Ablation found atrial scarring

It has been a little over two weeks since ablation and a recheck with the EP gave me more detailed info about what happened to my heart to cause this. I have an area of scarring in my right atria, shredded in appearance (think stretch marks), from unusual atrial stretching. He called it "athlete's heart". This confirms what I suspected, that I pushed my 60 year old heart too hard around 4 to 6 months ago when I took up mountain biking. I would ride up hills until my heart was pounding out of my chest...not smart! So he ablated as best he could until he could no longer induce arrhythmias, and ablated a flutter circuit. But he cautioned that he couldn't "carpet bomb" my atria and that I might need another ablation in the future. I was put on flecainide 100mg 2x?day to keep my heart as calm as possible during healing, but am still feeling that funny sensation in my throat like my heart wants to go berserk but the flec is stopping it. I am back to teaching yoga and usual daily tasks like shopping and household chores, but will wait at least a week or more to purposefully walk the neighborhood (I live at over 5,000 ft in the mountains of Arizona...not sure what that is in meters, but it is over a mile high elevation). I was told three months of limited activity and will stick to it. I'm not sure what the future after healing is going to look like since I have such extensive heart damage, but I am hopeful that I will be able to still be active...just not at near the intensity that I was in the past.

Anyone else have atrial scarring from over stretching? Athlete's heart???

16 Replies

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  • Like I always say, everything in moderation. I think there are far too many people with AF caused by over exercise. At your age this is actually unusual as it mainly applies to young endurance athletes and fighter pilots. Yes all those top guns risk AF from the hard work their hearts have to do to combat G forces of 9G whilst out play tag on tax payers money.

    Take it easy now.

  • I've never been in the slightest danger of developing athlete's heart. It might not have been a wise thing to have done and not the best to live with, but a real achievement to have pushed yourself beyond your limits. Not smart, you say. I'd be proud. There are so many who have damaged their bodies by not doing enough, by neglect, by over indulging, by not seeing the errors of their idle ways. Good on you!

    Hope your recovery goes well.

  • Thank you for that perspective...I'm in a stage of beating myself up about it right now.

  • Great reply Rellim, I echo that.

  • The statistical risk of developing AF from exercise is low. Yes it's one small risk associated with endurance exercise, and athletes-with-AF are a subgroup of the larger AF population, but the overwhelming majority of younger and older athletes never develop AF - no one should beat themselves up about developing AF that way

  • Re. athletes heart. I tramped over the Umbrian hills two years ago.....about 7 miles modest walking a day I was in my mid seventies and translated it into a young athletes work out.It seemed enough for me. Came back feeling fine and having lost half a stone I hardly needed to lose but all was well. I would suspect that with AF this was prob. enough.My usual routine is 10 minutes programmed exercise twice a day and lots of walking.I suppose it is possible I do not do enough but like Rellim I do not care to beat myself up with exercise.

  • Canyonsis, I understand completely why you pushed yourself - because you know you're in the kind of condition that can do it and you love the feeling of exertion - it makes you feel ALIVE. Do you have any idea what your heart rate was when riding? I'd guess it was above your theoretical max of about 160.

    I strongly suggest stopping flecainide. As I've written on this board, it suppresses the brain's immune system. I was on it for 5 weeks after an ablation last May and I now have an autoimmune disorder that has pretty much eliminated all the active pursuits I used to love. I'm now a former wilderness canoe tripper, former canoeing instructor, former whitewater paddler, former road cyclist, former classical guitarist (can't get to lessons). My view is that it's better to know about breakthrough arrhythmias than to mask them. My Cardio/EP agreed that they do not present a danger to a healthy heart. And mine is - or was - just about the peak of condition. (For what it's worth, the Cardio's bottom-line response to my arguments against the drug was, "We like to make sure our patients are covered." You can substitute "asses" for "patients" if you like.) BTW, I'm in southern Wisconsin.

    In June of 2013, after my first cardioversion (atrial flutter that came on in the Boundary Waters), I had a treadmill stress test. I was jogging along at 169 beats/min, having a nice conversation with the tech who was monitoring the test. Then he said he was going to stop it, that it made no sense to continue, since I was over my max HR of 156 (I was 64 at the time). I used to x-c ski at 174 and nearly bonked on my bike at 180 a few years ago, so I was curious about where my point of exhaustion was. But he stopped it anyway so I may never know.

