Lone AFib – Exercise Cool Down and Swallowing as Trigger?

webmd_rf_photo_of_atrial_fibrillationI’m in my mid 40s and exercise very regularly. And when I say regularly, I mean very regularly… (see Working out 7 Days a Week?!). About 7 years ago (years before I started my more intense exercise routine), I had my first episode of atrial fibrillation (AFib), which feels somewhere between weird and scary. At the time, I started going through all kinds of EKGs, ultrasounds and other tests (you name it). The end result: my heart is healthy, I have no other risk factors and I don’t abuse drugs or alcohol. The official term for this is “Lone AFib” (LAF), which basically means nobody knows where it comes from or what causes it.

Since then, I’ve now had a total 4 episodes:

  • I ended up in the ER every time.
  • Gaps in between were 4 years, and roughly 21 months thereafter.
  • The first time I was admitted and converted back to normal sinus rhythm due to drugs overnight. The 2nd time I enjoyed a cardioversion (read: defibrillator & electroshock). The 3rd and 4th time I spontaneously converted while already in the ER but without clear reason – maybe it was the stress of the ER experience or that the Flecainide ended up working after all. (After the first incident, my doctor advised me to take Flecainide only in case I go into AFib, not as permanent treatment.)
  • I stayed in AFib between 8 and 23 hours during those episodes.

Coming back to the mysterious trigger, there seems to be a common pattern that emerges from the various circumstances when my AFib episodes started:

  • Walking off the mat after a Tae Kwon Do class on a Saturday morning and taking a swig from my water bottle (2 occasions, exact same situation and day and time of day!).
  • Coming home from a jog and getting something to drink.
  • Sitting down after a hike up a mountain and starting to sip water.

It seems obvious: the 2 factors that always appear to come together are 1) finishing cardio-intensive exercise (the heart going into recovery from high BPMs) and 2) swallowing liquid. I’m wondering if the nerves controlling the swallowing reflex/process (vagus nerve?) intersect with or related to the part of the nervous system controlling the heart rate or if there is another way these two bodily processes relate?

From what I’ve read and the doctors I’ve talked to, there is no clearly documented connection. And yet at least for me this pattern is obviously way too consistent to be coincidental.

I’d love to hear from others who’ve been diagnosed with “Lone AFib” as to whether they’ve experienced the same or similar patterns?


On a sidenote: has anyone found that Flecainide affects the blood sugar level (a maybe undocumented side effect)?

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