5 months afib free but PACs when wading in cold water

5 months since my Natale ablation in Austin and I'm still afib free and off all meds. I'm running 6-7 miles a week and doing some (light) weightlifting. No problems with any of that. However, on two recent trips to fly fish the Brazos River, I had bad PACs (confirmed PACs by Shirley in Austin) for several days following. I fished this same area when the water was warmer with no problems. Now the water is colder and I can feel my heart rate jump when entering the river. It stays elevated the entire time. I leave and the the PACs come for hours. Is my heart or vagus nerve reacting to wading in cold water? Vasoconstriction? My heart gets very ticked off. It's very strange.

I've read several articles talking about cold water immersion and arrhythmia so there appears to be a connection.



Edited 2 time(s). Last edit at 12/23/2015 11:10AM by alangford.

Alan,
This is a little different scenario, but a few years ago I was golfing on a very hot summer day. After finishing a par three I proceeded up a long and and steep pathway to the next tee. My heart rate was elevated and I had a few cups of ice cold water from a water cooler. Within ten seconds I started getting missed beats and then into full blown afib. As I am extremely symptomatic, I was unable to continue playing golf.
I think the cold water thing is definitely a serious trigger for some of us.
Merry Christmas and heres to a happy healthy new year.

Lou



Edited 1 time(s). Last edit at 12/23/2015 03:17PM by Lou Toews.

Alan,

I do start the day with cold showers (as hypothermal conditioning) - 50 to 55 deg F - depending on where I am. I usually do about 1 1/2 minutes to start, turn on the warm water, clean up and shave and end with 4+ minutes of a cold shower. The low end of the temp range is a guess. Recently on a trip where the water was cold enough it would hurt if I left it on any spot very long. Never an issue with ectopics. I also exercise outside. On the same trip, I went out and jumped rope in the morning in shorts and a t-shirt with air temp <20 F and a fairly stiff wind. Also did body weight exercises. Again no temp issue.

Lou,

I have experienced PAC's from drinking very cold water. Now I can tell that it can happen, but no big deal. Goes away in a few minutes. When I was overconsuming calcium, drinking very cold water could actually trigger afib.

If I had to guess, I'd say Lou's experience is from the cold water hitting the digestive track creating a vagal trigger. I'd say Lou's is an adrenaline response to the cold and therefore an adrenergic trigger.

George

Yes George, Lou and Alangford,

Often sudden changes in temp with very cold water or ice hitting the esophagus which is just a couple mm away from the posterior wall of the left atrium ... Literally almost touching ... This triggering is a classic vagal response when ectopy or even full
blown AFIB is still the tendency.

Also, extended exposure over a large body area to cold can also trigger a similar response as sounds like what likely happened when you fly fishing in the winter cold river Alangford. In past times, you would very likely have triggered right into AFIB but no doubt thanks to the handy ablation at St Davids earlier this year it remained at transient ectopy.

George's insights from his own experimentation that calcium overload seems to be part of the puzzle in his case for a higher more hair trigger degree of reaction to such vagal-like cold exposure events is worth noting and following up on, just know that avoidance of such more extreme cold shocks to the LA and more longer duration exposure such as wading into winter cold water to fish for some hours is likely not high on the list of recommended activities for Afibbers ... At least not until you are 100% sure your heart is pretty much bullet proof to triggering into flutter or AFIB any longer from such insults. Either by a successful ablation process that has stood the test of some real time, or perhaps as in following George's lead and seeing if lowering serum and IC calcium overload can bring a similar buffer for you too from such cold water ectopic triggering.

Cheers!
Shannon



Edited 1 time(s). Last edit at 12/24/2015 01:44PM by Shannon.

Alan, I can't add much, but I can confirm that cold water, especially if it goes higher then my chest/heart area causes me to have vicious palpitations. Has ever since I was a child, I completely avoid it now, but I assume I'd have a full on afib attack if I tried it now.

It doesn't seem strange to me at all. When you enter the Cold Water, you put a sudden demand on the Heart, as now the Heart has to all of the sudden warm the peripheral of the body. That and you may be more tense and your breathing may be altered. If you have a Pulse Oxymeter, try using it before you go into the Cold Water, and then see how your HR and O2 Saturation levels change as you emerse yourself.

If it was me I would just avoid PAC-inducing events like this, Otherwise, and I have found that taking a comfortable Walk with deep relaxed breathing helps the PAC's to subside.



Edited 1 time(s). Last edit at 12/28/2015 01:55AM by The Anti-Fib.

Alan,
I have nothing overly constructive to add but I just wanted to congratulate you on 5 months. I had mine in Bordeaux almost 7 months ago and it's going well for me as well. I can also empathize since I've found a few little things that set off pacs and it freaks me out when it happens.
I wish you continued success.

Monty

Hi, I am considering ablation with Natale. Can u tell me about your experience. I have afib 5 months and am on multaq and metropolis. I did some research on different doctors and Natale was one of them.
Thank u for any info you can give me.
Vickie

afibbers Wrote:
-------------------------------------------------------
> Hi, I am considering ablation with Natale. Can u
> tell me about your experience. I have afib 5
> months and am on multaq and metropolis. I did
> some research on different doctors and Natale was
> one of them.
> Thank u for any info you can give me.
> Vickie


I had a great experience at St David's! I will only let Dr. Natale touch my heart. I made the mistake of having my first ablation done by a local doctor. The afib/flutter returned and turned out the first doctor also left me with some stenosis in two pulmonary veins. I wish I had started with Dr. Natale. If I ever need another procedure, I would not hesitate to see him again.

I started taking 1.5 grams of Taurine and the PACs are pretty much gone.

Wonderful. As advertised. Part of The Essential Trio, Taurine to the rescue, again!

Jackie