Hi all,
Just wondering if there’s anyone on here that has been diagnosed with this.
I was yesterday and I was wondering reference to the effects on riding and general training.
FYI I’m 43 and have been training in some form for the past 20 years.
Thanks in advance for your posts.
IS
I had it, was stuck in it. Had an inversion and had ablation 8 weeks later. In 2013. 100% recovery. 4 firsts and 2 2nds in IM’s events since then. I had a great doctor who I trust.
There a few threads on here you can look at. Find a Doctor who understands your lifestyle and do exactly what he says. Physiologist imo, don’ t even deal with anybody but a physiologist.
Hey Iron Snorks,
Right there with ya! Diagnosed earlier this year.
I wrote a blog post on my experience with a-fib & current thoughts on treatment here…
https://www.alancouzens.com/blog/arrhythmias.html
Hope it’s helpful.
Very nice write up Alan, as per normal. Your website really is a gold mine for me. Constantly referring to it as I make decisions about my training.
Make sure you read Alan’s summary of his episode, and what research that goes along with it. My doc 35 years ago told me what I did was not healthy, as compared to people that just exercise. Back then he had been studying all of this along with a couple colleagues, and they determined that elite endurance athletes were 3 to 4 times more likely to end up with heart anomalies, seems it has been pushed out to 5 now. Like he said, if you live long enough, and keep exercising, you are quite likely to get some anomaly with your heart, just how it is.
Good news is that there is a lot you can do, pre and post. One thing a lot of people overlook, or just fail to mention, is that your mineral balance can be a huge factor, even the trigger in a lot of cases. When you go to the docs for this stuff, make sure you get a full workup on magnesium, sodium, potassium, and note the ranges for your particular tests. You could be right on the low end, and guess what, they tell you are normal. But I guarantee you, one 3 hour hot bike, or hour run, and you are way down in the danger range. I have been around a lot of people with this, and magnesium seems to be the most important, but the others are not far behind.
And often times it is a combination of factors, had a few beers the night before, hard workouts the prior week, shitty sleep, few cups of coffee in the morning to snap out of that funk, spouse or work is causing you added stress, and you have been eating shitty for a few days. Then BAM!!!, you have enough of the stresses and you are in Afib. So now that you know, start to really watch all these things and mitigate them. Dont let them pile up all together, and as others have said, you have to unload every once in awhile to get back to being fresh again…
good luck, a lot of people once they know the triggers, can stay off the ablation surgery for a very long time. And even after, you still have to watch yourself, you are not brand new again. It often will come back in time, if you live long enough that is…(-;
I’m now 58, I was diagnosed a little over 2 years ago when I went into persistent a-fib. For 2 years prior to that, I had been having some issues with shortness of breath, and a noticeable decline in performance (which my primary doctor just wrote off as “you’re getting older”). I was put on Eliquis, metoprolol, and flecainide to to try to regulate my heart and prevent clots. The combination of medication and a-fib left me constantly fatigued, and a 1 hour ride at 12mph was a 100% effort that would leave me completely exhausted. I had an ablation a little over a year ago, and even while still on the medication (and having gained a lot of weight due to inactivity) my first bike rides were significantly faster than I had done in a few years. I was briefly taken off the flecainide and metoprolol, but there were few (completely unnoticed by me) minor episodes in my sleep, so I was put back on flecainide. I have a stress echocardiogram scheduled next week, and will probably be taken off the flecainide after that.
I feel much better than I have in about 4 years, and when I get rid of all the weight I gained I expect to be faster than I was in my early 50s…
Hey snorks - I experienced this out of nowhere at age 42. Long story short - drugs had no effect, had to be cardioverted and put on flec and metro like others. They KILLED my energy level - I could barely function let alone work out (wasn’t as active then as I am now). Got off those drugs pretty quickly with the warning of ‘it’s probably going to come back’. It did come back a few months later, cardioverted again and then ablated. Absolutely zero ill effects from that, and no symptoms since. Quickly ramped up the training after that and last year completed about 12 races up to half distance - in the best shape of my life.
