Hello, I'm Julian from the UK, 37yo male. I am (was) a keen cyclist & runner. 2 months ago I completed my first ultra distance event. The following week, on some very slow recovery rides I started getting my first AFib attacks. I was in AFib for a couple of weeks, diagnosed by ECG, but returned to NSR naturally.
Since then and for the last 4 weeks I have been mostly resting apart from some light to moderate cycling. Just as I thought I was getting better, after my last 2 rides I suffered AFib attacks whilst sat at my work desk, returning to NSR after a minute or so. It terrified me the first time as I thought I was having a stroke. So it seems like I can't do any exercise at the moment as it triggers my AFib.
I'm reading lots about the condition, and how it's prevalent in endurance athletes. But I can't find any accounts of such people. I am reaching out to anyone in this category - young, otherwise healthy athletes who have AFib, looking for your experiences and insight. Thank you.
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Mejulie69
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Hi. I'm a 39 year old occasional runner distance swimmer / triathlete. I've been struggling on off for a couple of years with paroxyml af. I don't have and great advice .. I haven't solved the issues myself hence turning up here. But you are not alone, and it's not life threatening - Just damned annoying!
Hi Steven. Have you identified any triggers for your AF or are they seemingly random? It is incredibly frustrating that I read everywhere that exercise should help AF, but it only seems to trigger mine.
I'm only just beginning to. I've been blaming diet , weight, etc. But I do think I have a direct link with exercise and af. Mine seems a bit different to yours. Not going in during excercise... But it's the day after a decent cardio session I have trouble with af. I cut right back on exercise this year and .. virtually no af. Now training (or trying to) for a swimrun and I'm getting problems with af (paroxyml) again even tho only exercising about 3 times a week. I would just ignore it and push on but I've read being in af strengthens pathways that lead to more af. So .. do I give up or way reduce excercise (sad face) in order to hold off the afib. At the moment I'm only under gp. On beta blockers for this along with high blood pressure. They have brought bp down but don't stop afib for me (all though symptoms less bad for me on beta). Reading here sounds like getting with the right specialist would be a good move. Interested to know how you get on!
Hi Steve, your reaction the next day is similar to mine, and your findings are my worst nightmare, that exercise is a clear trigger. For me, if I confirm this over the next few months, I will be pushing for surgery. I have a phobia of hospitals and needles, but I would be willing to deal with surgery if it allowed me to exercise again. Without exercise, my life has no sheen and I start to slip into depression. I have become a junkie, and endorphins are my fix. Stay in touch, and let me know how you get on.
I'm an ex rugby player so nowhere near your level of fitness, however, as for the procedure, please don't panic if you do go down that path, I'm as big a wuss as anyone but it really was a breeze, I've even started running again, only 10kms but it's more than I used to do, maybe looking to do Cardiff half next year
Hi Steven! There is a 5 fold increased risk of AFib in endurance athletes, typically males. Frustrating, but it seems to be a real line between the amount of exercise that is healthy for our hearts, and what puts too much stress on the heart and AFib is a reflection of that. Hypertension is also a classic culprit in developing AFib. Make sure you consult with a good EP (electrophysiologist) to formulate the plan to lessen your symptoms. Generally the thinking nowadays is to do ablation sooner than later because if you think of AFib as a bad habit for your heart, you don't want it to get used to doing it! Be well.
A presentation by Birmingham University in 2011 mentions a study of former professional cyclists with 10% having AF at 66 years of age. Many will have read the study of Finnish elite Orienteers who had their first episode of AF at an average age of 52.
Hello Julian, I am also 37 and in reasonable fitness without any other medical issues. I'm no athlete but prior to getting my AF I had been pushing myself in the gym doing lots of interval type training for a year or so. Then out of the blue AF struck, not whilst exercising but on a holiday relaxing. I dont have any other health issues that could cause AF so it was diagnosed as Lone Paroxysmal AF.
I had an ablation a year ago that has reduced the frequency and length of my episodes.
Since developing AF I have become much more aware of my heart. Doctors have said I can exercise to the same level but I find myself anxious about pushing myself the same as I used to.
My experience of AF so far has been difficult as I've struggled to understand why or when it might happen, but I think this is the case with most people. I have also found that an AF episode without panic mixed in is much more manageable, I guess this comes by understanding what's going on and realising your not about to drop dead!
I've tried to work out my triggers but they don't follow any pattern, the only one I have found is when I become stressed. But sometimes it just comes out the blue when I'm totally chilled and relaxed!
Hi Steve, I totally understand what you are saying about trying not to panic. I have only had 2 attacks which came out of the blue - the first one terrified me, the second one was nowhere near as bad as I knew what was happening. Having said that, it still left me feeling anxious for the rest of the day, and a little sore on the chest. Sometimes though, I don't know if what I am feeling are genuine symptoms of AF or unrelated or just in the mind. I guess I'll work it out as time passes. Thanks for your response, it is helpful to hear how others experience this frustrating illness.
Thanks for the info Steve. So after you had the ablation are you better able to keep exercising? What made you and your doc decide ablation was right for You?
Yes I started exercising after a month or so after and built up, I still have a little anxiety around exercise for no real justifiable reason! guess I've become a little paranoid when it comes to my ticker!
The decision to have an ablation early on was to try and hit it hard before it progressed as apparently the rogue pathways can become more established difficult to ablate over time. I'm fully expecting I will need another ablation in the next year or so.
