I had cardioversion yesterday after a bit of afib last Friday. Yesterday, before the cardioversion, my heart rate was jumping between 39 and 99 bpm just reclined in bed. This morning, after cardioversion, my resting heart rate is back to a normal range of 41 bpm up to 44 bpm during a Polar Fit Test. (My Fit Test this a.m. was 59, which isn’t too bad for a 70 year old.)
However, I’m very worried about relapse. The relapse rates are rather high, though most people getting cardioversion are much heavier and less fit than me.
Has anyone here had a cardioversion recently, and if so, did you relapse?
Btw, afib is really awful to live with. I wouldn’t wish it on that 40K cheater, YOU KNOW WHO.
Cardioversion gets you back to a normal rhythm but does nothing to keep you there, so yes, your likelihood of going out of rhythm again is significant unless you do something to address the arrhythmia, such as medication or ablation.
<------ Two ablations done at Penn by Dr. Marchlinski’s group (supposed to be the best in the business).
I still have episodes, but they are minor compared to when I had 12 - 14 hour ones where I could barely walk or stand up quickly without almost passing out.
Never cardioverted. Used two different beta blockers over time and fleccanaide (sp). When I used the fleccanaide and metoprolol together twice a day, it would control it but I felt like dog azz all the time and exhausted.
I ran a half marathon last year on zero training and finished in 1:59. I was ecstatic. To put it in perspective? I usually would run in the 1:25 range for an open half.
Yes, a-fib really really sucks. (Although it would be a tough call whether or not I’d want a certain nut suckin’ poster to have it. But even I am not quite that cruel).
Not a doctor, but i play one at work. Never had a fib, but have dealt with plenty of people who have. Cardioversion is only a temporary fix. You need to go to the root of the problem-electrical conduction pathway that is wrong- to give you a more permanent solution. Drugs, ablation, pacer may all be options.
To me this is one of the least talked about, yet most serious and debilitating problems out there. It affects many, many otherwise healthy people. There needs to be far more research done on this than there is. We spend so much time studying why obese people are getting diabetes and smokers getting cancer than on stuff like this imo.
Wow! I haven’t had an ablation yet, and am hoping to get through IM Mt-Tremblant on the cardioversion alone. My doctor is taking me off metoprolol on Monday, probably, as my resting HR is so low and he’s a bit worried about me getting too bradycardic. I must say, I haven’t felt this good in a long time. Much more energy…
What’s your view on whether you’d try an IM in my condiition. I realize you aren’t a doc, but…
There were about 20 people in the pre-OP room waiting for cardioversions and pacemakers. (They don’t do ablations at my hospital.) My doctor said this is one of the most common heart problems he sees. So, yes, I’m in total agreement more needs to be done. Seems strange for me to get it with no co-morbidities, no enlarged heart, etc. Just old I guess…
I have persistent A-Fib since 2007 or so. I was cardioverted once with no medication, and I was sinus for probably only a couple of months. Did it a 2nd time in conjunction with Tikosin, which is I think a potassium channel blocker. Sinus for longer, but still back in A-Fib within a year. My cardiologist believes that for persistent A-Fib, ablation has a fairly low rate of success, so just living with it for now. And I really don’t notice it except in very high exertion training, like track or hill repeats or trying to stay on the wheel of the friggin’ Cat 2 through the rollers, where I just don’t have the top end that I think I used to have. If it starts to affect me more, then he thinks I probably ought to consider going straight to MAZE, but that is really major surgery.
Have been in a fib multiple times over past several years. Sometime for only a few hours but often at least 24.have been scheduled for cardioversion on three occasions but have always self converted prior to procedure. Your cardiologist will put you thru a series of tests to rule out any existing heart disease. If none found will most likely put you on blood thinner. My cardiologist said that strokes from the a fib are what do the damage so blood thinner is to prevent that. I was in a fib one week before IM Wisconsin, self converted after 30 hours, saw cardiologist that day and he had no problem with my participation. Bottom line is discuss your concerns with your doctor, I had to find one who actually dealt with athletes and took that into account. Good luck
Yes, that’s why I’ve just been finishing most of my races by careful pacing. I’ve come to accept being last in my age group, but I’d much rather be healthy than finish first. If you hear of any new developments, I’d love to know about them. My doctor seems to think that I am a good candidate for permanent sinus rhythm mainly because of my fitness and no enlargement of my heart. We will see…
By the way, I went into afib this time doing 2 x 20’s on my trainer. I’d done the first one just fine at 205 watts and was in the 4 minute rest interval when all of a sudden my heart rate spiked into the 190’s. I have the whole thing on my polar watch… So, I’m going to keep the intervals down for the next few weeks before my race and hope I can just finish Mt-Tremblant under 17 hours.
