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Re: Atrial Fibrillation ablation � recovery [mopdahl] [ In reply to ]
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If you don't mind saying how old are ya"ll
I'm 65
just curious
Mike
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Re: Atrial Fibrillation ablation � recovery [olddude] [ In reply to ]
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40. looking California but feeling Minnesota.
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Re: Atrial Fibrillation ablation – recovery [JAM] [ In reply to ]
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My post isn't about ablation (yet), but I might get there eventually, plus I think it could be useful to keep our a-fib posts consolidated. If this gets ignored or any of you ablation folks object to my post here, I'll start a separate thread.

I had my introduction to a-fib this weekend at age 44 during the run portion of a hard bike/run workout. I didn't recognize what was going on (just felt...bad), so I didn't get to the ER until the next morning. After a couple of hours of IV treatment, I returned to a normal sinus rhythm without the need to resort to the paddles for an electroshock.

For now, the doctor and I agreed on 81 g of aspirin per day plus 1 dose of metoprolol per day. I just went for my first post a-fib jog, and I have to say the results were a bit depressing. My HR was about 25 beats per minute lower than normal for the pace, and my RPE was a little higher. Some or all of the RPE might have been due to heat and humidity, but I don't think all of it was, especially when you add in that I hadn't exercised in close to 72 hours (in fact, I was in the hospital a lot of that time).

Have I basically just installed a governor on the system that will prevent me from going as fast as I could 3 days ago? My "math" is: I used to need 180 beats per minute to run a 6 minute mile, but now I'm only going to able to get to 160 beats per minute. The volume of blood pushed by my heart in each pump is unchanged, and so fewer beats = less blood = less oxygen = less speed. So, is this what I'm look at with the metoprolol or am reading too much into 1 workout?

Maybe I'm willing to live with that scenario if it's correct, but I want to gather information to figure that out. I have a follow up with my cardiologist in 1 month, and I will solicit his input also, but my guess is that slowtwitch may have more experience with attempting to train with a-fib than the doc.
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Re: Atrial Fibrillation ablation – recovery [mr. mike] [ In reply to ]
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Everyone is different, and how they react to the various treatments/meds is different as well, so take all the advice with a grain of salt. Speaking for myself, I couldn't train/race at a high level on the meds/pre surgery. On the meds my power was down about 20%, and my top end just wasn't there---at 160 bpm heavy fatigue would set it. This was while I was on Multaq, Atenol, and 2-3 other different/similar anti-arrythmia medications. At best they helped me convert to NSR quicker (4-6 hours) than no meds (12-18 hours), but they certainly didn't help me stay out of arrythmia. For me the final straw was that the meds just weren't working---my arrythmia was progressing to the point that I was having Vtac episodes almost weekly/EVERY hard cycling race, and a massive heart attack was becoming a very real possibility.

6 months out post surgery I'm experiencing arrythmia about 2x a month---always after digging a huge hole for myself on training rides/races in the middle of 16-20 hour training weeks. Onset is usually in the middle of the night following a huge training day, and I always convert within 6 hours or so. Totally liveable, but we'll see if it gets worse this summer----if so I'll do a followup surgery this fall. However please keep in mind a few things:
1. I'm destroying myself on the bike---it takes a 4-5 hour ride w/8-10k climbing for me to dig myself a big enough hole to become symptomatic.
2. My diet/recovery program sucks. I drink alot of wine, and 90% of my post-surgery arrythmia episodes are after drinking moderate to heavy amounts of alcohol as part of my own unique personal recovery program. I also eat WAY too much simple cargs/sweets, and the simple sugars + alcohol + electrolyte imbalance/dehydration all combine to create a personal arrythmia tsunami for me.
3. IF I were to cut out two of the three contributing factors listed above I'm sure I would rarely, if every experience it.

Plenty of elite athletes can race/train thru afib using medication to govern the occurrences. Personally I couldn't, but also because I refused to eliminate some of the contributing factors from my lifestyle.

