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Atrial Fibrillation - post ablation
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Hi, I was diagnosed with AF in May 2011 It makes it very hard to train. I will get an episode a day for 2 weeks, then nothing for a few days, then more episodes. I sometime needs a cardioversion to get my heart back in rhythm.

I will get a cryoablation in the next few months, so hopefully that will solve my problem.

I haven't done an Ironman yet, only half Ironman, but I'm planning on doing an Ironman in 2013, if my heart can handle the training...

Those of you who got the ablation/cryoablation, were you able to get back into Ironman shape and compete it one? How long after the ablation were you able to resume training?

Thanks
Eric

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Re: Atrial Fibrillation - post ablation [butcher] [ In reply to ]
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I have had 2 ablations and I finally did my 1st Ironman! I am finally an IRONMAN!!
It was 4 years in the making and yes your heart can handle it. Train smart and listen to your body
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Re: Atrial Fibrillation - post ablation [coryalps] [ In reply to ]
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Congratulations! You're an inspiration. You must have good doctors.
Last edited by: TriBeer2: Oct 27, 11 14:29
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Re: Atrial Fibrillation - post ablation [TriBeer2] [ In reply to ]
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A GREAT COACH-DR PHIL SKIBA OF PHYSFARM who listened and trained me right.
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Re: Atrial Fibrillation - post ablation [butcher] [ In reply to ]
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I had a heart ablation carried out a number of years ago to deal with tachycardia issues (HR hitting 230's during episode's) caused by a tertiary pathway.

funny thing was they sent for me a "stress test" as part of the pre-op investigations which I completed without evening hitting my anaerobic threshold. i guess the idea of a "stress test" for sedentary, and usually older people isn't quite the same as what regualr ST'ers would have in mind!

I think this might be different to atrial fibrillation but the ablation has worked and I have been training away ever since, not for ironmans, but I have done plenty of sprint, oly and duathlon races
Last edited by: shouldbeworking: Oct 28, 11 6:00
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Re: Atrial Fibrillation - post ablation [coryalps] [ In reply to ]
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Congratulation on your Ironman.. this is great. Which one did you do?

How long after the ablation were you able to resume training (long run/ride, high intensity)?

Thanks
Eric
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Re: Atrial Fibrillation - post ablation [shouldbeworking] [ In reply to ]
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Was your tachycardia called Atrial Flutter? I have that also and they will fix it at the same time.

Eric
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Re: Atrial Fibrillation - post ablation [butcher] [ In reply to ]
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I don't recall it every being given a specific name.

I had always referred to it as palipatations but a doc friend of mine referred to as SVT (supra ventricular tachycardia). however, that wasn't a clinical diagnosis and VT / SVT is potentially quite serious so I don't think that is what I had.

re getting back to training, I don't remember what the instructions were post-op, but there was never any suggestion that I would have to give up competitive sport / training. presumably I took a few months off, but i don't really remember
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Re: Atrial Fibrillation - post ablation [butcher] [ In reply to ]
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tachycardia generally refers only, if i'm not mistaken, to ventricular beats. a-flutter and a-fib are arrhythmias specific to the two atria, rather than to ventricles.


Dan Empfield
aka Slowman
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Re: Atrial Fibrillation - post ablation [Slowman] [ In reply to ]
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Slowman wrote:
tachycardia generally refers only, if i'm not mistaken, to ventricular beats. a-flutter and a-fib are arrhythmias specific to the two atria, rather than to ventricles.

Incorrect. Tachycardia is a generic term referring to any abnormal increased heart rate regardless of cause. A-fib, v-fib, a-flutter, v-tach, WPW are more specific causes of tachycardia.
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Re: Atrial Fibrillation - post ablation [white wizzard] [ In reply to ]
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"Incorrect."

well, then, there you go. teaches me to keep my mouth shut about stuff i don't know enough about.



Dan Empfield
aka Slowman
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Re: Atrial Fibrillation - post ablation [butcher] [ In reply to ]
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Since extreme endurance training and racing has a well documented association with atrial arrythmias why would you want to do an Ironman?

Seems rather foolish to me.
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Re: Atrial Fibrillation - post ablation [Slowman] [ In reply to ]
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Slowman wrote:
"Incorrect."

well, then, there you go. teaches me to keep my mouth shut about stuff i don't know enough about.

It's OK. You are a medical lay person. We give fancy names to simple things to make us look smarter than we really are.
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Re: Atrial Fibrillation - post ablation [white wizzard] [ In reply to ]
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I've always wanted to do an Ironman.

