Vagal Atrial Fibrillation & ResMed F20 Strap Neck

[MoreBeers]

Hello Folks!

OK, this could be fun!

I have managed to create a new developmental Strap for the ResMed F20, by cutting up a couple of old F20 Straps, and then using thick Super Glue to join them, where needed. That stuck very well indeed, but I can get my wife to lend me a needle and thread tomorrow to add a few stitches, just to avoid the joins coming adrift.

In simple terms, what I have done is create a Forehead Head Strap (AKA now the Main Strap) from an old F20 Strap, using the old Upper Straps as the Straps now for the lower Magnets.

That works surprisingly well, and once positioned on the Forehead so the head loop is horizontal, the Strap Legs reach to the lower Magnet join locations very well, quite close to the extreme, but the Velcro joins with scope to tighten up when on, if needed.

To that I also added an over the top of Head Strap, to prevent that from wanting to slide down. Again, I just used an old Strap, and glued that on either side.

I then cut off the long Lower Straps from one of these old F20 Straps, and joined them so I had Velcro at each end and a wide glued join in the middle. That then threads through the upper Dog Leg Arms, and goes around the upper rear of my head, above the main Forehead Head Strap. That can be adjusted, either side, so I should be able to adjust out any upper air leaks.

So, the new Strap is actually in two pieces.

To fit I just have to:

(1) Put the Forehead Head Strap on, with the Magnets already attached. That may be too tight, so I may have to cut that and add an adjustable join if needed. That feels OK when test fitting, but could annoy when asleep if it feels too tight. Easy enough to add an adjustable join, if so.

(2) Fit the other Long Strap to both upper Dog Leg Arms, to form a unit comprised of the Frame, Mask, and one-piece Upper Strap as a Loop to go around back of my head.

(3) Offer up the Mask to my face, and pull the attached loop over to the top back of my head, above the Main Strap.

(4) Clip on the lower Magnet Joints from the Main Strap.

(5) Adjust as usual.

If this works, and doesn't leak, and doesn't want to wander down to the back of my neck (which should be stopped by the loop I added going over the top of my head), then this should mean I can get some sleep, with full CPAP, but with absolutely no Strap pressure to the back of my neck. Hopefully that should prevent any Cardiac Agitation caused by neck pressure.

If it works, I will post images tomorrow.

A useful feature is that this can be constructed from 2 old F20 Straps, so it should be easy to get on, and off, should be cool in summer, and it should still be adjustable.

Hopefully, it won't migrate down to the back of my neck, that being the key issue, and the whole purpose of the exercise!

More tomorrow. Fingers crossed this doesn't go wrong, slide down at the back, pinch my neck, and pitch me into Atrial Fibrillation like last night's Test did!

MoreBeers

[MoreBeers]

Hello Folks!

A useful Test, the whole concept of trying to avoid any ResMed F20 Strap from going across the back of my neck, is a good one. This has dramatically reduced background Cardiac Stress when asleep, so that pressure was indeed the cause.

The above 2-Part Strap Test did work in the respect of keeping Straps off my neck, but was a little prone to air leaks, because I have not got the lower pull direction right, it wants to pull upwards too much, when I need it to be pulling more horizontally and towards, you've guessed it, the rear neck area.

So I spent time messing around trying to adjust that, and did indeed need to add an adjustable section to the Main Forehead Headband Strap part, as that was just too tight.

The 2-Part Strap Test was heading in the right direction but, it's wanting to pull the Mask upwards too much, so is causing air leaks around the lower mouth area.

I need to work on a way to pull the lower Mask area horizontally towards the rear, without looping anything around the back of my neck.

I did look at a few Snore Stop Straps on the web last night, and something like that may be the way to go, such as a combined Main Forehead Strap, plus a Strap coming down from that to the chin. Then attach a Strap from the F20 Lower Magnets to that diagonal Chin Strap, to exert a rearwards pull, but one acting upon that diagonal chin strap, rather than looping anything around the back of the neck.

In summary, that 2-Part Strap Test went well and, despite the fiddling with the adjustment, and the excursion to add an adjustable part to the Main Forehead Headband Strap, and the many air leaks, when I did actually sleep, my heart was relaxed and beating steadily, with no sign of any Cardiac Agitation that any F20 Strap going around the back of my neck causes.

