AF Association
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Diagnosed at 30

Diagnosed at 30

Hi everyone, I'm new here. I found out I had paroxysmal AF when I was 30. I'm an endurance athlete and had just finished a cycling trip across Europe, cycling over 100 miles a day for 5 months. I've never been on any medication or had any treatment. I have episodes frequently, usually every other day, although sometimes longer periods in between.

Now that I'm 33, a female, and on oral contraceptives linked to a higher risk of stroke, I feel like it's probably a good idea to get checked out again and probably on some blood thinners. From what I understand, the younger one is with AF, the higher the risk for a major cardiac event.

Would love any feedback anyone has, and looking forward to learning and meeting others dealing with the same struggles. (Especially any other athletes who can relate!)

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G'day loneruck, Sorry your body has decided ( so young) to dump you in the AF club. But, looking at your activities all I can say is .... no surprise there then. You are just one of many, so called super fit sporting/athletic types, and in particular the cycling fraternity, who get it !

I'm not sure it's all doom and gloom though and I personally don't agree that you'll get a stroke. At 73 I'm far more likely to be up for one than you.

Look upon it as a warning and an opportunity to examine your lifestyle. Much depends on the degree of damage to the left atria as to how your condition will perform in future. Also there is the question of genetics, anyone in your family been diagnosed with AF? or suffer inexplicable strokes ?

To end with, my daughter was diagnosed with AF in her early thirties as a result of her two pregnancies. Now she has stopped breeding - no more AF. She has taken up Thai Kickboxing instead ..... no AF, well not yet. She'll see what happens when she gets into her 60's☺I must say that genetically AF tends to run in the paternal side of our family!

Good luck

John

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Welcome.....until the regulars 'pop in,' you might want to check this out.....physician/cyclist with AFib........http://www.drjohnm.org/2011/04/cw-treating-atrial-fibrillation-in-athletes-tough-choices/

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I think is the opposite, the youger you are, the less likely is to get a stroke. I was diagnosed young too when I was an avid tennis player. Had no medications, not even an aspirin for at least 25 years and did not develop a stroke. Nowadays, nobody will take such risk. It might have been my good fortune that kept me out of trouble though, but my example shows that nothing in life is 100%, or 0%. I might have taken some risks but it shows that not 100% of people with AF particularly if young, is going to have a stroke. My father did but he was old. On the positive side, AF did not stop me from playing tennis or from carrying a regular life.

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From my experience, it could be vertebrae issues in your back and neck. Search for some of my posts to see my comments. I suggest that you see if this could be a possibility. You will get lots of push back from everyone, especially heart doctors, but if you can find a competent chiropractor willing to try, you may find a no medicine/operation fix. It may take a year of adjustments, or maybe less since your are young, but it could be worth it. And if it does not work, you will at least have a spine that functions as best it can and that is a significant plus.

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I can't agree more with you!

I'm able to reproduce irregular heart rate at will!

This noon, I was in bed with my 3 year old while he was sleeping. I sit up with my upper back/neck against the headboard of the bed, reading some articles on iPad. Then when I finished, I laid down on my right side, and my heart immediately speeded up irregularly. I sit up right away, heart calmed down. In order to test it, I put my finger on the Kardia band of the Apple watch, while it was showing 80 bpm when I was sitting straight up, I laid down on my right side keeping my thumb on the band, it immediately showed 118 bpm and the wave on the watch showed irregular peaks (and I can feel it in my chest too). Then I sit right up, the heart calmed down to 80 bpm again.

The other days, if I didn't read anything with my upper back/neck against the headboard, I can laid on right side without any problem. I wonder if the reading position stressed my nerves so that caused irregular heart rate.

In the nights that the three major afib episodes woke me up, I read Bible on the Kindle with the same position, then I threw the Kindle on ground when I felt sleepy and went on to sleep. I think there's a link.

BTW, I'm 37 years old male. An Oracle tech consultant, which means very high demand and stressful job. About ten years ago I was told my neck didn't have the natural biological curve anymore, due to my at least 12+ hours of work in front of the computer.

