Looks like GERD/acidity is the culprit????

Recap...had ablation for PACs last Aug with Natale....PACs free for 7 months then they came back with a vengeance. As a result had to start taking Met+Flec again to tame the beast.

Been on meds for past 2 months...I stopped last week to do my 1 yr holter study...as expected as soon as I stopped the meds the PACs came back so "good news" is that they (Natale) are definitely going to see them on the report.

BUT, one thing that surprised me is that after 3 days of PACs...they disappeared, poof, just like that.

The ONLY thing I started doing differently is to take 20mg of Pepcid morning and night to fight LPR... that's basically acid reflux that makes it to the back of your throat.

Upon further reading, looks like LPR and GERD (acid) both irritate/stimulate the vagal nerve, which can initiate palpitations.

Is this the reason why my PACs would tend to show up around meals????

Don't know if I should be happy or not...cause while it's important to know your triggers, the issue here is that Pepcid and other acid meds can only be taken for a few weeks at a time...sooo...if this is indeed what's going on, what do I do? Lol

Try apple cider vinegar instead of the PPI/antacids. If you feel the burn coming up, or are getting burning belches, swallow undiluted a single tbsp of acv. This will stimulate your pyloric valve to close fully, prevent reflux, and prevent the Vagus nerve from objecting.

Works for me.

Many with GERD remain on H2 blockers like Pepcid, and//or PPI's for life. What it says on the OTC bottle is not necessarily applicable when you're under the care of a doctor.

Jim

Agree with gloaming that more acid may help. Here is a book on the topic.

A member here, Dean, solved his reflux related afib by stopping the PPI med and started consuming natto food in mid-2005 (fermented soybeans). He still posts occasionally. Here are all of his posts on the topic. Also his story was written up on p27 of this pdf.

I have been taking omeprazole (Prilosec) for a while now. It helps, but the problems come back every time I try to stop it.

For me, tapering off the Prilosec is working better than just stopping it cold turkey.

It appears my stomach over reacts to Prilosec being stopped by making more acid than needed amd certainly more than wanted.

My PCP suggested alternating days of Prilosec with Pepsid for a couple of weeks then tapering off the Pepsid on a PRN basis until gone, then experiement with reducing the Prilosec.

Over a 6 week period this has worked better for my wife than me as she regularly takes Prilosec every other day and requires Tums perhaps once weekly. I'm still alternating daily Prilosec with Pepsid PRN with no Tums needed so I should take the next step.

Good luck.

Thanks everyone for your inputs, truly appreciated. In a few hrs I'll remove my holter and ship back the equipment. But so far I can confirm (via Kardia) that in the first few days I was in constant PACs, then they stopped as soon as I started the famotidine for a few days, and then they came back as soon as stopped the famotidine. I am going to resume the famotidine tomorrow and will do a 2 weeks trial (will report back on results).

But, I can confirm that I read online that one of the experts in LPR states famotidine/pepcid is actually very safe long term, compared to PPIs which can give serious side effects.

So if my self-diagnosis is confirmed, this means that I will have to pick between a lifetime of Met+Flec, or a lifetime of Pepcid. I think/assume Pepcid is the lesser of both evils??? Pick your poison, as they say lol....

As someone who struggled with GERD for years I can tell you that any acid blocker will leave you deficient and block many essential nutrients from absorption, especially magnesium and B-12. How about just avoid trigger foods that cause the reflux? If you don’t wake up with acid reflux then carefully work on a list of a foods that will eliminate GERD. Or go all in on either keto or carnivore diet to solve it permanently as I did.

Quote
gloaming
Try apple cider vinegar instead of the PPI/antacids. If you feel the burn coming up, or are getting burning belches, swallow undiluted a single tbsp of acv. This will stimulate your pyloric valve to close fully, prevent reflux, and prevent the Vagus nerve from objecting.

Works for me.

Why would digesting acid stop GERD acid? I drink ice ice cold coconut milk when I am vomiting acid. It coats my sore esophagus and relieves the pain

Two different effects, Susan. As I explained earlier, the pyloric valve is not being induced to close itself properly, and the result is GERD or what seems like acid indigestion coming back up and possibly damaging tender tissues lining the esophagus. Taking the highly acidic apple cider vinegar serves to induce the closure of the pyloric valve. The recourse to which you refer is a palliative measure to keep pain away, or to protect the lining of the esophagus; it doesn't stop the problem, which is the rising acid. I think one should probably do the apple cider vinegar first, and then chase it down with something to soothe the esophagus.

I used to take Pepcid but got off almost entirely. I take it maybe once a month.

I also feel my afib is triggered by GI issues. I do use Tums- and Gas X (simethicone). I actually stopped a short but intense afib episode with simethicone! I read that someone got an IV version in an ER for afib- wish I could cite it.

Since I stopped eating after 5 or 6, got off dairy and gluten, choose foods wisely, eat small amounts at a time, and don't recline after eating, my GERD has gotten better. GERD also caused my "asthma"!