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what is Afib, really?
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after reading the "slowly killing" thread i started to wonder about real Afib. I always assumed my HRM was funky as VERY ocassionally (honestly like a handful of times in the last year) i'll hit 2teens or 170s for less than, say, i dunno, a minute? and then all goes back to normal (i don't think i've even gone over 160 at extreme effort). i always figured the HRM was funky as I didn't feel weird (i did pay attention to the last one) but it didn't feel terribly different and only mildly SOB so i chalked it up to a funky HRM or something other than the heart.

if you have AFIB you have other symptoms no? SOB or lightheadedness or something? and HRMs are known to do funky stuff like this right? or do i have incredibly infrequent AFIB?

http://harvestmoon6.blogspot.com


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Re: what is Afib, really? [kathy_caribe] [ In reply to ]
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kathy_caribe wrote:
and HRMs are known to do funky stuff like this right?
Trying to rationalize something there?

HRM's can report incorrectly high heart rates under conditions where the skin contact is poor, eg. just after you put it on and start running, and/or where there is a large amount of external interference such as when you're riding downhill at speed and your jersey is flapping over top of it and generating a lot of static electricity. Under steady state conditions, if your HRM suddenly jumps up to a high value, then you might want to pay attention to it.
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Re: what is Afib, really? [Big Endian] [ In reply to ]
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Big Endian wrote:
kathy_caribe wrote:
and HRMs are known to do funky stuff like this right?

Trying to rationalize something there?

HRM's can report incorrectly high heart rates under conditions where the skin contact is poor, eg. just after you put it on and start running, and/or where there is a large amount of external interference such as when you're riding downhill at speed and your jersey is flapping over top of it and generating a lot of static electricity. Under steady state conditions, if your HRM suddenly jumps up to a high value, then you might want to pay attention to it.

likely. :) thanks for the information. hmmm....i'll keep an eye out pay more attention. thanks.

http://harvestmoon6.blogspot.com


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Re: what is Afib, really? [kathy_caribe] [ In reply to ]
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Probably just the hr monitor... Mine has given inaccurate recordings due to poor contact in the past.
If you were in atrial fibrillation you would generally have symptoms such as dizziness, lightheaded ness, breathlessness etc...
As the atria are 'fibrillating' the ventricles are not being filled properly, thus when the ventricles contract there is a reduced cardiac output due to loss of atrial kick... The body receives less blood, oxygen etc and results in these symptoms.
Though sometimes patients can be asymptomatic.
If you are worried an exercise stress test may give you some piece of mind. All the best
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Re: what is Afib, really? [kathy_caribe] [ In reply to ]
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my SVT, feels kind of like,well hard to describe, but a little funny in the heart, a buzzing if you will. HR jumps up for a bit and eventually mine come back down on its own, but a vagal response resets it much faster. sometimes only jumps to 190s sometimes 230s. had it checked out and fortunately mine is not the dangerous variety. you don't have to this it is just afib, could be svt. my one afib episode was much different. everything was exhausting while in it for a few hours. my svt just feel a bit weaker during and usually after, ie power level will be off for a while after an episode.

get checked, 24hr monitor is a good start.
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Re: what is Afib, really? [kathy_caribe] [ In reply to ]
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blood goes into your atria. atria is the plural of atrium. you have 2 of them, these are 2 of the 4 chambers of your heart. the atrium pumps blood into your ventricles, and it's the ventricles that do the BIG work. atria fill ventricles, ventricles pump blood to your body.

as i remember it, right atrium pumps blood to right ventricle, right ventricle pumps blood to the lungs. blood returns from the lungs oxygenated, goes into the left atrium, is pumped to the left ventricle, then, whoosh, out it goes to the body. so the pa-bumb you hear when you listen to a heart beat is the left atrium (pa), then left ventricle (bump) or, in the case of an athlete, (bump!)

atrial fibrillation is when that "pa" isn't a pa but a pppp brrr ppp. literally mixed signals. it's like your flush toilet. the tank fills the bowl, then the bowl goes "whoosh". right after you flush, if you don't let the talk fill and you try to flush again, you don't get much whoosh. atrial fibrillation is like when you try to flush when the bowl hasn't yet sufficiently filled. you feel tired, you feel like you have sickle cell anemia. your tank (atrium) isn't filling your bowl (ventricle) so you don't get a good flush of blood throughout your body.

atrial fibrillation is not going to kill you, but it's a big annoyance. it's not a life killer, but it is a lifestyle killer. i'm 58, and i had my biggest troubles with a-fib when i was about 50. but i was living like the devil. i was pushing the throttle to the floor in every workout, drinking a man-sized homemade margarita every night, building this property every morning (i had just bought and moved onto the compound a few years earlier).

during WWII, doctors noticed a big spike in a-fib and it was soldiers on leave, drinking, partying, no sleep, 3-day binges. a-fib can be a permanent fixture in one's life, or it might be transitory and if you understand and can identify your triggers then it goes away. i have very few a-fib problems now, because i very rarely drink, i very closely watch my sleep, and i don't ever go really deep in workouts.

for those who have an a-fib problem that won't go away, there are a number of therapies, one of which is ablation, which is an invasive but non-surgical way of "shocking" the heart, trying to kill the offending part of the heart that's causing the arrhythmia. but there are other treatments being tested, such as enervating the pharyngeal nerve in the back of the throat, and if you've read what i wrote about pickle juice (front page) you'll see that this vaso-vagal reflex is really interesting.

but to the point of the velonews article, it's not just a-fib. it's also v-tach, i.e., ventricular tachycardia, and this is what sidelined greg welch. when you have an arrhythmia in your atria, that's annoying. when you have one in your ventricles, this is in the same family as a heart attack.

we will be writing more about this in the future on slowtwitch.