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Hi loneruck

I developed afib at 42 shortly after delivering my son whilst having severe preeclampsia. At your age I too cycled intensely- although not as much as you. I would make an appt with your doctor and see an EP. you should be an excellent candidate for an ablation- I’m getting one next week and can’t wait. You may not need blood thinners if you don’t have any of the other chads diagnoses like blood pressure. I am a bit nervous about you being on birth control while having regular episodes as many women without our issues have blood clots from them. I’m not a doctor but would follow up on all of Jesse issues. I also suspect the people in the know on this forum will likely advise you that you may need to forego this level of training if you want to remain symptom free. Exercise is fantastic, but it’s the incredibly intense endurance piece that seems to be an issue. Best of luck to you and know that you will be just fine! You are going into this in great physical health which is half the battle.

Tracy

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Hi Tracy,

Thanks for your message, being on BC is the piece that worries me the most too. I'm going to make an appointment and hopefully find out more. Good luck with your ablation!

DANI

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Plenty of sporty types on here who struggle with AF although most are older than you. Suggest you read Haywire Heart by Dr John Mandrola. I am a regular cyclist 120mpw and have modified my approach to keep cycling. I am 69 and use a heart rate monitor to control my effort.

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I just downloaded it, thanks for the tip! (What kind of heart rate monitor do you use? Something on the consumer market?)

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A Polar chest strap type with wrist strap display.

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You deserve a lot of respect for your cycling. AF is a pain in the butt for an athlete but at your level it probably only reduces your power output by 10% or less, not the 30% that is stated in medical text books.

A cardiac practioner Sister mentioned to me that Polar HRMs (with a chest strap) are less affected by AF. I've had a Polar RS400 for years and that has recorded peaks of over 220 bpm, later confirmed by a Bruce Protocol test with a multi-lead ECG and the display on a large widescreen monitor. I wouldn't trust my Polar M200 (without a paired chest strap) to do the same job.

I'll reply later about AF and exercise; apparently I'm just about to go shopping!

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There are quite a few endurance atheletes who have posted on this site at various times as unfortunately endurance sports can be a cause of AF in younger people.

The only addition to Carneuny’s excellent post is to ask to see an EP (Electrophysiologist) if you haven’t already - one of the tests you need is echocardiogram to see if there are any structural changes to the atria. You may also consider ablation as many atheletes have been able to return to their sports after ablations.

I think you need specialist advice to help you return to your activities and you may need to mederate the intensity to avoid further episodes but it is learning to manage your triggers.

Best wishes CD

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Hi CD,

I haven't had seen a Electrophysiologist yet, thanks so much for the advice, I'll be scheduling an appointment.

DANI

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Hi Loneruck

Done sport all my life i mean a lot PTI in the Army football up to now at 60

53 AF came into my life always had a low heart beat 35-45 resting

my heart was out of rhythm but does not go above 70 resting noticed a decline in performance been in permanent AF 2 years now had one ablation worked for a year

now treating myself had a blood test found out what foods to avoid heart is around 60 now resting just a few quick beats after about 30

can still do all sport that i enjoy just not as good but hey im 60 i started taking apixaban 2 years ago just to be on the safe side but anyone could have a stroke anytime its like bob said we are 5 times more likely in AF

to be honest ive just carried on enjoying my sport as i feel if you take it out of your life it could make the condition worse also its part of living Good Luck

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That's a lot of AF How many hours a week? Female on OC shouldn't you be on a blood thinner?

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I came off oestrogen as soon as I was diagnosed. Not worth the risk and the risk will be there. I would see an EP and consider anti-coagulants if recommended because it is better than a paralysing stroke. Also consider an anti arrhythmic like Flecainide to stop episodes happening because they may be increasing the likelihood of cumulative heart damage.

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good morning my love.yes go and get some blood thinners .thats very important sa you dont want a stroke and get some treatment xxx

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It may be worth having a chat with you doctor to ask for a heart scan. One of the effects of being super fit is your heart can swell and remodel itself, causing the electrical pathways to be modified and consequently cause misfires. The other popular cause of this event is swigging large glasses of wine/beer/etc. Hopefully a few checks can clarify events.

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Hi Loneruck,

I am 54 and have been an obsessive club cyclist for the last 40 years, with a bit of marathon running thrown in when I was in my twenties. I started having mild periods of energy loss in April 2015, which developed into persistent rate and rhythm problems in February 2016 and I was finally diagnosed with AF in June 2016. Looking back over my Strava data, I had several very short AF episodes stretching back a couple of years prior to this ; I had ignored these as they looked like blips on the HR meter.