That was my experience. Unfortunately my wife also had an ablation for a different arrythmia (after mine), doctor killed her AV node and she now has a pacemaker. So ablations are not without risk, keep that in mind. But for me, working in consulting, there was no way I could operate while on those heart drugs.
Flip side is that lots of people function for a long time not even knowing they have afib. So your mileage may vary.
Balanced, informative and succinct. Thanks Alan. Did you get into the habit of recognising AF by feeling your pulse?
Cheers,
Mark57
Not new to this, had it a few times within the last 8 yrs. once it went away by itself after 2 days.
2 times I had to be cardioverted (electrodes), 3 weeks ago it went away with „pill in the pocket“ (flac), which comes, like Monty said, with some magnesium and Kalium to kick in better.
Most important is to know what’s going on and not just training or racing with it while having an episode. I’m on daily pills for years (blood thinner,blood pressure,heart rate you name it) which doesn’t have any negative effect as far as I can tell.
I had an ablation in 2010, 9 years after being diagnosed with a-fib. Riding and training when you never know if it will strike (go into a-fib) is a mental nightmare. When it does go into a-fib, you lose aobut 30% of blood flow and your training stops on a dime. Even low speed riding is miserable with a-fib. Generally speaking, a-fib gets worse over time. So it’s better to address it sooner than later. I’m convinced the ablation is the answer. The techniques and procedures are better today than they were in 2010, so there is no reason to wait, imho. Once you have recovered, which is about 3 or 4 months, there will not be any restrictions on your activity level, assuming you have no other diagnosed heart anomalies. So you can go wide open.
I had it, was stuck in it. Had an inversion and had ablation 8 weeks later. In 2013. 100% recovery. 4 firsts and 2 2nds in IM’s events since then. I had a great doctor who I trust.
There a few threads on here you can look at. Find a Doctor who understands your lifestyle and do exactly what he says. Physiologist imo, don’ t even deal with anybody but a physiologist.
Wow. So even after AF and ablation, the doc gave you the go ahead on IM races?
I’m 28, about to race my 16th IM, and the AF threads worry me a bit.
Thanks Aaron! Truly appreciate the kind words.
Balanced, informative and succinct. Thanks Alan. Did you get into the habit of recognising AF by feeling your pulse?
Cheers,
Mark57
Thanks Mark!
Honestly, when resting, most of the times I can feel episodes of a-fib directly in my chest. A pretty pronounced ‘fluttering’. But yeah, if I take my pulse it’s not regular. Generally not super fast (tachycardic) just out of rhythm. Like a bah-bump then a long pause then a bah-bah-bump - that sort of thing.
When exercising, I don’t feel the direct effects (palpitations) as much during an episode but it manifests as feeling like the effort is ‘a zone up’ on what’s normal for me & I see that in the HRM. A hill that’s normally 140bpm will all of a sudden be 160bpm with the accompaning feelings of a strong effort - heavy breathing etc at a pretty easy pace. I’ll generally walk at that point and it eventually resolves.
Best,
Make sure you read Alan’s summary of his episode, and what research that goes along with it. My doc 35 years ago told me what I did was not healthy, as compared to people that just exercise. Back then he had been studying all of this along with a couple colleagues, and they determined that elite endurance athletes were 3 to 4 times more likely to end up with heart anomalies, seems it has been pushed out to 5 now. Like he said, if you live long enough, and keep exercising, you are quite likely to get some anomaly with your heart, just how it is.
Good news is that there is a lot you can do, pre and post. One thing a lot of people overlook, or just fail to mention, is that your mineral balance can be a huge factor, even the trigger in a lot of cases. When you go to the docs for this stuff, make sure you get a full workup on magnesium, sodium, potassium, and note the ranges for your particular tests. You could be right on the low end, and guess what, they tell you are normal. But I guarantee you, one 3 hour hot bike, or hour run, and you are way down in the danger range. I have been around a lot of people with this, and magnesium seems to be the most important, but the others are not far behind.