Thus, I am on the right track, the task now is to come up with a workable new Strap that I can make again easily, that is comfortable, and that can pull in the right directions to stop air leaks.

In my opinion, I think all CPAP Mask Straps that go around the back of the neck, are best avoided. I think these potentially cause more problems than Sleep Apnoea itself.

But the ResMed F20 Strap is a particularly bad design, the Straps are too thin, and the rear surface area is way too small. The upshot is if a Mask needs to be worn quite tight when using higher air pressure, there is a real danger of the Strap causing potentially life-threatening Cardiac and other effects.

In my case, the ResMed F20 Strap has caused both Atrial Fibrillation, and even when padded, it has still caused a low level of constant Cardiac Agitation, that has made quality sleep very elusive.

In my friend's case, it looks like it has pulled his neck C1 and C2 vertebrae out of position, and presented him with pulse, blood pressure and Stroke-like symptoms.

I urge anyone who uses a ResMed F20, who also has issues with Arrhythmia, to check if this may actually be caused by the F20 Strap.

I will update when I have a better design for the F20 Mask Strap.

MoreBeers

[MoreBeers]

Hello Folks!

These three images may help to show the progression from an original ResMed F20 Mask Strap that caused Atrial Fibrillation, to a modification when I added a rear Foam Pad that stopped the Atrial Fibrillation, but didn't fix an underlying Cardiac Agitation, to last night's test with a 2-Part Strap that totally alleviated all Cardiac Agitation, but needs work, as the air leaks were too high.

Original F20

   

F20 with added Rear Foam Pad

   

Latest 2-Part Strap Modification

   

I hope that helps to make it clearer.

Next stage is to add a Chin Strap, so lower Mask Strap can pick that up to give a more horizontal pull.

MoreBeers

[ewriter]

Hi,

I found your post very interesting and i hope you can possibly help me with my own issue of "flutter". I have posted details here: 
https://www.apneaboard.com/forums/Thread...-reduce-FL

For about 27 years i have been attempting to find the cause of a mild "chest buzzing" (left breast), which eventually turned into a rhythmic "pulsation" which starts when i am resting (sitting down or lying down) and snort; this can induce the "flutter". The "flutter" can last from ten seconds to much longer. It's possible that i am experiencing it when asleep for a long time but i don't know how long. I have had extensive cardiac workups in 4 countries (where i was living for work); but in spite of many Echoes, Holters, treadmill tests, and ECGs my doctors cannot find anything structurally wrong with my heart. Thank God, until today, i don't get shortness of breath or chest pain with the "flutter" however, i DO get panic attacks which, last year about a year ago, became so bad that i called the ambulance and ended up being referred to a psychiatrist.

I won't go into all the details here as they are all on the link given above (or connected links); but i do find it extremely interesting that my new series of "flutters" began on exactly January 2 or January 3, 2023 after i went to sleep using my old Respironics System One, and having consumed a few glasses of wine and some fresh crispy seaweed. Until that moment, for several YEARS i had not experienced the "flutter" in the same way, and it forced me awake (as it did for the next month, in which i got about 90 minutes' sleep a night because of the fear and because i was unable to fall asleep again).

The next year was so horrible i won't repeat it; but i am now forced to take Clonzepam (0.5 mg originally 3 mg) at night, together with Dayvigo (5 mg) and Melatonin (6 - 10 mg) just to be able to sleep until 4 or 6 am, with several arousals in between.

I abandoned my Aire10 APAP machine about three months ago and have been trying a iBreeze Resvent 25 A/ST and it has taken myself and my tech two months to get my AHI down to zero (everything is zero). However, we got to AHI = 0.00 on several occasions and with different settings (usually, BiPAP Auto ST but we also tried CPAP for awhile and S mode. I find the machine very comfortable (though i hate using it!) and i am extremely grateful for the sleep i am getting; but the severe anxiety that the "flutter" can generate is very bad and has made me suicidal. After all, i am afraid of it becoming Afib, Aflutter, or heart failure or a heart attack.

