About 20 years ago I battled a period of atrial arrythmia that included PAT, ectopic beats and rare but occasional afib. I had all the tests done including an EP study which unfortunately was done during a period when I was not having the problem. My condition became very unique in that all the rhythm disturbances were triggered by the action of swallowing. It did t matter if it was food or a dry swallow but eating became annoying at times. Long story short, I had a barium swallow test that showed significant reflux and was prescribed a PPI. After a few weeks the arrythmia and swallow triggered went away. I've been on the PPI's for many years now without issue but the swallow trigger returned a few days ago. It is so uncomfortable to eat or swallow as I immediately feel several palpitations. It was suspected that the vagus nerve was the culprit. The acid reflux is somehow irritating the nerve so that upon swallowing it causes this problem. I'm now 55 and just returned from a winter of aggressive mountain biking and hiking near Phoenix. I exercised hard and feel like im in the best shape of my life. But suddenly now the swallow trigger has come back. I suspect the physical conditioning has caused stinger vagal tone which has made me more vulnerable to the reflux. So...has anyone found a way to deal/treat this problem? I'm trying diet mod and other reflux self help but no success yet. I'd appreciate anyone's advice. Thanks Peter