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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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lloeding | @lloeding | May 27 8:57am
In reply to @tedshred "I have also been diagnosed with Paroxysmal AFib. My symptoms almost always occur at night as..." + (show)
Profile picture for tedshred @tedshred

I have also been diagnosed with Paroxysmal AFib. My symptoms almost always occur at night as I am falling asleep or when I am sleeping (it wakes me up). Big meals are also a trigger. When an episode occurs, I stand up and will do jumping jacks or run in place for up to a minute and then repeat after a few minutes. It will return to NSR within minutes to 45 minutes. I can sometimes return to NSR with breathing exercises. I am an otherwise healthy 60 year old runner who stays in really good shape without any other contributing factors. Since being diagnosed, I have stopped drinking alcohol and caffeinated beverages. Sleeping on my left side is a trigger. I take Magnesium Glycinate, COQ10, and D3/K2 supplements. I have seen two EPs. Only one was willing to consider the Vagal Nerve as being a contributing factor. When I explain what I am doing when I have an episode, they brush it off as being coincidental. I have ordered a TENS unit and will report back if there is improvement. I am convinced that my AFib is caused by the Vagus Nerve and I am hoping to treat it without having an ablation. I would really appreciate hearing from others on this topic.

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@tedshred I too think I have vagal afib. Former crossfitter for 10+years. Most of my episodes are within an hour after eating dinner or right before bed, almost always when my heart is at rest. This is a one of the main signs of vagal afib as I have read (as well as being physically fit).
My EP didn't really seem to care and said the recommended treatment (ablation) is the same. I have had 2 ablations and am hoping number 2 does the trick.
There is a doctor at Mayo that is focused on vagal afib and does specific ablations (cardioneural) for vagal AFib. Maybe check out his work?

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d050526 | @d050526 | May 28 7:16am

Your post rings true with the varied diagnoses that seem to be distributed by our well meaning doctors. I am a firm believer of digging through the information that is available to us now, which helps to educate. I am so glad you were able to get to the real root of your health journey. It encourages me to do the same.

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sheriff50 | @sheriff50 | May 28 10:14am

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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tootall10 | @tootall10 | 3 days ago

I too suddenly found myself having vibrations in my chest. Not knowing what was happening I got up and went to the ER. They didn't find anything (it seemed to go away if I got up and walked around). I did this twice and then one of the Dr.s prescribed Pantoprazol to see if it would help. (Another sign that I didn't pay much attention to was the burping. A fair bit more than I was used to.) Anyway, over the next couple of weeks the symptoms diminished until some nights I had no vibrations. (You had to sleep on your back.) When I ran out of the Pantoprazol I didn't immediately renew the prescription. Within a few days the vibrations came back. I renewed and they diminished again. I've started to do leg lifts while lying down to start to strengthen my stomach muscles. That also may be helping. And losing some weight. Anyway, I'm good now. Wish you luck.

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