I am 28 years old and otherwise a healthy individual. Last April I woke up one day with what I believe to have been atrial fibrillation, but by the time the EMT's arrived, I had converted. The doctor's at the hospital told me not to sweat it. I then had about two more episodes of atrial fibrillation after binge drinking the night before, but converted on my own. I did not think there was much of a problem until about a month and a half ago when I started to get PVC's every night. Then about a week after they began, I woke up with my heart wildly out of control. The EMT's came and hooked me up on a 12 lead and determined that I had a heart rate of about 280 bpm and that I was in atrial fibrillation along with Vtach and PVC's. I went to the hospital and stayed about 4 days. They thought maybe WPW, but my echo and stress test were negative for the delta wave or any other problems. I had an EP study performed, whereby my elecrophysiologist concluded atrial fibrillation. However, I think this conclusion was based on the notion that they were unable to reproduce my arrhythmia, so AFib was the default answer. I have been doing extensive research and thought my arrhythmias were related to GERD because I had noticed my PVC's were worse after acid reflux. It got to the point that every time I would lay down, I would have constant PVC's. On Thanksgiving I had bad heartburn, one alcoholic beverage, and atrial fibrillation the next morning. I had gone on a GERD friendly diet waiting to see the physician, and I magically felt a lot better. However, a few days later I started having PVC's at night again, but this time it was not when I laid down, but rather after I had slept for awhile. I had a barium swallow, which came back negative for GERD, but positive for duodenitis. Feeling lost as to my problem, I came across information about vagally mediated atrial fibrillation, which seemed to make the most sense. I believe my duodenitis to be caused by an over-secretion of stomach acid due to the vagus nerve, which is why the test was negative as to GERD. I am also male, young, otherwise healthy heart, former military and athlete. I now have PVC's, which occur after about every 5-7 hours of sleep. I can I get up for a few hours and then go back to bed (assuming my vagal tone is not so high) and I can sleep without palpitations. I feel my heart rate is not as consistent anymore as it used to be. My resting rate is about 75-85 bpm, but goes up to about 120 or 130 when I stand up and walk around. So my questions are: (1) does this sound like vagally mediated atrial fibrillation and PVC's? (2) is an ablation a viable option for vagally mediated atrial fibrillation? (3) are there any tests that can be performed to check the function of the vagus nerve? (4) Should I also see a neurologist, and if so are there any subspecialties to look for that focus on the vagus nerve?
I should note that I am seeing my electrophysiologist this week, and I am scheduled to see a gastroenterologist sometime soon. I am on diltiazem, but I only take as needed to convert out of AFib. However, I have taken the dilitiazem hoping it would help with the PVC's, but it did not seem to make a difference, and maybe even made them worse.