Dan Empfield
aka Slowman
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Re: what is Afib, really? [kathy_caribe] [ In reply to ]
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Atrial fibrillation can manifest in several ways. It can be paroxysmal, which is a short-duration event; it can be persistent, where it is present for extended stretches like days or weeks; or it can be permanent, irregular all the time. Events can range from mild, where you don't feel much if any difference to dramatic, where you really feel your heart racing. AF is not the only cause of a temporarily elevated heart rate, there is also ventricular tachycardia and supraventricular tachycardia. It is worth getting it checked out. Ventricular tachycardia can degenerate into ventricular fibrillation, which is life-threatening.

I am not a medical professional, but have been living with permanent AF for about 7 years now, so have had several discussions with a cardiologist and done a fair amount of Googling to learn more.

Brian

Brian

Kick over the wall, cause governments to fall, how you refuse it
Let fury have the hour, anger can be power, d'you know that you can use it?
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Re: what is Afib, really? [kathy_caribe] [ In reply to ]
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Kathy, there is a lot of info out there on the web re: A-Fib and I encourage you to look into it and talk with your doctor, as well. A-Fib is the leading cause of strokes in people but can be dealt with effectively using a number of different therapy options.

******WARNING - Blatant Plug to follow***********

My company manufactures blood pressure monitors for consumers. We have developed a unique and patented technology that can discern the presence of A-Fib while taking your blood pressure. rather than just highlighting an irregular heartbeat (which most BP monitors can do), we can discern the difference between A-Fib and other types of arrhythmia. While we cannot yet sell the technology in the US (thanks, FDA), we do sell it right now in Mexico (and many other countries around the world). It is a simple, cost effective way for consumers to screen themselves for A-Fib. You can find the unit at all Costco Mexico stores or through the Costco Mexico website.

http://www.costco.com.mx/...7.3,cos_7.3.1/629854

Please note that A-Fib is not always a "permanent state" condition. It can be transitory and not always present. So if you use our BP monitor and it does not give you a A-Fib warning, that does NOT mean you don't have A-Fib....it simply means that you are not in A-Fib at the time you took your reading. That said, we have conducted A-Fib screenings in clinics around the world and have positively screened many, many people (thousands?) for A-Fib who did not know they had it.

Again, I highly recommend that you discuss the issue with your doctor as a first line of attack.

A-Fib discussions aside, it is also not uncommon for a HRM to give high reading s for short periods of time when in the area of electrical wires or other environmental conditions.

Sorry for the plug, but felt it was relevant to Kathy's situation since the technology is available to here. if anyone else has any questions about it, feel free to PM me. Don't want to take up forum space.

Chicago Cubs - 2016 WORLD SERIES Champions!!!!

"If ever the time should come, when vain and aspiring men shall possess the highest seats in government, our country will stand in need of its experienced patriots to prevent its ruin." - Samuel Adams
Last edited by: Power13: Jul 30, 15 7:45
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Re: what is Afib, really? [Power13] [ In reply to ]
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Just curious about your BP monitor. Maybe it is my ignorance about A-fib, but can you detect A-fib when you are not exercising? or do you have to be under some sort of stress? Might have to see what I can do about importing one of these.
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Re: what is Afib, really? [PaulMoody] [ In reply to ]
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PaulMoody wrote:
Just curious about your BP monitor. Maybe it is my ignorance about A-fib, but can you detect A-fib when you are not exercising? or do you have to be under some sort of stress? Might have to see what I can do about importing one of these.

Sure....A-Fib is not related to exercise. Plenty of people have it and do not exercise on a regular basis. Nor do you have to be under some kind of physical stress to be in A-Fib.

Again, we cannot sell it Over-The Counter in the US due to the FDA, but it is available in most other countries in the world, including Mexico and Canada. i don't know that it can be exported from those countries into the US, though.

Chicago Cubs - 2016 WORLD SERIES Champions!!!!

"If ever the time should come, when vain and aspiring men shall possess the highest seats in government, our country will stand in need of its experienced patriots to prevent its ruin." - Samuel Adams
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Re: what is Afib, really? [kathy_caribe] [ In reply to ]
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Kathy,
My HR monitor goes bat shit every so often. It is usually at the beginning of workouts or when things get really dry/cool. I have always attributed it to a lack of moisture on the chest strap contacts.

I would imagine that if you were having this issue, there would be symptoms beyond what your HR monitor might notice (like suddenly feeling like you might die).

I read that article and admittedly am a little more scared than I used to be about this kind of thing (a few years older and little bigger family has forced me into some better perspective).

