Imagine going through your day, minding your own business, when suddenly something feels “off” in your body. Seemingly out of the blue, you feel exhausted. Your heart may be racing or doing flip-flops in your chest. You might feel dizzy, short of breath, or just out of sorts. It can be very disconcerting if you’ve never experienced this feeling before. You might wonder, “am I having a heart attack?” However, those already diagnosed are familiar with what’s happening: You’ve just had an AFib attack.
The healthy heart
Much like a home, the heart consists of four rooms called chambers. The top-level has two rooms known as the atria. The ventricles are the two on the bottom. Just as a house is wired with electricity, so is the heart.
When wired correctly, the electrical switch is the sinoatrial (SA) node located in the right atria. When activated, the SA node tells the top part of the heart to contract. The signal then continues to travel down, passing through the atrioventricular (AV) node and continuing to the bottom of the heart. Stimulating the AV node causes the ventricles to contract.
The SA node is the heart’s natural pacemaker, and when working correctly, it causes the heart to beat anywhere from 60-100 times per minute. Doctors call this “normal sinus rhythm.”
What is atrial fibrillation?
In some instances, such as AFib, the heart’s electrical signal is disorganized. Instead of beginning in an orderly fashion in the SA node, impulses generate from multiple areas in the atria. The rapid firing of these electrical impulses causes the atria to beat in a quick, chaotic fashion.
Thankfully, the AV node limits the number of impulses that get through to the ventricles. However, some still get by, causing the ventricles to beat erratically. Oxygenated blood cannot normally be distributed throughout the body, leading to dizziness, shortness of breath, and fatigue. Individuals in atrial fibrillation can experience heart rates up to 200 beats per minute.
Atrial fibrillation can come and go, called paroxysmal AFib. In other cases, it lingers for longer than a week or until medical intervention assists the heart back to normal sinus rhythm. Individuals who experience more prolonged bouts are said to have persistent AFib. Finally, for some, AFib never goes away. These individuals are said to have permanent AFib.
Why does atrial fibrillation suddenly start?
Most diseases come on slowly, giving a fair warning of the impending illness. While there are sometimes subtle warning signs for AFib, more times than not, it simply appears. Individuals diagnosed with AFib often explain that they were going through their daily routine when something suddenly changed in their hearts.
Over time, people with AFib begin to learn their specific triggers for the disease. These triggers vary from person to person. Identifying these triggers is essential for preventing additional unwanted episodes.
15 common things that can trigger an AFib attack
Over-the-counter drugs
We live in a society where popping a pill to feel better is a relatively common occurrence. Most people think nothing of taking an ibuprofen for a headache or a sleeping pill when they can’t doze off. However, it’s important to remember that all medications have side effects.
Certain over-the-counter drugs, such as cold decongestants, can trigger AFib attacks. Medications to decrease secretions constrict blood vessels and stimulate the heart, sometimes bringing on AFib. Studies have found that non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or aspirin can also prompt an AFib attack for some people. It’s best to check with your doctor before using over-the-counter drugs or even avoid them altogether.
Recreational drugs
Over-the-counter drugs aren’t the only medications to worry about. Recreational drugs, such as cocaine or marijuana can significantly raise the heart rate. Cannabis is a vasodilator, meaning it opens the blood vessels. As such, it causes a significant increase in heart rate, sometimes as much as 20-50 beats per minute. This additional strain on the heart can trigger an AFib attack.
A 2021 study of over 2.4 million hospitalized marijuana users found that individuals with heart arrhythmias were 4.5 more likely to die in the hospital than those with normal heart rhythms. While each individual is different, research has concluded that pot can induce AFib in predisposed patients.
Prescription drugs
Most people assume that medication prescribed by the doctor is safe. Sure, it might have minor side effects, but it won’t cause a significant health crisis. Wrong! Drug-induced atrial fibrillation is a very real thing.
Certain heart drugs, steroids, and breathing medications can prompt an AFib attack. While you should never stop a medication without speaking with your doctor, it’s worth examining what pills you are taking and how they might impact your heart. In addition, working towards eliminating medications may help ward off AFib down the road.
Dehydration
Fluids are essential for maintaining health, and dehydration is one of the most common triggers for AFib attacks. Dehydration causes the blood to be thicker, increasing the risk of blood clots. It can also contribute to electrolyte imbalances. Low minerals in the blood, such as potassium and sodium, can trigger an AFib event.
Adequate hydration is more than replacing fluids from sweat. Alcohol use, drinking caffeinated beverages, and traveling on planes all contribute to water loss in the body. While drinking high-quality water is essential, too much can also contribute to electrolyte imbalances. The solution is drinking enough water and consuming nutrient-dense foods to assist in electrolyte replacement.
Alcohol
Speaking of dehydration, alcohol is a diuretic, meaning it promotes water loss through increased urination. Not only does this worsen dehydration, but it accelerates the loss of essential minerals and electrolytes.
Researchers have identified other mechanisms by which alcohol triggers AFib. For example, scientists have found a relationship between drinking and the vagus nerve, the longest nerve in the body that innervates the heart and many other organs. They found that alcohol can increase vagal nerve activity and trigger heart arrhythmias.
While research shows that binge drinking is a significant risk factor for AFib, new research indicates that even one glass of wine might be enough to trigger an AFib episode. Therefore, individuals with a history of AFib or contributing risk factors should consider eliminating alcohol altogether.
