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Anyone diagnosed with PV AFib but actually had vagal ?

Posted by melloland @melloland, Jun 22, 2025

Hi everyone, I’m sharing my story to help others who may be misdiagnosed.

I was originally told I had paroxysmal AFib likely caused by pulmonary vein triggers. But during my ablation, no electrical activity was found in the pulmonary veins. Instead, activity was found in the right superior ganglionated plexus, nerve cluster confirming that my AFib was vagally mediated.

Looking back, the signs were there all along—but they were easy to miss:

I had no underlying heart disease and a structurally healthy heart.

I’m under age 55 and had episodes mostly at rest, especially after meals or lying down.

My heart rate was calm before going into AFib, unlike the stress- or exercise-triggered episodes more typical with PV-AFib.

Beta blockers made my symptoms worse, increasing fatigue, gas, and vagal pressure.afib episodes

This type of AFib reacts very differently to standard treatments. I wasn’t told about vagal AFib before the ablation, and I wasn’t given the chance to explore more aligned approaches beforehand.

If you’re dealing with strange symptoms, if your episodes don’t fit the typical pattern, or if you’re getting worse on medications that are supposed to help, you might want to consider vagally mediated AFib.

I’d be happy to share more about what I’ve learned and what’s helped me recover. You’re not alone—and your AFib might not be what they first said it was. Vagal is not the same as pv afib.

Interested in more discussions like this? Go to the Heart Rhythm Conditions Support Group.

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rushhome | @rushhome | Jul 7 9:03am
In reply to @sheriff50 "My symptoms do not fit afib diagnosis. How do you find out if mine are caused..." + (show)
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My symptoms do not fit afib diagnosis. How do you find out if mine are caused by the vagal nerve? I have seen every kind of doctor and had lots of tests. I am so discouraged.

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@sheriff50 curious why you don't think symptoms don't fit diagnosis? I recently was finally referred to an EEP who confirmed what I thought, I had one incident after covid that through my thyroid off. 18 months and several ekgs, a zio, a holter and an ultrasound he said I can quit Eliquis and carry as a pill in the pocket just in case. He called it situational afib, common after respiratory infections. I take nothing else beside synthroid.

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vmccann12 | @vmccann12 | Jul 8 12:23pm
In reply to @diane987654321 "I’ve been doing vagal stim of my right costa conchae daily since March. I credit it..." + (show)
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I’ve been doing vagal stim of my right costa conchae daily since March. I credit it with helping me reduce my afib episodes from weekly to once every 3.5 weeks. My PV were ablated in May, no afib since, but if I skip vagal stim I have a lot more PACs. I use an ear clip, ultrasound gel, tens device at 20 hz in my right ear for about 30 minutes. I can usually tell when it’s time to stop. I do it before bed. Cheap, easy and effective for me. I can provide references and links to what I use if anyone is interested. My heart rate is always bradycardic, vagal stim at the intensity I use doesn’t decrease it. I monitor it to make sure. I definitely had vagal triggers for my afib, but I think my pulmonary veins were the instigators. It is a lot easier and safer to do the PVs. I asked my EP to map me prior to ablating but I don’t think he did, at least I couldn’t find any tracings in my medical records. My heart is SO MUCH BETTER after my ablation.

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@diane987654321
I am interested in the ear clip treatment

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drherm | @drherm | Jul 9 9:29am

I’d be interested in your experience with vagal afib. Have felt like my symptoms fit. My EP says they are all about the same. Who can I proceed with? Mayo?

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diane987654321 | @diane987654321 | 1 day ago

Sorry to be slow to respond. I got inspired to try the estim of my costa conchae (my tragus is too small to hold a clip) from this study....https://pmc.ncbi.nlm.nih.gov/articles/PMC7100921/pdf/nihms-1545852.pdf. I used their parameters, 20 Hz and pulse width of 200 μs but I never did it for an hour. I usually did 20 minutes. I used it for about 4 months and I think it reduced my events and even stopped 2 afib episodes within 5 minutes of starting the stim. But, after awhile it didn't feel good, my heart seemed to have more PACs, which I hate. So I stopped. Then, about 5 months later my afib was going nuts so I tried it again. It seemed to work for a couple of months, I felt better after doing it. Then, I started having SVT that was hard to break that evolved into fib and flutter. So I stopped again.

I just bought this TENS unit...https://www.amazon.com/Therapists-Choice-Stimulator-ComboOTC-Accessories/dp/B09SMTNB72/ref=sr_1_1.

It allows you to adjust the pulse width and frequency.

The super cheap ear clips killed my ears. These hurt too, but were better...https://www.amazon.com/Double-Sided-Electrode-Long-Lasting-Anti-Loosening-Version/dp/B0FVZGXX17/ref=sr_1_11.

What worked best were ear molds electrodes I got from AliExpress. I don't see them on the site today.

I suggest starting super low intensity, go to you just barely feel it. Do it for a few minutes the first couple days and advance the intensity and duration depending on how you feel. Some people's vagal nerves are touchy. Don't blast it. If your heart rate drops after or while you are doing it you are going to strong for sure. Don't do that. I also suggest removing the clip before turning it off. Once I turned it up instead of turning it off while it was attached. I didn't make that mistake again. OUCH!

I did the ear stim watching dumb TV in the evening. I used to do it in bed but I didn't like waking up with my ear hurting.

I also suggest keep an afib diary, maybe in a calendar app or something. Record everything about your afib event, duration, intensity, heart rates, symptoms, what you think could have triggered it, etc.

Good luck.

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