I plan on getting checked out soon by someone that knows the subject pretty well. I think I am fine of course, but don't we all!

Ironman Certified Coach

Currently accepting limited number of new athletes
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Re: what is Afib, really? [Jim Martin] [ In reply to ]
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Kathy,

the way I found out I had AFib was just like you - occassional and unusually high HR spikes on my Garmin. It was usually during or just after a hard effort where I would see a steady state HR in the 140's (my max is around 170). I would suddenly jump up sometimes well over 200 bpm and stay there fore several minutes but always resolving itself. I had no symptoms other than sometimes feeling a slightly funny feeling in my chest. No dizziness. No shortness of breath. Many times I didn't even notice until I got back and downloaded the ride. More than once I edited the log file to remove the high readings so it wouldn't throw off my average HR!

After reading the forums, I concluded that my strap was bad (replaced several times) or didnt have good contact (tightened and started using electo-gel).

I found a friend of mine had a embedded defib and I asked him about it and after discussing my data, he suggested I get it checked out.

Did the holter monitor and after tying for a few weeks, finally caught an episode.

I am in the early stages of figuring out what is going on my my Afib and recently had a embedded heart recorder inserted under the skin on my chest to catch and record events so we can understand whether I need some additional procedure.

I am not a doc but based on my experience, I would suggest not assuming it is a bad HR monitor.
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Re: what is Afib, really? [jabbahop] [ In reply to ]
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Damn, and thanks.

Ironman Certified Coach

Currently accepting limited number of new athletes
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Re: what is Afib, really? [Slowman] [ In reply to ]
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Great post Dan. Just two things: the hearts sound is usually describes as "lub-dub" and what you hear is not the contractions of ventricles (they contract at the same time) but the closing of valves: lub= valva tricuspedalis and valva mitralis, the atrio-ventricular valves and dub = valva semilunalis and valva aorta.

8-)

Endurance coach
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Re: what is Afib, really? [mortysct] [ In reply to ]
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thank you for the clarification. an expert on this i am not.


Dan Empfield
aka Slowman
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Re: what is Afib, really? [kathy_caribe] [ In reply to ]
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On the chance you live on the Gulf Coast of FL, which your name doesn't suggest, I can recommend one the leading minds in AF therapy in the world. People fly in from all over to get trained and treated by this guy who has the rare blend of bedside manner and Dx/Rx skills. AF doesn't have to be that bad if you get on it quickly.....the big scary is if you are walking around with it and either don't know it or ignore it. That opens up an entirely new set of circumstances, none of which are good.
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Re: what is Afib, really? [Slowman] [ In reply to ]
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Be careful with the suggestions though. Atrial fibrillation can be vagally mediated, in which case your heart rate is not high, and the typical approaches to revert to sinus rhythm with a 'regular' Afib will not work, and will actually make things worse. Also, among well trained athletes, there is a slightly higher rate of vagally mediated Afibs, so even more reason to be cautious on what to do.

-------------------------------------------

http://www.fmcoaching.com
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Re: what is Afib, really? [Francois] [ In reply to ]
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i'm not trying to prescribe, rather to describe, or report. from what i've read you can both induce and abate afib via the vagal reflex. i also get the sense that this is all very new, and not well known.

so, for any of you reading, so that you do not misunderstand, i am an online magazine publisher and not a cardiologist, and this is a reader forum and not a doctor's office. everybody clear on that?


Dan Empfield
aka Slowman
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Re: what is Afib, really? [Slowman] [ In reply to ]
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That's correct. Very few docs will differentiate between a 'normal' afib and a vagally mediated afib, and in the ER with a vagally mediated afib, it's not impossible to see someone suggesting beta blockers (which wouldn't work...)

-------------------------------------------

http://www.fmcoaching.com
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Re: what is Afib, really? [Francois] [ In reply to ]
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it doesn't always have to be as pernicious or steady state as afib. I have a pvc, a rhythmic non-rhythm (or is it non-rhythmic rhythm). most HR monitors found on exercise equipment give me crappy readings but my docs tell me i am fine. ish.
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Re: what is Afib, really? [kathy_caribe] [ In reply to ]
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There is a really good article on point in this month's issue of Velo News. Although primarily focussed on long term effects on heart health to endurance athletes, it discusses A-Fib a fair bit. I am kinda following Slowman's approach of not doing the crazy hard stuff anymore that puts you in red zone for long time.
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Re: what is Afib, really? [Slowman] [ In reply to ]
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With all due respect to Slowman, a few small clarifications:

1. Afib can kill you, indirectly. It's not the abnormal rhythm per se, it's the fact that after 48 hours of continuous afib your chances of a stroke increase quite a bit because too much blood will pool in your atrium - so it's the stroke that can kill you or otherwise do a lot of damage.

2. Regarding ablations, it doesn't truly 'shock' your heart into submission (that's what cardioversion is for), it cauterizes the spots inside your heart that are carrying the electrical impulses. Also, I have a hard time calling it non-surgical. With a foley catheter as well as two other catheters inserted up your legs into your heart to guide the instruments that they stick up there, it's surgery in my book (although clearly not the level of open heart surgery). PM me if this is in the cards for you as there are some very real and serious risks that your doctor may downplay. There is also a new technique in use called cryoablation that freezes the abnormal areas, which is supposed to be more beneficial since if an area needs to be 'uncauterized', they just let it thaw out.