And often times it is a combination of factors, had a few beers the night before, hard workouts the prior week, shitty sleep, few cups of coffee in the morning to snap out of that funk, spouse or work is causing you added stress, and you have been eating shitty for a few days. Then BAM!!!, you have enough of the stresses and you are in Afib. So now that you know, start to really watch all these things and mitigate them. Dont let them pile up all together, and as others have said, you have to unload every once in awhile to get back to being fresh again…
good luck, a lot of people once they know the triggers, can stay off the ablation surgery for a very long time. And even after, you still have to watch yourself, you are not brand new again. It often will come back in time, if you live long enough that is…(-;
I’d echo Monty’s point on the importance of triggers too. I don’t see “you have a-fib” as a binary deal. I’d agree, based on my experience to date, that you can do a lot to impact the incidence (for better or worse).
When I dialed my caffeine way down and my sleep way up, the incidence of the episodes definitely decreased. I also avoid ibuprofen & I try not to do any high intensity sessions late in the day. I also watch my HRV and back off without any hesitation on day/s that might be iffy. Another thing that I’ve tried based on some studies is dialing my antioxidants way up (I’d previously avoided antioxidant supps because of the research on antioxidants messing with training response but I figure, at this point, this is more important )
For the most part avoiding doing the things that my dumb younger self did on a regular basis - not listening to my body, taking huge amounts of caffeine, ridiculously early morning starts/late night finishes to get the training in, ‘Vitamin I’ to quiet down all the aches and pains etc
The episodes are still present but I’d say the above changes have definitely impacted the frequency for the better.
A better description as experienced “in the field” would be hard to come by Alan, thanks again.
The pulse of AF is descibed in medicine as “irreguarly irregular”. I’m not chanelling Donald Rumsfield here but the “bump” as you describe is the powerful contraction of the ventricle when it is full of blood. The atria are wobbling away so it is only after a relatively long delay following the previous ventricular contraction that the ventricle is full enough to produce a more powerful surge of blood. You feel that as a stronger “bump”. That is a very noticeable irregularity. The “bah, bah” is the feeling of a ventricle that is not full. Because the ventricles fire at a completely random time (as demonstrated by the GIF) the stronger surging “bump” irregularity happens at an irregular time. Hence irregulary irregular! It is the random timing of the “bump” that can help distinguish AF from other types of arrhthmias.
Cheers,
Mark57
PS I hate to be a pedant but “fluttering” is a term used when the atria are firing rapidly but REGULARLY. It would be difficult to feel anything at the pulse (or the heart as you do) if you had atrial flutter. It probably would be associated with other symptoms if the ventricles were firing too rapidly to fill properly, ie shortness of breath or going up a zone as you beautifully described!
PPS As you know AF does not have to be fast. Heart rate control as well as stroke prevention are the treatment aims if AF cannot be converted to a normal sinus rhythm.
PS I hate to be a pedant but “fluttering” is a term used when the atria are firing rapidly but REGULARLY. It would be difficult to feel anything at the pulse (or the heart as you do) if you had atrial flutter. It probably would be associated with other symptoms if the ventricles were firing too rapidly to fill properly, ie shortness of breath or going up a zone as you beautifully described!
PPS As you know AF does not have to be fast. Heart rate control as well as stroke prevention are the treatment aims if AF cannot be converted to a normal sinus rhythm.
Thanks Mark,
That’s a really good (& I think, important) point. During the early stages, I was under the misconception that a-fib was associated with a rapid heart beat and while Googling around, the term ‘atrial flutter’ seemed to sum up what I was feeling in my chest. But, as you importantly pointed out, a-fib doesn’t have to be fast. When I learned that fact, everything made a lot more sense.
Balanced, informative and succinct. Thanks Alan. Did you get into the habit of recognising AF by feeling your pulse?
Cheers,
Mark57
Thanks Mark!
Honestly, when resting, most of the times I can feel episodes of a-fib directly in my chest. A pretty pronounced ‘fluttering’. But yeah, if I take my pulse it’s not regular. Generally not super fast (tachycardic) just out of rhythm. Like a bah-bump then a long pause then a bah-bah-bump - that sort of thing.
When exercising, I don’t feel the direct effects (palpitations) as much during an episode but it manifests as feeling like the effort is ‘a zone up’ on what’s normal for me & I see that in the HRM. A hill that’s normally 140bpm will all of a sudden be 160bpm with the accompaning feelings of a strong effort - heavy breathing etc at a pretty easy pace. I’ll generally walk at that point and it eventually resolves.
