Horizontal NSR Vertical Afib

This is weird. My heart has been acting up all afternoon, throwing PACs, the occasional PVC, hanging out in NSR for a while, then acting up again. The weirdest is this: I was lying on my bed, NSR in the middle 60s. Got up to take a bp, sat down in the usual chair, now I'm in afib (more or less). Lay back down, almost immediately back in NSR. Got up again, sat in the chair, afib. Lay down, NSR. All in the space of 5 minutes.

Anyone with similar experience?

The tightening discomfort of my darn BP cuff has put me in arrhythmias more often than not. I have a iWatch and take a reading at times upon waking up still in bed and once I stand up I also went into AF. I am sure it’s just a common fluke...or not. In the past taking a reading and being worrying if I am in AF would trigger it. Now I don’t care. It’s like our CA big earthquakes. The last recent one woke me up from the sound of items falling onto the ground and the shaking but I just rolled over and went back to sleep.

Are you using a Kardia? It sometimes display possible af during atypical low hr flutter or pauses. I only trust a 12 lead because it’s too frustrating and I gave up taking iWatch AND Kardia readings one right after each other and it switches back and forth from nsr or possible af when I’m just sitting.



Edited 1 time(s). Last edit at 08/30/2020 12:23AM by susan.d.

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wwoofbum
This is weird. My heart has been acting up all afternoon, throwing PACs, the occasional PVC, hanging out in NSR for a while, then acting up again. The weirdest is this: I was lying on my bed, NSR in the middle 60s. Got up to take a bp, sat down in the usual chair, now I'm in afib (more or less). Lay back down, almost immediately back in NSR. Got up again, sat in the chair, afib. Lay down, NSR. All in the space of 5 minutes.

Anyone with similar experience?

It's strange, indeed.
It's the opposite for me. When I tend having PACs, I've better not laying down, since it may trigger afib. When sitting and feeling ectopics, I'm used to stand up and walk around.
Does it give the same effect if you manage to leave your bed very slowly ?

Yes, movement and different postions... ie lying down or standing up...can certainly affect my heart when it is agitated. usually for me, when my heart is in it's agitated mode...lying down can make it worse or throw me into full afib...and then popping back up can put it back into NSR. I think many people expericne this type of thing.

Not had a similar experience myself, but do you by any chance experience orthostatic hypotension (blood pressure drop when you stand up)? A symptom would be brief dizziness or blurred vision upon standing. I suppose if that happened and the body responds (which it does) with adrenaline to bring the BP back up that could be a trigger for the arrhythmia.

Who knows...5 mins ago just sitting outside in the sunshine, ate a peppermint and went into rapid AF. HR currently 140+. Totally has spoilt my day's plans again!

In over 20 years I've just about given up on my triggers, altho eating is definitely one of them, so is walking, sitting, sneezing, lying on my left or right side, laughing, excitement etc etc.

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JoyWin
Who knows...5 mins ago just sitting outside in the sunshine, ate a peppermint and went into rapid AF. HR currently 140+. Totally has spoilt my day's plans again!

In over 20 years I've just about given up on my triggers, altho eating is definitely one of them, so is walking, sitting, sneezing, lying on my left or right side, laughing, excitement etc etc.

In other words, whatever random thing you were doing before an AF episode began appears to be a trigger.

This is why I don't believe in triggers.

Mostly, anyway. I believe in a small few.

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JoyWin
Who knows...5 mins ago just sitting outside in the sunshine, ate a peppermint and went into rapid AF. HR currently 140+. Totally has spoilt my day's plans again!

In over 20 years I've just about given up on my triggers, altho eating is definitely one of them, so is walking, sitting, sneezing, lying on my left or right side, laughing, excitement etc etc.

Do you have stomach issues ? (Silent) reflux ?

I'm like you, afib starting and stopping when it wants. Often related to body position and physical activity.
I'm vagal, so resting (and resting positions) favour ectopics and afib.
I've stomach issues, so resting while digesting strongly increases the risks.

I'm searching for triggers since late 2015 (my first afib events). 336 episodes since then gave me time to experiment, try meds or get 4 ablations! I've now found ONE sure trigger : fresh bread. I've checked this repeatedly, so I'm sure it's a trigger for me. I've just to eat more than 100g of fresh bread (say, three or four slices at midday meal), it takes 10min to get ectopics and afib. The episode lasts 20 to 30min. I think it may be a stomach reaction to gluten, but it has to be tested with a gastroenterologist (next exams in november).

There are a couple of other things I'm sure they're bad, like alcohol. But as the effect on HR may appear strongly a posteriori, it's hard to know. I don't think alcohol itself is a trigger, but its elimination creates electrolytes imbalances, so the effect of alcohol may appear hours later and, depending on what I've done and drunk (say, lots of water) before going to sleep, I may have a quiet night... or not. Dehydration is bad.

Same for exercise. 1 hour bicycling at avg 22km/h (which is not very fast) in the late afternoon strongly increases the risk of having afib in the middle of the night. I think it's because sustained effort in the day increases vagal tone at rest, lowering my HR and favouring PACs. To reach this avg speed, I've not to make trong sustained efforts (barely in the 90-100bpm with some peaks around 120), always keeping nasal breathing, but it seems to be enough for me.
Conversely, I may have a quiet ride with my wife the whole afternoon at avg 18km/h, chatting and having a couple stops, and nothing happens in the night. I wouldn't say sustained effort is a trigger, but it favours afib at rest.

But we're all different, as often said!