The cardiologist believes me to have an enlarge left atrium which appears to be causing the AF. I am a cyclist and walker 72 yoa and feel fit and I no symtoms. Tried the classic beta-blockers and the all make me ill. A week ago I went to A&E with an HR of 166 bpm, up from 120bpm, wihilst taking Metoprolol. Came out of hospital on Digoxin. After further consultaion with my cardiologist I am now on Digoxin 250mcg and Ramipril 125mcg. Thankfully without side effects. I continue to be very active and shall be skiing for a week quite soon.

Is anyone else in the situation and would they share their knowledge and experience.

16 Replies

  • My understanding is that enlarged left atrium can be a cause of AF since the natural pathways get stretched by the enlargement. On the other hand AF causes enlargement of the left atrium so which came first, chicken or egg?

    LEA to use your short form can also be caused by over exercise which is why endurance athletes and fighter pilots are prime candidates for AF in younger people.

    My advice is to accept what you have and learn to live as full as life as possible as it isn't life threatening just life changing. Read all you can from the fact sheets on AF Association website and ask as many questions as you want. You may wish to consider anticoagulation for stroke prevention as this is the prime consideration at your age. If you can't get satisfaction from your cardiologist then get in front of an electrophysiologist who is the electrician of the cardiology world and one who actually understand our condition.


    PS jealous of the skiing. My knees are shot so not for me.

  • Bob

    Thank you very much I realised in November that my AF was not the conventional type. Cardioversion did not work, neither have beta blockers etc.

    I have thought that technology has moved on but the good old NHS stays the same and so do the clinitians. I have written to my GP about this and she will be asking who are these electrophysiologist and where can they be found?

    My nearest cente of excelance is Leeds and my local hospitil is Bradford St Lukes, and Airedle. How do I find a electophysiologist in otherwords?

  • Go to the main AF Association website and there under patient information you will find a list by area.


  • Thanks Ill do that.

  • Bob, do you know if having bradycardia (I have resting HB in low 40's) means higher than usual vagal tone, and whether this can contribute to AF episodes?

  • Low heart beat usually by my understanding means LOW vagal tone. Richard Schilling once told me that AF was more likely when the vagal tone was low for example after a large meal or whilst sleeping. This of course is if your AF is vagally mediated which is not a given. I have no idea what percentage of AF is vagal and many doctors do not even look at this which is a shame since beta blockers are not always appropriate for those with vagal AF. A few old fashioned and out of date doctors do not even believe vagal AF exists.

  • Can certainly recommend Dr Lee Graham at the LGI from personal experience.

  • Is Dr Lee Graham an electrophysiologist and appart from ablation procedures, which my cardiologist says don't apply to me re; ELA etc, what can he help me with do you think? I need to make a case with my GP and keep her on board. I think she resents my attempt to gain control of this.

  • Bidens, are you in permanent afib with rapid ventricular rate?

  • At rest my HR is 100 to 120 average with at rest showing maximum of 122 to to 174 on Digoxin 250mcg and Ramipril 125mcg recorded from 23rd to 28th Feb. Much better than 27th to 31st Jan, when my HR AV resting was 166 with max. HR of 190 on Metoprolol 150mcg. On 31st Jan I went to A&E and they took me in monitored my heart and stopped the Metoprolol. so I am intolerant of beta-blockers. The HR results are taken from a sports HR device and coresponds with clinical divices well.

    I have permanent AF but not convential so the Cardiolost says Ablation won't work and Cardioversion has failed.

  • I was diagnosed with a similar condition - dilated cardiomyopathy - DCM in 2002. The cardiologist wasn't able to say whether the DCM caused AF or vice versa. I was able to get into NSR for about 8 years by having internal cardioversion via catheter and taking Amiodarone, but eventually had to stop the Amiodarone and am back in AF. But the DCM has virtually disappeared - drugs and exercise reduced it


  • ... You may want to look at the Cardiomyopathy UK website for more information about DCM

  • I too had an enlarged left atrium. Resolved by patiently waiting for the new Hybrid Ablation procedure which originated in the USA. 12 months on, after careful rehabilitation and 2 ops, one from outside of the heart & 3 months later on the inside of the heart, i am in NSR and back in training ( 67 yoa ) . Apart from losing some weight & watching what I eat & drink, life is normal.

  • Is it possible to say where this was done? How do I gain acces to this prcedure? I can then discuss with my GP and cardiologist?

    Are you free of all medication?

    Thank you in anticipatation.

  • This procedure was carried out by Mr Guy Hayward & a surgical team at Derriford Hospital, Plymouth, in Dec 2013 & June 2015. Still on meds for high BP, Statins & Rivaxipan.

  • That's v.good and no beta-blockers etc?

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