This "flutter" has ruined my quality of life (i used to be extremely active and could do just about anything, including driving in the City doing deliveries or transporting passengers, up to 200 km a day, go home and cook dinner for myself and my wife, and trade some Forex until 2 am). I believe it will resolve but, here is the issue: i experienced the "flutter" when i was in the UK in 2006. I had bad panic attacks then (didn't know that was what they were) and i went desperately from doctor to doctor. Doctor #6 or so prescribed 120 mg of Propranalol, which i simply took without question.

In 2005 i had been diagnosed with mild to moderate sleep apnea (AHI 23) but had refused to believe it; and i refused to buy a machine. Unfortunately, neither I nor any doctor or Cardiologist i subsequently visited connected the dots between my refusal to get onto PAP therapy; and the "flutter." The Propranalol basically dampened all of the "flutter" and i was able to sleep through the night, without any sedatives or PAP therapy, for the next six years, which were very busy.

I have enjoyed using PAP therapy now since 2011, when i bought my first CPAP, after being diagnosed a second time with sleep apnea. However, i am now experiencing the same "flutter" symptoms again, though the sleep apnea has markedly improved over the past six months, and i believe it will dissipate again, as i have now started an aggressive exercise regimen and am seeking to lose 10 kg (i weigh 79 KG but by BMI is not great); but i have reduced the Propranalol down to 30-40 mg a day (in January 2023 i was only taking 20 mg/day and was doing well).

So, here is my question: do you think it's possible that i am getting "flutter" from the Propranalol? I am Bradycardic and have been for some time (i don't know for how long) because when i take the beta blocker, my heart rate drops below 50 at night. When it does this, as it transits down from 60s to 40s i get the "flutter" and then (this is separate) my heart beat starts going up (usually not that high, maybe to 85) and then the "flutter" dissipates by itself (usually), and my HR comes back down. I experience the same "flutter" when my HR is going up, from the 40s and above. This is what is waking me up for the past 20 months and wrecking my sleep!

I am trying to get off the beta blocker (taper is now 16 years) but it's been very difficult to do so, because my blood pressure starts going into the 150/80s and 160/100s if i reduce it below, say 20 mg at night. How can i get off this!? i also feel very tired taking the Propranalol (my Cardio tried switching me directly to Bystolic; but i feel as if it doesn't actually DO anything and i get many problems when i take it) and i am certain the beta blocker is actually partly responsible for the "flutter." The research papers out there also suggest beta blockers do NOT improve morbidity or mortality AT ALL and, in fact, that they can induce arrhythmia including Bradycardia and even HEART BLOCK (short circuit between the atria and ventricles) in SOME individuals. However, my Cardiologists (three of them) have no problem with my taking them because they believe i was put on them for ANXIETY (and this may be true). I am also fairly certain, now, that my anxiety can, itself, induce the "flutter" so i am working on therapy for that.

I hope you might be able to shed some light on the cause of my "flutter" (i was getting it before i even went on CPAP; so it can't likely be the neck strap) and, how to deal with anxiety relating to any heart rhythm disturbance.

Looking forward to your reply,

Thanks!

Paul

[MoreBeers]

Hello Paul!

I think the Bradycardia side-effect of the Beta Blocker, is possibly a sign that that drug is not for you, quite possibly because the Flutter is linked to your Vagal Nerve or Autonomic System.

It's a fact that those who suffer from Vagal Atrial Fibrillation, do not show any benefit from many conventional Cardiac drugs, which have little or no effect on the issue, but do add side-effects, including Bradycardia.

I am still having no end of fun after my Cancer surgery at the end of 2022, which has left me with Atrial Fibrillation. Which I am also certain was already a lurking and growing problem driven by the 2020-2022 Vagus nerve damage or C1 Cervical Vertebrae instability, caused by the ResMed F20 CPAP Strap biting the sides and back of my neck.

The surgery just added a new strain on the issues, which I have also worked out, left me with a Functional Vitamin B12 Deficiency, because my Terminal Ileum was chopped around as part of the surgery, which is where the body absorbs B12.

The issues are overlapping because B12 is crucial to nerve function and health, so once a B12 deficiency was added to the existing Vagus issue, that got worse, as my body was missing the key nerve support needed for it to heal.

I was going downhill, fast, with a range of worsening neurological problems (mind fog, forgetting words, confusion, Symmetrical Paraesthesia, Peripheral Neuropathy and, oddly, hyperpigmentation of the upper skin of my feet).

