Can hunger cause PVCs/PACs/ectopics?

Hi guys,

I have AF but was - as many of us have been - successfully ablated around 2 years ago.

I've had just one episode for 2 hours of full-on AF since my ablation, that came 6 days after my ablation.

However, recently I've noticed a lot more activity and in particular I'm having a lot of positional ectopics.

But just now, I'd been taking food out to eat and I came over all 'funny' and my heart lurched big-time. It was probably the biggest 'pause' I've felt since the last time I went into full AF. It happened a couple more times and I now feel a bit weak and feel like I have a bit of a headache coming on too.

I've read a little online in the last half hour about a so-called 'hungry heart' syndrome in people with AF or heart conditions and I'm just wondering if hunger/not having eaten a lot for many hours can cause these ectopic beats? I ate at 6:30pm last night and all I'd eaten prior to my late lunch just now was a small crumpet about 10:30am and a piece of chocolate in like 19 hours.

Is it possible, does this hunger causing ectopics thing actually exist?

Cheers

Yes, going without food, especially protein, will cause me pacs, goes away after I eat. I don't know how people can go for days without eating
anything and believe that it is good for them.

Liz

I'm glad you said that.

I have a lot of new/other health issues in the past 9 months and I've been in and out of work, so this today was really the last thing I needed.

I've had a little issue in the past when I've left it a bit late to eat but I'm usually snacking throughout the day.

Absolutely terrifying, as I'd not had anything that intense happen for a long time.

Davros - Your description of "hungry heart" is what happens when blood glucose (sugar) levels become too low...a condition known as hypoglycemia. The brain's major energy source is glucose. As a protective mechanism, the body must protect the brain at all costs.. so when glucose drops too low, there is an adrenaline surge or "alarm" that indicates "fuel" intake is needed. The symptoms of this alarm or alert are varied... hunger, light-headedness, headache, fatigue, shaky feeling, sometimes panic, and also heart activity including PACs and outright arrhythmia.

Some of my earliest pre-afib signals were the hypoglycemia symptoms... if I hadn't had enough healthy fat and protein regularly and if the timing of my next meal was delayed ... I'd go into afib.... and after testing, I was diagnosed with with the hypoglycemia and adrenal dysfunction... mainly caused by the stress factor.

The remedy is to eat healthy fat and protein-containing meals and avoiding starchy carbs or sugary foods that metabolize quickly and exacerbate the problem.... and eat frequent small meals every 2 - 3 hours (or less) to help stabilize the metabolic process. A healthy fat/protein snack at bedtime is required as well. When I first started the protocols, the doctor told me to keep a healthy snack on the night stand to eat if I woke up in the wee hours to avoid the hypoglycemia. For something quick, he recommended a heaping spoonful of organic coconut oil... doesn't need refrigeration and quick to access. (He had a similar issue so that's what he found helpful).

It didn't take long to reverse the trend as long as I ate sustaining fats and protein, non-starchy veggies, and eliminated starchy carbs or sugary foods. Back then, it was modelled after the Atkins diet... then came a modified Paleo eating plan... emphasis on very limited carb intake and today we have the Ketogenic diet that is very useful if you work with a knowledgeable practitioner who can test appropriately. Check GeorgeN's posts on his success with Keto eating.

Jackie

Hi Jackie,

Thanks for explaining this, it makes a lot of sense. I'm not necessarily suggesting that I'm hypoglycemic but the lack of food, coupled with the extreme signs of hunger I'd been experiencing for a good few hours made me think straight away that my lack of food had certainly been a huge contributing factor.

I'd also just got back off a very long walk 20K steps. I probably had not helped myself by doing this.

I just hope it was my body warning me about my future conduct because it was a really unpleasant reminder, and I'm still quite stiff, bit of a headache and exhausted.

Dave

Quote
Elizabeth
I don't know how people can go for days without eating anything and believe that it is good for them.

Liz

It just depends on one’s level of keto-adaptation. When blood sugar (glucose) drops low for an extended period of time, the body responds by metabolizing fat into ketones. The brain and muscles can use these as energy. The caveat being, of course, that you aren’t diabetic. If you are, ketones are dangerous and will lead to ketoacidosis which lowers the blood pH out of the (very narrow) normal range and can be life-threatening. If you’re not diabetic then it’s just a matter of training your body to use ketones as fuel. None of this is necessary, it is personal choice.

