Vagal vs. Adrenergic AF - Is there a handy list of triggers?

I am still pretty new and trying to sort things out. Is there a link or list or document somewhere listing the common triggers for vagal vs. adrenergic AF so I can try to determine my type? I am starting to get a sense of how to distinguish the two types. But I suspect someone somewhere has put it in list format.

Also, if a person's AF is mixed vagal and adrenergic, is any single episode going to be either vagally or adrenergically mediated? Or can both forms somehow be involved at same time in triggering a single episode?

Thanks!
Kim

You might read the founder of this site, Hans Larsen's, book LONE ATRIAL FIBRILLATION TOWARDS A CURE also this [www.afibbers.org]

In general, adrenergic triggers are immediate and vagal are delayed. So with respect to exercise, if you exert yourself and go into afib, then that would be an adrenergic trigger. If you go out for a long run, come back, rest and maybe wake up in afib, then would be a vagal trigger. An exception to this would be direct vagal triggers, like consuming an ice cold drink, which could result in afib acutely, but would be a vagal trigger, because of the cold impacting the vagus nerve.

If you are mixed, then either adrenergic or vagal activities can trigger afib. Once you are in afib, it doesn't really matter how you got there. Afib is afib once you are in it.

Thanks for the info, George. I am reading Hans's book right now. Just started it this morning. It's a great book!

Will also check the afibbers link you gave for more info. Appreciated.

kim

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GeorgeN
If you are mixed, then either adrenergic or vagal activities can trigger afib. Once you are in afib, it doesn't really matter how you got there. Afib is afib once you are in it.

I wonder if that's entirely true. If it's vagal afib, then maybe the "cayenne" home remedy I have seen others post here would help. If it's adrenergic, then cayenne could make it worse. Although caffeine is often cited as an Afib trigger, I have known people who say a cup of coffee gets them out of AF. I bet those people have vagally mediated afib and need to stimulate/raise the sympathetic (adrenergic) part of the nervous system to rebalance. So I think in terms of my own strategies... it does matter how I got into afib, and will influence the strategies I deploy to try to halt it. Also... if I got into from a vagal trigger, then I shouldn't be taking the metoprolol as instructed by my cardiologist who told me I can use it at increased dose as PIP even if I don't want to take it daily. It has never helped as PIP and has sometimes made me feel much worse. So it seems to me, once we are in afib, we do need to know how we got there in order to end it rather than exacerbate it.

Kim,

Yes, in the short term after afib starts, it does matter. Many vagal afibbers can exercise their way out of an episode. Adrenergics can use vagal maneuvers to likewise convert. If an episode has been going on for a long time, these are less likely to work.

I've written about time around 2012 when I was going through a divorce and stress eating wheels of brie. It took me 14 months to figure out the excess calcium was negatively impacting my normally excellent afib control. Also things that aren't normally triggers, like cold drinks, became triggers. I recall consuming an ice cold drink, feeling my heart go off the rails and reversing it by drinking a bunch of hot water. Likewise the time immediately after orgasm became a risk time for me, the period of time when the heart rate is dropping like a rock. I could feel PAC runs which could quickly turn into afib. Change of position: going from prone to sitting up, standing or moving around was often enough to change the state of the autonomic nervous system and either convert or ward off an episode.

Thanks George! That helps me start to sort out which type I might be having in various situations.

kim

As George said. I'd add that vagal afibbers may sometimes experience afib while digesting.
Quiet exercise after meal may prevent this.

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Pompon
As George said. I'd add that vagal afibbers may sometimes experience afib while digesting.
Quiet exercise after meal may prevent this.

That's very good to know. Thanks! I am going to resume my earlier habit of an after-dinner walk.

kim

After trying for a year to identify and eliminate all triggers and usual suspects, I wonder if many of the identified triggers aren't just Baader-Meinhoff in nature.

Certain triggers are common (low mg, dehydration, stimulant use) while suspect triggers may only be coincidental to those common trigger/conditions.

If triggers really were triggers wouldn't elimination of all triggers and usual suspects resolve AFIB? For the majority, it doesn't. And when you get outside the bell curve you're going to end up chasing outliers and ether for as long as you're willing to believe there might be an easy solution.

I was this way and still hold a small degree of hope - but the reality is I've got AF and elimination of all triggers, suspects and applying all interventions hasn't worked yet.

Maybe this is the capitulation necessary to take the leap and schedule an ablation? It is for me.

When AF is gone, I can go on with my life. Ablation seems the straightest most likely path and to such a degree that even if I magically popped into NSR, I would only postpone the ablation until the next time a trigger or the tide sends me back into AFIB.

I went out for a bike ride the other day. I'm 57, maximum calculated heart rate is 163. At a very slow avg of 10mph on level ground, while in AF my avg was 165 and max during the ride was 197.

Last time I did such a ride in NSR my heart max was 108.

I am ready for AF to end and life to resume.

AMEN!! I must tell you, that I am so happy to have my life back. Ablation done May 11, 2020 and so far so good. I wake up every day thanking GOD I found Afibbers.org and the doctors they recommend. I am a diehard health nut, avoid all medications, doctors and the like. I ran from the idea of ablation for two years, eliminating EVERY hint of a trigger, but this ablation has been the best thing since sliced bread. Recovery was a piece of cake! You just have to go the the right EP

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PoetKim

As George said. I'd add that vagal afibbers may sometimes experience afib while digesting.
Quiet exercise after meal may prevent this.

That's very good to know. Thanks! I am going to resume my earlier habit of an after-dinner walk.

kim

At the very least it will lower your blood sugar

The only possible trigger in my Life was Anxiety but nothing I mean nothing would bring me out of AFIB except a ECV. I never bounced in and out of AFIB at least after it was detected at a yearly physical. I had a yearly physical every year since 1998 and no AFIB ever detected until Dec 2011.
Anyway,I do believe be a worry wart and staying stressed possibly could take one over the top.

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Joe

At the very least it will lower your blood sugar

It's true that quiet exercising after meal helps lower blood sugar; but it does not imply that those having ectopics or afib while digesting have abnormal blood sugar levels. It may be a combination of the variation of blood sugar level (in the "normal" zone), stomach reflux, body position and possibly a bunch of other things.
Afib is definitely a very sophisticated phenomenom. Understanding "how" is usually far more trivial than understanding "why". Those having found their sure trigger(s) are lucky!

I was very patient with my AF maybe too much. For 10 years doctors tried all possible drug combinations to prevent or intimate AF. Nothing worked
And it progressed to AF episode every two days lasting for 12,14,16 up to 24 hours. Decided to have ablation in Bordeaux. 12 years later after AF is back and straight after few months of dealing with beast I decided to have ablation again. My AF always very sympatomatic
Making me bed ridden for the duration of episode.