Hi Julian I m just like you a lone afibber I used to work out alot I felt my attack in 2014 after I passed out and I went to cardiologist and he told me its a one time thing and it happened because of Dehydration. So I was happy but again I passed out 2015 and did an EKG at emergency and no afib was found. After that I was on and off with palpitations and finally on January 2016 I felt the afib while I was playing tabletennis. Since then I was officially diagnosed with afib on EKG and put on flecanide 50 mg twice a day. No more afib after medication so my question is to you did you had any medications before ablation? And I m thinking of ablation to get rid of the medication after using for almost 3 years as it is giving me side effects. Are you getting af after ablation as I know that who are paraxysmol lone afib they have higher success rate relative to other types of afib. And I also young like you 27 years.
Hi Mejulie69,
Well I am not in any athletic category, rather at 72, I am an Ancient Briton.
However, there is mounting evidence to suggest that some of those involved in endurance athletic activities . such as cycling, marathon running are at some risk of developing AF.
Generally AF is not fatal, however, it has been noted in the media that one young lady several years ago died in the London marathon and in the article it was noted she was being treated for a heart arrhythmia.
More recently an Australian cyclist (international level and I seem to remember an Olympic hopeful) suffered the same fate. Sadly, I cannot now remember the persons name. He had been identified as having AF.
Problem is of course what the media never reported was the nature of the condition. AF/ arrhythmia are generally associated with the heart electrics, so, there may have been an issue with these two souls with their heart mechanics.
Thing is AF manifests itself in so many different ways and triggers are a nightmare to identify. And even if you do then successful treatment is highly individualised and varies so much person to person.
My experience at a personal level is - if you have AF then it is almost a given you have a problem with heart electrics. I bet you haven't been given an echocardiogram (nothing to do with an ECG) to assess the physical, mechanical state of your heart and arteries. Its basically an ultrasound of the heart. I had this done during the diagnosis process and it revealed a damaged left atria. This damage is irreversible and it will now predispose me to AF and to an AF generated stroke forever. Obviously the older I get the greater the risk.
Happily my AF is controlled by an amalgam of blood pressure and rate control medication and a major review of foods I used to eat which in themselves triggered AF. Since I altered my food intake I have remained AF free since April 2015.
Hi John. I have my first appointment with a cardiologist next week (standard NHS wait), although I have already had an echocardiogram - the technician who took the scan told me my heart was completely normal. So, I just wait to see what the cardiologist says. Thanks for your response, some useful stuff in there.
I would strongly suggest, from what I have read in this forum, that you should insist to your cardiologist that you need a referral to an EP for this. As BobD always says, the plumbers are useless when the fault is electrical. (Don't mention that to the cardio guy though!)
Well that's great about the echo..... and the results. At least the fault finding and treatment can now be focussed in one area. Good luck and I hope you are able to pursue your athletic interests in future.
I agree that symptoms and treatment are highly individual, but I'm interested in what your food triggers were and how you modified your diet as I suspect my PAF is vagal related.
It was some 10 months after diagnosis and after I'd returned to work that I noticed some digestive changes. Subtle at first then the symptoms became much more evident. Burping, intestinal gurgling ( very loud and anti social), diahorrea and massive, massive and painful bloating with the pain centred around the upper left side of my chest. Not at the same time, all totally at random and totally unpredictable. All mostly occurring between 6am and 8 am - generally after that I was OK. My GP had me tested for Coeliac Disease and IBS but the results came back clear. He offered to carry out more ( and intrusive) tests - I declined.
I consulted a Nutritionist who carried out her own tests that confirmed in her mind that my gut flora was quite abnormal. She put me on a long course of Probiotics (prescription only and not available over the counter at chemists or supermarkets). She also recommended I go gluten free, wheat free and perhaps consider some aspects of the FODMAPS diet. Over time I also went oats free and added sugar free. Long term result - no AF events since April 2015 although I still continue with my AF related medication.
I found it necessary to go beyond the Nutritionists advice and monitor all my food over several years ( and I might add I still need to take care). So, any food and some alcohol, containing gluten, wheat, oats and sugar are out. you think of it - its OUT !
Additionally, I cannot eat peas, runner beans, baked beans, pork, raspberries and cream (yet strawberries and cream are fine), soft cheeses - out - ( yet hard cheeses like Cheddar, Edam) I'm OK with. Yoghurt is out. Thick gravy is out - best is gluten free, watery gravy. Salad stuff is difficult - so, onions are out (but shallots are fine, as are radish and watercress), Lettuce is out yet small amounts of Rocket are fine. Tomatoes are OK so long as they are only small ones in very limited amounts. Any Rice product is OK - that said I have to be very careful eaten Chinese food, more so if I eat in as opposed to take away. Again rice noodles are fine and bean shoots too with limited meats, say chicken.
I have some misgivings about eggs at the moment. I'm not a big egg eater but they are very much on my 'suspect' list.
Alcohol - spirits no problem, any wines no problem. I love UK Real Ales but they are all - OUT ! Best beers are Peroni, Tiger beer and I can at a push get away with San Miguel. Tea and coffee are not triggers.
I'm sure there is other stuff, so, I hope this will give you an idea of my AF/Vagal/Digestive journey. Interestingly this food intake plan has not led to any weight loss - but it was never planned to - the intention was to calm the vagal nerve and calm the heart and for me at least - job done.
I want to add that I wear a Fitbit tracker and results over a long period of time show my resting heart rate to vary between 57 and 63 bpm. My average blood pressure these days is 125/70/65. ( My pre AF blood pressure was 136/90/88). I am 72, I work 30 hours plus a week driving a tourist bus which involves handling passengers luggage - of which not much weighs less than 15 kgs. So these cardio stats above include the 30 hours or so working.
Thanks for your very detailed reply. I too suffer with some digestive
problems, particularly trapped wind. I also have consulted a dietitian who was unable to pinpoint particular triggers but suggested I be treated as if it was IBS. Particular recommendations were:-
To increase fluid intake slightly
To avoid processed foods and ‘resistant’ starches
To reduce fibre intake
To include linseeds in your diet
To increase calcium intake to meet requirements
(I had a more detailed report included, specific to myself).