I eventually worked out that I had to be deficient in B12, so tried to correct that via oral B12 supplementation then, in an effort to bypass my digestive system, I tried Trans-dermal B12 Patches, and Sublingual B12 Drops. That all massively boosted my Serum B12, but did nothing for the Neurological issues. So I had boosted inactive B12, not active B12.

The big danger of B12 deficiency, is this can cause the Myelin Sheath protecting the Spinal Column to degrade, that can, if unchecked, lead to irreversible nerve damage, including paralysis, so it's a big issue.

I then started self-administered B12 injections, initially using Methlycobalamin via Subcutaneous Injection twice a day, and that worked within a few days!

The Neurological issues all started to ease, and all cleared apart from a low level of Symmetrical Paraesthesia (tingling in both legs when I move my neck), which is reducing, but could take a year or two to go completely.

I have reduced the B12 Jabs now to every other day, switching between Methlycobalamin via Subcutaneous Injection (short needle into fat), and Hydroxycobalamin via Intramuscular Injection (longer needle into muscle).

After around 6 Months from Surgery, the Atrial Fibrillation started and, after going in, and out, for a couple of weeks, I went in, and have yet to come out. That time-frame would probably also tie in with my body completely running out of all stored B12, so I think the Vagus/Autonomic issue was compounded by a subsequent lack of B12 following surgery.

In the UK, it took ages to see Cardiology, and they have been trying to reduce my Heart Rate via medication. I started with a resting HR of around 140 when it started.

Because I did not get on with any Beta Blockers, I was given instead a Calcium Channel Blocker, and then Digoxin. Neither had any obvious effect, which confused the Cardiologists no end, as they had expected my HR to come down fast with that medication and high doses.

I did say it's Vagal, so these would not have any effect. After my last visit, they were starting to agree.

Anyway, the other thing I have done in an effort to fix myself, was to step up exercise, and to switch my diet to Carnivore. I now mainly just eat Steak, and have cut out all sugar, and almost all carbohydrates.

That has helped no end and, over the last 40 weeks, I have lost around 26 Kg, and my HR has gradually reduced over that time. It is now straying below 100 bpm at rest, and looks like it will keep falling, and may well revert to Sinus.

My heart has no Structural issues, other than a recent slight enlargement of my Left Ventricle due to the prolonged Atrial Fibrillation, but Cardiology think that is reversible if I get my HR back down, and it reverts back to Sinus, as seems increasingly likely.

In summary, it's quite possible you may have an Autonomic or Vagus Nerve issue, in which case, Beta Blockers will do no good at all, and will just provide side-effects.

I regret that I know nothing about the other drugs, but suggest you consider changing your diet, and trying to go Carnivore for, say, 30 days, to see if that improves things.

I would also say add exercise, because the diet works better if so. Likewise aim for One Meal A Day, which becomes easy after a couple of weeks. Until then, eat plenty of things like steak, butter, eggs, bacon, sea food. After a little while, hunger will become less and less an issue, until two meals a day feels too much. Pretty soon it is then easy to switch to just one meal. Then you will also be adding Intermittent Fasting, with maybe 23 hours between the single meal, which accelerates the benefits.

Important to give it 30 days, because it will probably take a couple of weeks to get your body to remember how to be Fat Adapted, as in able to switch smoothly to its own stores of fat, when it has no dietary fuel to run with. Until then, side effects like headaches can be an issue, so it's vital to eat plenty initially, to avoid that.

Everyone is born Fat Adapted, and it is how our bodies have operated for 99.9% of our evolution. But a sugar and carbohydrate laden Western Diet, has cause all too many to become non-Fat Adapted, so even when needed, their bodies cannot switch to the ample stores of fat built up for just that purpose.

So, changing diet may really help.

It certainly helped me.

In view of the cancer, I have had many Blood Tests, and nothing adverse has cropped up since starting Carnivore. LDL up a little, but Triglycerides went down, and HDL went up! LDL is needed but only the big, fat, fluffy kind, not the small dense LDL. If HDL up and Triglycerides down, then it's pretty certain my LDL rise is just the good type of LDL, that the body needs.

Diet may fix the issue, and may allow you to come off all medication, as none of it will do you any long term good. Indeed, it may also fix or at least improve Sleep Apnoea.

Feed your body what it works best on, and this may help to mend any underlying nerve issues that could be driving the flutter.

