Alcohol induced tachycardia post ablation

Hello everyone
I had my second ablation in September and no AFIB since- feeling great. Alcohol- wine-was a huge trigger for me and I will, sadly, never drink it again. I now limit myself to two beers once a week. Twice now I’ve woken up after two IPAs with a pounding heart- and running 120. It didn’t feel like afib luckily. Needless to say I’m done- the feeling is awful and I can’t risk it leading to afib. Question- does this mean my ablation is shaky? Or is it simply that alcohol doesn’t agree with my heart period? Nothing else- except for major dehydration from colonoscopy this winter- causes me any blips. I’m hoping it’s just that my heart generally can’t tolerate alcohol- I can live with that.

Alcohol is often said being a trigger. But how much alcohol ? And it's likely individual.
Alcohol itself (reasonably) isn't a trigger for me. But I must take care of my hydration in the following hours.
Two beers with my midday meal or in the afternoon and there's no problem.
Alcohol in the evening, conversely, seems to be a bad idea. Hard to avoid ectopics while in bed, in this condition.
But it's me. You're likely very different.

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Dinodog
Hello everyone
I had my second ablation in September and no AFIB since- feeling great. Alcohol- wine-was a huge trigger for me and I will, sadly, never drink it again. I now limit myself to two beers once a week. Twice now I’ve woken up after two IPAs with a pounding heart- and running 120. It didn’t feel like afib luckily. Needless to say I’m done- the feeling is awful and I can’t risk it leading to afib. Question- does this mean my ablation is shaky? Or is it simply that alcohol doesn’t agree with my heart period? Nothing else- except for major dehydration from colonoscopy this winter- causes me any blips. I’m hoping it’s just that my heart generally can’t tolerate alcohol- I can live with that.

I reckon I had several flutters that I didn't identify as such (just palpitations) and they were after a couple of IPAs in hot weather..

I am 3 weeks past my first flutter and doing one IPA only... If I spin it out then it feels enough and there are no palps... ..

This flutter/afib stuff is scary though and I even worry about my morning coffee..... I quickly take a meto too cancel it out

It is so specific to the individual. It’s tough to say. I could drink beer until the cows come home and it won’t matter. It probably depends on the vagal vs adrenergic mediators of AF. Nonetheless it’s not really good for you, and avoiding it is always the best choice even if it sucks.

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allserene
This flutter/afib stuff is scary though and I even worry about my morning coffee..... I quickly take a meto too cancel it out

Coffee doesn't cause afib or flutter. In fact, there's evidence that it's helpful.

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Carey

Coffee doesn't cause afib or flutter. In fact, there's evidence that it's helpful.

Caffeine was a sure-fire way to a PAC storm for me in the year of my AF (2015). I have completely avoided it since. I won’t order a coffee at a restaurant unless I can see the server pour it from the orange decanter. On a few occasions that I haven’t, I suspect it was poured from the regular one because my HR went up by about 20 BPM almost immediately and I was gifted with PACs for the remainder of the morning. That’s not saying it causes AF or flutter, but it sure as heck pisses off my atria.

It depends on the individual, just like beer or wine does.

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Carey
Coffee doesn't cause afib or flutter. In fact, there's evidence that it's helpful.

There have been anecdotes in the ancient past here where coffee was a trigger for some. However when some switched to organic coffee, it was no longer a trigger. Hence it may have been the pesticides & etc. that were truly the trigger for some. As Wolfpack says, it depends on the individual.

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GeorgeN
As Wolfpack says, it depends on the individual.

I certainly won't argue with that, but the generic "wisdom" that coffee is a trigger needs to be reigned in. Everyone from doctors to your neighbors and relatives have been telling afibbers to avoid coffee for decades with zero evidence to support their advice. The only credible evidence I'm aware of suggests quite the opposite.

Coffee always gave me a brief episode within about 20 minutes of drinking it.

I never tried organic (or decaf) - just stopped.