If I understand correctly, it's relatively dangerous for anybody to do an Ironman. If my doctor tells me it's not more dangerous for me that it is for anybody else, I'll do it. If he tells me it's more risky for me because of my AFIB, I won't do it.

Thanks for the feedback everybody.
Eric
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Re: Atrial Fibrillation - post ablation [butcher] [ In reply to ]
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had ablation for a-fib and flutter April 28; have not had any episodes since and have returned to training
MRI showed best example of what they wanted heart to look like after the fact - said they were going to use photos in publication
feel good - but 5 weeks ago they call and say they want me on metoprolol - last monitor reading showed
abnormal beat from lower heart

metoprolol took a couple of weeks to adjust to - headaches, fatigue but seem to have subsided
see doc's in two weeks for another mri and consultation - hope to learn more; sure they'll want me to wear monitor again for a week
at some point - not sure why I'm been so accepting and in no rush to know more - maybe just to bug the wife
"i'm in heart failure leave me alone"
"is your life insurance paid up?"
one body, one mind, one swing through life
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Re: Atrial Fibrillation - post ablation [butcher] [ In reply to ]
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butcher wrote:
I've always wanted to do an Ironman.

If I understand correctly, it's relatively dangerous for anybody to do an Ironman. If my doctor tells me it's not more dangerous for me that it is for anybody else, I'll do it. If he tells me it's more risky for me because of my AFIB, I won't do it.

Thanks for the feedback everybody.
Eric

You are rolling the dice my friend. But hey, what's the worst that could happen. It's only your heart.
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Re: Atrial Fibrillation - post ablation [butcher] [ In reply to ]
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Eric,

The question you need to ask your EP cardiologist i.e. the person that ablates your afib focus- is that if post ablation, you are still at risk for recurrent afib with sustained exercise. Typically with those that we cardiovert with afib, we admonish to avoid extreme increases if heart rate. And by definition, training for high performance i.e. triathlons is considered so. Especially for those that are older, the concern is that the increased heart rate of high demand exercise makes you prone to having another bout of afib. The expertise I don't have is what happens post ablation. That is something that you need to ask your EP cardiologist. Oh yeah, also just a warning that finding the afib nidus may take some time so just plan on chillling for a while during the procedure. Best of luck!
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Re: Atrial Fibrillation - post ablation [heyMartin] [ In reply to ]
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They put me on metropolol for a while and I hated it. I was always tired, and it didn't work anyway, so they put me on bisoprolol and another I can't remember the name of.

Good luck..
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Re: Atrial Fibrillation - post ablation [gasman] [ In reply to ]
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gasman wrote:
Eric,

The question you need to ask your EP cardiologist i.e. the person that ablates your afib focus- is that if post ablation, you are still at risk for recurrent afib with sustained exercise. Typically with those that we cardiovert with afib, we admonish to avoid extreme increases if heart rate. And by definition, training for high performance i.e. triathlons is considered so. Especially for those that are older, the concern is that the increased heart rate of high demand exercise makes you prone to having another bout of afib. The expertise I don't have is what happens post ablation. That is something that you need to ask your EP cardiologist. Oh yeah, also just a warning that finding the afib nidus may take some time so just plan on chillling for a while during the procedure. Best of luck!

Cardiovert a-fib? That's a great way to give someone a stroke especially w/ a known hx of a-fib. Thats why they created Cardizem.
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Re: Atrial Fibrillation - post ablation [white wizzard] [ In reply to ]
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Just by curiosity, white wizzard, are you an electrophysiologist or cardiologist? You seem to know enough about AFIB to be convinced that I'll put myself in trouble. Have you ever heard of someone getting an cryoablation and then die in an endurance event later on? I'm only 38, does it change how you think, or is age irrelevant?

Thanks for your concerns,
Eric
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Re: Atrial Fibrillation - post ablation [gasman] [ In reply to ]
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Thanks Gasman, I'll make sure to print this tread to remember exactly what I need to ask.. :)

Thanks
Eric
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Re: Atrial Fibrillation - post ablation [butcher] [ In reply to ]
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Hi Eric-

I've had three ablations in my life, one in '99 for WPW (wolff-parkinson-white type II) and two for Afib in late 2009. The Afib ablations were pulmonary vein isolation using an RF ablation catheter. As you mentioned, they also did the A-flutter ablation line as a bonus while they were in there. At the time of the Afib ablations I was 35 year old Male with about 18 years of triathlon training, 5 IMs with a fairly consistent 10:30 time.