I do hope this helps in some way.

MoreBeers

[MoreBeers]

Hello Folks!

Another quick update, I managed to afford a ResMed P30i Nasal Mask, and that has dramatically improved my CPAP use.

I have been able to reduce Pressure to APAP 11-20, and most nights the ResMed S10 Autoset works at around 11-12.

Whereas with the ResMed F20, I needed the maximum 20 cm H20 in CPAP Mode.

I hope that also helps someone.

MoreBeers

[ewriter]

Hi,

Thanks for the very interesting and supportive feedback! I am especially impressed with your weight loss (over the last 40 weeks, I have lost around 26 Kg); i have also changed my diet and making a big effort to avoid carbs and eat good fats. I also stopped drinking alcohol (i loved the sweet liquers and wine; both of which hurt you in different ways!) pretty much altogether but have only lost about 3 kg in three months. My wife (who was recently diagnosed diabetic, though she only weighs 46 kg) and i have embarked on an ambitious exercise regimen, visiting the gym 3-4 times a week. I feel really good on the treadmill!

The main issue for me is not the "flutter" per se but the severe anxiety and panic attacks that immediately occur when the "flutter" starts. While i am also suspecting Propranalol to be at least partly responsible (anxiety is also a major effect when you try to start weaning off propranalol) for the "flutter," i am also very certain that a narrowed airway is directly responsible (i have proven this on several occasions, when i was sitting and starting to doze and "snorted" and got the "flutter"). The thing is, i get high blood pressure spikes whenever i get a bad apnea or hyponea; trying at least 100 different settings and different masks on the Aire10 did not help. I finally switched to a Resvent BiPAP AST and it has helped reduced my AHI often to zero.

I am grateful that after about 27 years of investigations, nothing significant was found in terms of cardiac structural or disease issues. The doctors are not just mystified, however -- they automatically refer me to a Psychiatrist, which has definitely not helped much. On the other hand, i have had to accept that i can induce the "flutter" by thinking too much about it; so there is clearly a psychosomatic component to it.

But, yes, i agree it could be Vagal in nature but to date there is no ECG or Echo evidence it's atrial fibrillation or flutter; but it COULD be pulmonary vein "spasms" (i think there is such a surgery called "Pulmonary Vein Isolation") or, it could also be caused by aerophagia (i used to be on CPAP at a pressure of 12-14 for many years and i would always get a lot of gas!) and/or eating late, causing my stomach to press against my heart and cause very bad "flutter" (especially when sleeping on my left side).

I desperately want to get off the Propranalol and the sedatives (i don't actually regularly take anything else except a small doze of Clonazepam), as for my entire life until the end of 2022 i had NEVER needed to take any sedative to get some quality sleep (though, as i mentioned, alcohol could be a BIG factor there!)

May you and i only get better over time and fully recover! I will keep you in my prayer :0).

Cheers!

Paul

[mesenteria]

PVI, or pulmonary vein isolation is the ablation procedure done to sequester the ostia of the pulmonary veins when there is a focus re-entrant there causing ectopy.  In fact, a PVI is performed first, and sometimes solely, for most index ablations (first ablations) because of the high probability that his is the entry point of the extra signals.  There are other points, though, such as the Vein of Marshal, and even around the mitral valve and in the left atrial appendage (LAA).  This is why a mapping procedure is done at some point, especially if a second or third ablation becomes necessary due to continued ectopy during or after the three months 'blanking period', they being the time it takes for the heart to reduce crankiness and for all the scarring to heal.  Additionally, every EP challenges the patient's heart prior to releasing the patient after a catheter ablation procedure.  They do this by administering caffeine, phenylephrine, epinephrine, adenosine, isoproterenol, metoprolol, and esmolol.   Sometimes all of them, sometimes only one.  The first five are 'catecholamines' that stress the heart and will induce ectopy if there are any unclosed paths or re-entrant foci still able to pass ectopy-generating voltages into the atrial endothelium. 