For the original poster, think of afib as a short circuit of sorts - an electrical impulse finds an abnormal passageway in the heart and instead of flowing through normally, gets caught up in a loop. What you'll see on a heart monitor at the hospital/clinic is a disconnection between the atrium and ventricle. One is racing at 170, other other is coasting along at 30. In terms of symptoms, your mileage may vary. In my case the first time was a very obvious racing heartrate while at rest on a normal business day. Could feel it racing away, then almost completely for a couple seconds, then hard pounding. On a monitor was going from 30-ish bpm to 180 to 50 to 160 within 15-20 seconds. Some shortness of breath, and not so much dizziness as lightheadedness. Second time was less severe with the SOB and lightheadedness. For some people it just stops on it's own. Other people respond well to heart drugs. In my lucky case, neither works and they had to zap me. I am 10 months post ablation with no ill effects, 42yo male, currently training for a half. Cardiologist wants me to do a holter monitor for 48 hours once per year just to make sure there aren't any episodes that I'm not feeling.

As for triggers, there is no definitive cause although booze (particularly binging), stress, caffeine and exhaustion are thought to be contributing factors. In my case the latter 3 were definitely in effect when the first episode hit.

My $.02 as a person that lived through this, as well as having a wife with SVT.
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Re: what is Afib, really? [kathy_caribe] [ In reply to ]
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I had a-fib and a successful ablation in Sept 2013. It was very obvious for me. One week I was in the break all day at a hilly road race, and a few weeks later I could not get up a flight of stairs without feeling very week. I also got dropped before the group ride started. I was "lucky" because when I went to the doctor I was stuck in a-fib so he could diagnose it right there. Like you I thought my HRM was on the fritz.

I read the Velonews article and while parts are misleading, the gist is correct. Basically a lot is still unknown but there is a link between excessive endurance sports and the heart issues he describes. My doctor was a runner and gave me the green light as long as I take a day off every week, a week or two off every 6 months, don't chug coffee after sleeping like poo and go hammer, all stuff you should be doing anyway, and of course I was not. I made a full comeback, 100%, but it took a while and hard work. KQ'd 6 months after ablation.

What you describe sounds like you should find the best heart doctor in your area who also is an athlete, and go see him, and do exactly what he says even if you do not like it. I love ST, but don't listen to anybody on here when it comes to your heart.

I should add I have a-fib on both sides of my family.
Last edited by: jjh: Jul 30, 15 15:29
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Re: what is Afib, really? [mblocher] [ In reply to ]
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"so it's the stroke that can kill you or otherwise do a lot of damage."

right. but - speaking as a guy who's spent up to 40 hours out of sinus rhythm - after EKGs, utrasounds, nuclear stress tests, etc., at the end of it all i take a baby aspirin every day. per the doctors orders. as my blood thinner.

others might have to take warfarin, but, have you researched the increased risk of stroke by this with afib? i ask because when i did it seemed to me the increase was pretty small, so much that when i see the TV ads pushing blood thinners for those with afib i really wonder if we've gotten to a kind of ridiculous stage.

so, i'm eager to be taught, but, what do you think the increased risk of stroke is, versus a similar cohort not beset with afib?



Dan Empfield
aka Slowman
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Re: what is Afib, really? [jjh] [ In reply to ]
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A lot of good discussion here. I wish more was known about a-fib as well. The relationship between endurance athletes and a-fib seems to be causal but no specific connection is known as far as I know. I have read that many type A professionals who are not endurance athletes suffer with a-fib. Until something more specific comes along it seems that a combination of behavioral and lifestyle choices predispose some to the problem.

I've had bypass surgery and have subsequently had a few episodes of a-fib. For me, alcohol, caffeine and stress seem to precipitate events, although having coronary artery disease is a risk factor as well.

Cathy, you only get one heart and heart heath is not always obvious. I was tapering for Boston after setting PB's at a Half marathon and a local 20 mile race, when I learned that I needed immediate surgery. It likely saved my life as my major artery was 99% blocked. I could have been another sad story like Jim Fix.

Like many readers, I have many different kinds of heart rate readings with both my Garmin and my Polar. Some of the readings are just fluff that don't mean anything, but there are others. . . Muscle strains and broken bones can be healed!
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Re: what is Afib, really? [Slowman] [ In reply to ]
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Slowman wrote:
"
so it's the stroke that can kill you or otherwise do a lot of damage."

right. but - speaking as a guy who's spent up to 40 hours out of sinus rhythm - after EKGs, utrasounds, nuclear stress tests, etc., at the end of it all i take a baby aspirin every day. per the doctors orders. as my blood thinner.

others might have to take warfarin, but, have you researched the increased risk of stroke by this with afib? i ask because when i did it seemed to me the increase was pretty small, so much that when i see the TV ads pushing blood thinners for those with afib i really wonder if we've gotten to a kind of ridiculous stage.

so, i'm eager to be taught, but, what do you think the increased risk of stroke is, versus a similar cohort not beset with afib?