I'm specifically referring to caffeine. So I will only drink decaf coffee and absolutely no sodas. There are a bunch more reasons to stay away from sodas other than caffeine as well. Even the so-called diet ones. As for the decaf coffee, I'll buy the Starbucks brand at the grocery store. I don't know if they're organically sourced or not, but I'm sure whatever I order at a restaurant is bargain-basement stuff replete with whatever industrialized agriculture is going to spray on the beans. Whatever it's contaminated with doesn't bother me.

I honestly have no idea if caffeine would still affect me 4 years post ablation. I'm not going to do the experiment to find out, however. I've no desire to ride out a 4-hour PAC storm.

While I was reading this, people in the TV were speaking about their sudden violent headache.
Most of them are in search of their triggers, and while listening to them, I got the feeling well all have our own ferocious beast inside our body, and we're all wondering how the hell keeping it asleep.

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Carey

the generic "wisdom" that coffee is a trigger needs to be reigned in. Everyone from doctors to your neighbors and relatives have been telling afibbers to avoid coffee for decades with zero evidence to support their advice. The only credible evidence I'm aware of suggests quite the opposite.

You are confusing evidence that coffee (caffeine) has long term benefit for preventing or reducing afib for those who tolerate it, with evidence that it is a trigger for those who are sensitive to it. A lot of people with symptomatic paroxysmal afib report triggers (74%) and caffeine is the second most common (28%) right behind alcohol at (35%); see HeartRhythm 2019.

I used to drink coffee but now get the kind of increase in PACs described above when I touch the stuff. I have tried many different brands hoping for some reprieve but get the same result. Also get this with enough tea or chocolate.

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safib
You are confusing evidence that coffee (caffeine) has long term benefit for preventing or reducing afib for those who tolerate it, with evidence that it is a trigger for those who are sensitive to it. A lot of people with symptomatic paroxysmal afib report triggers (74%) and caffeine is the second most common (28%) right behind alcohol at (35%); see HeartRhythm 2019.

No, I wasn't confusing them and I've seen the study you cite. I simply don't believe the results.

One successful ablation 12 years ago after 11 years of afib. More than one beer seemed to be a trigger on occasion, but not always. No other triggers suspected. Now, I have a glass of wine every evening and sometimes two on social occasions. Beer socially too. Maybe a mixed drink once a month when eating dinner out. Also, a 12 oz. caffeinated coffee every morning as well as a Mt. Dew every evening so I can stay awake until 10:00. Neither the wine/beer/drink/coffee or Mt. Dew have any impact with my heart rhythm.

One suit doesn't fit all, we are all different.

I have never found any actual triggers with the exception of stress, Anxiety. I do my best to not let my Anxiety ramp anymore. I have been detoxing off Klonopin for 18 months. I am down from 4 mg a day to .75 mg daily. Benzodiazepines are a BEAST to stop. It is 3x worse than sch 2 narcotics IMO.
My goal is to have this Klonopin gone before Jan 2020. You have to make small cuts slowly.
Never start Benzos of any type. If I knew in 2012 what I know now, I would have never took the Ativan which finally graduated to Klonopin. Your body quickly builds up a tolerance and you need more. Anyway, I will kick this beast!!

Caffeine is a huge trigger for me.

My first episode was coffee induced on Thanksgiving day 1978. I have to be very careful of caffeine. As in avoid it like the plague.

lisa
__________________________

So much of medicine is looking solely down the wrong end of the gun barrel, and that is really a pity for all of us---Shannon

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Carey

You are confusing evidence that coffee (caffeine) has long term benefit for preventing or reducing afib for those who tolerate it, with evidence that it is a trigger for those who are sensitive to it. A lot of people with symptomatic paroxysmal afib report triggers (74%) and caffeine is the second most common (28%) right behind alcohol at (35%); see HeartRhythm 2019.

No, I wasn't confusing them and I've seen the study you cite. I simply don't believe the results.