____________
"There are two novels that can change a bookish fourteen-year old's life: The Lord of the Rings and Atlas Shrugged. One is a childish fantasy that often engenders a lifelong obsession with its unbelievable heroes, leading to an emotionally stunted, socially crippled adulthood, unable to deal with the real world. The other, of course, involves orcs." John Rogers
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Re: Atrial Fibrillation ablation – recovery [mr. mike] [ In reply to ]
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I have intermittent A Fib Current regiment low dose asa 1 daily
and Propafenone 300mg 2 as needed for A Fib
When first treated was on beta blocker(class Atenolol
metoprolol etc) and had a TIA also tried me on coumadin which
I didn't like because of what we do. They couldn't get that regulated
so they gave up (thank god) I can w/o and race in A Fib but performance
suffers. Did Clearwater 07 and noticed I was in A Fib about 6-8 miles in bike
backed off and finished. When I downloaded my HRM at home I actually
started about 5min in the swim.
My cardiologist feels ablation has not developed enough to get consistant
results
Good Luck in your quest
Mike
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Re: Atrial Fibrillation ablation – recovery [olddude] [ In reply to ]
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all I read was the summary, but this is a pretty interesting study.

http://www.medscape.com/viewarticle/577981

Well, it would be interesting if this link got you to it. Here's the abstract, cut and paste:

Introduction: Atrial fibrillation (AF) may occasionally affect athletes by impairing their ability to compete, and leading to noneligibility at prequalification screening. The impact of catheter ablation (CA) in restoring full competitive activity of athletes affected by AF is not known. The aim of our study was to investigate the effectiveness of CA of idiopathic AF in athletes with palpitations impairing physical performance and compromising eligibility for competitive activities.
Methods and Results: Twenty consecutive competitive athletes (all males; 44.4 ± 13.0 years) with disabling palpitations on the basis of idiopathic drug-refractory AF underwent 46 procedures (2.3 ± 0.4 per patient) according to a prospectively designed multiprocedural CA approach that consolidates pulmonary veins (PV) isolation through subsequent steps. Preablation, effort-induced AF could be documented in 13 patients (65%) during stress ECG and significantly reduced maximal effort capacity (176 ± 21 W), as compared with patients with no AF during effort (207 ± 43 W, P < 0.05). At the end of CA protocol, which also included ablation of atrial flutter (AFL) in 7 patients, 18 (90.0%) patients were free of AF and two (10.0%) reported short-lasting (minutes) episodes of palpitations during 36.1 ± 12.7 months follow-up. Compared with preablation, postablation maximal exercise capacity significantly improved (from 183 ± 32 to 218 ± 20 W, P < 0.02). All baseline quality of life (QoL) parameters pertinent to physical activity significantly improved (P < 0.05) at the end of CA protocol. All athletes obtained reeligibility and could effectively reinitiate sport activity.
Conclusions: AF, alone or in combination with AFL, may significantly impair maximal effort capacity thereby limiting competitive performance. Multiple PV isolation proved very effective in these patients to restore full competitive activity and allow reeligibility.
Last edited by: mr. mike: May 26, 10 14:23
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Re: Atrial Fibrillation ablation – recovery [mr. mike] [ In reply to ]
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Beta blockers definitely act as a governor on the heart. I had the same experience. Because drugs didn't work and changing my lifestyle didn't work (diet, alchohol, coffee consumption), I went for ablasion. No afib at all since. About nine weeks out. I am on flecainide and coumadin and hope to be off that within three to four weeks. Flecainide hinders training as it too seems to act like a governor on my heart. I cut the daily dose in half (to 100 mg per day rather than 200) and noticed a marked improvement in my capacity to push it a little running, but then went back to origianl prescribed dose as I want to follow the docs protocal. I think all these drugs are rough on our bodies. Maybe ask your doc for an alternative Rx which is not a beta blocker. Good luck
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Re: Atrial Fibrillation ablation – recovery [mr. mike] [ In reply to ]
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I'm all in favor with keeping a-fib posts in one thread. My story:

After training for and completing a marathon in November 07, I had made a pretty sizable jump in my running fitness - I was 50 at the time, and my running prowess was actually pretty laughable, but hey I was finally able to consistently go for runs at < 10:00min/mi pace. I had a routine physical in January 08 and found to be in persistant a-fib. No idea when I went into it, but I had only done endurance training since maybe the previous October, and I was unaware of any symptoms. Was referred to a cardiologist, and we had several discussions about possible treatments. He explained that I didn't want to stay in a-fib even though I felt fine, because one of the things that can happen with persistent a-fib is that the atrium enlarges over time and eventually weakens. Not to mention the blood clot risk from incomplete ejection.

