Swallowing trigger with Vagal AFIB

Anyone else out there have AFIB episodes that are tiggered by swallowing cold or carbonated beverages? The vast majority of my episodes have been triggered this way, although there are almost always contributing factors such as dehydration, recent exercise, alcohol or travel/sleep issues.

It never affected me, but I've seen several people on another forum say they're triggered by cold drinks so apparently it's not that unusual.

Joe - You could do a search in the archived posts for " vaso-vagal " response which I recall being discussed
a number of years ago as either a response to something cold and also stretching both of which can involve the
vagus nerve. I don't recall the specific situation, but drinking something ice cold has been mentioned periodically.

Jackie

Hi Joe, the first time I went into afib it was right after I took a drink of very cold milk, it happened again later after drinking ice cold water. Now I'm more careful, I take smaller sips or I use a straw, it seems to help.

Hey Joe,

There was a time about seven years ago when I was consuming excess calcium (for me) from food. I've posted about this before. Anyway, there was an 18 month period when my normally excellent afib remission protocol got a bit ragged. I became much more sensitive to various triggers. Swallowing icy cold beverages was on of those triggers. I recall helping a friend move on a hot summer day. After we were done, I slammed down a glass of ice water, which put me into afib There were other times and times when it would just provoke PAC's. Sometimes I could reverse the process by drinking hot water (even hot tap water). When I realized my error and got my electrolytes more in balance, this issue went away.

George

I did it last June after a bike ride when I guzzled a cold water. It’s not uncommon.

Gulping Frozen Yogurt or Smoothies to fast is a trigger for me.

Yikes! How can you gulp frozen stuff?

There may also be a correlation between ingesting too much of anything too quickly and the need to essentially hold our breath as whatever it is we decided to swallow like we were a snake has to transit the esophagus. The quick build up of serum CO2 can also be arrhythmogenic (in addition, oddly enough, can also do the opposite). Serum CO2 does affect atrial refractoriness.

Quote
wolfpack
There may also be a correlation between ingesting too much of anything too quickly and the need to essentially hold our breath as whatever it is we decided to swallow like we were a snake has to transit the esophagus. The quick build up of serum CO2 can also be arrhythmogenic (in addition, oddly enough, can also do the opposite). Serum CO2 does affect atrial refractoriness.

My guess is it is a vagal response to the cold.

On the CO2, I'm guessing this is too short to really do anything from a CO2 perspective. I first referenced this paper <[sci-hub.tw] in this post <[www.afibbers.org] . It is a sheep study where they changed the composition of breathed gasses and tried to electrically stimulate afib. Interestingly, the time with high CO2 was protective from afib, it was the time after the air composition returned to normal that there was about a 4x risk for afib compared to controls.

From my linked post above, " it was determined that elevated serum CO2 (from breathing a high CO2 gas) caused lengthened ERP (effective refractory period) as well as slowed conduction velocity. This is the same thing that flecainide does."

George

Yes, I've had quite a few episodes triggered by drinking cold beverages. Many times this occurs if I bend forward (to get out of a chair, to tie my shoe, etc) immediately after drinking a lot of water, iced tea, etc.

ABSOLUTELY! It is one of my most reliable "triggers" of an episode. As soon as the cold or carbonated liquid gets far enough down my esophagus to be next to the heart, bam, afib. So, now I just don't drink anything cold or carbonated. At first it was very hard and I really felt like I was missing out. No more nice cold beers on a hot summer day, no champagne when celebrating, no ice cream shakes. Fortunately, I love tea and have embraced the sea of choices with that. I can sip room temperature ginger ale and if I really want a beer I either order what is on cask, because it is less carbonated and slightly warmer or my husband will warm my beer for me by holding the glass in his hands for a while. Then, because we all know alcohol is a trigger, I really enjoy my one beer that I only have if I'm well hydrated and have been feeling good. So, you can still have the iced tea but it is more of a "room temperature tea."
Once you learn all your triggers, you can help your body avoid afib. However, sometimes, we just have no control over it. For those times, I just try not to get too upset. Although, that is very hard. However, I am trying to embrace what is good about my choices now. Meaning, I'm really exploring different teas, I NEVER have a hangover or headache from too much alcohol because I only have maybe one drink if any. Also, if I do gave a glass of wine, I don't feel bad ordering something other than the house wine as, since I'm onmy having one and I rarely have any, I can justify getting a really good vintage! I always have water with me (usually "Wally Water) that my daughter won't drink on me, and when I say I'm tired and need to take a nap, no one tries to get me to do something else!

Sorry for the rant about wine and beer. I got off topic.
Basically, yes cold drinks are a trigger- a repeatable, reliable trigger. So is dehydration, electrolyte imbalance, eating a large meal, increased cardiac demand when anxious (ex. rushing through an airport trying to catch a flight while carrying bags) and being overtired.
Good luck! Hope you do well and stay in NSR ( normal sinus rhythm).