I’m on Xarelto (sp?) a blood thinner. Will stay on it for awhile says my doctor. My heart is in excellent shape per the echo tests. My ejection fraction was 60 while in afib. My coronary arteries are clear, and I have minimal calcification. No significant pulmonary hypertension. I actually have no co-morbidities, except a touch of asthma. My doctor wants to follow me for awhile before he makes a recommendation about racing.
FWIW, I just found out a friend of mine has had cardioversion and has been stable for over a year. I’m going to ask her if she has stayed on a beta blocker. She’s very very active, and a total jock.
Good luck to you too. I hope you never have another episode because it’s damn scary!
I did race the second of half of '09 on sotalol (a different beta blocker) and did not have a lot of issues. But I really pushed it for the months of September and October. Olympic, a week later another olympic, then a week later one of the Ragnar relays where I ran a total of 27 miles, then two weeks later the Baltimore marathon and two weeks after that the Marine Corps marathon. A ton of longer distance racing in a very short time.
Needless to say after that I started having stronger episodes and the sotalol did nothing. (A beta blocker does not fix the problem either, it just acts like a rev limiter so your heart rate can’t get a lot higher). So I took myself off of it. I was signed up for IMLP '10 and planned to really start my training in February when I was going to be in San Antonio for a week for work. I ran every day and was feeling okay. But in the evening I would have episodes. Finally on like Thursday I went out for an easy recovery run and couldn’t even get a mile from my hotel before I almost passed out. I had to stand there leaning against a wall for about 10 minutes and then walked slowly back to the hotel where I rested the remainder of the day. So I stopped training for a little bit. By the end of March it was obvious I could not train at the level where I needed to so I dropped out of LP and got my paltry partial refund.
By the end of '10 I was having episodes that were 12 - 16 hours long where at times I could barely walk without feeling like I was going to pass out. One morning dropping my youngest son off at pre-school I couldn’t get out of the car and told him we had to sit there for a minute. I seriously thought I was having a heart attack and dying (which would have really f’ed my sons up as we were already deep into dealing with their mother en route to dying from an extremely aggressive cancer). It was because my late wife was dying and having three sons that I went back to my cardiologist and asked for some better drugs. And then to discuss ablation. Again, I went to Dr. Marchlinski’s office at the U. of Penn in Philly after being reffered by my cardiology group in Maryland. Google him as well. The guy is basically the authority and one of the best in the world at doing them for chronic a-fib. He felt I was a strong candidate for it and we did the procedure a few weeks after my wife’s death in '11.
It came back again after I got off the medication at 6 weeks after the procedure (but nowhere near the same magnitude) so they scheduled a second procedure for July. They said there were a few spots that they touched up. They basically called it “warranty work” as when they are doing the burning there is scarring and swelling which can mask some of the areas that are still misfiring. That one was harder to go through for some reason, but in general it worked. I still get episodes, but they are very minor and more of an annoyance. I have not needed to take anything except once to get it to stop. I think it is correlated to stress as that is when I tend to notice that it happens to me now. I did a 50 mile ride a few weeks ago and that didn’t cause it to happen. But other days I’ll be upset or stressed at work or home and get some symptoms. But again, I’m not taking any more drugs, which is good! I do have some sitting in my house just in case I do get a longer more intense episode and can treat it like a “pill in the pocket” remedy.
If you are not aware, there is a link between endurance athletes and getting arrythmias. One long term study overseas showed that runners doing an average of 5 miles a day 4 or 5 times a week over an extended period have a 5 - 7% chance of developing a-fib compared to less than 1% of the standard population. Google it and read up on it. We are not doing ourselves any favors by being extreme in our exercise (although we are gluttons for punishment and love it anyway).