This generally brought about some improvement but did not 'cure me', and I have had several bouts of painful episodes which I could not identify a trigger.
I'll look at some of your 'No' list to see if any of those might relate to me.
Hi just curious to what type of foods you now eat, and what foods you cut out. I am 66 and had an ablation a year ago. AF free now for one year, although some days not as good as others as heart beat a little erratic and less energy. I have found getting a good night's sleep helps me have a better day.
I was a fit 54 year-old when AF first hit. Running one morning with my heart monitor I suddenly found it incredibly heard work. No wonder, when I looked at my monitor it was showing 230! I walked home and a couple of hours later I was back in SR. Being a man I did nothing about it. Three weeks later it happened again. After that I visited my GP. Then followed a period with 24 hour and then 7 day monitors trying to catch an episode but they showed nothing. I was advised to get to A&E the next time it happened. I continued to run and go to the gym several times a week. Then one morning as I was running up the stairs to a hotel gym AF hit and I duly drove to A&E where they had my on an ECG within minutes. By the time the consultant came I was back in SR. Over the next three years I had bouts of paroxysmal AF that always returned to SR usually within a few hours and occasionally up to 36 hours. I continued to train when in SR. Then I did my first triathlon with lots of intense interval training in preparation. 24 hours after the triathlon I went into AF - and stayed there for 6 months before receiving cardioversion! Like you I was on a waiting list to see a cardiologist but in the end I payed to see an EP (electro physiologist) privately (£125) who got me cardioverted within 3 weeks on the NHS. His advice was,"no more interval training - ever!" If you are prone to AF interval, high intensity training is the worst thing you can do. A bit of a life changer that took some time to get used to. At your age you'll find it even harder. But sadly this condition doesn't go away.
For the last three years I've been on flecainide which has kept me in SR with only a couple of very brief bouts of AF. With my EP's agreement, I'm not on anticoagulants as I have no other contributing risk factors, however next July I'll hit 65 and that will change. I still exercise, walking, pilates, occasional jog on the beach etc. but no more triathlons!
My advice is to find a good EP (they handle electrics, cardiologists deal with plumbing) and pay to see him/her ASAP. And modify your exercise regime, eliminating any high intensity interval training. Probably not what you want to hear. Good luck with it.
Thanks for sharing your findings Steve (no trigger in the name I hope .. there seem to be a lot of us Seves here!). You've confirmed my "push through it is not a good idea!" thinking.
I think for me at the moment, my AF is not regular unless I push it
Guys who had ablation - did that allow you after to go back to heavier exercise /intervals , or is that really a no-no once you have this diagnosis even after ablation?
UK people. I've been referred to a cardiologist early on and since just been tracked by GP. The guidance / treatment they are giving me matches ok with what I'm finding on here - but I'm surprised if EP's exist that I haven't been offered a chance to see one. Did others find it hard to see an EP in UK once you knew about them? Did you just ask for referal?
I would say a no, my electrical specialist told me not to over do it. I go to gym 3 days a week, not heavy exercise, as well as going for walks. Af free one year, use Garmin hr very good, some days it tells me irregular but not af .
I'm a little older than you in my mid-50s, and have been a regular runner for over 10 yrs (ad hoc before that). I'm certainly not as young as you, but I run regularly with others as young and younger and don't yet consider myself materially older.
I developed lone paroxysmal AF in the last year. I have the "fast" kind - when in AF my HR will be +60bpm (115-150 vs a normal 55-90). I have no other risk factors and an otherwise healthy heart, so no drugs.
Since I was diagnosed about 3 months ago, I have discovered that some things are not triggers. For example coffee - I ALWAYS drink a cup before every run and my run is only impacted if I was in AF before I drank it. I have also discovered some things that do appear to be triggers. For example alcohol - within a couple of hours of any substantial amount (2 or more pints), I have an odds-on chance of an episode, however I seem to be able to get away with small amounts (a glass). And for example red meat - several hours after eating it (maybe next day) I seem to have an odds on chance of an episode. My best guess is that my AF is vagal, and that anything that irritates my digestive system will trigger AF: I've noticed that I'm often in AF if I'm suffering any kind of digestive "disturbance", and that if I can clear that (multiple visits to the loo with a coffee to speed things up) then my AF will often stop.
Since they started my episodes seem to be getting more frequent. Although I can run in AF, I rarely do as my performance is severely impacted. I'm about 50% slower when in AF, which removes most of the fun and benefit ... and I worry (perhaps unduly) about running for too long when my HRM says my HR is above 200 (my normal HRmax is around 200).
I can't say that I've noticed any linkage to my running. But since I still run multiple times a week, its hard for me to eliminate that as a cause. The only thing I would say is that I usually do a hardish parkrun on Saturday morning, an 18-20k easy long run on Sunday morning, and a medium 6-8k on Monday evening without any issues. Recently on holiday for 2 weeks I didn't run once (very rare for me, but it was too hot) and I did experience some AF which I attribute to the massive burger I ate the evening before.
My AF most often happens at night, but I've tracked it with my HRM, and it happens quite often during the day too. It seems that I'm lucky that I only notice I'm in AF when I'm exerting myself (due to the impact) or when I'm resting (due to the lack of distractions) - most of the time I can't tell if I'm in AF or simply experiencing a few ectopics - I have to check my HRM to be sure. I have periods of consecutive days when I get very little or no AF (so little that I begin to imagine that it might be clearing up) and periods when it feels like I'm almost constantly in AF (although when I measure it, I realise that its not that constant).
