Left Side Trigger (sometimes)

After weeks of no afib, I was laying in bed last night and turned onto my left side. They were set off almost immediately.

Ok, what is strange is that during the weeks of no afib, I've been on my left side tons of times. For long periods of time.

What really is at play this time I think is dehydration (which is what set me into afib to begin with decades ago).

So when is a trigger not a trigger, but maybe just the last straw in a series of triggers?

Nancy

Nancy,

Left side is a common trigger for many. I've read an explanation, but don't recall it right now. In my case, when my electrolytes are out of whack, it can be a trigger. Otherwise not.

George

Nancy - what I recall in some instances of left side sleeping is how the stomach empties (or doesn't) compared to right side sleeping. If I recall accurately, it had something to do with stomach irritation that seemed to be a trigger in certain circumstances and in some individuals.

There is a CR session devoted to Left Hand Sleeping and AF... #36... [www.afibbers.org]

Jackie

That used to happen to me alot too, Nancy. I started sleeping on my right side more often...but am now back to sleeping on either side again - thanks to my ablation.

Barb

If I could sleep on my right side only, I might not have any afib episodes. 98%+ of my episodes start with positional changes, and 90% of the time those changes are shifting from my right side to either my back or left side. Less frequently they start when getting up from bed or from shifting from right to left. I can often sleep the first hour or two on the left side, but have to be on my right from midnight to 4 or 5 am.
I don't understand it. Clearly has something to do with the stomach. Maybe it is a direct physical pushing of the stomach into the diaghram into the heart. Maybe the vagus nerve is getting impacted. Maybe it is "stretch receptors" whatever they are- something Natale mentioned to me in a courteous but dismissing sort of way when I brought this issue up with him. I'd love to know what stretch receptors are, and what actually is happening. In the meantime I will continue to sleep on my right side as long as I can take it, and as long as it keeps afib at bay. If that changes significantly, I'll be scheduling an ablation.

I came upon this explanation a while ago from:
[my.clevelandclinic.org]

Stimpysan: why is it that every time I lay down, especially on my left side my AFIB starts.

Speaker_-_Dr__Bruce_Lindsay: I have wondered about this too. Many patients have experienced the onset of atrial fibrillation in certain positions. One explanation is that the heart is suspended in the chest and it shifts when you lie on your side or bend over. This may stretch some of the muscle fibers extending into the pulmonary veins and cause them to discharge electrical potentials that trigger atrial fibrillation.

I have also found this aetiology that may have some bearing:
[en.wikipedia.org]

The thing is - the left side as a trigger is NOT normal for me. It happened twice. The rest of the time I lay on my left side without any problem whatsoever. I wish there was a sign that said, "hey, tonight you can't lay on your left side." that showed up .

It's not food, my diet is pretty stable, nothing different from those 2 nights it set it off vs. the rest of the time.

And the time was the same-- 9:30pm.

What I'm trying to figure out is why it won't be a trigger most of the time, and then twice it was.
Nancy

Hey John, that Roemheld syndrome entrry is an interesting find. Probably the most accurate description I've heard of my problem. Not that there are any answers associated with it though : (

@Ralph,
I thought the same. After a bit of reading i tried active charcoal capsules, and then Bloateze (active charcoal and Simethicone). It does help when i am feeling full in the stomach.
[www.bloateze.ie]
Best is, there don't appear to be many side effects.

John, I just listened to this one hour program that I found after googling Roemheld Syndrome. [superhumanradio.com]
A markety web-site host interviewing a markety M.D. who has his own supplement web-site, but very on point in my opinion. Seems to me that this (bloated stomach pushing diaghram up into heart and probably impinging vagus nerve) should be a front and center piece of the afib puzzle. It is for me at least. He is trying to sell a blood test and some supplements, but other than that he is describing the scenario and the mechanical aspects very well, and suggesting some things that could help that don't involve a profit for him. Required listening for any vagal afibber I would say.

Ralph:

I have never had stomach problems, like you are describing, yet I get AF, I am a vagal afibber as well, lots more to this puzzle.

Liz

No doubt there is more to the puzzle Elizabeth. But my guess is that this is a big piece for many vagal affibers, right up there with magnesium and potassium. Also, although I'm not suggesting this is true for you or anyone else, I never thought of myself as someone who had a stomach problem until I started paying attention to what was happening.

High Nancy,
Correct me if I am wrong but the main thrust of your question is why is it a trigger sometimes and why not at other times.
One theory of triggers is that its like filling a bucket with water. The closer you are to the top the less you need to make it overflow and cause a problem.
When my heart is in good shape and months since the last a fib attack my bucket is nearly empty. I can lay on my left, jump down on my left, I could not trigger an episode at all.
If it was close after an attack, say the following day or I was very tired or compromised for any other reason my bucket is nearly full and the smallest thing can set off a.fib (the bucket overflows easily) including lying on my left side.
I have actual documentary evidence of deliberately causing every single heart beat to be an ectopic just by a body positional change. It was for about thirty beats but I felt it would cause an a.fib attack if I didn't move so I changed position and it stopped immediately.
This was a deliberate attempt by me to document myself starting and stopping ectopics at will by a body positional change.
This was back in 2006 when my bucket overflowed several times a day. I could not do that now it would be impossible.
My reasoning for this is that my heart is inflamed after my a.fib episode therefore it was larger in size and hence more susceptible to this strange occurrence. This is the reason I take ibprofen for several days after an episode which I feel really helps.
I have the image on my computer but do not know how to upload to this post. I feel it was one (of many) that were uploaded by George N for me back in the day if anyone could provide the link.
I think my evidence of this is pretty conclusive whatever you here to the contrary and should to any medical professional who dismisses that positional changes cause changes in heart rhythm I would politely ask them to explain away this hard physical documentation.

Mark