Recovery from the WPW ablation was fairly immediate - swimming within a couple of weeks, half IM (pretty slow!) at 5 weeks, and my first IM later that summer. Recovery from the afib ablations was an entirely different matter. Leading up to the Afib ablations my fitness was at an all-time low from three years of decreasing exercise due to increasing severity of Afib, with about 6 months totally sedentary prior to the procedures. it's fairly standard to need multiple ablations to fully 'cure' the afib arrythmias. My two were ~4 months apart. Recovery was (and still is) a long long process. post procedure ~ 1 or more months totally sedentary, then walking on a treadmill, working up to slow jogging over a multiple-week time period, etc. Then gradually increasing duration and/or intensity over the last two years. After the first ablation I was still having Afib episodes at 3 months, always associated with exercise (though it was much much better than it was prior to the ablation), so we decided to go ahead with another ablation. The Doctor said he re-burned almost everything the second time, as there had been a lot of healing and return of conductivity to the tissue. The Afib ablations do a lot of damage inside of your heart - it's much different from a single-point ablation for other arrythmias, or the line for A-flutter.

I did have frequent PVCs (premature ventricular contractions) immediately after the procedure and continuing with decreasing frequency for a year or more. These are fairly common in many people, but can be extremely disconcerting (a lurching/skipped beat feeling in your heart rate) and were specially worrisome for me as they were a common signal that I was going into Afib prior to the ablations. These PVCs have now decreased to the point where they rarely happen (~1/month or so now) and are almost always associated with increased fatigue or stress (both from work or training loads).

For the first year after the procedures I fatigued easily, had no capability for hard efforts, and recovered poorly. if I did do a longer/harder ride or something I would be exhausted for a week or more recovering from it. that has improved gradually this summer to the point where I feel pretty close recovery-wise to where I was prior to the afib problems (though I'm now 5+ years older). I still do not have the upper-end ability to go hard that I did prior to the ablations. My resting pulse has permanently increased from the high 30's to low 40's up to mid to high 50's BPM now - apparently this is a common side effect of the ablations. My max HR spent a year at 15-20 BPM lower than pre-procedures. This summer my max HR and ability to sustain it has gradually crept back up to close to pre-operation levels.

This summer I've gotten back up to 10+ hrs/week of consistent exercise, done several rides of 5-7 hrs length, swam a 55 min IM split (as a relay), and still can't run worth beans (I sucked prior to the ablations). I'm at the point where I don't think about my heart very much - where last year I was very focused/worried about it every workout). I have hopes of a spring marathon and late summer IM next year... in short, I think I'm back to the point where longer consistent training can be a happy and healthy part of my life.

Other people on this forum have reported faster recovery from afib ablations than I've experienced, but I would argue strongly for taking things slowly and carefully. if you don't have an IM fitness base going into the procedure I would guess it might take a couple of years to get back to the point where you can train consistently enough to get ready for an IM. so... an IM could definitely be in your future, but 2013 may be too early depending on your starting fitness level and how your recovery goes.

The ablations are not without risk and the recovery has been a lengthy process, but having the procedures done was the best thing I could have done. It is hard to explain how much living with consistent Afib sucks to people who haven't experienced it.

If you haven't already, search this forum for Afib, Arrythmia, etc. There are a lot of posts in the archives by me and others about the issues we're gone through. Please send me a PM if there is anything you have questions about. Consistent Afib is a life-altering disease, and the ablation procedure seems to currently be the best way to address it for active people.

Good luck!
J
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Re: Atrial Fibrillation - post ablation [JAM] [ In reply to ]
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Hi Jam, thank you very much for this detailed reply. It's very comforting to know that it can be done, and also it's good to know that it might take me longer to recover than expected. If I have to wait until 2013 to do it, I'll wait.

BTW, I also have PVCs and they often lead to AFIB. I think that the PVCs are caused by the medication, but I might be wrong..

Thanks again.
Eric
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Re: Atrial Fibrillation - post ablation [gasman] [ In reply to ]
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Eric - gasman is correct. Very correct actually. Ablation for a-fib is just a different animal than the other diagnoses discussed above. In some cases, if there's a recurrence (of which you already know is a higher probability in a-fib patients), it can be pretty far down the road following treatment. That said, we are simply internet posters who have your best interests "at heart." You'll get the answer that's correct for you and your specific pathology from the physician who provides your care and knows the details of your case.

We, of course, wish you all the best!

John

John H. Post, III, MD
Medical Advisor, TrainingPeaks
Ironman Certified Coach
Contributor, IRONMAN.com, LAVA digital
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Re: Atrial Fibrillation - post ablation [johnpostmd] [ In reply to ]
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Hi John, thanks for the reply.

When you say far down the road, how far down the road do you mean? 1 year? 2 years?

Thanks
Eric
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