The process of evaluation (Holter monitor, various echocardiograms, EKG under stress, etc.) took a period of months partly due to my reluctance to aggressively deal with it because I still didn't feel any effects, and what I had googled about some of the meds used to chemically control it scared the bejeesus out of me. Then the first group rides of the year started, and I immediately realized that things were amiss. If someone at the front really lifted the pace, or we got into some hills, I was gasping. So I decided on cardioversion. I only stayed sinus for 3 1/2 months, so my cardiologist recommended another cardioversion, but combined with Tikosyn/dofetilide (potassium channel blocker, twice daily), Lisinopril/prinivar and one regular aspirin daily. That was in August 08, and I have been sinus ever since; although I have had at least a couple of episodes that self-corrected and I have had occasional arrythmia that is not fibrillation. So fingers crossed, I am not yet a candidate for ablation.

What I have noticed - I seem to not be able to get my heart rate as high as I used to, say during a climb or at the track. Average heart rate for a given workout also seems to be lower. Although as I continue to train, I am actually faster overall than I was when first diagnosed. Resting heart rate seems to have stayed pretty constant. When I first started the meds, my blood pressure dropped a lot, to the point where I was getting light-headed on occasion. I bought one of those electronic blood pressure things, and would occasionally see as low as 80/50. This seems to have self-adjusted over time. This was from the Lisinopril/prinivar, which was prescribed to help the atrium recover. I was found to have significant enlargement of my atrium right before the first cardioversion, but it has dropped significantly and I am getting tested again this July.

There was a further complication from the aspirin. The aspirin is an insurance policy against clot risk from an occasional bout of a-fib. It's much less risky although less effective than Coumadin/warfarin, which I was on for several months but was insistent on stopping once I was sinus for a few months. But I happened to be one of the 20% or so of the population that develop stomach ulcers from daily aspirin use. Again, I wasn't immediately aware, but as I trained again for the marathon in the fall of 08, I was doing great up until the week before the marathon. I was tapering, but wanted to do some small stretches here and there at faster than marathon pace. These felt terrible. I was still sinus, so that wasn't it, so I figured I just needed to cool it as I had done some really hard training sessions in the build up. Stuff I hadn't done for the first one, like a long easy run but several miles at the end at marathon goal pace. At the marathon, I started off running by feel, and I found that I could only run comfortably at last year's pace. I was disappointed, but figured maybe I'd at least feel stronger at the end and be able to make some improvement. Hahahahaha. At mile 17, I felt really strange, and had the sensation that I was lapsing in and out of conciousness while running. So I walked a mile, and then went to try to run again. No. Walked/thumbed a ride back to the car, didn't do anything for a couple of days. But never recovered, really struggled to run even a couple of miles, and easy bike rides were down to like 14 mph. Back for my annual physical, and I was found to be severely anemic. Family doc thought it had to be bleeding, I didn't believe him. But wasn't getting any better, so finally went for colonoscopy and upper GI, and sure enough the aspirin had caused ulcers. Stopped the aspirin. It took many months to recover my blood count, but by the fall of last year I did a couple of tris and running races, and I'm maybe even a little faster yet now that I've been able to train consistently for the better part of a year. Actually podiumed at JerseyMan a week and a half ago.

So sorry to be long-winded, but someone out there might recognize similar symptoms and at least know what to ask his/her physician. Bottom line, if you even suspect some sort of heart arrythmia, get it checked as quickly as you can, and by a good cardiologist.

Brian

Brian

Gonna buy a fast car, put on my lead boots, take a long, long drive
I may end up spending all my money, but I'll still be alive
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Re: Atrial Fibrillation ablation – recovery [JAM] [ In reply to ]
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JAM wrote:
I recently underwent a pulmonary vein ablation for atrial fibrillation. I know some people here have had the same procedure – I was wondering what your recovery from the procedure was like?

The doctor said it was quite common to experience ‘healing arrhythmias’ after the procedure. How long does it take for these to go away? It’s been two weeks since the operation and, if anything, my bouts of Afib are getting worse instead of better. I’m having episodes that are as bad or worse than prior to the surgery, with continuous Afib for 10-15 hours. My non-arrhythmic heart rate now is quite elevated from my previous resting rate (it’s 70-80 now, rather than 40-50 BPM), and skipped beats/fluttering is quite common. I’m also experiencing some deep, dull pain in my heart and lungs, I assume from things healing the damage of surgery. I’m quite short of breath, to the point where even talking is difficult – I have to take breaks to breathe.

