ectopics and indigestion

I have a question that probably doesn't have a good answer, but I'll ask it anyway.

What switch gets flipped that causes indigestion to cause ectopics? Meaning, before my first big afib episode last October, I had plenty of indigestion without ectopics and skipped heart beats. Ever since that episode, now it seems indigestion causes ectopics and funny heartbeats to occur about 50% of the time, if not more. Almost as if a switch had been flipped.

Could whatever cause the switch to be flipped get turned off? Or now that it's here, it's *here*?

-Eric

Eric,

Don't know if this will help, however for most of my afib career, I was not subject to gut issues being triggers. I don't have a lot of gut issues anyway, but when they did happen, or if I ate cold food, it was not a heart issue. Then I had a year of deteriorating control and increasing afib. It was associated with divorce stress, but I later figured out it was related to my stress eating wheels of cheese, which added enough calcium into my system to through it off. During that time, gut issues, cold food, laying on my left side, the vagal aftermath of orgasm & etc all became triggers. Once I hypothesized it might be a calcium issue and went cold turkey on the cheese, so to speak, all these were no longer triggers. So for me it came back to balancing my electrolytes. When my electrolytes are balanced, I can be "As vagal as I wanna be" without any afib issues.

George

George,

Interesting. So, you think the underlying issue was an electrolyte imbalance and not the stress? or the stress triggered a reaction that made you more susceptible / sensitive to changes in your electrolytes?

Right now for example, I am having anxiety / heart racing issues, tied to bowel movements. As I get closer to having the movement, or as things are moving thru my intestines, my anxiety level (fear, chest tightening) and heart rate goes from (from 60 to 80 resting or so). Then post-poop, things subside.

The differences today were, I felt a bit "anxious' when out with a friend at dinner, I had felt anxious after talking excessively. Also, I had BBQ and ice cream, which, is rare for me these days, normally I eat fish and veggies for dinner. Then I didn't have my after dinner banana (for potassium).

The thing that's weird overall is that, for the first 35 years of my life, I could eat all the BBQ and ice cream with no issues, and now its like a switch has been flipped, and I'm having a horrible night because of it.

It'd be one thing if these things happened at 70 or so, but at 35 it all just feels too young for this to be happening.

Anyway, enough complaining tonight!

Thanks!

-Eric

Eric

My problems started at 36, Im 52 now. I began having terrible GERD, stomach gas, indigestion. as a matter of fact my first tachy episode was during the procedure where they scope down your throat.
There is some very close connection. I limit barbque, spicy foods, onions, peppers. Why it all of a sudden begins......evidently no one knows. I never ever had any prob before that age. There are other things that trigger mine also like stress but this all started the same as you.
tim

Eric,

I originally thought my deteriorating afib control was associated with, what I perceived, as a high level of stress. However the stress subsided over time and and started a new and very positive relationship. So my perceived stress was dropping and the afib control kept getting worse. My initial thought was that enough structural and electrical remodeling had occurred that I'd crossed a line that made afib very easy to start. Then I remembered the calcium afib connection and correlated that with my cheese intake. I calculated the calcium intake from the cheese. I don't recall the number now, but it was material. Of course the cheese also is high in sodium, but sodium intake has never been an issue for me. In any case I decided to quit eating it, and watch my calcium intake elsewhere. My control reverted to excellent - I haven't had an afib episode in 15 months. At its worst, I had afib nightly for 5 nights in a row at one point. I was able to control that by changing from flecainide on demand to convert to nightly flec before bed. I subsequently added powdered ginger in to the pre-bed routine and titrated the flec dose down to zero over a month or so. I continued the ginger, but I still would have periodic breakthroughs. I would have to watch things like cold foods or being prone on my left side. I was also subject to PAC's turning into afib in the vagal aftermath of orgasm. I was unwilling to give up having them for the prevention cause... I could feel the PAC's coming on and could preempt afib by sitting up or standing up and moving around till the ANS had normalized. It worked but was less than fun. At least I have an understanding partner.

Then I figured out the calcium cheese connection. Once I quit eating the cheese, I no longer had to be careful in any of these circumstances.

