The heart, stomach connection

Okay, the way to a mans...is through his... But I mean something a bit more intimate.

Like today... There I was, sitting at my table, working quietly on a project. Nothing unusual kind of day, no stress, not much exertion, the usual walks in the morning/afternoon. Ate a couple of quesadillas. Continued working...

Then, I start getting a queasy feeling in my stomach. Check my pulse, it is okay. Queasy feeling continues...

All of a sudden my rhythm goes crazy = palpitations (I almost NEVER get palpitations), and then I'm in afib - my usual kind of afib episode.

My episodes have been lasting around 12 hours recently. I'm taking 50 mg metoprolol ER, half in the morning, half in the evening, an extra half when I have an episode. 200 mg magnesium/day, 2000 mg vit C, B complex, D, L-Carnitine...I've been skipping the Taurine recently. Eliquis for stroke prevention, baby aspirin, atorvastatin for cholesterol control.

Most of my recent episodes have been associated with diet improprieties - too much sugar mostly, but also other stomach related things (I think I had a bad egg McMuffin).

Point is, it seems that when my stomach is having a problem, I'm more prone to afib episodes.

The reverse is also true - that is, when I go into afib, I usually feel it in my stomach. As I said, I hardly ever get palpitations...I just notice a feeling in my stomach, check my pulse, and, sure enough, I'm in afib.

Just wondering if anyone else has had any similar experience. (And, if so, any thing you did that helped?)

I had GI issues and AF before my ablation. I am vegal so throwing up triggered my AF.

I recommend bland foods, maybe the quesadillas did it. I stopped gluten and it helped. MSG was my trigger. Check your ingredients. Good luck.

When I've afib, it's always coupled with stomach discomfort. IMO, my afib is not induced by stomach problems. It's vagal tone. Afib comes and go, and when I'm back in NSR, my stomach discomfort disappears. I don't think a real stomach problem would come and go as quickly as afib does. The culprit seems to be my vagal tone.

Quote
wwoofbum
My episodes have been lasting around 12 hours recently. I'm taking 50 mg metoprolol ER, half in the morning, half in the evening, an extra half when I have an episode.

Is your metoprolol prescribed only because of afib or high BP, too. I ask because your condition sounds very vagal and a beta blocker can exacerbate the problem. They are OK to take during the episode for rate control. If you have a BP issue, perhaps a different, non BB med like a calcium channel blocker might be more appropriate.

Quote
wwoofbum
Point is, it seems that when my stomach is having a problem, I'm more prone to afib episodes.

This is very common. Long time poster, Dean, from Australia has kept his digestion triggered afib at bay for ~13 years by consuming natto food (Japanese fermented soybeans, an acquired taste). Here is a search on his posts on natto.
<[www.afibbers.org]

George

Quote
GeorgeN
I ask because your condition sounds very vagal and a beta blocker can exacerbate the problem. They are OK to take during the episode for rate control. If you have a BP issue, perhaps a different, non BB med like a calcium channel blocker might be more appropriate.

GeorgeN- I think my recent PVC’s are vagal because they are worst after drinking /gulping water or eating or GERD or standing up. That said, yesterday I saw my small vessel disease cardiologist specialist and she witnessed my PVC’s and suggested a very small dose of Tenormin with my current multaq because she feels long term pvc will weaken my heart and could lead to heart disease.. You posted above that if one is vagal, a beta blocker will exacerbate the situation and she thinks Tenormin may help reduce my pvc. I can’t google this. I’m not doing anything until I hear back from Dr. Natale’s NP and get her advise..but my heart is not calm especially the pvc I get after 5pm every night and upon waking up...are the worst.

Multaq with Tenormin? It was ok with flecainide/Tenormin but multaq is a different drug.



Edited 1 time(s). Last edit at 10/25/2019 11:59PM by Carey.

Susan,

Tenormin is a beta blocker. Beta blockers can be used to one's advantage for those with a sympathetic or adrenergic trigger. BB's are normally contraindicated for those with vagal triggers. I'm not a doc, see what Natale says.

