I'm adrenergic, but, am I also Vagal?

Dear folks:

I've read Hans book and am still struggling with a 'diagnosis'. I've had afib for five years now. The first noticable episode happened during opera rehearsal and the second in the midst of a round of golf. Ground jalapeno peppers always put me in afib, and I sometimes get afib during the 'digestion' period. Large meals can sometimes be a trigger. When I go to bed and put on the C-PAP I sometimes get afib that can usually be ameliorated by lying on the right side. The major trigger in this last escalating sequence of events that began in September was work related stress, which, in the month of November regularly put me in afib. Just seeing someone related to my work at Christmas Eve services put me in afib for 15 minutes.

Again, a couple of weeks ago I had a stress-echo. I had some PACs, then flutter before the test. Again, before the test, while the nurse was taking some pre-test ultrasound readings my heartbeat went from 84 - 64 bpm in one beat. She commented that she had never seen that before. I told her she had just 'touched my heart' (which was probably true and also got the desired laugh). When on the treadmill I was not in afib, and they tried to induce me. But, 14 minutes on the treadmill and no afib. I had plenty of lactic acid build up. The technician commented that he often observed that people went into afib after exertion, and, sure enough, about ten minutes into the rest period I went into afib for about 10 minutes. I told the technician that good joke often restores NSR. He told one and I laughed and immediately converted.

Chocolate is definitely a trigger.

But, I have never awakened at night with AF, which seems to be the telling experience for vagal afibbers.

I have been thinking I'm 'mixed'? What do you veterans out there think. Am I 'vagal', 'adrenergic', or 'mixed'?

john

John,
I've been through Hans' book a few times now, as well as surfing many sites on afib, and the one thing I am sure of, is that I an neither vagal, nor adrenergic, as defined by the literature.

I've spoken with a few people now who are definately one or the other, but while by all I've read, I should be chalked up to the vagal team, but my only constant trigger is stress. Yes, I have had a fib after a HUGE thanksgiving meal, but one episode, a vagal sufferer does not make.

I feel very lucky that I have been able to control my episodes by breathing, and supplementaion, and am now off the rythmol.

Chocolate? let me at it! Wine or beer? No problem! A week dealing with a systems upgrade? A complete mess! There is no time pattern to my episodes, and the instance that I thought was exercise induced, I realized I was in afib prior to the exertion. I've never had an attack by laying down, or on one side, or any of that. My resting heart rate is 60-62....

Bahhhh! I'll stop blathering on, but my point is: I think that it is very likely that you are a mix. I'm quite sure that I am some sort of afib mutt, which in its own strange way is comforting

Good luck John. Happy New Year!
sm

sm

John,

It seems to me that your episodes are about 50:50 adrenergically and vagally mediated so I would put you in the mixed category.

Hans

John,

I would have to say you're mixed, just as I am. Oddly, I believe the mixed version came after diagnosis and meds. Prior to that, I was definitely adrenergic, with the few episodes I had, being exercise induced, but there still remains the possiblity that I had episodes I didn't know about. When on beta blockers, my scenario turned from flutter to AF, and then most of my AF appeared right after dinner, when sitting, or when lying down. My heartrate would plummet all the time, and I believe this was due to insufficient adrenalin and sympathetic tone, which is what the betas were blocking. I'm now on flecainide, and most of my episodes come on in the day and can be caused by exercise (once, day), eating Doritoes w/bean dip (sulfites or free glutamate, night), eating out (same as previous, day), eating Jimmy Dean sausage (MSG, day), and taking a particular supplement (either free glutamate or phospatidyl serine, choline, inositol, day).

In my case, I believe I'm chemically sensitive, and my sympathetic tone is not sufficient. This has pretty much been shown in all my molecular testings, due to being seriously low in B12, B6, folate, molybdenum, and disrupted pathways of serotonin and noradrenalin and adrenalin. The above nutrients that I am lacking are important for the methylation pathways (see conf. room) and producing s-adenosyl methionine, which is a rate limiting step for adren. and noradren. The sulfation pathway is dependent on molybdenum, which breaks down sulfites to useable sulfates. So hopefully, the harm has not been so extensive, that I cannot rectify with dietary changes and supplementation.

So, my vote is you're mixed.
Richard

i think we my sometimes confuse ourselves about stress and exercise. i get a.fib with these. but if i look closely its just after the event. ie immediately exercise is finished the vagus stimulation kicks in.