I should note before, during and after my period of poor control, I consumed my magnesium (2-5g/day), potassium (1-5g/day) and taurine protocol (4g/day). This has always been the foundation of my keeping afib in remission. With the exception of about 15 months, it has worked very well for 10 years. I'd previously learned, when I stopped taking all of the above after not having afib for 2 years, that it was necessary as I got afib within two days after stopping the supplements.

So, for me, I would say that if the electrolytes aren't balanced, I'm very prone to afib. If they are balanced, I'm pretty bulletproof.

George

Fascinating stuff guys.

I just got back from the cardiologist office. I woke up in a pretty hardcore afib. They only last 2 hours or so, but this is my 2nd in two days after being afib free for months.
Maybe I'll try experimenting with mag again. When I tried it last time, I had instant diarrhea. I take ginger (thanks to you George) and Potassium everyday. I also eat two bananas and make sure to have potatoes or another food high in natural potassium. I am not taking taurine yet as my cardio said it could cause afib, but given that the beast seems to be back for a bit, now is the time to experiment, I have nothing to lose.

-Eric

tsco,

Where are you now with things?

Eric - the stomach connection to Afib has been discussed here on and off over time... and one answer is that the vagus nerve which innervates the stomach along with many other areas such as heart and diaphragm, can become irritated or pinched (impinged upon) by gas and bloating. Often that happens because of lack of stomach acid and improper digestion of the last food deliver to the stomach. There are a couple reports on the GI connection to Afib which offer some ideas on why this happens... see:

The Gut Connection to Afib
[www.afibbers.org]

Digestive Wellness –What You Need to Know
[www.afibbers.org]

No More Heartburn
[www.afibbers.org]


All afibbers need to pay attention to proper intracellular levels or stores of the critical (essential) electrolytes… first of which is magnesium followed closely by the proper ratio of potassium to sodium so that cellular energy and activity can function as intended.

As George notes, he ate too much cheese and the high calcium blocked the all-important magnesium function. Too much sodium does the same thing with potassium.

Magnesium repletion takes time and patience to make sure you ramp up dosing slowly.. .Be sure you are using the right kind of magnesium that helps avoid the bowel issues until you are repleted. It may take several months to optimize the IC magnesium stores.

When you rely on sweet fruit (bananas) and starchy carbs such as potatoes as sources of potassium… (and they do have it)… you add insult to injury because it utilizes more electrolytes to process the high glycemic carbs to metabolize that sugar. (and ice cream)

Your other food choices of BBQ offer high sodium (knocks out potassium), sugar, and also a risk of food additives which are excitotoxic such as MSG…common in commercial sauces and foods.

Taurine is not known to cause arrhythmia … in fact, it can be very calming to the heart… however when all electrolytes are low, then it may not be able to function as it should. Be aware that taking just additional potassium before your magnesium levels are optimized can make arrhythmia tendencies worse. That finding was noted a very long time ago by magnesium researchers.

Jackie

Eric - here's a previous post on the vagus nerve topic... FYI - maybe something useful to which you can relate your situation...

Discussions about postural and positional triggers of arrhythmia must include the vagus nerve and the GI is definitely involved.

Numerous factors influence vagus nerve irritation. One consideration is to address your posture and sitting habits and the impact of sitting for hours at a time - as many do - working at a computer station…or your home desk or sitting scrunched on the couch with a laptop. Sitting continually, for long stretches, causes a myriad of problems aggravated by:
• Adiposity in the midsection.
• Weak Core muscles
• When heavy meals are eaten and the stomach is full or distended and then, followed by more sitting that scrunches the midsection
• Full stomach or one that becomes bloated with gas after eating and exerts pressure and displacement of surrounding organs and pushes upward on the diaphragm muscle.

When a nerve is pinched or trapped, it’s called ‘impingement.’ Impingement of the vagus is well-known and afibbers are typically very familiar with postural triggers of AF. Sometimes it’s bending over from the waist; other times lying down in a supine position allows for the positional shift of the stomach and diaphragm which pinches the vagus.