Executive summary, my cardiologist reckons stroke risk is roughly double for me, but warfarin introduces other risks that make it much closer to a wash.

When I first presented with permanent AF, I was cardioverted. Didn't last more than a month or so; cardioverted again and put on Tikosyn (dofetilide), a potassium channel blocker. Several months later I was back in AFib. At that point, my cardiologist presented these choices:
  • the various types of ablation procedures
  • the Maze procedure
  • do nothing but take warfarin
  • do nothing

His experience is that the reversion rate of the various ablation procedures is pretty high when you check a few years down the road, and he has done a lot of them. So he no longer recommends ablation. The Maze procedure is open-heart surgery, which has all the risks associated with that. And it is not guaranteed, either. My AF is quite moderate, I never realized I had developed it until an annual physical, and except at high efforts, I don't notice it at all. When doing something hard, like intervals or following some froggy SOB on the group ride, it feels like I don't have the last gear or two I used to have, but I don't notice it at all at moderate steady-state efforts. Given that, he recommended doing nothing, unless things worsened to the point where I couldn't do the activities I wanted to do. Regarding warfarin, his opinion is that a person without other risk factors has approximately a 1% risk of a stroke. Not treating my AF will double that. I have read articles online that have said the increased risk is 5x, but I think he factored into that my overall fitness and activity level. Warfarin in his opinion introduces a similar overall risk increase; stroke risk does not rise as much, but there is the bleeding thing and some other warfarin side effects. He recommended a daily aspirin, but after some months of that I started to feel really crappy, like overtrained. My GP immediately thought GI bleeding, and he was right, I am one of the 20% who will develop an ulcer from a daily aspiring regime. Discussed again with the cardiologist, and decided against warfarin for the reasons above. Knock on wood, but it's been a couple of years now with no treatment and things have not changed for better or worse.


Brian

Brian

Kick over the wall, cause governments to fall, how you refuse it
Let fury have the hour, anger can be power, d'you know that you can use it?
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Re: what is Afib, really? [ergopower] [ In reply to ]
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"Executive summary, my cardiologist reckons stroke risk is roughly double for me"

right. it can be fivefold. but getting a decade older doubles your risk. being white lessens your risk. not having high blood pressure, not smoking, lessens your risk. so i think you've probably got a lesser risk, with afib, than a typical guy in your cohort, your age, who does not have afib.

that's why i say, yes, while you can die from an ischemic stroke where afib is the proximate cause, i just don't think people should get too awfully freaked about afib, unless you're just not in sinus rhythm period. then, don't be freaked, but get it fixed.

we have a 92 year old relative, a 100 pound lady, who lives with us fill time. alzheimers. strong as an ox. has afib. doc finally took her off coumadin for a number of reasons. she's my longevity hero.



Dan Empfield
aka Slowman
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Re: what is Afib, really? [Power13] [ In reply to ]
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"My company manufactures blood pressure monitors for consumers. We have developed a unique and patented technology that can discern the presence of A-Fib while taking your blood pressure. rather than just highlighting an irregular heartbeat (which most BP monitors can do), we can discern the difference between A-Fib and other types of arrhythmia. While we cannot yet sell the technology in the US (thanks, FDA), we do sell it right now in Mexico (and many other countries around the world)"

Ummm... I'm pretty sure it's illegal for an employee of a company to promote a medical device for use in a market it hasn't been approved for. I work for a medical device company and we have very strict rules (mandated by the FDA and other regulatory bodies) on what we can and cannot discuss with our customers based on what products have been approved in the different markets. You might want to check your quality system/ training requirements on what you are allowed to promote.

For Kathy and others interested in Afib symptoms and ablations there has been quite a bit of discussion on this forum over the years by myself and others that have gone through the procedure. My personal experiences are well-documented in other threads - if anyone has any additional questions please feel free to PM me or post here.

-J
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Re: what is Afib, really? [JAM] [ In reply to ]
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I fought a-fib for 9 years and after trying medicine after medicine, I went for the ablation. Totally cured. The ablation is, without a doubt the best decision I ever made. No limits on what I do. The last thing I would wan to do is march through life as a wounded soldier when there is a solution at hand.
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Re: what is Afib, really? [kathy_caribe] [ In reply to ]
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kathy= yeah, the article was concerning, and a nice summary of an area that is emerging, no real population-based epidemiological studies done yet. So, here we are, on the cutting edge of a phenomenon I don't think anyone really wants to be on the cutting edge of. So here's my own N=1 experience to add to the data base:

White male, current age 60. Been doing IM's since 2000, tri's in general since 91'. Professional dancer before that, pretty commonly have 40 hour exercise weeks, x about 15 years. General sports, surfing, swimming, running growing up. So a lifetime history of exercise, and quite a few years of a LOT of exercise. Had my first bout of Afib at mile 20 in IMFL 2009. Everything was great until then; HR steady at 134, then boom! 210. Felt SOB, a bit dizzy, went to a walk, did some relaxation breathing exercises, it went back down to 150, and I managed to walk/slow jog to the finish. Went to the med tent, happened to be a cardiologist there. we talked, I was very dehydrated, and had been using a lot of caffeine. The consensus was that dehydration, some sleep deprivation, excessive caffeine use, caused the tachycardia. after a couple hours, everything was normal. He advised me to get it checked, I told my primary care doc, and that was that. It would occasionally reoccur, and there was a pattern of sleep deprivation, dehydration, caffeine use, and intense extended exercise.

