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Medical and other procedures triggering afib episodes

Posted by anngunion @anngunion, May 16, 2023

I have paroxysmal afib episodes that seem to be primarily triggered by specific body positions, breathing patterns, acid reflux and swallowing too fast. Wanting to learn if others have encountered problems with appointments that require/involve specific body positions and/or different breathing patterns. In my case these situations have/may trigger afib episodes. I basically need to have my head in an upright position. I have had to terminate dental appointments as the required reclining position of the chair triggered an episode and also required that I change my breathing pattern. I breathe primarily through my nose - taking in air through the mouth is often a trigger. I have also avoided having a colonoscopy since this requires specific reclining positions, and am also concerned that swallowing prep liquid before that procedure might be a trigger. Another situation might be having a hair treatment that involved putting the head in different positions. Any suggestions on how to manage such appointments would be greatly appreciated!

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anngunion | @anngunion | May 18, 2023
In reply to @windyshores "I don't do hair appointments and my dental hygienist modifies my position. I do at home..." + (show)
@windyshores

I don't do hair appointments and my dental hygienist modifies my position. I do at home DNA testing (ColoGard) rather than colonoscopy. I also cannot bend my head back at all due to spinal cord issues so not only because of afib.

I find that GI gas it the biggest trigger and positioning makes a difference. Ironically the ambulance and ER put me in the worst possible position. If they would let me move around and find the right position I think the episodes would be shorter!

Swallowing too fast and GERD could create gas bubbles the press on the heart. At least that is how it feels to me. I cannot confirm medically!

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Thank you windyshores for your reply to my post. I will look for a dental hygienist that is prepared to work with me on setting up a position that might work. Interesting to know that I am not alone in experiencing that acid reflux, 'correct' swallowing and body positioning are primary triggers. Have you had or considered an ablation? I'm seriously considering having this done as my current meds are not working as well as in the past. I'm in the process of setting up some consultations here in California.

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1 reply
anngunion | @anngunion | May 18, 2023
In reply to @scolio "This is a good question, and I hope you find some work-arounds. I'm curious to know..." + (show)
@scolio

This is a good question, and I hope you find some work-arounds. I'm curious to know if you are getting any treatment generally for the atrial fibrillation? I've read that in a small percentage of people it can be associated with high blood pressure?

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Thanks for responding, scolio. I don't have high blood pressure. When I was first diagnosed with afib my episodes were infrequent. I only took meds (Eliquis, Atenelol, Propafenone) when I had an episode. Currently I take these meds daily, in low dosage, and my body tolerates this. Recently I have had episodes more often and with more apparent triggers as mentioned in my post. Now considering ablation but need to learn more. Seems that more than one ablation is needed to really make a difference.

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1 reply
anngunion | @anngunion | May 18, 2023
In reply to @afibguy "My experience with afib and medical procedures: I have had persistent afib since 2020. I started..." + (show)
@afibguy

My experience with afib and medical procedures: I have had persistent afib since 2020. I started on Tikosyn in 2021 and it was effective for about a year and a half and then I started having breakthrough episodes of afib that were becoming increasingly more frequent and intense. I had an ablation late last June and it stopped the afib episodes. I remained on Tikosyn during the blanking period. The plan was to stop the Tikosyn in October or November. Unfortunately, I had to have abdominal surgery under general anesthesia at the beginning of October and I had several episodes of afib, along with frequent PACs, for about a month afterwards. I have been afib free again since then, except for when my EP tried stopping the Tikosyn in January. Fortunately, I went back into NSR immediately after restarting the Tikosyn. But now, I worry about general anesthesia. I am having hand surgery next Wednesday and I convinced the surgeon to do it without general anesthesia because of my concerns. I am having a second ablation this coming November, so hopefully it will take care of all of this. Good luck to you.

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Thanks afibguy for your post. Encouraging to hear that your first ablation with continuing Tikosyn stopped afib episodes. I'm not familiar with Tikosyn. Hope that your hand surgery and second ablation are successful.

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windyshores | @windyshores | May 18, 2023
In reply to @anngunion "Thanks for responding, scolio. I don't have high blood pressure. When I was first diagnosed with..." + (show)
@anngunion

Thanks for responding, scolio. I don't have high blood pressure. When I was first diagnosed with afib my episodes were infrequent. I only took meds (Eliquis, Atenelol, Propafenone) when I had an episode. Currently I take these meds daily, in low dosage, and my body tolerates this. Recently I have had episodes more often and with more apparent triggers as mentioned in my post. Now considering ablation but need to learn more. Seems that more than one ablation is needed to really make a difference.

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@anngunion so did your doc give you short term anti-coagulant medication? For how long? This is what I need- for month or so after an episode over 5 hours.