I, for one, eat one meal per day usually. I exercise in a fasted state all the time. I’ve done this for years and, to me, it’s more comfortable. I have an extremely slow metabolism and find it discomforting to have a bloated belly full of food during the day. I suspect part of that is low stomach acid production, something that led to my GERD and esophageal ulcer 5 years ago. I also have a hyperkinetic gall bladder (diagnosed by HIDA test) which I think wreaks havoc on gut flora. So I’ve got issues on both ends of my GI tract! I treat the upper end with zinc and B-12 and the lower end with probiotics. I’ve managed to improve GI transit time down to about 12 hours from upwards of 72. Still it’s too slow for me to consume 3 meals a day. Thus my choice to keto-adapt and fast for most of the day.

If I do overindulge and experience a “backlog”, my favorite thing to do is eat something ridiculously spicy. So if you see me heading for the bathroom, don’t get in the way!

I'm not keto adapted i think. Water fasted this week for 36 hours. At the end my blood glucose was 3.8 mmol/L (68.5 mg/dL) Ketone -1.5 mmol/L.
My heart felt very regular throughout and when taking BP it looked regular as well.
After eating b'fast (1Ts oats,1Ts chia, 1Ts linseed, 1Ts brewers yeast, 1Ts hemp seed, 1 Ts whey, 1 Ts cocoa, blueberries 130g, little cinnamon and powdered gloves with about 360ml coconut 'milk')
Glucose went up to 140.5 after 1hr and 156.7 after 11/2hr, 95.5 after a bit over 2 hrs. (possibly slightly insulin resistant?)

Anyway, just shows we all respond differently to low and hit blood glucose levels? I've had not abltions but it take 50mg Flec before bed.

I’ve never measured blood glucose or ketones. Perhaps I should. My definition of adaptation is simply how I feel while not eating. Which is fine. I do not experience hunger nor are my mental capacities diminished in any way. I work full time as an integrated circuit designer for high-speed serial links. I also do word puzzles all the time (NYT Saturday edition anyone?) and usually solve them on recollection/deduction alone. I take that to mean my brain doesn’t need glucose for its only fuel.

Quote
Jackie
Check GeorgeN's posts on his success with Keto eating.

True hunger is typically driven by low blood sugar as Jackie suggests. In most people, the brain fuels 100% on glucose and when blood sugar levels drop, the brain wants fuel. This can create a sympathetic nervous system adrenaline response. This can be a trigger for some afibbers. Low blood sugar typically correlates with low insulin. When insulin is low, it signals the kidneys to excrete sodium (when insulin is high it signals the kidneys to conserve sodium). In some cases, this is strong enough to cause the body to excrete potassium at the same time. This electrolyte disturbance can cause arrhythmia (PAC's, PVC's & afib) in susceptible people. This is also why keto adapting can be a risk period for afibbers. In my case, I keto adapted 9.5 years ago using an "Atkins" approach - 20 g/day carbs. It was not a gentle approach and though I knew about electrolytes to a certain extent, I have learned more since. I did have an afib episode during this time, though I have not had one since that was tied to low insulin. Supplementing with sodium can offset this and is fairly standard advice in the low carb world <[www.dietdoctor.com] Also supplementing with potassium & magnesium.

I've since learned there are more gentle ways to accomplish this adaptation. The adaptation is signaling the body to up-regulate the enzymes used to create and use ketones. In most people who fuel primarily with carbs, the ketone system is in "mothballs." There are a small number of people who genetically lack this ability, but most can turn the system on. My wife adapted slowly and never experienced any "keto flu."

Quote
Elizabeth
Yes, going without food, especially protein, will cause me pacs, goes away after I eat. I don't know how people can go for days without eating
anything and believe that it is good for them.
Liz

My first wife would be symptomatic (headaches, migraines & etc) if she did not eat frequently. She is thin, a BMI of around 19. For the 30+ years we were together, this was true. As we are still friends, she knew of how I approach this. In the last few years, she changed her diet and now eats in an 8 hour window daily, fasting 16 hours. This would have previously been unheard of. I have another female friend who'd had the same issues and would have extreme symptoms if she did not eat frequently. This started for her around puberty. After chatting with me five or so years ago, she changed her diet and now can fast 16 hours/day comfortably.

If one is adapted, then not eating is not a crisis or stressful for the body. If one isn't adapted, then it can be.