From what I've read, even if you find a trigger, there's a good chance that it's just one of many, and that over time your triggers may change so that you'll feel like you're chasing a ghost that can't be caught. Unfortunately, I haven't read of anyone who has been able to fully control it through lifestyle changes, but it seems many (more often those with the vagal type, I think) have been successful in mitigating it enough to make a worthwhile difference.
Good luck - if you can confirm that your AF is vagal then as a cyclist and runner, you may just be enough of a data junkie (many are) that you can find some of your triggers to help you control it enough to maintain your sport.
3 Steves with AF on one thread... I see a statistical correlation
Thanks for the reply, some excellent insight, especially the bit about chasing triggers. It gives me comfort that you are able to maintain exercise around your AF. I pray that I can do the same.
I, too, am a Parkrunner, and I really hope to get back to it when I have worked out my AF. Right now, it feels a million miles away.
Hi, quite a a few cyclists and runners on this forum. I am 68 and had AF for the passed 8 years but have developed a regime where I can keep my cycling going but at a modified rate. I use a heart rate monitor and aim for a max of 120bpm. First thing is you need to see an EP and get a sound diagnosis. Then work from there. We are all a bit different in our conditions and solutions. It is a long term journey. Have a look at previous posts to see how we have coped. Best of luck. A good read is The Haywire Heart by John Mandrola.
Hiya. I'm 40, and since my late 20s have been quite fit. During most of my 30s I played 11aside football twice a week, 5aside once or twice a week, and running on nights I wasn't playing!
However, my AF started when I was 39, a year after I had stopped playing any football, due to injury. It didn't come on when exercising, but when relaxing.
I'm actually now trying to build up my fitness again, and hoping to return to at least playing 5aside again. I've been running for a couple of months without any issues.
AF seems to affect us all differently. For some people it means giving up, or changing, exercise, some people stop drinking. Apparently I have to stop relaxing! (Joke, I think my problem comes when dehydrated).
I think you are right with dehydration causing af to start. It can be many different things. I don't believe anyone knows for sure.i was laughing at Peter Kay on TVs and af started. Every one is different,
I'm 67 MD. Regular cyclist. I'm silent afibber (afibs without any symptom), thanks to God I work for small company which develops a small, wearable Holter monitor and I'm testing the device. So I basically can monitor myself almost continouosly and of course I'm highly interested in endurance sport - afib connections.
Here I can summarize for you my experience and knowledge collected from medical literature:
- high endurance athletes are at 5x risk of developing afib
- the dependence is U shape. Too much exercise and too little exercise both leads to afib development. The workload should be optimized for the given person
- in general the optimization means that during the most of the training session we should not drive at max pulse rate. Example with my numbers: My resting heart rate is between 50-60 bpm. My top heart rate during mountain biking is 150 bpm. My normal training is road biking with ~15 min heat up on 70-80 bpm. After heat up riding between 80-100 bpm, depending on road quality.
- please not, that professional devices simply cut out the segments arrhythmias, so if you have symptomatic afib the polar, fitbit etc may give misleading pulse rate,
- BUT even the symptomatic afibbers have silent (afib without symptoms) afibs, sometime pretty much. The asymptomatic could be detected by some detected. I use Scosche armband connected to Strava for tracing my training. At the Strava pulse rate plot clearly displayed the the elevated pulse rate that is one hallmark of afib.
- At beginning of the athlete’s afibber carrier the development of afib is the sign of the overtraining syndrome. The medical proof of the overtraining related afib is displayed at ECHO cardio picture. The left atria is dilated and the dynamics is changed. In this case detraining is suggested. Sometimes it could be as long as 3 month. In my case after detraining (less or zero exercise) the atrial dilatation is reverted. Unfortunatly in my age there are other risk factors, than over training so I still have afib events.
- Detraining is hard time for us. First of all because we are sport addicted, but also important, that detraining may result in overweight that is also risk factor for obesity and hypertension. The solution is the cross training. During this period other sport advised (tennis, gym etc.) where you are not experienced and you can’t reach your potential maximal effort.
- One more option is the better regeneration with relaxation technics. My afib readily terminated during cycling. So I often go for cycling just as selfcardioversion. But after any afib event I take around one relaxation with target heart rate below 50 bpm.
What an interesting post, thanks Mercurius . I note that my fitbit jumps up about 10-15bpm when I have palpitations or a short run of AF. I can see it clearly after the event. The Fitbit then takes an age to come back down to my actual pulse rate (e.g. it shows 138bpm when I'm 110bpm when measuring myself)
Just a little comment on technology through personal experience..... I use a Fitbit and seperately, a Miio Heart Rate monitor (viewed via my Garmin). They both use similar technology i.e. green lasers. The Fitbit is very approximate at best and does not adjust quickly. I wouldn't rely on Fitbit for accurate HR info. The Miio HR strap and Garmin combination is deadly accurate - I can see minute changes in my heart rate almost instantly, for example, when I feel a little jolt of adrenaline, I see the HR increase immediately.
Soon I will take delivery of a personal ECG machine callled a Healforce 180B0, so that I can see even more detail, which I figure will help ease my mind about when I am in and out of AF
Thanks. Yes, I'm finding the Fitbit isn't great at responding to changes in HR, but it is still useful to spot AF or even palpitations when resting (or sleeping).
It's interesting that the Miio HR strap seems better than the Fitbit, even if they use the same technology. I'm sticking with the Fitbit for now as it's less obtrusive to wear all day.
Let us know how you get on with the Healforce. I know a lot of people here use a Kardia machine, and I'm tempted to get one but I've read a number of negative reviews on the app store about them so I'm holding off for now.