So, for anyone out there that has gone through this procedure, what was your recovery like? How long did you have post-procedure arrhythmias? What other pain and symptoms did you experience? How long did it take before you were able to live a ‘normal life’ (i.e. function at work, do household chores, etc.)? How long before you were able to exercise again?

I haven’t been able to train consistently or race for about 4 years now, and I haven’t been able to exercise at all for over 6 months. I’ve been dreaming about being able to just go for a walk or an easy bike ride. So far my recovery hasn’t been as smooth as I had hoped…

Someone give me some hope here!

Thanks,
J
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Re: Atrial Fibrillation ablation – recovery [NYCBugkiller] [ In reply to ]
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i have a-fib., have not had the ablation but have talked to a couple of doctors about the procedure. currently taking meds for the problem..
i know 4-5 people who have had it and most were back working out within a couple of weeks and they do not report episodes of A-fib.
Amanda Lavato had it done back in October. read her blog....
here is a video from a guy who had atrial flutter and he talks about his post op.
http://www.youtube.com/watch?v=XQG44Jjr0aw

hope you get better soon. i know how you feel...
jana



http://www.triontherunfitness.com
http://www.triontherun.com
http://www.ontheruntx.com
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Re: Atrial Fibrillation ablation – recovery [jana] [ In reply to ]
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Hi Jana. I don't know what I did but somehow all I did when I did my posting that you replied to was I just forwarded someone else's that I had read on here. I just had afib ablation done this passed Tuesday January 29th 2013 at St. Barnabas Hospital in New Jersey by Dr. David Dobesh. I had contemplated the surgery for the past 8 years and at last I did it. I had open heart for mitral regurgitation back 10 years ago when I was 36 and ever since I have had episodes of afib. I have also dealt with pvc's on a daily basis ever since. Sometimes the pvc's would last all day for days or even weeks. Then they would cut down to a few a day and then come back again. I noticed that when they got real close together, that is when I would get afib. I had Paroxysmal atrial fibrillation which is where I would go into afib and then they could bring me back out after maybe 30 minutes or more with drugs in the emergency room. 40mg of Cardizem was usually used to bring me out. I feel very lucky that I never had to be cardioverted. That doesn't look enjoyable. Well It's been three days since my afib ablation and I feel pretty miserable. I just feel sore, tired, weak and just a bit dizzy. Well I actually felt worse for the first two days because my heart was beating very erratic with pvc's. I was taking 100mg of Toprol every morning (which they lowered after surgery to 25mg) along with 100mg of Flecainide in the am and another 100mg at night. They just added 150mg of Pradaxa to the mix. 150 in the morning and another 150 at night. They told me that thirty days after surgery they will be dumping one of my meds and then after 60 days they will dump another and then after 90 they will dump the Pradaxa. Sounds great to me considering I have been taking 2 of these meds for the past ten years. I am so looking forward to life without drugs and afib. I feel very positive about it. The doc told me that when I was under and they induced afib that he had noticed that they afib was gernerating from more places that he had originally anticipated. That caused the operation to go from a normal 4 hours to 8 hours. He also told me he feels very confident that I won't be needing a 2nd treatment because of all the areas that were initially treated. The operation I had is actually called Robotic-Assisted Catheter Ablation. You can check it out at this link http://www.barnabashealth.org/services/cardiac/physicians/beat_dec12.html . Good luck with your decision Jana. I feel positive that I made the right one. You can email me if you have any questions or concerns. JimmyTag@hotmail.com.


James
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Re: Atrial Fibrillation ablation – recovery [NYCBugkiller] [ In reply to ]
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Did you make a 100% recovery fitness wise from ablation? I just had it a week ago and my resting HR is now 60 and was 40. Did you experience anything like that after surgery?
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Re: Atrial Fibrillation ablation – recovery [JAM] [ In reply to ]
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Did you make a 100% recovery fitness wise from ablation eventually? I just had it a week ago and my resting HR is now 60 and was 40. Did you experience anything like that after surgery? How long before you were back close to pre surgery fitness?
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Re: Atrial Fibrillation ablation – recovery [jjh] [ In reply to ]
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Had my first one in March of '11. They kept me on my meds (flecanaide and metoprolal) during the recovery. No arrhythmias. Took me off the meds at 6 week check up. Ran a half marathon in May. Boom, a-fib back strong again. Back on meds, scheduled another ablation. Got that one in July. Doc said it was basically "touch up warranty work." When they burn a lot, it starts to get enflamed and scarring. So that will often mask where there are misfires during the procedure. So going back in allowed them to get the places they missed before.