These quotes are from Hans Larsen's (the founder of this site) book: <[www.amazon.com]

The findings that adrenergic afib is preceded by an increase in sympathetic activity while vagal afib is preceded by an increase in parasympathetic activity explains why adrenergic afibbers can sometimes ward off an episode by quickly chewing and swallowing part of an atenolol (Tenormin) or propranolol (Inderal) tablet. Taking these beta-blockers decreases adrenergic activity and shifts the balance back in favour of the vagal branch. Similarly, vagal afibbers have found that getting up and moving around when an episode seemed imminent can sometimes abort an episode. Physical activity increases adrenergic tone and thus shifts the balance away from vagal predominance. There are, of course, many other approaches to preventing episodes and these will be discussed in future chapters. First though, we will take a look at other atrial (supraventricular) arrhythmias that may accompany AF or be mistaken for AF.

Drugs in vagal LAF {Hans used to do surveys}
Twenty-six of the 35 vagal afibbers (74%) were taking antiarrhythmics or other drugs to prevent further episodes. There is ample evidence that vagal afibbers should not take digoxin (Lanoxin), beta-blockers or antiarrhythmics with beta-blocking properties as these drugs will markedly worsen their condition[2,3]. Yet of the 26 vagal afibbers on drugs 14 (54%) were on a drug contraindicated for their condition. These people spent an average of 105 hours in fibrillation (over 6 months) as compared to 40 hours for the people on the drugs best suited for vagal LAF flecainide (Tambocor) and disopyramide (Norpace, Rythmodan). Even vagal afibbers taking no drugs at all spent less time (90 hours) in fibrillation than did the people who were on the wrong drugs. Vagal afibbers on flecainide did the best and spent
only 23 hours in fibrillation and had an average of 6 episodes (average duration of 3 hours) over the 6 months. This compares to 6 episodes (average duration of 24 hours) for non-drug users and 24 episodes (average duration of 13 hours) for people on contraindicated drugs. There was no significant difference in age or time since diagnosis between the drug and non- drug groups.

George

Susan:

Here is a study that substantiates what what George (and Hans) are saying.
[academic.oup.com]
If you are just trying to stop the PVC's then a trial of with-holding Multaq would make more sense than adding another Drug that slows down your Heart potentially aggravating your Vagal reactions.

Thanks for the link Anti-Fib! No wonder i'm so unclear as to my trigger(s).

Quote

In fact, we recorded heart failure, coronary artery disease, valvular heart disease and hypertension in as many patients having the vagal form of the arrhythmia as in patients with adrenergic AF.

Seems that the wise thing to do if one wants to improve odds of AF minimization is taking care/reversing CV disease?

Did notice by it's absence the blood glucose and insulin levels/status/response. Would love to know these parameters.

Thank you GeorgeN and the Anti-Fib. Priceless info!
I’m both vagal and adrenergic. AF from throwing up/GERD/bending over (vagal) and adrenergic emotional surprises (1st AF @49yo brother’s funeral both myself and mom came down with AF-my first AF-and we were hospitalized one room apart, last AF that started the adrenergic marathon was upon hearing the news of my mom’s death this March. AF marathon again when someone kept calling asking for ATM cash withdrawal —elder abuse extortion— or he will come over with a gun. Arguing with police on phone to please come by after emailing the station detective the threatening tests-they refused to come saying when he comes by take his picture because just saying he will come over with a gun is not a threat unless he says what he intended to do with his gun..I was frightened out of my mind ...so severe emotional stress or fright. Scary movies had triggered AF.

There is absolutely a heart / stomach connection. It is a matter of finding the triggers. For me, it's eating too much in one meal. Also, certain foods can be irritating like spicy fooods. Cold drinks will also bring it on. It's different for each person, but the large meal seems to be very common. With afib, it's always something. Basically, take your Mg religiously in the form of the Wally Water found in this forum, eat small meals slowly, and try to avoid other triggers. If I feel flutters, I drink extra Wally Water and go lie down. That usually helps. Also, if I've eaten cheese, I take potassium. Good luck!!!

When I was having Afib, and it was a lot over the course of 10 years, it was often triggered by burping...which was triggered by eating bread, for me. I distinctly remember eating the whole bread basket at a restaurant (bread IS my weakness), and then I started burping....and went right into Afib. I was a vagal afibber, so for me, I could make it stop by taking a brisk walk, until I finally "kicked into gear" and went back into NSR.

