Does anyone know the connection between heart flutters (PAC's) and the vagus nerve?

Question

I heard that acid reflux and stomach upset can trigger the vagus nerve, causing what feels like heart spasms/flutters or PAC's. I experience these quite a lot, sometimes in runs for hours and days. Usually when I have the flutters it feels like it is triggered after a big meal, and feel like I have a lot of gas and need to burp a lot. Sometimes they happen when my stomach muscles are tense or are puttng pressure on my chest, maybe due to eating a large meal (not necessarily due to anxiety or stress, in fact, it usually happens when I am quite relaxed). Since hearing about this possible connection, I've tried taking antacids and anti-gas medications, but it hasn't worked. Has anyone experience these, and is there anything else I can try to relieve/prevent them?

Note: I have had EKG's, echocardiograms and also wore a holter monitor. The echocardiogram was fairly normal, and with the other tests, some showed PVC's, and some showed PAC's, but never to the extent that I was actually feeling them. Every doctor I've been evaluated by says that there is nothing that they find wrong-- this is what makes me think the problem is gastrointestinal in nature.

Answer 1

No specific research has been done on the relationship of acid reflux (GERD) to atrial arrhythmias to my knowledge. However, there may be a pathophysiologic relationship between the two conditions relating to the activity of the vagus nerve. The vagus nerve innervates both the heart and the digestive tract so an overactive vagus nerve could conceivably precipitate both reflux and atrial arrhythmias.



Until effective reflux medications became available, treatment for severe gastroesophageal relfux was ligation of the vagus nerve and resection of the portion of the stomach that produces the most acid. Such treatment would be too drastic for your problem. . .


Non-pharmacologic measures to treat reflux consist of avoiding tobacco, alcohol, and caffeine, elevating the head of the bed 4-6 inches, and avoiding food for 3 hrs. before sleep. Stress certainly can exacerbate reflux so stress management may also help. Finally, there are powerful medictions to drastically reduce gastric acid secretions (Prilosec and Prevacid) that may also help. Better treatment of your reflux should control your atrial arrhythmias.


I hope you find this information useful.

Answer 2

I successfully treated PACs and palpitations with antacids for a while. The vagus nerve runs up by the stomach and reacts to how full or empty it is, thereby triggering a rush of blood to the stomach to aid in digestion. Unfortunately, gas can cause pressure that tricks it into thinking your stomach is full and requires more blood to that area. It releases adrenaline, speeds up your heart and that quick burst sometimes causes palpitations or PACs. As you said, anxiety (stress) can also trigger them and keep them around. Try breathing exercises to make them go away. Breathe from your stomach instead of your chest (lay on your back and make sure your stomach rises).
I avoid all caffeine these days and that helps a lot too.
One thing to keep in mind: I thought I was having PACs and palpitations and it ended up that I had atrial fibrillation (google it). Depending on how old you are and what your general health is, it's not really dangerous but there are treatments (beta blockers or ablation). Only a cardiologist can tell the difference so if a case comes on, get to a doc so it can be correctly diagnosed. Some people are put on blood thinners as the blood can pool in your atrium over time causing clots. When your heart goes back into normal rhythm, it can release these clots to other parts of your body and cause (gulp) strokes or other complications. That's mainly only a concern for older people and those with othe existing conditions or compromised heart capacity.
Either way, if you aren't getting relief and they are causing concern, get them looked at. Beta blockers helped me for a while but I'm off them now. Avoiding caffeine, getting light, regular exercise, avoiding stress and getting enough sleep are usually enough to get rid of them altogether. Don't let them stress you out too hard but after a checkup, you'll feel much better about the idea that they're not dangerous.
Hope that helps.