my case, detraining from this was a big part of my afib remission strategy (in addition to magnesium, potassium & taurine). While I remain very fit, I do other things. Also, if I push my luck on doing too much high heart rate endurance activity during a day, it can be a trigger. The trigger is delayed, not during the exercise.

Many of my afib episodes have an early morning start. I am definitely vagal.

George

I agree with George. In my last few episodes, I either had extreme emotional stress or physical stress th bday before the onset. The episodes didn’t happen while I was experiencing the stress but when I was sleeping at night. I think when i am awake, my brain is doing its job to regulate heart rate and nerves. Then when I go into sleep, without intervention from the brain, the autonomous nerves go hay wire. I always think if we can find a way to restore the balance of the autonomous nerves, the it might not trigger afib anymore. I think George’s ginger intake some how helps him in balancing the nerves.

Same for me. Early morning start.
Sometimes just while resting, no need to sleep, so it may start late in the evening if I'm quiet.
Afib may start when I'm awake and staying in bed for some time...

I agree George, while I’m not an endurance athlete I do go to the gym 5 days a week, and I also think it had a lot to do
With the autonomic nervous system as well, Kong what you said makes sense as well, our system slows down so much
While at rest and having a vagal response in our sleep there is no way to wart it off.....

I too believe I'm a Vagal AFibber. After a meal, relaxing by the TV, eat or drink a bit too fast, and bang. I'm away.

Tonight grabbed a piece of licorice on the way to the kitchen and immediately went into very rapid and chaotic AF.. I kept wanting to pass out and HR was so fast I couldn't catch my breath. Chest pain was nasty as well. I think this was the scariest episode in the fifteen long years I've suffered with it.

I'm still in AF as I type, HR back to about 145-155...but chest pain settled and not as dizzy.

Whoever finds the 'cure' for this complaint will be a hero to millions, and very rich to boot