I don't see the Vagus nerve as a likely culprit in what you describe.  While it certainly CAN BE the case for some AF sufferers, when you say anxiety brings it on, that is the precursor to the flight-or-flight response, or what would be called an 'adrenergic' response, where the adrenal glands are called into action.  Epinephrine, or adrenaline, is one of the catecholamines I mentioned just above, which is an agonist, and will quite likely generate ectopy in an electrically disordered heart.  The various beta-blockers and calcium channel blockers are meant to reduce the rates of repolarization across membranes, making the contractions less frequent and more feeble.  This last effect makes beta-blockers a good early intervention for those with early stages of hypertension.

Note that I am not a health care professional of any description; this is just my own personal understanding based on a great deal of reading.  I could actually be mistaken.

[MoreBeers]

Hello mesenteria!

Many thanks, makes perfect sense. That should help Paul I think.

In the UK NHS at least, the role that the Autonomic (and Vagus Nerve) plays in Heart Rate issues, is generally very poorly understood amongst many Cardiology Departments, as in not even considered.

My own simple analogy is that it is like going to a Garage with a car that has a misfire, and the sole point of focus becomes the engine (AKA Heart), without even slightly considering if there is a problem with the ECU (AKA Brain), or the Wiring (AKA Vagus Nerve) between Brain and Engine.

So, the Heart gets coshed with various drugs when, in some cases, there is actually a Vagus wiring issue in terms of the pathway between Brain and Heart.

As I understand it, the Vagus, or 10th Cranial Nerve, exits the skull via small holes either side of the big hole where the Spinal Column exits. So, after the Brain, the Vagus Nerve splits into Left and Right, before it branches off and wanders almost throughout the whole body. Hence the name Vagus, derived from, I think, the Latin for Wanderer.

In broad terms, the Right Vagus links to the Heart's Sino-Atrial Node ("SA"), which is the Heart's Pacemaker, and the Left Vagus links to the Heart's Atrio-Ventricular Node ("AV"), which is the Gate Keeper that regulates Action Potentials (AKA Heart Beat signals), as they pass down the middle of the Heart (AKA the Bundle of His).

In a normally functioning system, the SA sets the pace, and the AV helps to regulate that pace. That balance can be ratted up if a Heart has, say, an accessory pathway that allows a signal to flow from Atria to Ventricles bypassing the AV Node. In those cases, it can be very dangerous to prescribe, say, Digoxin, as that slows the AV Node, but has no effect upon the short circuit, which can allow unrestricted flutters down to the Ventricles. The most common is the Wolff-Parkinson-White Syndrome which I gather tends to go down the outer Bundle of Kent area of the Heart. They should always check for any signs of that before prescribing things like Digoxin.

The Autonomic System keeps the Heart Rate ("HR") operating in line with physical demand, by increasing the HR when needed, such as when climbing stairs, or by slowing it down again when the top of the stairs have been reached, and the Heart can be allowed to slow down.

So the Fight or Flight mechanism, also known as the Sympathetic Response, and the Rest & Digest mechanism, also known as the Parasympathetic System.

This is why if you jump in to cold water, your heart rate should slow down, known as the Diving Response, but it is the Autonomic Parasympathetic Rest & Digest system activating, to slow the Heart to conserve body heart. Likewise, when you run a fever, the other side kicks in to elevate Heart Rate, to cool down the body by circulating more blood to the skin and peripherals.

The Vagus Nerve complex also envelopes many organs, but especially the Stomach and Colon, and from there, the Vagus nerves passes very close to the Heart, and especially the Left Atria in some people.

So I think that explains why many have Palpitations after eating certain food, where I think the Stomach is affected, which triggers Vagal activity, and those signals pass close to the Heart on the way to and from the Brain, which can trigger a few bursts of Arrhythmia, probably by triggering Ectopic Beats as the electrical activity of the Vagus causes matching activity in the Left Atria, which is what leads to what feels like missed beats or flutter.

I do not mean this is always the cause, but it is a factor in some people, and explains the Gastro-Vagal-Cardiac issues that many people experience.

In my case, I suffered a severe problem with my neck from the ResMed F20 Mask Strap, that either damaged my Vagus Nerve via external pressure to the sides of my neck, or did so via imposing a force onto my C1 Cervical Vertebrae, which then damaged my Vagus Nerve. Bearing in mind that the Vagus is not protected within the Spinal Column, but runs down outside of it, so it is vulnerable to Cervical misalignment issues.

