Heart Palpitations at night - caused by vagus nerve issue?

Posted by warpedtrekker @warpedtrekker, Mon, Feb 4 12:47pm

I'm 47yo, 220lbs, 6'1" male. I have sleep apnea and AFIB which are both controlled for now. I use a BIPAP and take Multaq for AFIB. I also wear a chin strap, and a neck brace at night, due to my apnea and palpitation issues. Some nights, when I lay on my left side, or on my back, I will wake up in the middle of the night with very bad heart palpitations. I believe I may be pinching a nerve or it's something to do with the "vagus nerve". So what type of doctor would i see about this condition?

I have been to local sleep doctor, cardiologist, and electrophysiologist. Also a neurologist and spine doctor. They have no solution for me. The issue I have is, that before I was on Multaq, the palpitations were much worse, and I had an AFIB incident in 2017. But last year, also had issues with Bigeminy.

The issue also can happen, if I'm reclining back on my recliner for a period of time. I will feel this "anxious" feeling, then if I get up, it causes major palpitations and sometimes a racing heart. My doctors have claimed it all due to anxiety, and I'm taking medicine for anxiety again now. But the issue in my sleep keep occurring with palpitations.

I'm not sure what to do about it anymore. I dont want to live this way anymore! The neck brace has seemed to help, because I would have a lot of obstructions at night before that. But I'm tired of these palpitations occurring.

I've had EKG's, stress tests, and recent echocardiogram and holter monitor for two weeks. Nothing was found concerning.

During the Holter Monitor for 2 Weeks, did you have the symptoms, logged the time, and asked for the doctor to specifically look at that time. I'd keep the log book, as required, when I was wearing a Holter Monitor, but used my watch to record times, I'm not sure that's a good idea if the Holter clock isn't in perfect sync with the watch, I remember the doctor saying I have no activity for a few recorded events, but I'm not convinced it wasn't due to the differences in my Watch and the Holter's time keeping. I synched my watch before I started, but by the end of 24 hours, it was off due to the Holter Clock, not my watch.

I'm in afib now, I was going to have an electro conversion and be placed, in the hospital for a few days to start Sotalol, but after reading an abundance of medical literature, they advise only highly symptomatic patients to do that, and I'm not highly symptomatic but for one thing, namely when I ate my heart would go nuts in afib. But that settled down, mostly. But on days when I feel the afib, eating too much, or drinking too much, I still get a lot of symptoms.

Avoid excess sugar, avoid all alcohol, drink only decaf coffee, preferably only once early in the morning (even decaf has caffeine, and you really can't be assured as to the % of caffeine, regardless of the label), avoid carbonated drinks. At dinner, avoid big meals, very light snack in the evening, I have a couple of pretzels that have practically no salt on them, only have a small non-alcoholic non-caffeine non-carbonated drink, preferably not acidic excessively. Do not drink a lot of water at bedtime.

My esophagus must actually be touching my heart, if I sit a certain way, I can hear coming out an opened mouth, a pop, pop, pop, with each heartbeat, I mentioned it to the doctor. I read a story of a man that had his esophagus slightly repositioned, he was undergoing ablations due to an arrhythmia and apparently the irritation of his esophagus rubbing on his heart was the culprit.

Your heart and lungs are separated from the stomach, liver, intestines, etc. by the diaphragm, an opening in the diaphragm allows the esophagus to pass through, but under certain circumstances, part of the stomach can buldge up through the diaphragm, and I'd imagine it can add to certain arrhythmias, such as the one caused by the esophagus. Medication is not necessarily the solution, sometimes lifestyle changes can help.

I believe my afib is worsened by Vagus Nerve issues, before I was in afib I had a period of time where every time I swallowed, towards evening, a PVC occurred, even saw a doctor for it. Even today, I'll get PVCs and seconds later a violent upheaval (I'm exaggerating a little) in the intestines, and this happens again, and again.

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