Blew up on me again in 70.3 Miami in 2012, and it seemed to be happening with increasing frequency, but not entirely predictable. Interestingly, it started on the swim in Miami-that's my strongest leg, but it seemed exertion with some breath holding was a trigger. Got it checked out and diagnosed at that point; doc recommended doing nothing, and see what happened over time, as I had no other risk factors, and a stress test provoked nothing. Finally, this year after Afib recurring more frequently, I wore a monitor for a month, induced it a couple times swimming and once riding, and they recommended an ablation. In the meantime, I had done my research, and found an amino acid protocol that seemed like it might help. I tried it, and damn! It really made a very noticeable difference in a short time. 2000mg Taurine, 500 mg L-Arginine, and 1000mg Magnesium. However, not a cure. So I had a cryo ablation 4 weeks ago. Still in the healing process, and the research says you can't quite tell if it took for 1-2 months, but I'm feeling pretty good. So I'm hoping to do IMCOZ in November; we'll see.
My recommendations are to be cautious-become a skilled observer of yourself and see if you can identify a pattern to the events; consider trying the amino protocol; my med providers and pharmacist said no harm from those aminos, and I'm continuing to take them. I'm now able to push harder in swimming than I could for the past two years without feeling I was about to go all tachy, so I'm encouraged.
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Re: what is Afib, really? [Slowman] [ In reply to ]
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Great post.You are speaking from experience-and knowledge from reading up- a combo that more posters should emulate.
The flush toilet analogy is spot on.

Slowman wrote:
blood goes into your atria. atria is the plural of atrium. you have 2 of them, these are 2 of the 4 chambers of your heart. the atrium pumps blood into your ventricles, and it's the ventricles that do the BIG work. atria fill ventricles, ventricles pump blood to your body.

as i remember it, right atrium pumps blood to right ventricle, right ventricle pumps blood to the lungs. blood returns from the lungs oxygenated, goes into the left atrium, is pumped to the left ventricle, then, whoosh, out it goes to the body. so the pa-bumb you hear when you listen to a heart beat is the left atrium (pa), then left ventricle (bump) or, in the case of an athlete, (bump!)

atrial fibrillation is when that "pa" isn't a pa but a pppp brrr ppp. literally mixed signals. it's like your flush toilet. the tank fills the bowl, then the bowl goes "whoosh". right after you flush, if you don't let the talk fill and you try to flush again, you don't get much whoosh. atrial fibrillation is like when you try to flush when the bowl hasn't yet sufficiently filled. you feel tired, you feel like you have sickle cell anemia. your tank (atrium) isn't filling your bowl (ventricle) so you don't get a good flush of blood throughout your body.

atrial fibrillation is not going to kill you, but it's a big annoyance. it's not a life killer, but it is a lifestyle killer. i'm 58, and i had my biggest troubles with a-fib when i was about 50. but i was living like the devil. i was pushing the throttle to the floor in every workout, drinking a man-sized homemade margarita every night, building this property every morning (i had just bought and moved onto the compound a few years earlier).

during WWII, doctors noticed a big spike in a-fib and it was soldiers on leave, drinking, partying, no sleep, 3-day binges. a-fib can be a permanent fixture in one's life, or it might be transitory and if you understand and can identify your triggers then it goes away. i have very few a-fib problems now, because i very rarely drink, i very closely watch my sleep, and i don't ever go really deep in workouts.

for those who have an a-fib problem that won't go away, there are a number of therapies, one of which is ablation, which is an invasive but non-surgical way of "shocking" the heart, trying to kill the offending part of the heart that's causing the arrhythmia. but there are other treatments being tested, such as enervating the pharyngeal nerve in the back of the throat, and if you've read what i wrote about pickle juice (front page) you'll see that this vaso-vagal reflex is really interesting.

but to the point of the velonews article, it's not just a-fib. it's also v-tach, i.e., ventricular tachycardia, and this is what sidelined greg welch. when you have an arrhythmia in your atria, that's annoying. when you have one in your ventricles, this is in the same family as a heart attack.

we will be writing more about this in the future on slowtwitch.
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Re: what is Afib, really? [kathy_caribe] [ In reply to ]
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Hello kathy-caribe and All,

As posted in another thread my wife had an ablation about 4 months ago for a-fib. We educated ourselves as best we could prior to surgery .... and my wife debated having the ablation. It has been partially successful.

An incident occurred when our cousin went into a tachycardia and afib and after 48 hours she could not be cardioverted. She was already on a pacemaker and while not an good candidate for surgery, and ablation was her best option.

She did not have another relative for an advocate close by so we were with her for the bedside consultation just prior to surgery.

We were familiar with the doctor's reputation as best of best so felt good about that. He had done 3 prior ablations that day and was tired and the surgery was going to start at about 2100. He spent time with our cousin and us diagraming the choices ... one of which was to put her on the totally on the pacemaker (which we discouraged) ... but left open as an option if no other solution was available after getting inside.

