Cycling

Since there have been quite a few comments and questions around cycling and exercise with AF I thought that this piece from a cycling EP might be of interest.

drjohnm.org/2011/04/cw-trea...

Have a jolly good Christmas everyone!

[Rellim296]

Thanks for that - an interesting read.

[paulh1]

One has to decide whether they can live and with how things are now or not. My endurance has not bounced back since the stents and the afib. Some days I have it some days i don't. Each day is a new beginning sort of. Never know if I'll be able to finish my routine or not. Decided to have cryoablation done in the next few months. I guess I'm on a new path now. Hooray for 2016!!!

[Barry24]

Hi Buzzard,

Happy Xmas by the way. Great article that you have posted, just read it. I follow Dr John myself in respect of his views on Atrial Flutter.

I wonder why Dr John who has mild AF I believe? not gone down the ablation route?

Best Wishes

Barry

[paulh1 in reply to Barry24]

Wondered the same thing also.

[canyonsister]

Oh Yeah! Biking (especially mountain biking) is SO different from other aerobic pursuits because you are off the bike and walking if you slow down enough to lose momentum (easy to do on a long steep rocky climb!) So you push. Just like Dr. John pointed out.

I technically have multi focal ectopic atrial tachycardia, not AF, although the EP could induce a flutter circuit during my ablation 2 months ago by putting the "pedal to the medal". But the dropped beats and tachycardia are miserable because they are constant and feel like a fish flopping in your chest. Because of over filling with the dropped beat, it can lead to right sided cardiomyopathy and heart failure.

I am still negotiating the territory of living differently than I did 6 months ago, but have figured out what I CAN do that still gives me pleasure and scratches that itch to be very active. My husband and friends and I are walking the West Highland Way in May for a start (and I live in the US so that's a big deal) and I am back to teaching fitness classes and yoga. BUT I have good days and days when I am very depressed...it seems to just come with the territory!

Thanks for posting this. I was just looking up some easier mountain bike trails to ride on once I get clearance from my EP next month.

[paulh1 in reply to canyonsister]

Understand where you are coming from. I never know if that day I'm going to be able to finish my exercise routine or not. Sometimes I just have to get off the bike and "catch my breath" or stop swimming.

[Peter1955 in reply to canyonsister]

Did the West Highland Way about 10 years ago, it's a great hike. On the whole, there are not many big climbs, it is not like climbing the Munros (Scottish mountains over 3,000 ft, or 914 metres). I expect you have checked it all out, but accommodation is scarce in some areas, so it's advisable to book ahead. I have just had persistent AF for about 10 months. I now clock a high pulse on tougher climbs, and lack power.

Good luck, and I hope you are well enough to enjoy the WHW!

[Kodaska]

This is very good. I would add that athletes tend to know their own bodies and responses better than most. When you tell your doc that you don't want to take a drug, and s/he insists on the basis that "everybody does it" or the equivalent, take a stand. Don't let someone who doesn't know you well persuade you that something's good for you when your gut says it isn't.

I knew I didn't need flecainide after my second ablation last May. I didn't mind occasional arrhythmias or a somewhat elevated heart rate. The doc insisted, I caved in, and now I have an incurable autoimmune disease that keeps me off my bike and out of my canoe.

And a happy holiday to all!

[Hidden in reply to Kodaska]

I think that you make a very valid point about knowing our own bodies Kodaska. Whilst I will seek advice from my GP I am very aware that GPs are Jacks of all trades and cannot be expected to be experts on all things medical.

I want to be the person who knows what is best for my body, accept expert advice and then make my own decisions. Your experience of taking a, potentially harmful, pharmasutical product against your own inner feelings and then finding that you were correct simply hardens my resolve to be the expert and I thank you for that.

[Kodaska in reply to Hidden]

Thanks. I just wish I'd known earlier. What's interesting is that my cardiologist was unaware that flecainide is an immunosuppressant. There's no mention of it in the drug website. Next stop: to find out if the manufacturer was aware of that quality.

[CDreamer in reply to Kodaska]

Kodaska were you aware that Flecainide is/was used as a treatment for MS? I think as an immunosuppressant.

[Kodaska in reply to CDreamer]

CDreamer, you're correct. I learned that about two weeks after I started doing research into the side effects (symptoms that continue now, 9 months later). My cardiologist had no idea.

[CDreamer in reply to Kodaska]

Yes I came across it by accident when I was first researching treatment for my Mg - which is often referred to as MS's little sister (little because it is rarer). There are far more treatment options for MS and I was very surprised when I looked on the MS site to see Flecainide listed as a treatment - so I researched it and asked both my Neurologist & Cardiologist - Neuro knew about immune suppressant effect - Cardiologist did not. In view of this I asked my cardiologist to please check with my neurologist before prescribing any medications. This was about 18 months ago - but had forgotten about until I saw your post in this thread.

Thankfully they both have offices in the same corridor and see each other quite regularly and have been very co-operative, yet another reason we need to keep on the ball!

Another thing that has arisen very recently, don't know if you caught it, is the interactions between some of the new NOACs and other meds? It was thought there were none but it seems some are now appearing........

[Kodaska in reply to CDreamer]

Not only do cardios not know about it, but there is no reference to flecainide's immunosuppressant qualities on any of the several drug websites I've seen. I wonder if it didn't show up in any of the trials.

[CDreamer in reply to Kodaska]

Drugs.com have a support group for people taking Flec - lots of reports to FDA of immunosuppressant drug level after taking Flec for AF - eg of just one post -

I have not had a single episode of AF since I started taking 50mg Flecainide x 2 daily in October 2012. Now my blood tests show borderlline neutropenia (low white blood cell (WBC) count) and I see this is a known possible side effect of Flecainide. I tried twice stopping Flec. but each time my HR became irregular after about 4 days. I am wondering if taking Flec. every other day might allow my WBC to recover while keeping AF at bay. I'd appreciate any comments.

NB - 'known side effect' ! Known by whom I wonder?

What is interesting for me is that technically speaking if that is the case why would it exacerbate Mg rather than help control it? The rat experiments seem to relate to suppression demyelination of the nerves - as I am not a chemist I didn't understand all the nuances of the process.

[Kodaska in reply to CDreamer]

Yes, there is a flecainide support group at drugs.com. One person posted a comment about flec being an immunosuppressant. That was me, and the question I posted has had no replies. If there's more than that, I'd like to see it. Can you share a link?

[CDreamer in reply to Kodaska]

ehealthme.com/ds/flecainide...

[CDreamer in reply to Kodaska]

ehealthme.com/quick_search/...

[CDreamer in reply to Kodaska]

Yes I saw that and there was another post by Alexander -10days

I found 1 other medically accepted report which was report to the FDA prior to 2008 - don't think that was you?

[Kodaska in reply to CDreamer]

Thanks for the info. I'll look into those links.

No, the pre-2008 FDA report isn't mine.

[Kodaska in reply to CDreamer]

So I looked at those web pages and recognize them. There's nothing there that connects flecainide and immunosuppression, unless I somehow missed it.