Good combination. I tested Mio as well and I have handheld ECG similar to Healforce. The Mio will alert you, that you may have aFib (or other arrhythmia), with handheld you can verify wether you have aFib. Please not, that having afib likely you have atrial and ventricular ectopic as well (often also with tachicardia). The ECG will show which one do you have actually. Moreover the record from the handheld you can download to your computer and print it out for discussing with your Doc.
Also please note, that you should use the Handheld during the suspected afib under very quiet circumstances with the lowest heart rate is possible. aFIb causes tachicardia, but above ~120 bpm heart rate sometimes even ECG can't identify the afib.
When I do intense exercise, I consume drink with electrolytes (Sodium Chloride, Calcium Lactate, Potassium Chloride, Magnesium Carbonate), so I doubt that vitamin depletion was the cause of my AFib.
I will look into this further though, and perhaps experiment with supplements.
Just to add my 2 cents here. I'm a 38yr old UK male who was diagnosed with paroxysmal AF last December, but I think I was developing it ever since I had a bad bout of pneumonia the February before. I am/was relatively fit, going to the gym three times a week, along with the occasional long leisurely cycle ride. However, until I know more about the cause of my AF, I've drastically cut back on exercise, doctor's orders.
My general cardiologist ordered a raft of tests, including an echocardiogram (normal), CT angiogram (normal), 48hr holter (normal), and MRI scan (abnormal). If he hadn't ordered the MRI I would have thought I had lone AF and would have gone back to something similar to my previous lifestyle. However, the MRI scan has meant I've had to stop the gym until we know more about what's going on. I don't want to worry you, but I guess I'm saying this as it pays to be careful until your AF is fully investigated and you're satisfied you know the cause. You don't want to exacerbate whatever's going on, and the less AF you have now, the less you'll have in the future. I would definitely scale back on the exercise until you know more about your condition. Really try to look after yourself, e.g. cut out/back alcohol, coffee, reduce or even stop exercise for a bit, get plenty of sleep, try to stress less (easier said than done).
Once it's been fully investigated, and a care plan set up, you'll more than likely be able to get back to some exercise, although perhaps not as rigourous as before, but you'll still get the endorphins going and still get your fix. Thanks to this forum I've found many people who live very full lives with this condition. Hopefully you'll just have to make the odd adjustment and then just crack on.
Very sensible words. My family are telling me the same, but I struggle to listen. The problem is, I've always been a risk taker, and hugely lacking in patience. So I'm finding it very hard to not exercise.
Just wondering if you have any more light to shed on what the MRI found and why you have had to stop exercising?
I know, I'm the same. I've always pushed on through and now I wonder if that's caused the fibrosis that the MRI picked up on. My cardiologist thinks that it will most likely reduce and not be a problem, as long as I take it easy and take my meds (5mg bisoprolol (a beta blocker that really reduces exercise tolerance) and 5mg ramipril). He's told me to stop pretty much all exercise and to restrict coffee to one cup a day (and as many decaff as I like) until I have another MRI scan in 6 months time (or possibly longer given the pressure the NHS is under). Everyone is different and the cause of my AF seems different to yours, but it's best to play it safe until you know what's going on.
I've arranged an appointment with an electrophysiologist to get a second opinion from an expert in heart electrics, given my cardiologist is a general cardiologist with an 'interest in arrhythmia', rather than a qualified electrophysiologist. I would recommend you do the same as they are the best people to understand these issues. I simply asked my GP to refer me to one (you can find a list here - heartrhythmspecialists.org).
I'll never know for sure, but I suspect that coffee played a part in me developing AFib. I was always extremely caffeine sensitive and always thought it affected my rhythm. I have seen articles about studies that say there is no connection, but I simply don't believe them.
The only good thing that has come out of this is that I have broken a life long addiction to caffeine. For many years I was stuck in the cycle of addiction. Now I am completely clean, and feeling much better for it. Shame it took me developing Afib though
Paradoxically, developing AFib can be a cause for good. It can make you look at your lifestyle and make adjustments that can only make you healthier and potentially live a longer life in a more appreciative way. I also used to drink a lot of coffee and rush around all day in a stressful job. I'm still doing the same job, but now I make sure to keep it in perspective and see my family more. I'm slowly getting used to my new life, it's still scary, I have off days, but we all do. At least I know what I have now, and I can start to do something about it.
Very interesting. Viral infections can provocate afib. During my flu I had afib on every day. Inflamation sometimes is not so obvious. A so called "C reactive protein" test can identify the risk of inflamation induced afib.
Yes, I think I pushed it after the pneumonia. Subsequent CRP tests have revealed I don't have any chronic inflammation, hence the cardiologists supposition that hopefully a bit of rest and medication could halt or reduce the fibrosis. I just hope we caught it in time and it's still reversible. Only time will tell.
Concerning Mejulie69's problem worth to mention, that overtraing syndrome also elevates the CRP level and the overtrained athletes more easily, more frequently get infections, flue etc.
When i had my first diagnosed AF episode at the age of 44 i was unable to do any running as normal. When attempting a run it felt like my engine was misfiring and i couldn't get any rhythm going and felt breathless.
I was DC cardioverted to get me back in rhythm after 5 months of persistent AF. When i eventually plucked up the courage to attempt a run i still didn't feel quite right and ended up requesting a treadmill test with an E.P
He confirmed all was well and said i was ok to run. He put my symptoms down to my loss of fitness.
I did eventually get back to running but not to the same level ( historically i have always had to build up slowly anyway). Unfortunately one evening only a few minutes into a steady run the AF came back, however with the knowledge i'd gained from this site i went to A&E the following morning and persuaded them to cardiovert (chemical this time)
I did go into persistent AF again a few months later which lasted 7 months. I was (and still am) on a list for an ablation, but reverted eventually with no intervention.