To answer your question as to would I race?? I did until my episodes got so bad that I couldn’t exercise. Stupid of me? Yes. But that is how we tend to be when it came to exercise. That has changed for me now … I’m just happy if I can get out there every now and then for a 4 or 5 mile run.
Be VERY, VERY careful if you are on Rivaroxaban (Xarelto). This is a potent blood thinner which is better than coumadin because you don’t need to do a lot of blood tests to monitor its function. However, if you were to fall off your bike, even a small bump to the head could be fatal from cerebral hemorrhage. Your doctor put you on this medication to ensure that you don’t develop clots in your left atrial appendage, which can also be dangerous… so it’s a good medicine to take, but you have to be very careful you don’t fall. Swimming, running and indoor cycling are fine, but I would personally avoid riding outdoors because no matter how careful you are you never really see the accident coming!
I’ve had three episodes of Afib over the last 11 years. I got electrically cardioverted each time. My a-fib is related to drinking cold liquids immediately after exercise so it seems that as long as I avoid this I’m OK. It’s a bitch in hot weather when there’s nothing I’d rather do than slug down a cold liter of gatorade!
Don’t let it slow you down too much unless it becomes apparent that you’re doing something specific that triggers the a-fib. I’ve done 15 Ironman races and dozens of marathons since my first a-fib and while I’m pretty sure I wouldn’t have ever had a-fib if I didn’t exercise at all, I don’t think the racing itself has harmed me…
Ablation of the arrhythmia is something people consider when they start having persistent a-fib. I told myself that I’d get an ablation once I started needing cardioversion every few months. Once every three years I can live with!
Again, I can’t emphasize enough how important it is to be careful on the bike when you’re on Xarelto. If you’ve got a very safe, low traffic route I suppose that’s OK… it’s all about your comfort level with risk versus benefit.
Your piece actually brought me to tears. You have been through the wringer, and I wonder if all that training has actually helped you cope with some of this?
For me, the positives of training far outweigh the negatives. I do expect life to kill me and am ok with that. But, you have three boys…so you must have your eye on the higher purpose of raising them.
My wife is right on board with this notion. I have two indoor trainers, so I will be doing long trainer rides between now and IM Mont-Tremblant. I will go off Xarelto in three weeks I was told, so I won’t be on it for the race. Your response is the type of response I was actually hoping to get…someone who had a positive outcome to cardioversion. So many people have relapsed… Like you, I could live with having cardioversion once or twice a year until the researchers come up with a better solution.
No problem. I have always tended to have a much more casual approach to things and it takes a lot to phase me. When you watch someone really close die in front of you it puts a much more sobering perspective on things. The little sh-t in the world takes on a lot less meaning. But the bigs things become more important.
I hope for the best for you. I do not wish anyone to go through the level of episodes that I had in the past with my a-fib. I just ask that those that have had episodes really really pay attention to them. If they start to get worse, just be ready to get the best help to take care of it. There is a problem that when your heart starts to have an arrythmia that it will over time “learn” that it is the way it is supposed to act. So you start having more episodes. Think muscle memory just like in training. Please stay on top of it and be aware. That was the only reason I would wear a HRM in training and some racing. When your ticker is broke, you want to keep a keen eye on it.
I wish you all the best and relate the following only as a N=1 that I hope offers you some hope?
Had A-flutter which is a sort of cousin of A-fib. pretty bad and nearly passed out and died doing Great Aloha Run with my son so went to Tripler on Oahu and next I know I’m in ICU and then on to the heart specialists. Got sent downtown Honolulu to a civilian electro heart specialist who did an ablation (3 burns on the AV node) and was back in sinus rythm. Was on cumadin for a while both for concern of clot in heart and leg where cath/wire went in femoral vein–spent a year in Iraq immediately after the procedure and just had to come off the thinner as I went in country. In the words of my doctor “don’t get shot for a week or two.” Spent a pretty brutal year physically and emotionally in Iraq and was fine HR wise; came back and did Honu HIM twice in Big Island heat and wind–HR fine. It’s been about six years now and I’m finishing up a year in Afghanistan and again HR fine. I don’t think I’ll ever do a long course Tri again but other than some minor recurrences I’ve been fine since the ablation.
I wouldn’t wish it on that 40K cheater, YOU KNOW WHO.