The check anatomy diagram at this link…showing organ placement and note how everything is neatly compressed into the abdominal cavity. It’s easy to see how the stomach could exert upwards pressure on the diaphragm which is the dividing muscle that between the chest cavity and the abdominal cavity In this illustration… only half the diaphragm is shown, but it covers both right and left sides in real life. Note that there are no abdominal fat accumulations fat added to the photo so you have to envision how fat accumulations affect the crowding of those organs… and then envision what poor posture, stomach gas, bloating and distension would exert pressure, push organs out of place and for this topic, cause the vagus nerve to be pinched and irritated. [www.webmd.com]

The Vagus nerve is the Tenth Cranial Nerve and is called “The Wanderer” because of its extensive length and pathways to various organs. Wikipedia offers a particularly elaborate description complete with dissection photos.[ [en.wikipedia.org]] If you are prone to AF triggered by positional changes, it would be useful spend time looking at the medical diagrams of the path of the vagus and branches so you can envision what happens.

The vagus comes out of the brain, enters the body in the area of upper cervical spine area and is extremely vulnerable to subluxation or spinal misalignment. Starting in the area of the Atlas (bone) which is the first cervical vertebrae or C1, anything out of alignment there, affects everything downstream. [en.wikipedia.org])

The vagus nerve directly innervates the heart, larynx bronchi and lungs, esophagus, stomach, small intestine, abdominal blood vessels, liver, gall bladder, pancreas, colon is the link between the vagus and pelvic parasympathic, rectum, kidney, bladder and external genitalia. Branches from the main nerve, when impinged or distorted by various pressures, cause problems in other areas (referred), but track directly back to the vagus. Example… a mal-aligned Temporomandibular joint (TMJ) causes impingement on the branch of the vagus that goes to the ear..causing not only TMJ pain but also ear involvement..(maybe tinnitus). So, it is with the vagus and all the vagal branches.

Impingement or pinching of the vagus nerve anywhere weakens the body.

The Vagus is a parasympathetic nerve and impingement alters the function of the vagus in its entirety and can affect the heart, lungs, liver, gallbladder, spleen, pancreas, small and large intestines, thyroid and primitive brain-stem medulla. (Baroody)

As this all relates to a true Hiatal Hernia or can be symptoms of the HH syndrome when movement the stomach up into the diaphragm pinches or crowds the vagus nerve. Symptoms are likely to be the result of postural changes… such as lying down or middle-of-the-night shifting that cause symptoms such as afib and shortness of breath, gastric distress. The vagus goes down beside the stomach and when the stomach is malpositioned or abnormally distended, the vagus can be pinched.

Those who address the vagus involvement in their clinical practices are typically chiropractic physicians, and acupuncturists who treat nerve pathway obstructions. Their world revolves around the body’s energy flow through meridian pathways and spinal alignment to ensure that the muscles and organs served by the Autonomic Nervous System (ANS) are not blocked or impeded. Blocked energy flow or electrical signals affect every cell and every organ in the body and interrupts communication with other cells and organs… so it makes sense that if afibbers have impingement on the vagus, all of the other pathways can be adversely affected to one degree or another.

No one discusses the function of the vagus nerve more completely than Steve Rochlitz, PhD who has written prolifically about his clinical experiences treating patients with vagus nerve involvement. Whether this involves a true hiatal hernia or the Hiatal Hernia Syndrome complex, or the crowding or impingement on the vagus, Dr. Rochlitz who is Physicist, Nutritionist and Kinesiologist addresses every aspect in his prolific writings much of which is found online..

Clips of interest from Dr. Rochlitz’s articles on Hiatal Hernia/Vagus Nerve Impingement Syndrome

….”The Vagus Nerve, like the hiatal hernia itself, probably needs time to heal and for everything to be done right for a span of several months. Soda with the extra gas it contains should be avoided. Trapped gas makes this syndrome much worse. Indeed the sufferer may have episodes of feeling as if dying only to be relieved by belching or perhaps the gas passes down the other way unnoticeably. Likewise when the practitioner pulls the stomach down, much gurgling is often audible. One hundred years ago, medical schools taught Roemheld's, (or Gastro-Cardiac), Syndrome which described significant cardiac complaints arising from stomach problems. Unfortunately, this now seems to have disappeared from all but the homeopathic, medical literature.”