That was 6 months ago. I have been doing 15 - 20 min HIIT sessions since and (touch wood) have been ok. My only medication is bisoprolol
I don't know what my trigger (if any) could be, however i have almost completely stopped any caffeine intake and my diet has improved. I was in a stressful job also until 5 years ago. I think the change in stress levels may have played a part. Who knows?
Hi there, sorry to hear about your torrid time although glad to hear of recent improvements. Caffeine is a big contributor for me, even though studies disagree!
While I am older than you at age 62, my long distance road cycling likely contributed to my AFIB about three years ago. I initially had two AFIB incidents on consecutive rides and then it stopped suddenly for almost 8 months before starting up again fairly regularly even after I stopped riding for months. Following meds and finally after my second ablation, the AFIB has stopped and it's been about a year now since my last incident. While I no longer do 100 mile rides with 10,000 foot climbs, I still ride regularly 3 x per week with rides around 30 to 40 miles in length and less climbing. As noted in other posts, there is a link between long distance athletes and AFIB.
Suggest that you get a good electrophysiologist and consider your options- meds, ablation or both. Since you are young and assuming that you don't have any other heart ailments, an ablation may be very helpful.
Regardless of your treatment approach, you may still need to scale back the riding a bit longer term.
Hi Jeff, I too, am (was) a hardcore cyclist. The last big ride I attempted was 180 miles and 18,000ft, but AF struck as did the weather, and so we abandoned. The first time I have ever abandoned a ride! In hindsight, it was probably a good thing.
Very happy to hear that you have been able to return to 30-40 milers. I would take that now if offered. Abstinence is killing me right now.
I'm a bit older than you, at 57, but just wanted to say I know exactly how you feel with regards exercise and AF. I had been a squash player for more than 20 years, until June 2016, when I had a bad attack of AF and spent the night in the local hospital (the JR in Oxford). I used to play 3 or 4 times a week, to a reasonable standard, thought I was really fit. Then hit with AF, I have been unable (felt unwilling) to do very much at all in this past year and I am going a bit stir crazy sitting on the settee!! While in the JR, they did an angiogram and told me I had mild coronary artery disease (CAD) as well, which was another shock, considering the lifestyle I had been leading, which was to keep myself fit and eat healthily. Had an echo and, thankfully, that was all clear. Had the CHADS2-VASC score checked (for stroke risk) and that came out as 1, so, I'm in the grey area as to whether I should be on an anti-coagulant or not. In the end, they decided to leave me on aspirin for the CAD instead - I had been taking aspirin for a few years as a general precautionary measure. I was put on Sotalol (Beta Blockers) at 2x40mg daily, but when I first started on these, they wiped me out, so stopped again.
I've tried a few 2 mile runs, but find that virtually always brings the AF on (I also get flutter as well as fibrillation and, sometimes, my heart is seemingly stuck at 140bpm for several hours, I think 34 hours has been my maximum to date). Thankfully, I've always reverted back to sinus with no intervention so far. However, I am now pretty frightened of doing any vigorous exercise, although I really would like to. I've also had spells where I get attacks start up in the middle of the night, being absolutely fine when I go to bed, but then wake up in the middle of the night in AF - horrible and I've seen lots of others on here report this too. I have now started back on the Sotalol and that does seem to have helped with the middle of the night attacks. Like others, I'm convinced there is a strong connection with my digestive system as well as with exercise, as I know if I eat too big a meal, too late, or a spicy curry, too late, I am very likely to get an attack. I've cut back on alcohol, but still like a couple of pints at the weekend, if I can manage it.
My GP has referred me back to the arrhythmia clinic and they have offered me the chance of putting my name down for an ablation. I was very interested in your question to the group: After an ablation have people been able to return to the levels of exercise they were doing before? That would certainly be a strong driving force for me to go ahead. Otherwise, I am really unsure. It sounds like the cure, the right thing to do, to have an ablation, but I am also really nervous of the procedure and the risks which go with it, although I know these days, this is seen as a pretty routine procedure and, perhaps, I shouldn't be so scared.
Definitely, get yourself seen by an EP and hear what they have to say. I will be interested to hear if you decide on ablation or drugs as the future. I live in hope that we can both do some AF free exercise again one day. And thanks to this group for the tremendous support on here, it really does help to know you are not alone.
Hi Andy, you raise a very interesting point about the pros and cons of ablation. I am hospital phobic and needle phobic (!), but I feel that I would be willing to go for ablation if it meant that I could return to a level of exercise that would keep me happy. From the accounts that I have read, it sounds like the majority of people with one or more ablations return to moderate exercise. Some lucky ones return to high intensity exercise. Some unlucky ones aren't cured.
I had ablation over two years ago after 25 years of PAF. I have been in sinus rhythm since. I had never lost my ability to excercise when not in AF so I just carried on as normal after the ablation. However, I am not an endurance athlete. If I was I would not have gone back down the path that caused the AF in the first place.
Do you still have afib so far as I m thinking of ablation
Hi Julian and welcome. It's a strange contradiction that endurance athletes have a greater susceptibility to AF. Despite that being known for years since a study on Finnish Orienteers back in the day, I've never seen it mentioned in any articles in fitness magazines and blogs. I suspect that most of us cardio bunnies are delighted with the three sprints to failure that establishes our maximum health rate (MHR) far in excess of the 220 minus your age - mine was 153% of the age-related MHR - so we and clinicians don't recognise the early onset of AF during exercise. One GP told me when I was about 60 that I must have the arteries of a 21 year old to achieve those heart rates. The medical text books say that AF reduces power output by 30% but my body has adapted over the years to limit that to 8 to 10% and, it quickly resumes normal rhythm when I stop exercising. I found that running with AF was unpleasant and reduced me to jog / walk. However, turbo training, Spin bikes and, a Concept 2 rowing machine produce 160 to 180 bpm despite being nearly 71. I now realise that I had the beginning of exercise induced AF in my 30's. I can't take beta-blockers as with most cardio bunnies my heart rate can drop to the mid-20s when I'm asleep and, has been recorded with 2 second pauses.