There is solid evidence that caffeine raises the amount of circulating catecholamines in the blood (how much and for how long depending on how fast a metabolizer one is and other factors as well), and also that increased levels of circulating catecholamines are associated with arrhythmias. I suspect that even those who are less sensitive to caffeine in coffee could consume enough to elicit the effect. I see no reason to dismiss the study, and I praise the efforts of the researchers to start to quantify triggers for afib.

While there is ample evidence coffee can be good for you in relative moderation, and the preponderance of well-structured long term observational studies and meta-analysis I’ve read strongly suggests even a possible beneficial impact to coffee, at least in moderation, that is not associated with AFIB triggering. In my own long ago past experience, as well as what seems to be for legions of other coffee drinkers who are still in a very active phase of their AFIB history, we do (did) often report excess caffeine consumption to at least being temporally associated with a more active heart.

What I can attest from my own experience too, is that once one’s AFIB has been durably vanquished, then, if any effect at all, in my case I actually seemed to have a consistent calming effect from organic press coffee on my resting HR. Even though with a transient half hour long mild bump in BP after consumption. I have had zero issues with two 16 ounce organic press coffees a day with the first one being a full caffeine and the second one a half caffeine in which a smoother water extraction decaffeination process is used rather than chemical extraction is used for the “half-Caff’ half of the second shot.

As such, I tell people in early very active AFIB who report frequent temporal triggering associated with coffee to abstain or go pure decafe until, and only if, they get rid of their AFIB for the long haul, at which point they could experiment and see how they fare. If, like me and many others, coffee no longer seems to bother them at all then go for it moderately at least.

Concerning Alcohol

The preponderance of most recent good evidence for alcohol use is much less benign regarding AFIB than is coffee evidence overall.

Just use common sense here. If you are an active Afibber who has not been able to drastically and consistently reduce your AFIB burden via the Life style improving and dietary/nutritional steps we strongly recommend you embrace, and thus you are still procrastinating about getting your still active AFIB fixed once and for all, then if you notice a strong connection with coffee ...or alcohol ... don’t drink it!

If you don’t trigger at all with coffee no matter how much AFIB you have, or don’t have, then enjoy it (at least in relative moderation at first).

While many can tolerate moderate alcohol consumption after successful ABL, at least for good long time, the science is clear that alcohol is simply toxic, over time, to myocardial pacing cells. So, in essence even if it seems you can get away with it once back in durable NSR, you would be simply throwing some degree of gasoline on the fire of potential new arrhythmia by drinking alcohol, even if you seem to tolerate moderate drinking again after a successful ablation.

Many folks may well be able to get away with it for a long time after a successful ablation process. But my question to any Afibbers who have had a long struggle with the beast and who had learned not to need or even like alcohol during their active AFIB days and who are now gratefully free from all AF/AT either from expert ABL or from natural means, is this: “Do you really want to play a bit of Russian Roulette by adopting again a habit of frequent alcohol use whether moderate or not?”

Sure, many will proclaim about how it doesn’t bother them at all any more post ablation, but each person has to judge how important alcohol consumption is in their own lives? If they really feel deprived without it, then best wishes to them, but I would still at the very least council real moderation in consumption ... and better yet avoidance except perhaps on special occasions having a glass of two.

And while I have not done any scientific investigation of our group, for what it is worth, at least in my anecdotal assessment of the many many hundreds of Afibbers I have followed at length through an expert ablation process, I have clearly noted that while AFIB is vanquished ‘after completion of a successful expert ablation process’, on average a majority of those who resumed moderate drinking seemed to have more active blanking periods, and beyond, overall with more frequent bouts and often longer runs of ectopy. And I’ve also noticed just more reports of having “an unstable”, or “jumpy feeling heart” well passed their blanking period, and even though their KARDIA or EKG readings still show only NSR.

At the least, it’s more food for thought. As such, and assuming for the moment that since alcohol can be toxic to pacing cells and we know that AFIB is a progressive disease marked by a shift to greater structural and fibrotic remodeling over time. Is it really worth tickling the dragon again even after having won a hard fought battle for freedom of all arrhythmia? Each Afibber will have to make that call for themselves, and there may well be no absolutely right answer. I’m mostly an err on the side of caution kind of guy.

