AF Association

Back in AF after 3.5 years (possibly)

Back in AF after 3.5 years (possibly)

Hi everyone, waiting to fly home after a ski touring trip in the Atlas Mountains. Unfortunately I think the altitude and effort triggered my first AF attack for over 3 years post cryo ablation. I was staying at a 3000m refuge for 3 days but the approach was over 3500m col. Had a few strange ectopics during the climb up to the col and the same the next day at around the same altitude. I have been operating fairly regularly at that altitude so nothing particularly new there. Later that night in the refuge I recorded what looks like a proper AF session. Converted shortly after fortunately. Made the decision to get down to lower altitude and exited the mountains by not entirely conventional means.

Well, it’s been a great 3 years. I’m guessing I’m on the 2nd ablation path now. I’ll make an EP appointment as soon as I get home. Any comments on the ECG appreciated.

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There are acouple of good p waves inthe lower trace so difficult to be sure if frequent ectopics or AF. You were lucky to access an ecg - was it a Kardia?

The reduced oxygen of altitude plus exertion would be the precipitating factor.

Not sure about future management - maybe pill in the pocket flecainide??

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Thanks for the feedback. I had stopped carrying my Kardia device but someone else in the group who suspects AF had one of the new versions, so very lucky to catch it. I did have propherone but didn’t take it because my HR was fairly low at 72 and didn’t want to bring it down any further. Has no experience of flecainide.

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I use Propafenone and when not in AF have Bradycardia I have not found Propafenone reduces my heart rate.

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Well DrDave01 did invent the Kardia and he often reports ECGs here. You could PM him.

Otherwise I agree with goldie11, who is the acknowledged expert here.

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was just going to say wait until Goldie has seen it- and then saw he has!! Good advice re PIP- may all settle now but you may need to restrict height/exertion activities??

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"exited the mountains by not entirely conventional means." that's piqued my interest! do tell

I am being cardioverted for my AF on Friday (diagnosed in late November last) and then off skiing on 9th March for 2 weeks so it will be interesting to see how I get on. cardiologist is happy enough for me to go as he probably knows I'm a stubborn bugger so will be difficult to stop and as a 30+ year skier I know what I'm doing on the slopes so can judge how I feel.

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🚁

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hope you enjoyed the chopper more than the time I was choppered off the hill after breaking my jaw - I was unconscious and missed the trip around Mt Blanc to Chamonix Hospital on a beautiful clear day.....:-(

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Three years ago I went on my first ever skiing holiday; a week in Wengen then aged 53 as a PAF sufferer, controlled by PIP (Fleccainide). Hadn't had an AF episode for over 18 months until then. Had 2 in a week on separate nights, after much exertion on the slopes and probably altitude. PIP worked after about two hours on each occasion. It has put me off going skiing again. Also I wasn't the most natural skier!

There is little research online about altitude and AF, unfortunately I have convinced myself it is a trigger for me and haven't bothered to try again. Obviously though as usual on this forum we are all different in how AF arrives and affects us

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That ECG looks to me like a load of PAC's but not AF. Perhaps coincidentally or not (also being a runner), this is exactly how my ECG would look on the run up to AF. My recent ablation fixed my PACs and my AF so the 2 were definitely connected (so far anyway.... fingers crossed).

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Thanks for the feedback. Hoping it’s PACs but the effect on my ability to move in the hills was probably the same.

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Yeah I expect that when you are getting this many PAC's, your heart is pumping inefficiently.

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This matter obviously requires a great of detailed research. Wengen is situated at about 4,500 feet with easy access to 1000 metre lifts. I have considered this matter very carefully and feel that, for the greater good, I should volunteer to go and stay in Wengen this summer. I will try to keep my expenses to a minimum and to carry out regular reporting of any events that take place. Do you think I should commence a crowdfunding campaign immediately?

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Hi RSC, there are further factors I believe are relevant to AFers and skiing. Not just altitude but 'scary moments' part of the fun I know and post 'a great day' if vagally mediated, as you relax in the evening/ sleep possibly after a few drinks. My theory is one factor on their own may not cause AF but a combination of these can 'make the glass overflow'.

It is with some regret (but not for my wallet) that I have given up skiing until my AF is sorted properly and I have adopted fully a more relaxed lifestyle.

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I also had a bit of a chesty cough which probably didn't help. Ultimately I need to find out what is going on and have a solution before I return to remote areas. The big problem in this instance was the 500m climb back over a ridge to get out. Not sure if I could have managed that under the circumstances. Many thanks for the feedback everyone!!

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