The important thing for you is to get prescribed an anticoagulant. I was told by an EP that I was low risk and shouldn't take an anticoagulant. Eighteen months later I had a full stroke that has left me blind on the right-hand side and some difficulty in planning a route to places that I know. The downside of the anticoagulant will be the risk of falling off your bike and hitting your head.
Being any kind of athlete tends become part of our identity and, that is a kick in the gut when you can't get out there and train with that sense off satisfaction or the tingle of adrenaline. You're not alone, don't give up. If I get despondent, I look at the brilliant Paralympians, the Services men and women who've been seriously injured by IEDs but carry on and, a young former work colleague who has terminal cancer; I have nothing to gripe about! My former yoga teacher would say this is a learning experience about ego and life.
Hi John, thanks for the reply. Glad to hear that you manage to live a good quality of life despite the AF and stroke. The first thing the Doctor did for me when they saw my ECG was put me on Apixaban (anticoagulant). Like you, I have a slow resting heart rate (around 38bpm) and so they can't medicate my AF. The more I read the more it seems like no one recovers from AF without surgery, so I'm expecting that ablation will be my only chance of returning to exercise. But I am just at the very start of my journey. I'm a bit gutted about the whole thing, but as you point out, there are people out there with far far worse problems.
It's interesting that your doctor put you on an anticoagulant. Mine is adamant that, at my age (38), the negatives outweigh the positives and that I don't need an anticoagulant.
I think your doctor is correct. Truth is, I haven't actually seen a cardiologist face to face yet. The decision to put me on Apixaban was made over the phone GP to cardiologist when my GP was panicking about my ECG - she thought I was having a heart attack (my HR was around 30 bpm and highly irregular). I am seeing the cardiologist next week and expect he might take me off the drugs as I am only in Afib for a minute every week (at present). The drugs make me feel a bit crap, so will be pleased to see the back of them.
Hi I'm a 42yo female from NZ, I experienced my first episode of Afib in 2008 after completing a duathlon. I have always been active running, competitive women's soccer league and crossfit. At times I would be doing 8 crossfit classes and 4 hours of soccer training a week. I experienced the odd afib episode during soccer mainly and would have to come off and would pace and cough along the side line until it calmed down. I really struggled for oxygen during these episodes but I knew it would pass so I would manage the best I could. I then suffered an episode during an early morning run, this episode the symptoms felt worse again and I actually called an ambulance, I now finally had a diagnosis as they captured afib on the ecg. Due to my age and history there was no need for blood thinners. I had appointment with a cardiologist who performed the usual stress test (nothing happened) and echo cardiogram, all looked normal. I went for a number of years of perhaps having only 3-4 episodes of exercise enduced symptomatic afib during the year. 2015 I was back at the cardiologist stating again I was having short episodes that were correcting themselves over 10-15 mins but these were starting to increase in duration and symptoms were starting to become more of a problem, particularly the feeling of not being able to breath. Then following one epsisode of afib I had approx 7 days of absolute fatigue and any minor walking would cause disturbing palpitations, after about a week I seemed to be back to normal. This cardiologist recommended I carry a "pill in the pocket" Flecainide. I chose to not fill the prescription and never used this option. I carried on with the odd episode until this year, 2017. Playing soccer I began going into afib every game after approximately 30 minutes on the field! I was frustrated at this point. It began to also trigger off at casual soccer training sessions so I went back to the cardiologist. I had also noticed that my Apple Watch had recorded all my readings and that my Pre season training sessions for soccer consisted of 2 hour fitness sessions, sprints etc. I had been noticing that I was suffering extreme fatigue those evenings and the following days after our Sunday games or the training evenings. When looking at my Heart rate recordings I noticed low readings of 27-33 bpm during the afternoons when I was feeling the most tired. Normal resting bpm was between 50-65. The cardiologist performed a 24 hour holter monitor recording nothing other than the occasional Premature beat, they then decided to put me on a 10 day event monitor. During this period I really only wore it for games or trainings as that is when afib was obvious and symptomatic to me. I experienced the odd palpitation and 1 minor afib episode during these 10 days. I most cancelled the cardiologist appointment as I did not expect to hear anything different. I was extremely surprised and taken aback to have the cardiologist telling me that my heart rate was very fast (235) during my "mild" episode. He advised considering it was a mild episode it could very well be going a lot faster than that when suffering a "bad" episode. I was informed at that point to stop the usual activity that triggered afib and commence taking flecainide and diatilzem and once on those I could commence and see how the afib responded. It did not respond well, first time back playing I was off the field with afib in 29 minutes struggling to breath to the point an ambulance was called. Both drugs were stopped at that point, no soccer or afib inducing activity and an ablation procedure was scheduled. It took me 6 weeks of no activity to finally decide to go ahead with the ablation. With 3 children and considering the risks of the procedure with this being more of an elective procedure rather than a life saving required procedure it was a tough decision to make. Anyhow I had the ablation done 20th Oct 2017, 3 days ago. It wasn't pleasant but it's done. The mapping showed my Pulmonary veins were the cause for afib so those were isolated. I was informed I have a Patent Foramen Ovale (25% of the population have this) which allows then to use this hole to access the left Atria! I'm now on Pradaxa and omeprazole for 2 months. I feel okay, at times I feel nauseas all of a sudden and need to lie down but otherwise ok. Leg puncture site bleed out initially after first attempt to get up after procedure but no problems since and healing well. My resting heart rate is consistently 88-93 which is a lot higher than usual but expected after the ablation. I fully expect that I have no further episodes of afib and that i can get back to my active lifestyle within the next couple of months.
