Feed back regarding interm. fasting/extended fastg, exercise and my afib episode out of no where

Good afternoon! A little about my experience and any thoughts from people who wish to comment that will be helpful is great. I am a breast cancer surivior (lumpectomy, taxol and herceptin as chemo proton therpy for radiation.) I had a lone afib episode abt 5 or so years ago after I was leaning forward in a seated stretch with my head low and then got up to a big glass of ice cold water and boom my first episode hit. I received the meds in ER and it took hours, but finally my heart regulated at abt 1 in the AM and it was determined a lone episode as there was nothing wrong found in all their looking so started my regimine of an aspirin a day. With that, fast forward to my cancer experience, on the 4th 5th and 6th treatment, each time I went into afib, chemo on Monday, afib episode on Wed or Thur eve to the ER for cardioversion, uhg. At that point the docs put me on Eliquis, Metropolol, and flecainide, but when I finished chemo I asked to try slowly weaning off and I did, I took the last Flec pill Oct 3 2019 so 9 months ago. That was a bit of a back story, but here is the current. I have been looking a lot and working with some intermittent fasting and wanted to try something more than 16/8. I tried a week of 5/2 thats 5 days eating and 2 days fasting and it worked ok so I wanted to try 2 days fasting together and this is what happened. I fasted a Mon and Tues, had a day of eating Wed, and woke up Thurs not feeling ver hungry, so I went for a walk about 2.5 miles. When I got back it was hot but was doing stuff round the house etc.. went to the garage to get something from there and there is a pull up bar that I grabbed to do a couple of kinda half pull ups, just to wake up the back muscles and on the fourth one I came down and boom the afib over rvr started. My heart goes like a race horse 200 plus. Well I ended up sent to the ER by the docs office where they cardioverted me again! I am not sure and am very concerned what the trigger was for the epsisode? Was it over exherting myself, the heat, the fasting?? I just wish I knew!! So frustrating as I hate when these episodes happen, getting shocked is what it is and I bit my tounge in the process!! Anyone have any thoughts on fasting or exercise, I am really trying to stay off major meds if I can! I also need to add that I am a 51 yo perimenopause female, so wondering if that is even a trigger as I was on my cycle also the day of the attack. Who knows?? I hate afib thanks for listening and help, blessings!

As a male, no experience with cycle, so no comment on that. You'd eaten after the 2 days of fasting, so not in the middle of a fast, except overnight (which sounds like is common for you). Fasting & keto can cause electrolyte disturbances leading to ectopics & afib, but you'd been eating. A 2.5 mile walk doesn't sound strenuous for you, however if it was hot, perhaps you got dehydrated? It appears the exercise triggered the afib and also indicates a sympathetic (vs vagal) trigger. So stress of some kind can acutely trigger afib, which may have been the exercise in this case.

The 2 days of fasting might be added stress for your system, so perhaps limiting it to a 5:2 with the fasting days separated.

Was the 200 bpm different than other afib episodes?

Hi George, had a whole respone typed out and then deleted it accidentally Going to look more at the sympathetic trigger you mention? Wondering if there is a way to help that as far as episodes go especially in the season I am in of change etc... I really value your input so thank you and will contnue to explore fasting but as you said maybe not more than a day at a time. Also wanting to look at suppliments that may help? I take magnesium, but not all the time and maybe something helpful for stress. It is difficult because most doctors are so "medically" trained and not very supportive of natural/nutritional things. Thanks again for your input, blessings

While it's still fresh in your mind - just chart and take notes. I guess if you're like most you'll just notice that AF incrementally gets worse over time. I chased every solution I could find and now on the schedule to get an ablation. Kind of resigned to that reality.

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LaDonna
Hi George, had a whole respone typed out and then deleted it accidentally Going to look more at the sympathetic trigger you mention? Wondering if there is a way to help that as far as episodes go especially in the season I am in of change etc... I really value your input so thank you and will contnue to explore fasting but as you said maybe not more than a day at a time. Also wanting to look at suppliments that may help? I take magnesium, but not all the time and maybe something helpful for stress.

Hi LaDonna,

As my afib has vagal triggers, I don't have a lot of experience with sympathetic ones. I just know that an exercise stress can trigger them. For example, a friend who is a hunter, had his first afib experience when he killed a deer and was going to haul it out up a hill. That exertion triggered the afib. Others can get a sympathetic trigger lifting weights, for example. Vagal triggers tend to have a delayed effect, when you are relaxed, eating or sleeping long after exercise.

In my case, being very consistent with magnesium is a cornerstone of my keeping afib in remission. Consistently drinking the potassium citrate drink I suggested for my afibber son-in-law has seemed to make my excellent afib control even better.

Your cycle may have something to do with this. Making note of it may help. Where you are on your cycle may make your body more sensitive to stress from fasting, exercise or whatever. So maybe plan your activity to minimize those kinds of stresses during a period in your cycle that you are more sensitive.

In my link about my son-in-law, I talk about what I've suggested to him as far as endurance exercise goes. I figured this out subjectively around 15 1/2 years ago when creating my afib remission program. When I started coaching him, I wanted to quantify what I did and the result is in the linked post.

For weight training, a "super slow" or "Body by Science" approach. This is because the weight required is much less than what is traditionally suggested. I would think that high intensity (HIIT, Tabatas) would not be a good idea for sympathetic triggers. Especially during times you think you might be more sensitive.

Just the thoughts that come to mind.

Hi Ladonna,

Sympathies for your travails.