Medical procedures
Atrial fibrillation is the most common arrhythmia after surgery. Postoperative AFib (POAF) occurs in up to 12 percent of those having non-cardiac surgery. What’s more concerning is that these individuals are at higher risk of stroke and death. While the exact causes of POAF are unclear, surgery is stressful to the body. Inflammation, anesthetic medications, temperature changes, and electrolyte imbalances may contribute to new-onset AFib.
It’s not only major surgery that could trigger AFib. Relatively straightforward procedures such as colonoscopies or biopsies have been linked to atrial fibrillation.
Stress
Stress is as dangerous to the heart as a poor diet and lack of exercise. Several studies have linked mental stress with AFib. For example, in a study of 100 patients with AFib, participants identified stress as the number-one trigger of their arrhythmia. Stress can trigger an AFib episode, and it can also increase the severity of the symptoms.
There are multiple reasons why stress contributes to AFib. Not only does stress impact the heart directly, but it also leads to other health issues that trigger AFib, such as high blood pressure. Also, stress activates the sympathetic nervous system, negatively impacting the heart.
Illness
Illness places a significant amount of physiological stress on the body. Even a seemingly benign disease, such as the common cold, can strain the body and trigger an AFib episode.
Some scientists speculate that viruses may be directly to blame for AFib. Most recently, physicians are finding individuals with COVID-19 at higher risk for developing AFib. While the research is still developing, upwards of 20 percent of patients with COVID-19 develop AFib.
Caffeine
As enjoyable as it is, your morning cup of joe may be setting off your AFib episodes. Caffeine is a stimulant found in coffee, tea, and even chocolate.
The evidence is mixed on the impact that caffeine has on triggering AFib. While some people can enjoy a bit of caffeine in their diet with no effect, others notice heart palpitations right away. For some, it’s possible that caffeine is not the culprit but rather the toxins associated with unhealthy beverages. Those who can tolerate a bit of coffee should ensure that it’s organically grown.
Lack of sleep
Sleep is essential for health, allowing our bodies a much-needed respite from daily life stressors. The sympathetic nervous system rests during sleep, cells repair and replenish, and hormones regulate.
Numerous studies link poor sleep to the development of AFib. However, few researchers have identified sleep as a direct trigger for the disease until recently. A 2019 study of close to 1,300 people found that 21 percent of individuals with AFib identified lack of sleep as a direct cause.
For some, AFib and sleep apnea go hand-in-hand. Sleep apnea is a disorder in which individuals have pauses in breathing throughout the night. Those who have AFib or difficulty sleeping may benefit from a sleep evaluation.
Food
Food is a significant trigger in atrial fibrillation for some people. For example, cold food, such as an iced beverage, can prompt an AFib episode. For others, foods with MSG can trigger arrhythmia. Gluten is also a common ingredient connected to AFib. Therefore, individuals with AFib need to identify trigger foods and avoid them.
AFib patients also need to consider their food quantity. For some, large meals trigger an AFib episode. Digestion takes energy, and eating shunts blood from the heart to the stomach. Additionally, large meals may stimulate the vagus nerve, setting off heart palpitations. Eating smaller meals more frequently often eliminates this problem.
Exercise
Exercise is an integral part of a healthy lifestyle, including people with AFib. However, for some, vigorous exercise is a trigger. For example, long-distance runners and endurance athletes know first-hand the risk of strenuous exercise on the heart. A recent study found that athletes have two and a half times the risk of AFib than non-athletes. Additionally, exercise is often a trigger for individuals with adrenergic AFib.
For most people, however, exercise wards off the risk of AFib. A recent study found that regular exercise can reduce the risk of developing atrial fibrillation.
Air pollution or toxins
The long-term effects of chemical exposure on the heart are well-known. For example, air pollution increases the risk of cardiovascular disease, as does chronic exposure to toxins in the home and workplace.
However, new research indicates that even short-term exposure to poor air quality can trigger AFib. A 2019 study found that air pollution triggers AFib and increases hospitalizations. The study confirmed previous research showing that exposure to poor air within the last 24 hours increased emergency room visits.
Body position
Some individuals are affected by positional AFib. These people can identify certain body positions that trigger an episode. For example, studies have shown that lying on the left side while sleeping can initiate AFib for some people. For others, lying on their back sets off the arrhythmia.
While there is little research on positional AFib, many patients anecdotally report a change in heart rhythm after moving their body in a certain way, such as leaning back in a chair or bending over to pick something up. It’s entirely possible that specific movements may stimulate the vagus nerve, thus firing off AFib.
Hormones
The relationship between hormones and the heart is complex. For example, there is conflicting evidence surrounding sex hormones’ impact on atrial fibrillation. However, we know that AFib impacts men and women differently, indicating that hormones play a role in the disease process.
Many women report recurring AFib episodes during certain times of their menstrual cycle. While more research is needed on this topic, hormonal changes can trigger an AFib attack.
Next steps
Addressing the underlying triggers of AFib episodes helps prevent subsequent attacks. However, the real success comes in identifying the root causes of your health imbalance. The expert practitioners here at Natural Heart Doctor can help you do just that. The body is meant to be healthy, and when provided with the right tools, it can return to a state of balance.
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Medical Review 2022: Dr. Lauren Lattanza NMD
