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Cold drinks and atrial flutter
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Cold drinks and atrial flutter

38yr old male diagnosed by Cardiologist with "classic" atrial flutter.  Had catheter ablation performed.  Doc could not quite reproduce flutter during electric study.  So he performed the ablation using a trace from a captured episode.  Three months after ablation, had another episode, so I'm a bit bummed out.

The arrythmia follows the same exact pattern.  I exercise (cardio or weights) for about an hour.  I get a shower afterwards with no problem (10 to 20 minutes goes by).  

KEY ISSUE: After my shower, I get a cold fitness shake (containing frozen yogurt, protein powder, bananas, peanut butter, ice).  Almost as soon as the first sip hits my system (barely seconds to one minute goes by)...the atrial flutter begins.  It has happened this same exact way before and it happened again after my ablation.

Question:  Could a cold fitness replenishment drink be triggering my atrial flutter? Something in the drink causing my heart to react?  If not, it seems very highly correlated.  But quite an odd trigger.  
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251395_tn?1395961265
Hello...

I, too, notice that very cold drinks will exacerbate my Atrial Fib...It's known as "Deglutition induced SVT" it is an uncommon condition postulated to be a vagally mediated phenomenon due to mechanical stimulation. Patients usually present with mild symptoms or may have severe debilitating symptoms.

Treatment with Class I agents eg. Flecanaide, Propafenone which are both Na channel blockers, beta blockers (BB's), calcium channel blockers (CCB's) has shown to be an effective therapy in treating this type of induced Tachy Arrhythmia problem.

Hope this helps to answer your question and concern. Have you discussed this with your Cardiologist?
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1124887_tn?1313758491
Hello.

As Brooke mentions, it can be caused by mechanical stimulation, through vagus / sympathicus stimulation, or simply because left atrium is a close neighbour to esophagus, cold drinks can certainly trigger PACs, and it's really not ulikely it can trigger other arrhythmias, too.
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Avatar_m_tn
Thanks for that info!  I have an appointment on Monday to chat with my Cardio Dr. about the recent event.  I really don't want to do yet another ablation.  Will have to do some more reading with some of these new terms (Deglutition induced SVT) and vagus/sympathicus stimulation as posted by is_something_wrong.  How'd you find this stuff?  
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251395_tn?1395961265
Hello...

Being a registered nurse I have access to many professional journals as well as a few friends who happen to be Dr's. I have definitely learned alot by reading, more than I did in college...LOL...

I hope that your appt. yields you a simple solution to this. Keep us posted :)
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1137980_tn?1281289046
Just giving you a heads up hh1224 i think what may also be helpful to you is that you also have access to all of the medical journals as well so you can access them yourself either on line or at your local library.  Many docs use the PDR or Physicians Desk Reference or you can go onto sites that the New England Journal of Medicine puts out as well and the AMA or American Medical Association.  I also had a pretty heavy duty medical background as Brooke does and think that all members should be aware that everything that we are privy to is also available to all forum members as well.  The only thing that i would seriously caution you on however is to definately do not use what you read or re search to self diagnose but at least you will be fully informed on the possiblities as well as what the normal treatment plan is and what options are open to you.  Bear in mind that both nurses and doctors go thru extensive training but the same info is there for you for general knowledge and at least in researching yourself you will know what the appropriate questions are for the docs and what to ask during your appt. instead of their "telling" you.  It is after all your body and you know it best and the doc should be open to question and answers...good luck to you.....
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Avatar_m_tn
After I commented, I actually visited your profile and read a little bit of your background.  Thanks to you, cindy707 and is_something_wrong for highlighted the available materials.