When I first started with the persistent symptoms in 2016, I was upset by the slow progress of the medical process. I was convinced that an ablation would have more chance of success sooner rather than later, but I was slowly moving through a series of tests, and had to complete one before being put on the waiting list for the next. I was unable to exercise properly (HR restricted to 130 on doctors orders) and looking at a possible future without bikes.

Eventually after an echocardiogram, an enlarged atrium was spotted and I was given Bisoprolol, Rivaroxaban and an appointment for cardioversion. The CV put me back in rhythm for a couple of weeks, showing that ablation was an option, so I was put under the care of an EP.

In October 2016, I was accepted onto a medical trial with a hybrid ablation, The second (and hopefully final) part was completed in October 2017 and I am slowly getting back to normal. i am not taking any drugs at all and my left atrium appears to be getting smaller. I am still riding at what I consider to be the level of light exercise, but others may see as overdoing it . However I have the full consent of the cardiologist to get back to normal. The only caveat is no interval training.

I have an appointment for a review in April, after which I expect to return to relatively normal levels, although I don't expect to compete again in the future.

If you are interested, you can look back at my previous posts here, or you can see a chronological blog of my recovery at wordpress.com/view/afibandc...

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Hi John,

Thanks so much for your message, I'm checking out your blog now. Awesome to hear from another cyclist, and your journey through this.

What do you use to track your heart rate with Strava?

DANI

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Sorry if the blog is a little dull in parts, I added my thoughts on a very regular basis at some points, but I did think it might be useful for athletes with AF to see my progression through treatment.

I used a Garmin 500, with its original hard style chest strap. Strava (and Garmin Connect) records the GPS of the route along with the speed, HR and Cadence throughout the ride.

When I started to get a few extreme peaks of around 190 - 200, I assumed it was the fault of the strap; it was then 5 or 6 years old. After a while I bought a new Garmin soft strap but this was still recording the same peaks. Unfortunately, a friend of mine also bought a new strap at the same time and his was showing similar readings. At the time cycling forums were rife with complaints about the quality of the new Garmin straps. Eventually I bought a new Polar strap and cut down the rubber on the sensor contacts to fit the Garmin sender. At this point I realised there was a problem with my heart and booked an appointment with my Doctor.

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I'm interested in "my left atrium appears to be getting smaller." Did you get an echocardiogram sometime post ablation to compare the readings?

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How did you establish that you had AF and, is it independent of exercise or linked to it? Some GPs classify an irregular heart beat as AF.

If this is self-diagnosis, some HRMs become inaccurate with AF or irregular heart rhythm. The upper range of Polar HRMs are good particularly if the sample rate is changed from the default 5 seconds to 1 second. The post-exercise download after steady state exercise should show heart rate as a relatively steady line gradually increasing with cardio creep over time. If the heart rate has spikes and dips, it's a good chance that it's caused by AF. The next step is to see an EP and ask for a Bruce Protocol test, where your heart wave form is observed and recorded whilst you walk on a treadmill that has incremental increases in speed and elevation; you will need to ask foe an extended test because of your aerobic fitness.

With your exercise history you will have a slow heart rate - bradycardia - that will be even slower when you are asleep. This can be checked by a recording monitor that you wear for two or more days. A slow heart rate means that it's unlikely that you can take beta blockers.

With your cardio fitness it's unlikely that you've noticed AF much and it won't have reduced power output by more than 10%. Discuss exercise with the EP.

My background: I Orienteered, ran, cycled, did Spin and fitness classes, and indoor rowing for many years. The GPs would look at the HRM heart rate print outs I gave them and would only say that I must have the arteries of a 21 year old. I eventually had to insist that I had exercise induced AF. That was confirmed by the Bruce Protocol test. Subsequently I had pulmonary toxicity secondary to dronedarone and amiodarone. I was advised by an EP not to have an anticoagulant as I'm a bleed risk, but I had a stroke in July 2016. However I'm now 71 and my Consultant Neurologist is content for me to exercise on static bikes and rowing machines (I have a Concept 2) and, my GP says that 180 bpm should not be exceeded.

Come back and tell us how you are getting on.

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