My initial Atrial Fibrillation ("AFib") started after a massive nape of my neck pain, that put me into AFib for almost 3 Months, that only stopped when I fabricated a Foam Rear Pad for the back of my neck. The AFib stopped same day, and only came back after the Cancer Surgery. But the Pad only alleviated the problem, it didn't remove the Strap force, it just reduced its effect.

The Right Vagus also, particularly, innervates the Caecum, Ascending Colon and most of the Transverse Colon.

I had all of that removed, which would have seriously impacted Right Vagus function, which may partly explain why I went into AFib 3 days after Surgery?

It did not help that after Surgery, they forgot to give me any pain relief at all for around 6 hours, and poor pain management post-Surgery is also a known factor in post-Surgical Atrial Fibrillation.

The Vagus issue was also compounded by the on-going F20 Strap pressure, even though I had reduced that effect via the Foam Pad.

After that, I had a rough time, with bad neck ache, lots of clicks and cracks in my neck, and a sharp pain in the mid top of my head, that happened when ever I moved my head to the right. Suggesting a constriction in my Upper Cervical area, or else the pain would flow downwards to, say, an arm, if the problem was lower down in my Cervical Spine. So I think this also pointed to a C1 or C2 issue.

Then add the B12 deficiency issue after Surgery (a life-long issue now), and other Nerve issues started to appear, and my Vagus would have taken longer to heal because of this.

Long story, I have been unable to get anyone to look at my neck. I have tried, but the NHS is a nightmare to navigate, with many areas ring-fencing themselves, so it's hard to get anyone to take a general look, to see how, say, Neurology, Skeletal Structure and Cardiology can inter-relate.

Neurology only seem interested in Dementia or actual brain damage.

Physio only seem interested in aches and pains.

Cardiology only seems interested in the heart, not what signals that to operate.

My own self-help seems to have had a beneficial effect.

Things like:

Further alleviating the F20 Strap issue, until I was able to switch to a ResMed P30i Nasal Mask. All neck pain now gone, and no more pain in the top of my skull when I move my head.

Injecting with Vitamin B12, which stopped the neurological problems.

Taking a range of B vitamins to try and improve nerve repair, especially B1 and B3, plus a B Multi.

Going Carnivore and doing as much exercise as I can.

Cardiology last visit seemed to agree there is a Vagus issue, but did not know how to test for that.

I do have a Referral to Neurophysiology, that was on hold whilst Cardiology had a go, so that should now be pushed again. They should be the people to look at Vagus Nerve issues, and may be able to look at Vagal signalling, to see if that is what has caused the AFib problems.

My Heart Rate has basically been a mix of a fast and a slow beat, as if my Autonomic system is having a battle between Sympathetic and Parasympathetic, with the former dominant, hence elevated HR, and the latter only chiming in intermittently, manifested by slower beats being thrown in.

My own efforts, seem to be working, with an improving mix of Heart beats, so fewer fast beats, more slower beats, with a better and improving mixture that is slowly moving towards Sinus Rhythm. I think my Vagus is healing, reflected by a better functioning Parasympathetic side.

The Cardiac drugs have dampened things down, so it's harder to see P Waves on my little ECG, so I'm not there yet, but it's looking better each week in terms of Rate and Rhythm.

In summary, I caution everyone to keep an eye on any neck issues linked to CPAP Mask Straps because, in my case, at least, it did cause major problems.

I also hope the above may shed some light on why there is a link between digestion and Heart Rate, which may help to explain some people's general observations without previously understanding the likely mechanism. For example, I noticed that I was particularly affected by Trans Fats and Palm Oil, both of which trigger Arrhythmia shortly after (usually accidental) consumption. So fast that I think they must antagonise my stomach, which agitates the Vagus around the Stomach, which in turn affects the Left Atria as that increased Vagal electrical signals passes close to the heart.

I may well need an Ablation at some stage, to reduce that effect, if that can be established.

At the moment, I think my Vagal system is in a state of repair following the Strap issue, and then the major Cancer surgery that removed many areas that the Right Vagus innervated. I have resolved the linked B12 issue via injection, so I'm hoping I may recover from this.

My Heart is not yet affected structurally, albeit the Left Ventricle is slightly enlarged because of the prolonged AFib over 6 months. That should be reversible provided I get my HR down, and hopefully revert to Sinus Rhythm over the coming weeks.

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