A lot of triggers for Afibbers seem to be the same as those for migraine sufferers too...not necesarily bread (like mine), but caffeine, alcohol, cheese, etc. For me, it got too complicated and my Afib became too frequent, and that's when I headed to see Dr. Natale and get an ablation. Thank God....the relief from Afib is still a blessing.

Barb

Barb, are you able to eat bread since your ablation? My weakness is chocolate which I read here in 2004 that it could trigger AF...so the closest I’ve got to a chocolate experience is going (if I’m around the area) to Starbucks and sniff hot chocolate that customers are drinking. I would love to one day have chocolate. I’m not sure if it’s the caffeine or sugar that triggers AF. Sugar and even high carb rice gluten free breads used to trigger my AF so I haven’t had since March. ER visits always showed elevated glucose labs.

Are you dairy and gluten free? It may help your burping. I’ve stopped both in 2009. The only burping I get is a marathon after each multaq dose and upon waking up.

Quote
LindaE
There is absolutely a heart / stomach connection. It is a matter of finding the triggers. For me, it's eating too much in one meal. Also, certain foods can be irritating like spicy fooods. Cold drinks will also bring it on. It's different for each person, but the large meal seems to be very common. With afib, it's always something. Basically, take your Mg religiously in the form of the Wally Water found in this forum, eat small meals slowly, and try to avoid other triggers. If I feel flutters, I drink extra Wally Water and go lie down. That usually helps. Also, if I've eaten cheese, I take potassium. Good luck!!!

I'd like things to be that simple, but they're not. Not for me.
I agree with the heart/stomach connection. I've this sensation too. But finding my triggers is another challenge.
Nearly four years since my first afib episode - and close to 300 episodes, I'm still searching.
If only it could be that simple : "I do this, I eat that... and it gives me afib". But no. It doesn't work this way for me.

Through my hundreds of posts on this forum, I can't count the stupidities I've written. Not about my afib or ectopics (they are what they are and I'm so symptomatic I can't miss identifying them when they come), but about what cause those troubles and what can relieve them.
I can't count the number of times I've thought "here's the culprit", "here's a good remedy". But I was all wrong. They were coincidences, nothing more.

Triggers remain a mystery for me. I imagine they might be the combination of several things or conditions, but what things or conditions ? I still don't know and, believe me, nearly 300 afib episodes gave me time to experiment.

I did a science experiment in 2004 when my AF were almost every evening by testing the results of frozen entrees to getting AF. We were having a kitchen remodel so I had no oven so we ate frozen dinners from our bathroom counter microwave. It was either the sodium or salt that triggered my AF. Or the stress of 9 months of using my toilet as a garbage disposal with no kitchen while like clockwork at the end of each day when HoneDepot contractors were using a gardener blower in my living room to move around the wood dust. I would get AF after they blew the dust. So stress was also a factor. I think most people on this forum has experienced stress, dehydration or diet to their AF breakouts. As mentioned above, it’s a mystery.

After my second visit to the ER in 2001 for afib my GP (very forward thinking!) sent me to a Gastroenterologist as he suspected silent reflux was behind my SVT/PAF.

Gastro sent me for an endoscopy which indicated a loose LES then sent me for a 24hr pH study and esophageal motility study.

The 24hr pH study involved inserting a tube with a metal sensor on the end into my throat and positioned half way between my LES and mouth then connected to a Holter type recorder. Bloody awful for 24hrs!

During the 24 hours I noted when I laid on the couch the pH monitor went from a pH of 6 or 7 (neutral or normal) to 1 or 2 (acidic or reflux). Also when sleeping if I lay on my left side it did the same thing, down from 7 to 1 (reflux again). Also from 3am to 7am when sleeping it was again 1 or 2 (silent night time reflux).

So over the 24hrs every time I laid down or slept the pH dropped from 7 to 1 or 2 and I would have a run of ectopics (PAC's ect.) at the same time. So for me this indicated the “smoking gun” behind my ectopics and afib.

If I had a Holter monitor on at the same time it would have confirmed the ectopics were triggered by the reflux.

So if your ectopics or AF are triggered when in a sleeping position or bending over then strongly suspect silent refux is behind it and have a Gastroenterologist check you out.