My experience mirrors NLAMA, except now post AF ablation 2005 and post AFL ablation 2011, despite ablative measures in 2005 to prevent 2011. I too tried everything.
Most are looking for the "solution". IMHO such a thing is unusual. For most it's much more complicated than that.

As the great French cardiologist Philippe Cozumel (RIP), who wrote the forward to Hans' first book on LAF, opined, AF requires three components
1) a defective substrate (flutter and fib prone)
2) electrolyte imbalance (a trigger)
3) autonomic imbalance

NLAMA and I are/were probably top heavy in #1. Others may have less of #1 and may be able to control episodes by attending to #2 and #3.

My episodes were primarily closely linked to K and Mg, postprandial hypoglycemia, post exercise during the vagal rebound, poor hydration, positional or a combination of these.

Listen to George. He's a real smarty pants (ha-ha).

I would suspect dehydration and the fasting, probably in combo. Separate the variables and figure it out. Don't give up yet like NLAMA and me. No need to be as stubborn as George.

Good luck

Hi Ladinna,
Your experience mirrored mine. I speculate you have HER-2. Herceptin and taxol at the infusion room and AF would pop up during the treatment. I would finish the drip and walk across the street to the ER. If you are still getting Herceptin I would recommend a very slow 4 hour drip instead of a faster infusion of toxic chemicals.

What state do you live in? There is a wonderful cardiologist who specializes in woman’s heart health issues caused by chemo. She is a brain. She moved to Atlanta so I had to stop seeing her. Also I saw the chief of oncology at Sloan Kettering in NY. He wrote many papers and had studies that Herceptin is cardiac toxic. With me he said “i would rather put a loaded pistol to my head than give you Herceptin and taxol.” For HER-2, the actual drug protocol is 3 drugs not 2. Two chemos plus Herceptin. But with me, he finally approved for me a water down treatment of only taxol and Herceptin when my Oncotype tissue test results returned bleak if I didn’t have Herceptin and taxol. He evaluated the risk of cardiac death from Herceptin to my Oncotype results. Google her2 platinum drug treatment.

Sorry you had to go through this. I speculate your af was from dehydration and not drinking to flush out the toxins in chemical treatment. Especially Herceptin. Are you on a five year treatment plan to take Arimidex?

One last thing- my post AF during chemo stopped after I convinced the infusion nurses to slow down the drip to 4-5 hours.

The cardiologist that is experienced in women’s heart issues including the cardiac affects of chemo info is below. She takes telemedicine appointments. I didn’t know that. I may make an appointment. Her Cedars-Sinai replacement doesn’t shine compared her. In addition to being an expert, she has the kindest sweetest demeanor.

[providers.emoryhealthcare.org]

Wow Susan, thank you so much for that info. I am post cancer treatment at this point, and although my cancer was her2+ I was ER neg, so I am not going to take the tamoxifen or AI because of my other health issues like the AFIB as it is my understanding that none of these things are heart friendly. This is one of the reasons I am experimenting with intermittent fasting and nutritional improvement in the hopes that there is not a recurrence. Trying to reduce my weight as I read that obestity can be contributing factor. Trying to eat my veggies which I fortunately enjoy anyhow, cut sugar, trying to cut white stuff, processed stuff aside from the occasional handful of chips. I am hoping that by reducing weight I can cut my potential for both cancer and afib risk. I take a 365 mg aspirin every day with an oderless garlic suppliment and a magnesium glycinate but I think I have to be more consistent with the mag and make sure I take it 2x a day (morning and night) but its hard on the days I am fasting but perhaps if I keep an avacado around it would help to eat a little avacado with taking the mag? anyway, poking around in the dark as a nube. Oh, about the drips, both of them were very fast. Taxol took a couple of hours, hercptin maybe took 30 min! But as I said finished at this point. Tried fasting during chemo hoping for a protectice factor over the rest of the healthy body to the best of my ability. I am in middle TN, justtrying to find a decent electrophysiologist here. The one I go to, I contacted the patient portal to ask follow up questions 3 or 4 days ago and they have not gotten back to me yet, a little put off by this so looking for a new doctor, and praying asking God to guide me to a doctor that will be good for me and listen and not just want to throw metaprolol or flecianide at me "next"! I am not totally against any of these, but I am only 51 and would like to deal with things in a healthier way if possible. Thanks again!

IMHO it’s too late now but perhaps not fasting but drinking mire after a chemo infusion would had flushed out the toxins of the chemo chemicals. You should consider not fasting. Each and every ER for AF showed by lab work that I was dehydrated. You don’t want to be dehydrated. But the best one to ask is a trained EP.

You had a fast a Herceptin drip. I’m sorry. Arimidex didn’t bother me so requested an additional 9 months of Arimidex. I’m off of it with more AF than being on it.

I wish you a 100% cancer free recovery.

Why are you doing different sorts of fasting? If you have experience (as George does) making sure your electrolytes are balanced, you ought not to do any fasting.

You’ve had enough episodes of going into Afib, especially with different fasting schedules, to stop and asses your situation. There is a wealth of information on this site that will shed and/or guide you on what supplements are crucial to help keep you Afib free.

You’ve been through a lot, go easy on yourself. Good luck.

Before my ablation, I got kicked into Afib by the following sequence. Sitting on the couch, getting an urge to change a lightbuld and moving a chair in place to do so (so far so good) and then reaching up to change the light bulb. Was it bending to get the chair, or reaching up? Who knows, but something to do with the sudden onset of adrenaline to move from a dead rest. Sounds like you did something similar with the pull up to "wake up". We all have triggers. Al we can do is try to avoid them within reason.