Weird new trigger...

It's been a horrible winter here, and I've been having withdrawal symptoms from not being able to get out on the golf course. So, I tried a few practice swings in the house, and put myself into AF! My gastric problems have eased lately, so I don't think I can connect it to that. I guess it's the torso stretching that goes on through the rotation of the swing, but it's a new trigger. And something other activity to be apprehensive about.

I always said that the decision re the ablation was a no-brainer if I couldn't exercise without going into AF, so that's it for me now - I'm about to ring the Heart Hospital and ask to go on the list!!

David, sorry the practice swings beget AF. Reminded me of the many times I was in dominant vagal mode (just awoken, or was tired, or sitting a long time, or digesting) then did something rather suddenly that created too abrupt a shift from vagal to sympathetic mode and led to PACs and/or an episode. Don't know what your body's state was just prior to those practice swings, and obviously there could be different mechanisms at work in your case, but brought back memories of my struggles with a dysfunctional autonomic system where vagal was too dominant too often.

Randy, now that you mention it, I realise that those sudden postural shifts have been triggering a run of PACs - I'd just forgotten about them. Yes, dominant vagal tone seems to be at the heart of it. Did you find a way to reduce vagal tone?

I've also been researching alternative medications for Paroxysmal LAF of the vagal kind. The flecainide hasn't really worked for quite a few years, and I just use it as PIP strategy. Even then I converted just the same without it (my episodes are almost of 1-1.5 hrs duration). I was considering propafenone or disopyramide. Wonder if anyone has had experience of these?

Mine was lifting and carrying things with my left arm. Sometimes you just have to ask, what the heck?
Nancy

David, I recently had an ablation but am assuming I still have poor (high) vagal tone, which was contributing heavily to the AF. I assume that my autonomic issues, whatever portion isn't genetic, are influenced by things going on upstream. So, I am just now starting on a quest to explore different issues (adrenals, GI health, there are many) that may be contributing to the vagal problem.

Randy,
That's very helpful (and encouraging). I guess what you're saying is 'the vagal tone is still high but the ablation neutralises the triggers'. Is that right? (I know it's early days so soon after the ablation)

David - that's the vagal irritation issue. I had it long ago when I golfed but it bothered me when I bent from the waist to put the tee in the ground.
I saw a chiropractor who did the stomach/diaphragm manipulation over a period of a couple weeks to free the vagus from the impingement. It worked quickly. I was in daily Afib and after the first treatment, it stopped for a few days and returned; but by the end of two weeks with bi-weekly treatments. The afib was gone.

Jacie

David,

In Nov 2012, my afib was very sensitive to vagal stimulation. I started taking powdered organic ginger spice, which did seem to offset the vagal stimulation. I recall, that when I looked into it, it raised the adrenergic side rather than lowering the vagal. Some others have had positive responses to ginger and I recall Hans wrote about it in the Afib Report.

Here is a search here on ginger - you'll have to root through every thing, but myself and a few others have written on it: <[www.afibbers.org]

I took as much as a tablespoon of it before bed (3AM afib being my problem). As I recall, I reduced that to teaspoon quantities over time. In April 2013, I surmised that my increased vagal sensitivity might be due to too much calcium intake from food, reduced that and my sensitivity reduced dramatically.

Alternatively, the med propantheline bromide is an anticolinergicthat will reduce vagal tone. It is an off label use. There are some papers on this and I can provide some info if you want. I got a script for it about the same time as I started taking ginger, but never took it. It does have some side effects, such as photosensitivity as well as gut motility issues. But I know someone who used it effectively to keep afib at bay for a number of years.

George

Hi Jackie,
Yes, that sounds familiar. I actually did have a chiropractor do some manipulation of the diaphragm a few years ago. It was designed to bring my hiatal hernia back down into the stomach. I can't say it worked, and my stomach really hurt for quite a while afterwards.

Also, the prospect of doing something which may trigger daily afib (albeit for a short period) isn't very appealing!

I guess I'll have to re-double my efforts with diaphragmatic breathing, instead!

George, I take liquidised ginger root very often for my IBS - it certainly helps with the stomach ailments, but it doesn't appear to have done much for the vagal tone.

I just read that vagal tone can be increased through stomach clenching and I guess I do that unless I actively relax!