After the second one they took me off meds. Two years later I'm back on flecanaide again for mild symptoms. I don't want to go in for a 3rd procedure since the symptoms are not nearly the levels that they were before (I was basically useless when they were going on and it was becoming more and more frequent through '10 and early '11). I'm running 3 - 4 days a week and occassionally getting on the bike. But not racing anymore. I know I'll never be as fast as a I was, nor will I be able to go long again. So I'm resigned to that fact and have accepted it and just try to stay healthy and in somewhat good shape.

_____________________________________________
Rick, "Retired" hobbyist athlete
Trying to come back slowly from acute A-Fib
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Re: Atrial Fibrillation ablation – recovery [jjh] [ In reply to ]
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Well I wasn't able to work out that much before or right after surgery because I was afraid of getting my heart rate up which would usually send me into afib. Now almost 9 months after surgery a push myself lifting weights occasionally and walking a lot. Well I keep a pedometer on me and I try to average over 5000 steps each day. When I go golfing I usually average like 18,000. I am only 47 so I am pretty active and it hasn't really set me back much at all. To this day I am very happy I had the operation. I still get pvc's and pac's since surgery which are sometimes bothersome but I am learning to deal with them. Doctors have always told me that they are benign and not life threatening anyway. I haven't taken any drugs in the past 6 months and that is the best parts of my recovery. I was so looking forward to getting rid of them. It's such a change in my life to wake up every day and not have to look at the clock making sure I take my meds. Overall, I suggest to anyone that if you have afib, definitely consider having afib ablation. Good luck.
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Re: Atrial Fibrillation ablation – recovery [jjh] [ In reply to ]
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A friend had ablation a couple of years back. He quickly got back on the bike and, as far as I can tell, has fully recovered his pre-afib power. His resting HR is higher than before. As I recall it went up from around 28 into the low 40s. He rides ~15hrs/wk.
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Re: Atrial Fibrillation ablation – recovery [JAM] [ In reply to ]
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I had one in 2001 when there was only about two places in the country you could get them done. My afib prior to ablation pretty much halted my ability to compete. I was fortunate enough to have Marcus Wharton (then at Duke University Medical Center) supervise mine and at the time one of the leading pioneers in the field. I was back to full go about 6 weeks later with no complications. The procedure worked 99.9999% of the time with only a few bouts of rhythm disturbance lasting less than a minute in training and racing for about eight years after. The afib has started to come back in the last two years. At IM Wisconsin a couple weeks ago I was in afib for about 5 - 10 minutes on the bike, recovered to normal sinus and then for the first 3 miles of the run and got it back and was good for the remainder of the event. It killed my bike times at two other races this year as well but the duration was longer. I was in afib for about 20 miles of Buffalo Springs 70.3. What my EP told me was they are finding the procedure seems to hold well for 5 - 7 years and then starts to come back. One thing that really helps reduce the duration and extent of the afib events is taurine and l-arginine. This works fairly well and anyone listening here should at least give it a try. You need to take 6 - 7 grams , yes grams, of taurine and l-arginine 2 x a day along with 500 mg of magnesium. All are inexpensive and can be found at The Vitamin Shop. I wished I had put a dose in my T-2 bag at IMWI. This therapy is the only reason I have not yet gone in for a second ablation.
So back to your question. After my procedure I did have some flutter and small events for several weeks but they eventually went away. The procedure is now so much better than when I had it done but I would still make sure the doc doing it has done several hundred first.
Also for you afibbers avoid the following leading up to a race: tomato sauce, garlic, peppers of any kind, dark chocolate, red wine, fish oil capsules, too much caffeine, stress, or any foods that give you heart burn especially if your afib might be vagally mediated. Do not slug down cold drinks during your event sip them or store on board and let them warm up a bit. This sets some of us off frequently.

Regards and good luck.

Jim

Jim Lukanich
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Re: Atrial Fibrillation ablation – recovery [jjh] [ In reply to ]
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"Did you make a 100% recovery fitness wise from ablation eventually? I just had it a week ago and my resting HR is now 60 and was 40. Did you experience anything like that after surgery? How long before you were back close to pre surgery fitness? "


I'm now at a bit less than 4 years after my two ablation surgeries for afib. My resting hear rate increased immediately after the procedure and has remained higher than it was pre-operation. before the ablations I had a resting HR in the low 40s. immediately after the operations it was in the 70s, i'm now down to upper 50s, low 60s, depending on my fatigue levels. One doctor I talked to said it is common to have a permanent increase in resting HR after the ablations.