I'll let you know what my Doc says on Monday.  I'll reiterate that my pattern of flutter onset is regular and predictiable literally to the minute after my workout routine and cold beverage.  I'm hopeful that there is some simple solution that'll help me limit the episodes just by adjusting my routine.  But predicting the days it'll happen are like predicting the stock market recently.
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Avatar_m_tn
It's been two years, and it's happening again.  Went to Australian open today, (super hot) and had skipped beats.  Cold drink at Starbucks, and now it's extra-beat city.  Feels different though.  It feels irregular.  Hope it clears up soon!
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1569985_tn?1328251082
Is the cold drink worth the hassle?  I am continually trying to figure out triggers for my Afib, pvc's & pac's.  When I know for sure something causes it, i.e., chocolate, I remove it from my diet -- haven't had chocolate in over a year.  If getting rid of the cold drink works, why not just drink things that are not cold?  That said, my EP thinks looking for triggers is a waste of time, it will happen when it happens.  Good luck with this, I know what a hassle it can be.  
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Avatar_m_tn
Thanks for the comments!  99% of the time, I drink room temperature liquids now...or hot tea/coffee.  And it sure has cut down on my episodes.  Just in this case, I didn't really expect the results ( I generally don't think about it since it happens so rarely).  It was probably because it was so very hot here in Melbourne and I was out in it all day.  The temperature contrast with the cold coffee just set it off.  Yes, it's a hassle and it honestly scares me still, even though I know what it is.  I'm pretty overly-conscious of my heart activities!

And, it must be pretty hard eliminating what many consider the elixer of life...chocolate!  In any case, I think I'll take your advice and stop looking for triggers.

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Avatar_m_tn
Hi All:
I was walking alot on a warm, breezy day distributing campaign literature in my neighborhood and let myself get dehydrated (and hungry).  Legs felt a little fatigued.  I stopped and got a slice of pizza and a slushee type drink.  I drank about an inch of the slushee and got the worst brain freeze I ever had.  I then felt it down my throat, chest (esophogus?) and immediately went into afib. I had to be e-cardioverted/defibrillated. The ER cardio doc said really cold drinks can be a classic trigger and vagally induce afib.  Except for a few bouts following an inadvertant partial suffocation during a sleep study  over 2 years ago, I had been afib free and med free for over 6 years following RFA catheter ablation.  I didnt even think of the possible issue with an slush drink.  I feel great though, now, and will avoid extremely cold drinks.  I am optimistic and still look forward to another 6 years of afib med free living. Thanks for the discussion on this subject.
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Avatar_n_tn
It looks like we have a common theme here.  I have now had 4 afib episodes brought on by very cold sugary drinks.  Each time, the arrythmia began within seconds of taking a long cold drink of fruit juice or sports drink.  It seems like other common factors are fatique and possibly some level of dehydration.  

This happens to me about once a year and I sometimes forget, and then wham, it hits when I wasn't even thinking about it.  The electrophysiologist I've seen says to expect more episodes in the future and that ultimately ablation will be necessary to stop it.  
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Avatar_n_tn
In my case, I know what the trigger is: long  cold sugary drinks.  The challenge is to be vigilant and avoid making the same mistake again.  For me, this type of cold drink is definitely not worth the risk!
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Avatar_n_tn
I have had this happen twice.  Both times the event was triggered by an extremely cold drink.  Fortunately my heart reverts to normal rhythm in about 45 minutes

I avoid extremely cold drinks and foods.

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1569985_tn?1328251082
I can still have cold drinks, I just sip them, rather than gulp them.  And I don't think I would try a slushee type drink.  I have had a milk shake, which I would take by the teaspoon, rather than drink it.  I think when it's hot and you're extremely thirsty, it is easy to forget and get into trouble.  I had another event just a couple of months ago after drinking a glass of cold coconut water.  Constipation seems to be a factor for me too, perhaps making conditions just right for trouble when the digestive system is upset.  I also have gone into afib after a very large meal.  Unfortunately I end up having to have a cardioversion to get back into normal rhythm.  A lot of knowledge on this board.  It is very helpful.
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Avatar_m_tn
I am 67 and have enjoyed close to perfect health all my life.  Run, bike, and weight training.  Recently I was drinking a frozen drink which is unusual for me.....I almost never have them.  I guess I drank it too quickly and gave myself the chest version of a brain freeze.  I immediately  began feeling a fluttering in my chest.  I got it checked out and it turned out to be atrial flutter.  I went to see a cardiologist (new experience for me) and told her my story.  She told me she has had other patients that have had a similar experience. Still have the flutter that is being treated.  Wish I could turn the clock back and rethink ordering that drink.
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Avatar_m_tn
I had an episode of afib once and it kicked in right after chugging a cold gatorade.  There certainly seems to be a connection between cold drinks and arrhythmia.
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