Although PAF is classified as a “heart condition” don't just rely only on a Cardiologist of EP to treat it. Explore every avenue and especially the reflux stomach connection.

Dean

Dean, thanks for your input. I've a weak LES too, and those position related ectopics. A gastro endoscopy a couple years ago revealed silent stomach reflux. They did nothing better for me prescribing a PPI drug. Awful ! I stopped it after about ten months.
As you said, I'm more likely having ectopics (sometimes leading to afib) while resting. When laying on my back, I've often PACs in bigeminal form, particularly in the early morning. They are discomfortable, but in that form, they don't trigger afib.
What do you do to lower your silent reflux?

Pompon, I started on PPI's (omeprazole “Losec”) in 2002 and was on them until 2010. It was ridiculous to take them for this long but I was scarred afib would return if I didn't.

I also greatly modified my diet and cut out all those things they say caused reflux and in early 2005 started eating natto food every second day which is a very strong probiotic amongst other things. Had I known the natto food was helping my reflux I would have stopped the PPI's much sooner.

In 2010 out of disgust I just threw the PPI's into the bin and went cold turkey. There was no reflux rebound effect and to this day hardly ever have reflux issues.

Dean

Thanks, Dean. I understand natto food has qualities, but I'm wondering how it can act as strengthening a weak LES, but who knows? It might work, after all.

Quote
Pompon
I'd like things to be that simple, but they're not. Not for me.
I agree with the heart/stomach connection. I've this sensation too. But finding my triggers is another challenge.
Nearly four years since my first afib episode - and close to 300 episodes, I'm still searching.
If only it could be that simple : "I do this, I eat that... and it gives me afib". But no. It doesn't work this way for me.
.

I absolutely agree. Sometimes, it just happens and there's nothing that could have been done to prevent it and, usually for me, only a cardioversion stops it. My cardiologist's answer to my question of why it happens was once, "maybe you looked at a blue wall." He was NOT being condescending at all, he was just stating that sometimes, it just happens. As he said no one knows why sometimes. (Of course this is all besides the usual suspects of alcohol, being tired, untreated sleep apnea, etc., etc.)
I'm just really grateful that there are such things as ablations to help give us some chance of an afib free life!!

Good luck to us all!!

woofbum-

In addition to the many related responses to your initial post on the heart/stomach connection, you can check these archived posts on the topic as it relates to the vagus nerve.

[www.afibbers.org]

Jackie

What an interesting thread!

I've only had three episodes of afib in the last 4 years and, from what I read here from folks like George, I am quite clearly a vagal afibber. all three episodes were when I had eaten, drank quite a bit of alcohol and gone to sleep on a full stomach. I am extremely in tune with my heart and any skip that occurs immediately makes me acutely aware. Lately I have been trying to understand why - in the morning and evening - I seem to get PVCs for a short amount of time only when I am sitting in my chair at my computer and almost always after I have eaten something. I religiously take potassium and magnesium, along with CoQ10 in the morning. If I get up and move around (or go for an evening walk) the PVCs vanish, most of the time for the night. Sometimes, manually increasing my breathing rate makes them vanish - and it may just be my imagination, but when I am sitting and my breathing slows to a certain rate, the skips come back.

I really have no idea if I should be concerned with these PVCs or just manage them by walking around.



Edited 1 time(s). Last edit at 11/12/2019 03:30PM by Ghost.

Ghost,

Try testing via stool or endoscopy for h pylori or any other infections of the stomach which also can cause GERD and inflammation and that can irritate the heart anytime the stomach is full. That’s what happened to me with h pylori and I didn’t know it for 18 months. Tried everything, all magnesium and potassium in the world didnt’t make any difference if my stomach was full. Any sudden moves, sitting down or laying would provoke PACs/PVCs. After I successfully treated h pylori its no longer an issue regardless of the movement or position but eating too much will still cause burps and indigestion, which is normal as the stomach takes a long time to heal. I believe a fella named Dean on this forum also had this issue and few others with bloating, you might want to read their posts.

I will certainly check it out. Other than the aforementioned, I don't really have stomach issues. Did you have any other symptoms?



Edited 1 time(s). Last edit at 11/13/2019 02:52PM by Ghost.