My maximum HR has also decreased ~10 beats or so (though I am also 5 or 6 years older than when I was last able to really exercise at intensity).


So I haven't made 100% recovery of my fitness after my procedures. But my fitness before them was pretty high. One the positive side, I haven't had any incidence of afib since the second ablation, and I am able to exercise regularly for ~6-15 hours/week. I'm fit, but not quite as lean and fast as I was six or seven years ago (I'm currently 39, so there might be a bit of performance degradation due to age and career and family responsibilities as well...). I also don't have quite the same motivation to pay $500+ a year in advance for the privilege of spending my only vacation either standing in line or being swallowed up by drafting packs. :) I don't really race anymore, but I don't really miss it either. staying fit and healthy is reward enough for me.


I still feel like I'm getting stronger and healthier as time goes on - I think i'm still recovering fitness from the operations. For instance, up until 6-8 months ago, I was still getting PVCs and other 'harder, heavier' heart beats always associated with fatigue and harder exercise sessions. Those seem to have gone away almost entirely now, and I've recently bumped the cycling back up to 6+ hour hard rides on the weekend without issue.


The one thing that really hasn't returned post-ablation is my ability to really really push myself. It feels like my upper end HR has been cut off. I just can't go really hard anymore. But, realistically, I'm old, and going that hard hurts and probably isn't that healthy for you anyway- I'm probably better off with an internal governor.


So, hang in there, recovery can be a long (multiple years) time, but hopefully you'll continue to get stronger and remain free of afib.


Good luck!
Jeff
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Re: Atrial Fibrillation ablation – recovery [JAM] [ In reply to ]
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I am struggling through a lot of the same symptoms, my question is this: After all that you have endured, and BIG congrats on that, is there anything you can share as to the secrets of proper diagnosis? It is costing me my small fortune to get it figured out. Thanks and again, way to go!
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Re: Atrial Fibrillation ablation – recovery [kml] [ In reply to ]
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For me diagnosis was extremely simple as I was in a fib in the doctor's office and had been in it for weeks and my power dropped 30-40%. Get the best cardiologist in your town.

If you get the surgery I got one piece of advice for everybody, Pediatric Weenie Cathether!!!
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Re: Atrial Fibrillation ablation – recovery [kml] [ In reply to ]
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"After all that you have endured, and BIG congrats on that, is there anything you can share as to the secrets of proper diagnosis? It is costing me my small fortune to get it figured out."

by the secrets of proper diagnosis, do you mean how the diagnosis of afib was finally achieved?

assuming this is the case - if you search for posts by me (JAM) you can dig up pretty much my whole history of heart issues.

The short answer is have your girlfriend leave you, go on a multi-week angst-fueled orgy of excessive endurance exercise and sleep deprivation, wait until you're in afib, then go to the emergency room complaining of heart problems and be hooked up to an ECG faster than you can think. Then you finally have an ECG trace you can show your disbelieving cardiologist demonstrating that there is, in fact, a problem, even though their various tests over the last few years didn't find anything.

In a bit more detail-

I developed a heart arrhythmia at a very early age (like 7 or so) that was mostly controlled via medication until my early 20s. At that point it was frequent enough that I underwent an ablation for what was later called 'Wolfe-Parkinson-White type II syndrome' (spelling might be off). My understanding is this was a single-point ablation to fry a node in my left atrium, a much less complicated procedure than what is used to treat afib. The side effect of this is I was highly sensitized to heart issues, and had confidence in what did and did not feel right with my heart beat.

At this point I was symptom-free and had the best ~6 years of my athletic life filled with excessive ironman racing, getting faster that I ever believed possible. At some point I started getting weird fatigue symptoms and occasional highly elevated 'jumpy' heart rates with excessive intensive endurance exercise. With my history of heart problems I of course went to see a cardiologist and got hooked up to the treadmill stress test, the 24 hour holter monitor, and the month-long event recorder. None of these showed an issue.

After a few more years, a few different cardiologists, and a bunch more testing the afib episodes got a little more frequent (every few months, rather than once a year) and a bit longer duration (10s of minutes, rather than a few minutes). It was during this time that I had an episode trigger after a hard swim on little sleep, and it lasted long enough that I was able to get to an emergency room to get that 'proof' that there was a problem.

