Postural arrhythmias

I think he is on to something, at least for some of us....some of the time. It makes sense. When we're active, our minds become engaged in other pursuits, and we are distracted from the sensations we feel when we indulge our anxious selves when calm...and turning our minds to our arrhythmia once again. Even so, when I was in AF and trying to sleep, it was worse on my left side, which is the 'best' side to try to fall asleep on if you have eaten much in the past two-three hours so that gas can escape and stomach acids can remain below the pyloric valve. It is why the 'recovery' position after a colonoscopy is always in the fetal position, left side down. When trying to relieve the pressure from sleeping on my right side, which was the 'quieter' side from the heart's point of view, the left side had my noticing the thumping and erratic timing much more, with the result that I slept much less.
But, again, I think there's a lot of truth to his claim. If I got up and paced around the house, or went for a walk, or did some chore, I soon forgot the arrhythmia, and next thing is was gone.
However, let me assure you that a great many of us simply know, myself included, that when I do certain things and strain, say bending over and tying my shoes at my heavier 70+ years of age, I would have ectopy come on at least 50% of the time. Not now, because after two ablations, and still enjoying my butter, I don't get any ectopic beats when straining physically such as when lifting, bending, supine, prone, etc.
I wish the hair loss were not a consequence for you. Your EP doesn't want to try another drug?

I’m sure it’s true that many people have no idea what their hearts are doing. It’s why 50% of Afib patients in my EP’s practice never knew they were in Afib. They found out in a routine exam. Which blows his and my minds but there you have it. Most people don’t feel their hearts. There is a cardiologist in the UK that addresses postural ectopics. They are real but the why of them is not understood. So when docs don’t understand something they often doubt the anecdotal reporting of it. I have ectopics when I lean over the sink, bending forward. I have them when I lie on my back. I’ve had them for half a century. It’s just now, post ablation they are really bad. It’s funny that my doctor didn’t hear any when he listened to my heart while I was sitting on the table but as soon as he had me lie down for the ekg they went crazy. It’s a “thing.” As to beta blockers and hair loss, they all have that as a side effect. Even my husband lost a lot of hair on Metoprolol and it stopped when he stopped taking it. Calcium channel blockers are contraindicated for me so beta blockers are my only choice. I’m just hoping that my heart is still healing and I will eventually return to my baseline of tolerable ectopics that don’t interrupt my sleep. Then I won’t need to take a beta blocker.

These posts are all a mystery to me. I have worn a monitor and have no afib that I am not aware of. When I do have it it is dramatic with heart rate close to 200, very short of breath, chest and jaw pain. I remain calm but I end up in the ER, one time in the ICU, because low blood pressure makes treatment difficult (meds). This happens once a year. I cannot imagine not feeling my afib!!

I was on atenolol for years. It was a trip to the ER because of severe PVC's that the ER doctor, upon noticing I was taking atenolol, said something negative about it and changed me to metoprolol. I started having internal vibrations more than when I was on atenolol and wanted to see if it was the metoprolol causing it so we switched back to atenolol and my PVC's started going crazy. After about 3 days I went back to metoprolol and now I might have maybe 3 episodes every 10 days or so. I also take 400mg magnesium daily. I take COq 10 too.

We are all so different. I’ve taken atenolol for decades, only at night when needed, for PACs. When I changed doctors she refused to give me atenolol and put me on Metoprolol. That was horrible for me. It caused sleep disturbance and even three episodes of sleep walking. My doctor didn’t believe me but it’s in the literature, clear as day. My EP was baffled as to why she refused to prescribe atenolol and he put me back. It calms my heart at night and puts me to sleep.

I just met with my new doctor yesterday. He said he’s 100% sure that postural ectopic beats are real. After over 20 years of practice he said he has witnessed it in so many patients. He believes it has to do with the vagus nerve and how in different positions it can trigger the heart and how it beats. He says he’s heard the argument that people just don’t notice it during the day and only when resting in bed at night become aware and he doesn’t buy that explanation. For one thing, as I said above, sitting on the exam table my heart beats normally. Lie me down on the table and boom, PACs. He’s seen that over and over. I was glad to hear a doctor acknowledge what so many patients experience. Just because the mechanism is not understood doesn’t mean it’s not real but that is exactly what so many doctors do.

I'm very pleased to see you prevail and with the help of a kind...and experienced...physician. Bravo!

I've long suspected that my vagus nerve has had something to do with my afib. For instance I noticed having them at about the same time on Friday nights as l was lying back in my chair to watch TV. How can this be corrected?

I feel,PACs and pvc more when I lying down. On occasion I feel them during a day when i am not busy. I’m pretty sure it’s because I am distracted during the day. If I feel them at rest, I start patting my heart with a rhythm similar to a heartbeat. I can’t feel them and it is very soothing. I wish I could buy a gadget that would pat my ribs because the wrist gets tired.

I’m a 77 year-old female. This thread and others have educated me, with the reports about the vagus nerve’s involvement in afib—postural or otherwise— and the interrelationship of my esophageal and electrocardio issues, all discovered / identified in the past year. After years of what were probably postural PVCs and an ER dr.’s recommendation that I wear a monitor for a month, the monitor recorded and reported a 4.5 second complete electrical blockage on New Year’s 2023. It had made me so lightheaded that I’d put myself on my knees , ready to faint. Four days later my two-lead pacemaker was implanted. I really don’t notice the PVCs any more during the day and can now walk for exercise again and bend over in yoga without lightheadedness. But my recent silent reflux diagnosis, which means sleeping on my left side, among other things, conflicts with my new paroxysmal A-fib diagnosis, which was diagnosed by my bedside pacemaker monitor. So yes—postural interactions play out in my life, but I doubt it can be corrected. I have “silent” Laryngopharyngeal Reflux, with a small hiatal hernia, and thanks to these Mayo group postings am starting to understand the critical importance of the orientation of the vagus nerve in these issues. Thank you all.