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windyshores | @windyshores | May 18, 2023
In reply to @anngunion "Thank you windyshores for your reply to my post. I will look for a dental hygienist..." + (show)
@anngunion

Thank you windyshores for your reply to my post. I will look for a dental hygienist that is prepared to work with me on setting up a position that might work. Interesting to know that I am not alone in experiencing that acid reflux, 'correct' swallowing and body positioning are primary triggers. Have you had or considered an ablation? I'm seriously considering having this done as my current meds are not working as well as in the past. I'm in the process of setting up some consultations here in California.

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@anngunion I just went 23 months without an episode. Usually I have an episode once/year (always dramatic and need ambulance). I was at the dentist yesterday and they didn't even put the chair back when I told them I cannot go back!

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anngunion | @anngunion | May 18, 2023
In reply to @shoshin "On the subject of the fickleness of incident paroxysmal atrial fibrillation: This (what follows) sums up..." + (show)
@shoshin

On the subject of the fickleness of incident paroxysmal atrial fibrillation:

This (what follows) sums up just about everything I have come to know about the fickle & very often infuriatingly unpredictable nature of paroxysmal atrial fibrillation (AF), whatever its genesis (whether it's iatrogenic or "Lone" AF or AF caused by myocardial damage from incident myocarditis...which was further caused by administration of the mRNA COVID-19 vaccines or by a COVID-19 infection)--& I quote the first lines of this erudite & lengthy tract (which I heartily encourage others to read):

"It is likely that LAF only develops when three conditions are met:

1) The autonomic nervous system is dysfunctional.
2) The heart tissue is abnormally sensitive and capable of being triggered into and
sustaining an afib episode.
3) A trigger or precipitating cause capable of initiating an episode is present."

An abnormally sensitive heart tissue, if triggered, becomes a source of premature atrial complexes (PACs) or ectopic beats that, if frequent enough, may run together to create atrial fibrillation. German researchers have recently confirmed that the majority of afib episodes are preceded by a series of premature atrial beats. The origin of these beats is the left atrium in almost 80% of all cases."

See: https://www.afibbers.org/resources/aldosterone.pdf, entitled "Aldosterone: Villain of the Peace?" by Hans Larsen, MSc, ChE

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Thank you, Shoshin, for your responses, summing up just about everything you have come to know about the fickle & very often infuriatingly unpredictable nature of paroxysmal atrial fibrillation, and for the reference to "Aldosterone: Villain of the Peace" ( will try to read this). Will also try to learn more about metabolic/hormonal intervention. As you say, afib is extremely frustrating.

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Mentor
Jennifer, Volunteer Mentor | @jenniferhunter | May 18, 2023

@anngunion Hi Ann. I see you have had a lot of responses, but what you said about beauty parlor appointments may be pointing to an issue with your cervical spine. Moving the neck in different positions can bring on symptoms in a person with spine problems. That was a clue to my own diagnosis of cervical stenosis, not a beauty parlor, but moving my neck in different ways could reproduce symptoms. Some people have had strokes because of the head position over a sink at a beauty parlor when they tilt your head back. That can kink some of the blood supply to the brain in some people. It might be worth asking a few questions of your doctors about checking to see if you may have a cervical spine issues. Some spine patients do have increased heart rates because of spine issues.

Are you able to lay down to sleep? and if so, what do you have to do to support your neck so you can go to sleep reclined?

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2 replies
shoshin | @shoshin | May 18, 2023
In reply to @kravmaga "I too have the urination problem and have stated that before. As far as the rest..." + (show)
@kravmaga

I too have the urination problem and have stated that before.
As far as the rest of your post I think you are way above my pay grade (-:
I left you a personal message last week, however you never responded ?
Click on the head icon in the upper right corner and go to messages you should see it.

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Thanks so much for the private messaging instructions: I will respond (shortly)!

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1 reply
lizzie63 | @lizzie63 | May 18, 2023

I just had sinus surgery under general anesthetic that was "boring" for the surgeon and anything but boring for me. I have Afib that is well-controlled by Sotalol and I am at significant risk of stroke with abnormal cerebral arteries that would probably make any stroke pretty significant (also coronary artery disease). I had to advocate strenuously for heart monitoring overnight following the surgery, for the Sotalol, for low flow oxygen to address OSA when supine, for short walks to the toilet instead of bed pans, etc etc. In short, the onus was on me to maintain the routines that have helped me to manage Afib for almost two years. Just simple stuff, nothing like the measures the folks above are taking. So even when we go the medical route, we are still more or less on our own.

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Krav Maga | @kravmaga | May 18, 2023
In reply to @shoshin "Thanks so much for the private messaging instructions: I will respond (shortly)!" + (show)
@shoshin

Thanks so much for the private messaging instructions: I will respond (shortly)!

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At your convenience
Thanks

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