So I lay awake last night for night number four. I've had sleepless night after sleepless night while I wait for the pain of pericarditis to subside. I finally gave in and took a pain pill (Hydrocodone). Oddly enough, it gave me profound bradycardia (40's) and I had no SVT. I did some quick research and saw that it can stimulate the vagus nerve to cause slowed heart rate as well as respiratory rate. So obviously, my evening/nocturnal SVT must be mediated by the vagus nerve. Is there some treatment that would simulate that? It presents an interesting series of thoughts for me on my situation. What could be done to kick in the vagus nerve to stop the irritability of my heart?

Cold water or ice bathing. I do this, say 1 minute soak at 34 deg F and it takes a long time for my heart rate to increase, even with sprint interval training. In fact, I caused an afib episode after doing the soak, then only warming up for 3 minutes before doing 8x 20 seconds max sprinting on a fan bike then 10 seconds rest (Tabata) with a 3 minute cool down. The afib came on maybe 20 seconds after I stopped the cool down. I hypothesized that a 20 minute Zone 2 warm up and a somewhat longer cool down would allow the Tabata without an episode. I tried this a few days later without incident. I also have a near infrared heat lamp sauna. Without the cold plunge, but with exercise, I start sweating profusely at 15 minutes. With the cold plunge, but after exercise it takes 24 minutes to really start sweating.

I live in a cold climate, so this time of year I have a 100 gallon Rubbermaid stock tank that I fill 80% with water. It will freeze over most nights, so I break the ice with a hammer and get in up to my neck. In this post is a photo from last winter.

You could start with a cold bath and see what happens. Much warmer water (say 45 or 60 deg f), perhaps for longer (I've done both these temps for 20 minutes) might do the trick. The first time I went from the sauna to a tub full of 46 deg f water and sat down quickly, I got a very strong vagal response and a lot of PAC's. I then later tried with a 30 second slow entry without issue. I've adapted so much that I never get that response any more. If this works, don't over use it, look for minimum effective dose, so you don't adapt as much and get rid of the response.

Vagal Maneuvers Suggest not doing carotid massage for safety reasons.

Accessing the Healing Power of the Vagus Nerve

There are numerous devices that stimulate the vagus nerve and some of them are medically approved. Some use a tens machine with a clip attached to the tragus of the ear. The most sophisticated one I am aware of is the Parasym device, though it is expensive. It is a medically approved device with a lot of research. I was interested in it and recently contacted them as many such devices are not suitable if you have a pacemaker, but his one is (I even called tech support at my pacemaker manufacturer). Here is a link: [www.parasym.co]

Per @Daisy, here is a whole thread on the topic of ear vagal stimulation [www.afibbers.org]

Slow breathing (generally 4-6 breaths a minute) increases vagal tone.
Resources:

Type 1 diabetic friend found slow breathing helped his blood sugar control and runs this site: [www.google.com]

The Oxygen Advantage app has some slow breathing exercises (not all exercises in the app are slow breathing): [oxygenadvantage.com]

Do you nasal breathe at night? Any apnea episodes could cause a sympathetic spike. Here are two posts I did on the topic: [www.afibbers.org]
[www.afibbers.org]

Yoga Nidra guided meditation scripts are very parasympathetic. [www.google.com]
The Insight Timer app has many examples [insighttimer.com]
Non Sleep Deep Rest (NSDR) is pretty much the same thing [www.google.com]

For all of these, you might try timing them before your sympathetic drive kicks into high gear. That is prevent the drive rather than stopping it.



Edited 1 time(s). Last edit at 12/18/2023 01:18PM by GeorgeN.

Fantastic! What an amazing resource you all are! I have also jt ordered the TENSPro and am going to give that a try! Thank you for all of your wisdom and willingness to help!