A bodybuilder was hospitalized more than a dozen times with a mysterious heart condition that was triggered by drinking water.
It took years and 25 hospital visits for Franklin Aribeana, 35, and doctors to trace the source of the problem — drinking ice cold h20 after a work out.
They theorized that when the freezing cold water hit the back of his throat, it irritated the vagus nerve that connects the brain to the heart.
Because his heart rate was already ramped up from working out, they suggested it caused the organ to beat eratically — in a condition medically termed atrial fibrillation.
The Houston, Texas, native already has an irregular heartbeat and an enlarged part of his heart, which may make the eratic beats more likely because his heart is already under increased stress.
Franklin Aribeana, 35, from Texas, would collapse after drinking icy water (Pictured above working out)
Mr Aribeana, pictured above, is also a bodybuilder. Doctors were initially stumped as to the what was triggering the heart problems
He suffered the reactions for more than a decade and a half before he became suspicious that cold water might be the trigger (Pictured above in hospital after an episode with his heart)
Mr Aribeana described the condition to local media: ‘As I’m drinking the water, [I feel] probably the most noticeable thud in my chest… I’d never experienced it before.
‘I am taking a gulp of cold water and as I am settling back down, I feel the double thud.’
Describing another incident when he collapsed on a golf course, he said: ‘I took a sip of cold water, and the next thing you know, literally palpitations out of my chest.
‘They took off my shirt, and you could see my heart literally pounding out of my chest, and then I passed out.’
To treat his condition, doctors cauterized the connection between his vagus nerve and his heart — or severed the connection.
Cold water can trigger the vagus nerve because it can activate a response known as the ‘diving reflex’.
This is normally triggered by exposure to cold water, but can also be triggered by cold water in the throat in rare cases.
The reflex triggers the slowing of the heart rate to help conserve oxygen as well as the tightening of blood vessels in the extremities, like the hands and feet, to redirect blood to vital organs.
Normally, these changes are short-lived and resolve as soon as someone is no longer exposed to cold water.
But in people with underlying medical conditions, such as an enlarged heart chamber, the reflex can cause a sudden drop in blood pressure — leading them to collapse. It can also cause the heart to start beating eratically.
Mr Aribeana said he has not had any complications since the procedure and can now drink cold water without any issues.
He is still on medications for his heart, however, linked to his genetic condition.
Mr Aribeana said he first collapsed in 2007, at the age of 18 years, after drinking cold water while he was on a golf course on a hot summer’s day.
Since then he has also reported collapsing while at the gym, again after drinking cold water.
Dr Khashayar Mematpour, a heart disease expert at Texas Medical Center, said Mr Aribeana’s condition was rare.
He also diagnosed his genetic heart condition — caused by mutations to the gene RBM20 — which caused the left chamber in his heart to become enlarged.
Tests showed it was caused by cold water stimulating the vagus nerve in the throat, causing the heart to start to beat eratically
Mr Aribeana has now had his vagus nerve cauterized and can drink cold water without suffering the reaction (pictured)
This makes atrial fibrillation — or the disruption of electric signals causing the heart to beat eratically — more likely because the heart is already under increased pressure and may contain more scar tissue that disrupts electric signals.
This condition is not common, suffered by fewer than one in 2,500 people in the US according to estimates.
Dr Mematpour said: ‘Franklin is a phenomenal individual! He’s got a lot of drive! He was very much on top of his treatment.’
He added that Mr Aribeana’s trigger was rare and would normally cause ‘subtle symptoms’ such as ‘feeling a little tired more than usual, being short of breath or having some chest pain’.
The vagus nerve is one of 12 cranial nerves in the body and runs from the brainstem to the abdomen — via the throat.
It is part of the autonomic nervous system (ANS), or the part of the nervous system that controls involuntary functions such as heart rate or breathing.
This nerve can be stimulated by objects in the throat, such as cold water, which may cause it to send erratic signals to the heart, leading to atrial fibrillation.
Complications to the nerve can be caused by previous injury to the neck or compression of the nerve by surrounding tissue — such as enlarged blood vessels.
They may also be linked to genetic conditions that affect the heart.
Problems with the vagus nerve may be diagnosed using a breathing test, which shows how much the heart rate changes in response to shifts in the pace of breathing.
