Triggers of Arrhythmia

I just created an account on EventLoggers, a journaling and data integration tool created by @dreeds, who is active on this forum. It seemed like it could be useful to me in a project I’m doing to investigate the triggers of my arrhythmias. Through some self-tracking and sharing my data in a video conference with a cardiologist, I’ve learned that these are most probably all premature ventricular contractions (PVCs). It’s a common condition, and many people find they are triggered by alcohol, coffee, stress, sleep problems. I’m not sure enough about what’s going on to do a very rigorous experiment. My tolerance for controlling my daily life through very careful timing of events and lifestyle changes is not very high, so before I try to do something difficult I want to know more about what’s going on. So I’m going to keep a journal on EventLoggers for two weeks and then assess.

I normally drink about 5 drinks a week, rarely more than 1 to 1.5 ounces of 80 proof liquor per drink. I’ve been leaning against this and haven’t had a drink since Sunday night, and also haven’t had a severe arrhythmia period since Tuesday. So – a more or less natural experiment is already under way. Eventually I’ll have another drink, certainly by this Sunday when some in-laws come over for a (well distanced) visit outside on our lawn. I’ve also limited myself to a single cup of coffee in the morning.

What is responsible for my improvement? Less coffee or no alcohol? Or both? Or something else all together? Over time, I hope to find out more.

This would bother me enough to go the “elimination diet” route, i.e. cut out everything that’s known to cause issues, and then if that helps, start adding things back… Otherwise, in the absence of a single, strong factor, you could end up collecting data for a year and still be inconclusive!

Yes, I may get there. But right now the candidates are: stress, poor sleep, carbs in diet/blood sugar, alcohol, coffee, vigorous exercise (as a trigger). I suspect that an “elimination” approach as a first step will fail due to not being able to maintain it. So my first phase is to log meals, sleep, and arrhythmia events. I’ll do this until sometime next week, and then try to see these on a timeline together. Maybe something will jump out at me to try more rigorously. So far, I’ve done the easy thing, which is to make some modest changes all at the same time: cut coffee to one cup a day, cut out alcohol mostly (<1.5 ounces of alcohol all together over the last days). Sleep is harder, but I’ve managed to sleep in several days.

Here’s April/May data. I started to change things on Monday the 18th. You can see things got a lot better with the exception of Thursday, when I had a bad episode during the afternoon. I was keeping a log then. I had an unusually heavy lunch with white rice that day, so carb/blood sugar as well as heavy eating in general stays on the list of suspects. Interestingly, before I posted this I looked at the data but not at the log. I asked myself: What happened Thursday? I couldn’t remember anything related to possible triggers that day. It was only a few days ago, but I didn’t remember what I had for lunch, and didn’t think about that as a possible culprit. Then I looked at the log, and remembered there had been a particular heavy lunch outside at the picnic table in which I efficiently confronted all the left overs from last night’s dinner with my family. It was funny to me that I had eliminated this from memory.

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Supporting the idea of meal triggers, independent of content of meal, is this breakdown of episodes by hour. The spikes in button clicks seem to roughly come right after meal times. It’s not crystal clear, possibly due the face that my lunchtime doesn’t occur at the same time every day, but it roughly corresponds.

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Noting that I had a device issue today (lost it temporarily). Reminding myself that time of day data will not be accurate for June 24 2020 and should be left out of any analysis that looks at this level of timing. I added some observations for the day, approximating the correct total, but the time stamp will be wrong.