The operation was successful and while she still had the pacemaker she also had her natural sinus rhythm .... and did not have to worry about a catastrophic pacemaker failure or interruption.

At the time of the operation the doctor described a device that would go into the small triangular chamber of the atrium where a large clot can form during afib and then get released to cause a stroke when normal sinus rhythm resumes. It is currently about 1 year away in 5 year FDA trials. It would sort of fill the space and filter the clot ..... where the clot forms reducing the possibility of stroke and reducing the need for warfarin or other anti-clotting agents.

After the success of our cousins operation my wife decided to give the operation a shot for herself as the frequency of her incidents was increasing.



.

Cheers, Neal

+1 mph Faster
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Re: what is Afib, really? [JAM] [ In reply to ]
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JAM wrote:
"My company manufactures blood pressure monitors for consumers. We have developed a unique and patented technology that can discern the presence of A-Fib while taking your blood pressure. rather than just highlighting an irregular heartbeat (which most BP monitors can do), we can discern the difference between A-Fib and other types of arrhythmia. While we cannot yet sell the technology in the US (thanks, FDA), we do sell it right now in Mexico (and many other countries around the world)"

Ummm... I'm pretty sure it's illegal for an employee of a company to promote a medical device for use in a market it hasn't been approved for. I work for a medical device company and we have very strict rules (mandated by the FDA and other regulatory bodies) on what we can and cannot discuss with our customers based on what products have been approved in the different markets. You might want to check your quality system/ training requirements on what you are allowed to promote.

For Kathy and others interested in Afib symptoms and ablations there has been quite a bit of discussion on this forum over the years by myself and others that have gone through the procedure. My personal experiences are well-documented in other threads - if anyone has any additional questions please feel free to PM me or post here.

-J

Please go back and re-read what I wrote.....Kathy is in Mexico and our BP monitor is available in Mexico. I also specifically note that we do not yet have OTC clearance for the technology in the US (although we do have it for use with a Rx)

Not certain how you read that as me promoting it for use in the U.S. market.

Chicago Cubs - 2016 WORLD SERIES Champions!!!!

"If ever the time should come, when vain and aspiring men shall possess the highest seats in government, our country will stand in need of its experienced patriots to prevent its ruin." - Samuel Adams
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Re: what is Afib, really? [Slowman] [ In reply to ]
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I'm not sure I understand your question Dan. I do not specifically remember what the ER doc said about the increased risk of stroke, all I remember is him giving me that stern look (you know the ones doctors do) and saying "we don't like it when someone is in afib for more than 24 or 48 hours" (I can't remember the hours exactly). I guess I read that as 'I don't want to be sitting here at 48 hours continuous acute afib with a wife and 4 year old risking stroking out at 41 y.o.'.

Also, I do remember them putting me on coumadin for either 1 or 3 months after the first episode, again to reduce risk of stroke.

Trust me when I say I'm not for drugs as a first resort. The drugs they wanted to keep me on were awful. On top of the fact that there is now a pill for everything, including things I don't even think are things (restless leg syndrome, really??).

Perhaps there are 'levels' of afib - chronic vs. acute? I don't know I'm just a software guy, not a doctor. For something chronic and low key, perhaps doing nothing is the answer (that is where I'd start). If your chosen doctor thinks you are at higher risk of stroke for some reason, a blood thinner (aspirin or Rx) seems like a reasonable course of action if that works for you (my only side effect was being cold all the time, and I'm NEVER cold). At the end of the day, it's every individuals right/responsibility to weigh the risks and rewards of every procedure/prescription.
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Re: what is Afib, really? [kathy_caribe] [ In reply to ]
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kathy_caribe wrote:
after reading the "slowly killing" thread i started to wonder about real Afib. I always assumed my HRM was funky as VERY ocassionally (honestly like a handful of times in the last year) i'll hit 2teens or 170s for less than, say, i dunno, a minute? and then all goes back to normal (i don't think i've even gone over 160 at extreme effort). i always figured the HRM was funky as I didn't feel weird (i did pay attention to the last one) but it didn't feel terribly different and only mildly SOB so i chalked it up to a funky HRM or something other than the heart.

if you have AFIB you have other symptoms no? SOB or lightheadedness or something? and HRMs are known to do funky stuff like this right? or do i have incredibly infrequent AFIB?

Hi Kathy,

Please, please, get this checked out. There has been a lot of good information about atrial fibrillation in this thread, but that is NOT the only arrhythmia that can cause a heart rate to jump into the 200's. Other possibilities include supraventricular tachycardia, atrioventricular nodal reentry tachycardia (whew!), non-sustained ventricular tachycardia, and ventricular tachycardia (yes, the one that can turn into ventricular fibrillation = sudden cardiac death). A HRM can only show you the rate - it does not show you the EKG tracing that would distinguish between these arrhythmias. Holter monitors, event recorders, loop recorders - these devices can record the actual EKG tracings that occur over time, so a physician can correctly diagnose the arrhythmia, and develop the appropriate treatment.

Good luck,
Sharon

P.S. No, you do not have to have symptoms with atrial fib. Some of my patients can tell exactly when they go into afib, others have been in and out of afib for years without any knowledge.