    You have to be your own doctor.

  • I imagine I was close to 170 based on what 160 felt like on the stress echo. I wasn't wearing a HR monitor during biking though, so can only go by what it felt like. Here is an excellent article about "athlete's heart"..

    velonews.competitor.com/cyc...

    I was a perfect storm for this...had fallen (off my bike) and broken a rib 4 weeks prior to first episode of palpitations, continued to ride hard even after that (bad advise from cardiologist after normal stress echo), wasn't eating or sleeping well, was under a lot of emotional stress (separated from husband), was using more caffeine and alcohol...doing just about everything wrong. Water under the bridge....

    Please post references to flecainide and immune suppression...I am decreasing my dose and want to wean off. I think the EP wanted my heart as calm as possible to "retrain" correct electrical pathways as it heals. But to create another serious problem would be awful...I'm so sorry you are going through that!

    I have friends formerly from Minnesota who were avid BW canoeists and just went back for a trip last summer....never been but want to go someday. I do lots of backpacking and worked as a guide in the Grand Canyon for 15 years. Clearly we have much in common.

    Thank you for your reply and I hope things improve for you in the future...

  • Soooo I have AF - just had a catheter ablation performed for atrial flutter - would to hike some of tbe Appalachian Trail and Pacific Crest Trail - what are your thoughts on this - areas you should definitely go to & not Togo through.

    I live in Swansea UK.

  • Boy...I'm still waiting to see what kind of activity I can and can't (or shouldn't) do once my heart is fully healed. My ablation was pretty extensive and I still have a huge area of scarring in my right atria. That is not going to go away, so will impair function since it can't stretch. If you had a fairly simple "isthmus dependent" flutter ablation with no evidence of atrial scarring, you will likely be able to hike just fine. I have never hiked the AT, so can't help you there. The PCT is beautiful and I have backpacked there a lot...altitude might affect you there though. I love the area in California around Mt. Whitney and would recommend the east side of the Sierras. I plan to wear a heart rate monitor and just slow everything down! And walk up steep hills on my mountain bike...but being just two weeks plus out from ablation, right now I'm just letting my heart heal and taking it one day at a time.

  • Hi - thank you so much for your reply - my friend's husband is going to hike the PCT with some friends so will pass on that I info.

    I do hope your recovery goes well and that you get out there as soon as you can.

    😀

    Thank you Canyonsister

  • Canyonsister, I'm very interested interested findings of your EP. How were they able to diagnose the scarring "stretch marks" on your atria? Was it by echo or MRI, or was it spotted during your ablation surgery? I am asking because I wonder whether this is what I have done to myself, too.....

  • I believe they can tell by the mapping of electrical activity that is done at ablation. Areas of fibrosis will show as "dead zones" electrically, which cause the problems in the first place. I was told that the atria are too thin to have an MRI be of much value. Ventricular scarring can be picked up with advanced techniques using an MRI. That article I posted a link for is quite sobering, huh?!

  • Interesting the fact that they cannot heal it but just ablating it mmmmm

    It was much better heal it.

    Damage from exercise become very common I can confirm it ....I using a powerful electric bike so I can CARESS MY HEART gently it work so fare as still on bisoprolol 2.5 thanks God.

    My suggestion is.....do gentle exercise gently rush blood in that area of the heart keep your heart no more than 120 HB you should feel the benefit.

  • Max HB depends on your age and also other factors and illnesses.

  • I was told that a scar is a scar is a scar...like the ones I have on my legs from falling off my bike. Or the stretch marks on my belly from three kids! When there are heart muscle cells that are next to abnormal non conducting tissue like a scar, electrical activity doesn't conduct normally, thus the arrhythmias. An ablation blocks electrical pathways that are abnormal almost like "grounding" an electrical circuit. I can feel my heart adjusting as it heals (7weeks out now) and have kept my Heart rate under 110. I'll increase gradually but probably forever avoid going above 140 or so, at least for very long. I'm 61 years old and have no heart disease, in fact have an athlete's profile on a stress Echocardiogram.

    Good luck and keep cycling!

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