As to extended fasting and health, one reason to do this is to upregulate autophagy, mitophagy & other cleansing mechanisms. When we eat continually, the body never activates these cleansing and restoration programs. Valter Longo, at USC has demonstrated upregulation of stem cell activation and renewal of some body parts and systems with extended fasting in rodents. A mouse will lose 20% of its body weight when fasted for 2 days. Much longer and it will expire. It might take a human 60 days to lose 20% of its weight. However Longo has created a fasting mimicking diet (FMD) that he thinks can create some of these effects, using it for 5 days at a time. There are some fairly dramatic case studies (anecdotes) in humans of positive benefits with long extended fasts, many of whom had exhausted all avenues of traditional care for their situations. If someone is sick and on meds, then medical supervision would be indicated rather than doing it unsupervised.

Quote
wolfpack
I, for one, eat one meal per day usually. I exercise in a fasted state all the time. I’ve done this for years and, to me, it’s more comfortable.

Likewise for me. I don't test all the time, but I do test out of curiosity. The most cost effective ketone meter I'm aware of is <[keto-mojo.com] I actually don't eat an extremely low carb diet now, but maintain keto adaptation. My diet is ovo-pegan and significantly plant based and low saturated fat with the fats being mostly monos. I can easily fast for a few days. For example I was traveling Thursday and Friday so I didn't eat Thursday and then did on Friday evening when I got home. Out of curiosity, I checked my glucose (63 mg/dL or 3.5 mmol/L) and serum ketones (3.9 mmol/L). I've actually dropped my glucose as low as 31 mg/dL (1.7 mmol/L) and gone to the gym and had a good workout. When I related this to my neurologist climbing buddy, he says the only people he's seen with glucose in the 30's are comatose. This would be true for someone who is not adapted and a true emergency. T1 diabetics can face this because of the exogenous driver (insulin) they consume. T1's who keto adapt report dramatically fewer symptomatic hypoglycemic events. An extreme example of what can be done was an experiment by the late George Cahill from Harvard in the 1960's. They fasted obese divinity students for 40 days, then injected them with insulin driving their glucose to 18 mg/dL (1 mmol/L) with one guy down to 9 mg/dL (0.5 mmol/L). They were completely cognitively asymptomatic! This study design would never get passed and IRB (Institutional Review Board) today.

My advice for DavrosT would be to a) pay attention to electrolytes, b) do as Jackie suggests and consume frequent fat/protein meals, and/or c) slowly adapt your system to be a "hybrid" (being mindful of the risks while doing so).

George



Edited 2 time(s). Last edit at 04/20/2019 04:51PM by GeorgeN.

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Edited 1 time(s). Last edit at 04/21/2019 12:50AM by GeorgeN.

Cheers for your responses.

In terms of electrolytes, what would be sufficient? I am currently taking 200mg daily potassium, although I don't get enough natural potassium. I'm also supplementing 400mg magnesium daily.

I drink around 1.5-2lt water daily, I also drink a few cups of decaf tea with coconut milk. Totally cur dairy out of my diet. I could really so with more protein though and may have start eating protein bars.

My diet is limited at the moment, as I'm having a lot of other health issues, gastro amongst them. What else can I do to replenish electrolytes though? Thanks for all of your advice

Quote
DavrosT
Cheers for your responses.

In terms of electrolytes, what would be sufficient? I am currently taking 200mg daily potassium, although I don't get enough natural potassium. I'm also supplementing 400mg magnesium daily.

My diet is limited at the moment, as I'm having a lot of other health issues, gastro amongst them. What else can I do to replenish electrolytes though? Thanks for all of your advice

Carey and others who've done the saliva testing over the day for potassium will tell you it changes very quickly. If you kidney's are healthy, any excess are excreted as urine. I make my own "time release" form of potassium by putting powdered potassium citrate in about a liter of water and drink it over the day. I use 2 tsp which is above 4 g of potassium. If you choose to do this, start with a lower dose and slowly work up.

My doc is big on treating gut health. Most won't eat off his lists, but many of those that do have found them beneficial. The keto version: <[drive.google.com] and non keto: <[drive.google.com] His books that explain the why's are: <[www.amazon.com] and <[www.amazon.com]

Does anyone do the Wheat Belly Diet by William Davis, MD ? I am wondering if that is a good diet for Afib.

Thank you for any information you can give me.

Maryann



Edited 1 time(s). Last edit at 04/29/2019 11:04AM by Maryann.