Festina Lente
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Re: what is Afib, really? [Slowman] [ In reply to ]
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Slowman wrote:
blood goes into your atria. atria is the plural of atrium. you have 2 of them, these are 2 of the 4 chambers of your heart. the atrium pumps blood into your ventricles, and it's the ventricles that do the BIG work. atria fill ventricles, ventricles pump blood to your body.

as i remember it, right atrium pumps blood to right ventricle, right ventricle pumps blood to the lungs. blood returns from the lungs oxygenated, goes into the left atrium, is pumped to the left ventricle, then, whoosh, out it goes to the body. so the pa-bumb you hear when you listen to a heart beat is the left atrium (pa), then left ventricle (bump) or, in the case of an athlete, (bump!)

atrial fibrillation is when that "pa" isn't a pa but a pppp brrr ppp. literally mixed signals. it's like your flush toilet. the tank fills the bowl, then the bowl goes "whoosh". right after you flush, if you don't let the talk fill and you try to flush again, you don't get much whoosh. atrial fibrillation is like when you try to flush when the bowl hasn't yet sufficiently filled. you feel tired, you feel like you have sickle cell anemia. your tank (atrium) isn't filling your bowl (ventricle) so you don't get a good flush of blood throughout your body.

atrial fibrillation is not going to kill you, but it's a big annoyance. it's not a life killer, but it is a lifestyle killer. i'm 58, and i had my biggest troubles with a-fib when i was about 50. but i was living like the devil. i was pushing the throttle to the floor in every workout, drinking a man-sized homemade margarita every night, building this property every morning (i had just bought and moved onto the compound a few years earlier).

during WWII, doctors noticed a big spike in a-fib and it was soldiers on leave, drinking, partying, no sleep, 3-day binges. a-fib can be a permanent fixture in one's life, or it might be transitory and if you understand and can identify your triggers then it goes away. i have very few a-fib problems now, because i very rarely drink, i very closely watch my sleep, and i don't ever go really deep in workouts.

for those who have an a-fib problem that won't go away, there are a number of therapies, one of which is ablation, which is an invasive but non-surgical way of "shocking" the heart, trying to kill the offending part of the heart that's causing the arrhythmia. but there are other treatments being tested, such as enervating the pharyngeal nerve in the back of the throat, and if you've read what i wrote about pickle juice (front page) you'll see that this vaso-vagal reflex is really interesting.

but to the point of the velonews article, it's not just a-fib. it's also v-tach, i.e., ventricular tachycardia, and this is what sidelined greg welch. when you have an arrhythmia in your atria, that's annoying. when you have one in your ventricles, this is in the same family as a heart attack.

we will be writing more about this in the future on slowtwitch.

What an incredibly articulate and intelligent reply. Thank you for putting this into such easily comprehended terms (not withstanding the correction from other poster).

“Bloom wherever you are planted"
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Re: what is Afib, really? [docpeachey] [ In reply to ]
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wow, youse guys are amazing! i was traveling from CO to MN so I'm just starting to go through this thread. My symptoms are so super infrequent i can't imagine they could troubleshoot them but i do have a great cardiologist in my town so i will start wtih that. now to read the thread.

http://harvestmoon6.blogspot.com


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Re: what is Afib, really? [kathy_caribe] [ In reply to ]
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Damn it, now I'm getting WebMD paranoia here (finding matching symptons to a non existent condition).
I was doing a search trying to find info about my irregular HR readings from my last race and stopped on this thread.

So anyway, before I rush to the doctor (I have to go about something legit anyway)...

I noticed my HR was REAL high in my racing yesterday. Normally I expect a few bad readings, and spikes from a bad connection, bit this was persistent and caught my attention. But the persistence and symptoms makes me think it isn't AFib. My HR climbed normal, but just went way higher then what I thought my max was and stayed high. Bare in mind, this was a 4 stage MTB race at 7000' elevation (I live at about 1000') so the hardest event was about 30 minutes, half climbing (XC portion). The HR reacted similar in all four stages, the only spike was the downhill stage where I would expect.

I tested my HR several years ago by doing a warm up, then full sprint up a hill until I felt like I was going to die, then looked at the data. A VO2 treadmill test a year or so ago had a similar number (slightly lower, as I expected) at 185 or so. Yesterday I saw over 200! The data looks accurate. I see 208 twice on the hill climb stage, once for 10 seconds, the fastest I'm moving is 10 MPH and I'm pretty soaked in sweat by then.

Sound like a reason to panic (well, my type of panic, which is sleeping for everyone else)? Or just ignore it and assume my max HR is higher now then a few years ago (I am more fit now)?

Short background, sleep is an issue due to a shit work schedule (nights, over then the weekend, so races are after a full work 'day'), I don't drink, diet is meh. I'm mostly short distance after figuring out that I'm way better at mountain bike XC racing then tri and running (the Oly tri is still a love). 140.6 and 50k finisher in decent times. I don't normally race short distance with an HRM, so no historical data. I did ride 40k on my TT in 1:06 at 90°, 40% humidity, and 12 MPH wind (out and back, so tail wind heading out) and my HR looked normal; 159 average, 182 max.

My other, other, other, other ride has four legs.
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