You have demonstrated that AF is a worsening disease. I think we are very similar and I hope to be offered ablation when I see my EP next month. Please keep me informed of how you get on in the coming weeks and months.
Just thought of a couple of questions I wanted to ask you: 1) did you ever find out why exercise aggravates AF? (I haven’t, although I know it does); 2) do you expect to return to full strength if the ablation is successful?
Hi there, the one thing I noted is that my episodes of afib became more frequent when I cut down on my activities. I had cut right down on the crossfit in the months leading up to these recent episodes. I was really only focusing on the soccer. I found that strange. My ablation mapping found that it was the PV's causing the tachycardia/a-fib. I tried different approaches to prevent episodes such as hydrate replenish drinks, altering the pre game food and routine, I could not pin point anything that would help prevent or identify anything that would initiate an episode of exercise enduced afib.
Hi kiwicoan.Hopefully, you are doing good.My situation is similar to yours. I was diagnosed @fib 3 years ago and was put on medication since then no afib. But I m feel tired and fatigue so I stopped excercising. To make my life better i am thinking for ablation. I just want to know how are you feeling after ablation?
Hi Samiul, sorry to hear you are suffering. I was only on medication (flecainide and diltiazem) for 2 weeks before suffering a debilitating proarythmic episode on the soccer field. I was removed from both drugs and booked In for an ablation at that point. I have been drug free since 3 months post ablation and have had only one minor episode of symptomatic afib since this procedure and that was at the 12 week mark during a CrossFit class. My resting heart rate has finally come down since the procedure (8 months) and now sits in the normal range. I do occasionally, during exercise, feel that sensation that my heart wants to go into afib, that flip sensation, but it does not progress into afib. I still get the usual palpitations at times and I note that after a hard exercise session my heart rate often drops to the low 40’s that afternoon/evening along with tiredness. I also note that when I have been unwell and vomiting (2 occasions)my heart struggles during retching and feels like it wants to stop, flipping and taking my breath away. That being said all in all it does seem to have worked and the afib is at bay. Cons of the ablation procedure....I found the procedure itself very traumatic and in fact part way through a anaesthesiologist was called into the lab to provide a general. I could feel the burning and at one point rather than a sedative being administered I was pumped with the remaining isoprenaline left in the line which sent my heart into a frightening tachycardia. I highly recommend if possible to be asleep for this procedure. After my ablation I stumbled across some information on sympathetic and parasympathetic nerves and how they play a role on our heart rhythm and I wished I had of known and would have certainly paid to see a chiropractor/osteopath prior to having this ablation. I noted one soccer afib episode being triggered by receiving the ball on my chest and another during burpees at CrossFit, both involve movement through the thoracic area. I would recommend at least researching this yourself to see if this could possibly be a trigger for your afib. Remember ablation only treats the symptoms it is not resolving the cause!
I wanted to respond opening and honestly and not sugar coat my experience. I wish you the best and hope you find the best solution for you.
Thanks for your honest and kind reply. I am scheduled for ablation on Oct as I don't want to continue medications for the rest of life. And I will take your advice for to keep me asleep during the procedure. And i know as an extremely active person like you it is difficult to take thing slow in life. So I think you may consider yoga class even some sort of meditations will help you to reduce upto 40 percent of afib ( I read it some where) and you also did ablation hence afib will be almost non existent for you. You can kick afib out of your life.😀
Hi kiwicoan.Hopefully, you are doing good.My situation is similar to yours. I was diagnosed @fib 3 years ago and was put on medication since then no afib. But I m feel tired and fatigue so I stopped excercising. To make my life better i am thinking for ablation. I just want to know how are you feeling after ablation?
Hi Mejulie69, just come across this post and found it most interesting. What's the current state of play? Have you seen EP had ablation or controlled by meds? I had a successful ablation about 7 years ago and went back to cycling gradually after that, since done several 100 mile charity rides. 2 months ago I had an episode of AF HR 160 for several hours but brought down with beta blocker (Bisoprolol) I have continued to cycle but only up to 50 miles or so. seeing an EP next week. My resting HR is around 50 average over the ride is 120 with max at 160. Whilst I still get some short episodes of AF nothing major has happened since and HR always reverts to about 70-80 within an hour of stopping. I am 67 and not stopping cycling!
Gordon, sounds like your heart has developed new pathways since the ablation (which I think is considered quite normal to us people who have a genetic tendency for AF, and enjoy riding our bikes a bit too much)… if it’s bothering you, I expect that a second ablation would fix you for many more years. After I wrote this post, I had a bout of AF every single week and I stopped exercising. My life turned upside down, inside out. My EP said that drugs wouldn’t work for me as they’d cap my max HR, so he recommended me to go straight for ablation. I had it done 8 weeks ago yesterday, and so far so very good. I haven’t had a jot of AF since I woke up from the procedure. I was unable to do anything physical for 4 weeks post-op, but the last month I have started exercising again - not anywhere near what I used to do, but I did a 20 miler on Sunday and felt amazing. I am starting to get my life back, and I am eternally grateful for the wonders of modern science and technology. Julian
That's great that you are on the "road" to recovery. I feel quite lucky that the Bisoprolol appears to be keeping things in check at the moment as others appear to have bad experiences from it. As I said I am seeing my EP next week so lots to discuss. I have just been accepted for Ride London so won't be doing anything in a hurry to jeapordise that! Regards Gordon
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