Best,
when you are feeling an ‘irregularity’ to your pulse, you may or may not be having a-fib–
when there are lots of ectopic beats (pac’s or pvc’s-early extra beats from the top or bottom heart chambers), that can feel very similar to AF but it is NOT the same in terms of risk
and people may or may not be symptomatic-which is why rhythm control may not be needed or desired, but AC (anticoagulation), when indicated, will certainly lower the stroke risk-and an aspirin, although not a ‘blood thinner’ since it works on the platelets and makes the blood ‘slippery’, does work to somewhat lower the risk
the new apple phones are really terrific for seeing the rhythm-in addition to the many monitors that we use in cardiology
Balanced, informative and succinct. Thanks Alan. Did you get into the habit of recognising AF by feeling your pulse?
Cheers,
Mark57
Thanks Mark!
Honestly, when resting, most of the times I can feel episodes of a-fib directly in my chest. A pretty pronounced ‘fluttering’. But yeah, if I take my pulse it’s not regular. Generally not super fast (tachycardic) just out of rhythm. Like a bah-bump then a long pause then a bah-bah-bump - that sort of thing.
When exercising, I don’t feel the direct effects (palpitations) as much during an episode but it manifests as feeling like the effort is ‘a zone up’ on what’s normal for me & I see that in the HRM. A hill that’s normally 140bpm will all of a sudden be 160bpm with the accompaning feelings of a strong effort - heavy breathing etc at a pretty easy pace. I’ll generally walk at that point and it eventually resolves.
Best,
I used to have a stat back in my pacemaker rep days about how often medical personnel got their patients heart rhythms wrong by taking a pulse from a wrist, sooo I hesitate to suggest relying just on a pulse taken by feel. And A-fib can come in different forms especially if you include A-flutter which is distinctively different than A-Fib and can be text book regular. And you could have A-Fib and still have a pretty regular rate too. I myself have always had sinus arrhythmia (heart rate increases and decrease significantly with each breath) that is very distinct and prominent. But anyway, given that I am pretty geeky, I picked up an AliveCor Kardi so I can see the electrical interruption of my heart. I use it to assess my heart rate in the morning with something I can absolutely trust because I can read what it is reading electrically. The devices are made for a-fib but it is the perfect tool for the geek to get a solid electrical interpretation of their heart. Highly recommend for the typical older ST crowd who want to stay in tune with their bodies and be better able to communicate and understand with doctors down the road.
Super boring read, but Rapid Interpretation of EKG is a great book for understanding all of rhythms the heart can have. Definitely overkill but I thought someone out there might like it.
when you are feeling an ‘irregularity’ to your pulse, you may or may not be having a-fib–
when there are lots of ectopic beats (pac’s or pvc’s-early extra beats from the top or bottom heart chambers), that can feel very similar to AF but it is NOT the same in terms of risk
Agree. I hope you would also agree with me that both would warrant a check up.
and people may or may not be symptomatic-which is why rhythm control may not be needed or desired, but AC (anticoagulation), when indicated, will certainly lower the stroke risk-and an aspirin, although not a ‘blood thinner’ since it works on the platelets and makes the blood ‘slippery’, does work to somewhat lower the risk
Also agree but I did say “rate” control. I guess I was being more generic in my answer of controlling the rate of AF if it is too rapid…the setting in which I see it the most. Apologies to all if I’ve added to any confusion.
The point of my post was twofold.
- To thank AC for a well thought out summary on AF (I forgot to thank him for emphasising reducing the risks for those prone to AF)
- To get people to check their own pulses. It is not diagnostic as you and Thomas point out but it helps! At the very least it will confirm or deny your HRM and it will help your doc when you see him or her because by then the AF may be gone and your pulse is back to normal.
(“First, check your own pulse”, Samuel Shem “House of God”!).
Thanks for your thoughts Alan. One thing my doctor told me, and I try not to do more research outside of him, is that caffeine in normal amounts is not a trigger at all, as in zero. But he advised giving up alcohol almost entirely. Most of what else he advised has been said on this thread. At least a week off after IM races, and one day off a week.