The heart itself can be crowded, and pressed on, by the stomach being “where it doesn't belong.” These last factors and the direct hyperexcitability of the Vagus Nerve's connection to the heart, leads to many Emergency Room visits and “pseudo-heart attack” symptoms of chest pain, difficulty breathing and left arm numbness. (The reader, if experiencing these complaints, should seek emergency medical care, and not assume they are arising from the HHS.)

There is a remarkable similarity between Hiatal Hernia Syndrome and angina. Both can cause similar symptoms and both can occur after similar events such as overeating, exercise, and heavy lifting.(The appropriate) examination also looks for the potentially, dangerous pre-cancerous, esophageal condition called Barrett's Esophagus, which can occur after long-term GERD

From an imbalanced Vagus Nerve, any other organ can begin to malfunction depending on genetic weakness and various other factors. Of course, the diaphragm itself will directly be affected and breathing normally no longer occurs. Other openings in the diaphragm itself now stretched or torn allow the major blood vessels to and from the heart to pass through it. Thus spasms in the abdominal aorta and inferior vena cava can occur. Indeed, Baroody found kinesiological (muscle) tests for two separate “stuck diaphragm” conditions related to abdominal aorta and inferior vena cava imbalances4.

“Dr. Rochlitz also details Schatzki's ring which is a disorder of the Lower Esophageal Sphincter (LES). He also discusses the influence of the Longitudinal Muscle Contraction (LMC) of the esophagus and how relates that connection to trigger points, which may be created directly, or indirectly, by mercury or other heavy metals or other toxins. The active trigger points then could cause the Esophageal LMC as trigger points are deeply entwined with muscle spasm.”

Any and all of which could contribute to postural or positional triggers for AF.


These are a few links to reports by Dr. Rochlitz:

Hiatal Hernia/Vagus Nerve Disorder: a leading cause of allergies & chronic illness
Letters to the Editor - Letter to the Editor
Townsend Letter for Doctors and Patients, Jan, 2004 by Steven Rochlitz
[castlehighkingdom.proboards.com]

[www.wellatlast.com]



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Hiatal Hernia/Vagus Nerve Impingement Syndrome

Avoiding caffeine and any other neurotoxins and/or excitotoxins such as MSG, (monosodium glutamate), or aspartame is also crucial. Perhaps the most nerve-damaging substance is mercury. Perhaps too the vagus nerve, due to its high metabolic rate, preferentially absorbs mercury, or other toxins, more than other nerve tissue? And this combination of VNI/HHS and mercury can be devastating. The Vagus Nerve, like the hernia itself, probably needs time to heal and for everything to be done right for a span of several months. Soda with the extra gas it contains should be avoided. Trapped gas makes this syndrome much worse. Indeed the sufferer may have episodes of feeling as if dying only to be relieved by belching or perhaps the gas passes down the other way unnoticeably. Likewise when the practitioner pulls the stomach down, much gurgling is often audible. One hundred years ago, medical schools taught Roemheld's, (or Gastro-Cardiac), Syndrome which described significant cardiac complaints arising from stomach problems. Unfortunately, this now seems to have disappeared from all but the homeopathic, medical literature.

The heart itself can be crowded, and pressed on, by the stomach being “where it doesn't belong.” These last factors and the direct hyperexcitability of the Vagus Nerve's connection to the heart, leads to many Emergency Room visits and “pseudo-heart attack” symptoms of chest pain, difficulty breathing and left arm numbness. The reader, if experiencing these complaints, should seek emergency medical care, and not assume they are arising from the HHS. There is a remarkable similarity between Hiatal Hernia Syndrome and angina. [See the CRUCIAL UPDATE at the end of this article for Rochlitz' breakthrough linking the heart and the H.H.S.] Both can cause similar symptoms and both can occur after similar events such as overeating, exercise, and heavy lifting. This examination also looks for the potentially, dangerous pre-cancerous, esophageal condition called Barrett's Esophagus, which can occur after long-term GERD