I waited another couple of years for things to get worse before I decided the risk of surgery was worth it due to the impact the (now almost daily and hours-long) afib episodes were having on my life.

I'm afraid I'm not much help in how to diagnosis the problem cheaply. The best I can offer there is stress yourself out as much as possible and make sure an emergency room is handy (disclaimer- i am not a medical professional and I don't actually recommend this as a method of diagnosing heart problems!). But I can at least offer some sympathy and my experience - It can take a long time for modern medical science to track down and diagnose intermittent medical problems. In my experience, how I felt was a much more sensitive test than anything the doctors were able to do.

I have heard of a small, implantable monitor that can be used to diagnose heart issues with more confidence. if you're really having issues this might be something that you could discuss with you cardiologist. The one I've heard about is the Medtronic Reveal:
http://www.medtronic.com/...ing/device/index.htm)

(Disclaimer: I work for Medtronic, but in an unrelated business unit. I don't know anything about this device other than seeing it at a product fair once)

Best of luck, and know that you're not alone.
Jeff
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Re: Atrial Fibrillation ablation – recovery [JAM] [ In reply to ]
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Sounds so similar (even the GF part) except mine is HR too slow (low). There is no pain just a dull thump in center of chest, lightheadedness and neck, jaw irritation. This has been a constant since Feb. PCP said take ibuprofen and get more sleep. EKGs show nothing out of ordinary. All fitness is gone, I struggled yesterday on a flat 5K. Two trips to ER in last three years drained the account (recessions didn't help either), nobody knows what it is, latest diagnosis is idiopathic pericarditis. The next round of testing is estimated to be 10K which I do not have. I read with great interest your story and those of others thinking I should sell the farm and hire a cardiologist, but I keep hoping that one day I'll wake up and be 'normal' again. It appears that I my qualify for some assistance with the affordable health care, so I am keeping fingers crossed. Good luck mate, sounds like you are fighting the good fight. My last Ironman I took a DNF on the run in Penticton. There is not a day that passes that I wish I could have that decision back.
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Re: Atrial Fibrillation ablation – recovery [NYCBugkiller] [ In reply to ]
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Hey James.
glad to hear you are doing better. I was wondering how your recovery was going. I am still "waiting" on making my decision. still taking my meds. still get A-fib every couple of weeks....
do not exercise at all. tried running ( even walking) a couple of times but went into A-fib when my heart rate went up to 100+.
I am hoping I wake up one morning and my life and heart are back to normal and this was all a nightmare....( I know, that's not going to happen)
OR they perfect the ablation to be easier, quicker and more successful... I hear of people having 1, 2 or 3 ablations before it stops the a fib.
I would love to be able to train and race again. My life has changed so drastically in the past year and a half.
jana



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Re: Atrial Fibrillation ablation – recovery [jana] [ In reply to ]
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Jana I honestly think you should just do it. It's a routine operation for allot of these doctors these days. My surgeon told me that there isn't any downside to having this procedure done. I was thinking like you and just watching the miserable years pass me by. I think I was lucky with only having to have it done once. You could be as well. Recovery really isn't that bad. Just a couple small incisions between your legs where they insert the catheter. You'll be fine. Life is too short to live it worrying about afib. Go for it and let me hear the results.

James
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Re: Atrial Fibrillation ablation – recovery [jana] [ In reply to ]
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Just my 2 cents here. Three years ago when training for my 4th IMC I went into a-fib. One the of the 6% or so, that they have no idea why as my heart, valves, vessels are all in great shape. After my 3rd cardioversion last Dec, I went in this past Feb for my ablation. 6 hour procedure, 120 burns. No discomfort, no pain before or after the procedure. Stayed overnight and went home the next day. 2 weeks after started lifting weights again, and started taking walks. 4 weeks after on the trainer and six weeks started run/walking. A few high HR spikes at first. Now it's run 3 times a week, bike twice and lifting 3 times. Not in training, just trying to be active. Slower than I was, but more mental now, and nervous about pushing it. HR is higher, but before going a-fib my HR was really low, and was lower when I was on drugs.

5 days before the procedure stopped taking my Multaq and haven't been on it since. Off the Coumadin since May, and just on baby aspirin now. A-fib free. Next follow up in 5 months. Procedure was spendy, $74,000. Insurance cut it down to $66,000. My part was $2,000, my out-of-pocket max.
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