Best wishes what ever decision one makes!
Shannon



Edited 1 time(s). Last edit at 05/19/2019 03:56PM by Shannon.

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safib
I see no reason to dismiss the study, and I praise the efforts of the researchers to start to quantify triggers for afib.

I don't outright dismiss the study; I simply don't trust the data to be accurate. That's for two reasons. The first is because it was a poll conducted online and anonymously, and anonymous online polls are notoriously inaccurate. I would mistrust almost any study conducted that way.

The second reason is I've participated in the forum on stopafib.org where the poll was conducted for many years, and I can't count how many times I've seen people say they gave up coffee because it was a trigger for them. When quizzed, I find out that it's usually based on a single incident. "I had a big cup of coffee and 20 minutes later I was in afib so I never drank coffee again." When I've asked if they tried it again to test their theory, the answer is almost always no. They're absolutely sure that one correlation proves it when in fact a single correlation is nothing more than coincidence until proven otherwise. After all, everyone was doing SOMETHING before every afib episode. I've also found the answer I often get is because their doctor/friend with afib/brother/sister/know-it-al-neighbor told them it was a trigger. Doctors have been preaching that for decades with absolutely zero evidence to support it. My sister is a great example. She was diagnosed with persistent afib 20+ years ago, and her doctor told her at the time she had to give up caffeine, so she did. WTF? Think about how ridiculous that advice was. She's in permanent afib so what's to trigger? Nevertheless, that's what doctors have been telling patients for eons. After I pointed that out to her she cautiously resumed drinking coffee and has happily continued doing so ever since.

I'd love to see a high-quality study on triggers, but I don't think that study is it.

I would certainly agree with Carey on polls.

However my own experience with coffee was definite. My wife and I had to go to a village 20miles away once a fortnight and as a treat we went to a hotel which did very tasty scones and coffee.

I was reluctant to stop and repeated the treat many times before giving up. The result was always the same - Afib about 20 minutes later.

Sam

PS Decaf tea and scones had no effect.

safib

The coffee/caffeine discussion relative to AF is an interesting topic for me since, many years ago, I connected AF to a low intake of caffeine ( 1 cup in the morning as a stimulant). I switched to organic decaf and while I had some reprieves from almost-certain AF with regular coffee, the switch didn’t completely eliminate the AF. I had always thought perhaps because of my multiple chemical sensitivity (MCS) condition, I was reactive to the high-count pesticide residues associated with inorganic coffee. Eventually, I just gave up coffee but have always rather ‘wistfully’ wanted to resume because of the many documented health benefits.

Additionally, exacerbated by the caffeine, I also had the stress-related issue of adrenal fatigue (aka burnout), as evidenced by adrenal stress profile testing via Genova Diagnostics. After following the adrenal recovery program as directed by my functional MD, I enjoyed a significant lessening of AF events for a period of time which was obviously very welcome. With time, the adrenal fatigue was no longer a problem but I did continue follow the prescribed program and still do…. since that helped manage related stress/hypoglycemia and elevated cortisol levels which also resulted in a significant lessening of AF. Eliminating caffeine is important for addressing problems with cortisol/adrenal function and it certainly helped me in that regard (and continues to do so), fortunately.

I’m not suggesting that anyone who has stopped their AF by eliminating caffeine should resume consuming, but there is an abundance of very positive benefits attributed to coffee. And, there are some very negative effects as well.
I’ll list the positive benefits findings in the General Forum.

Jackie

Sam said: "My wife and I had to go to a village 20miles away once a fortnight and as a treat we went to a hotel which did very tasty scones and coffee. I was reluctant to stop and repeated the treat many times before giving up. The result was always the same - Afib about 20 minutes later."

To me, it seems clear that the 20 mile drive and the anticipation of tasty scones that was the trigger.

For what it's worth, I had a cup of coffee and chocolate cake just a little while before my Afib event in November 2018. That was when I was diagnosed.

I still drink about 2 cups of coffee every day. Haven't.
given up dessert either 😊