Hiatal Hernia/Vagus Nerve Disorder: a leading cause of allergies & chronic illness
Letters to the Editor - Letter to the Editor
Townsend Letter for Doctors and Patients, Jan, 2004 by Steven Rochlitz
[www.oxygentimerelease.com]

As described, the vagus originates in the brain and comes out of th

Besides output to the various organs in the body, the vagus nerve conveys sensory information about the state of the body's organs to the central nervous system. 80-90% of the nerve fibers in the vagus nerve are afferent (sensory) nerves communicating the state of the viscera to the brain.

vagus nerve, also called Tenth Cranial Nerve, longest and most complex of the cranial nerves. The vagus nerve runs from the brain through the face and thorax to the abdomen. It is a mixed nerve that contains parasympathetic fibres. The vagus nerve has two sensory ganglia (masses of nerve tissue that transmit sensory impulses): the superior and the inferior ganglia. The branches of the superior ganglion innervate the skin in the concha of the ear. The inferior ganglion gives off two branches: the pharyngeal nerve and the superior laryngeal nerve. The recurrent laryngeal nerve branches from the vagus in the lower neck and upper thorax to innervate the muscles of the larynx (voice box). The vagus also gives off cardiac, esophageal, and pulmonary branches. In the abdomen the vagus innervates the greater part of the digestive tract and other abdominal viscera.

The vagus nerve has the most extensive distribution of the cranial nerves. Its pharyngeal and laryngeal branches transmit motor impulses to the pharynx and larynx; its cardiac branches act to slow the rate of heartbeat; its bronchial branch acts to constrict the bronchi; and its esophageal branches control involuntary muscles in the esophagus, stomach, gallbladder, pancreas, and small intestine, stimulating peristalsis and gastrointestinal secretions.

Eric,

Start slowly if you add taurine (or any supplement). It has never bothered me, but some individuals can always react differently. I doubt if it would cause afib, but digestive upset has been reported by a few. Likewise with mag, take a good bio-available form like mag glycinate and start small, like 100 or 200 mg/day. My gram level intake is unusual.

Another area to explore is one of the gut biome. There are some links to follow in these posts: < [www.afibbers.org] <[www.afibbers.org]

George

DANG George how much cheese you eatin fella?


Eric,
I feel your pain I have been in the exact same spot many times. I tried the magnesium pills, rubs, baths, etc. nothing worked. Had to start Flecainide. It was the only drug that would curb the ectopics and afib and then once I can get calmed down it seemed the mag and other stuff helped.

I am five ablations into this thing. Right now im ok but still have daily ectopics here n there.....hate them

tsco,

I've found a daily cucumber, carrot, celery juice seems to keep the ectopics away most of the day. I only have to supplement with a little ( 500mg of Potassium at that point the rest of the day and evening.

tsco,

five ablations?! Have you gone to Dr Natale, or does your health care not cover seeing him? I really want to avoid taking flec or other drugs. How symptomatic were you when you started flec?

Jackie,

Thanks for those great articles! The only issue is, I don't know what actionable things I can do based on that knowledge. I'm pretty sure my vagus nerve is the issue, but how do I go about "fixing" that. This is my main issue with afib, I don't really know where to go, who to talk to, who to believe, etc.

My cardiologist thinks supplements, and all this stuff is bunk, but i trust her ability to monitor my heart. I'd love to find someone who understands the vagus nerve and could help me treat it, but I fear they may not understand the heart like a cardiologist. Any suggestions?

Thanks!

-Eric

I've got that to. My Doc said it is stimulation of the Vagus nerve. I get eptopics, then sometimes Flutter going into AFIB, after I gulp down smoothies, and frozen yogurt. When I slowed down when I eat these things the symptoms subsided. Could be something about swallowing air, or maybe to much cold at once, anyway I noticed this like 30 times or so.

The cold would certainly do it, when I was in my sensitive period. Hot water would stop it (thanks Hans for that suggestion!).

Erich

It would be best to avoid flecainide I just couldnt. I do have my doses down to very low amounts tho.
Yes I saw Natale. My second ablation was right artial tachy that they couldnt stop. I was sent to him and they helped me.
My tachy slowly morphed into AFIB
Flec is a good drug for helping some of this but I know it does give me other problems.