Back in AF?: My other half had his... - Atrial Fibrillati...

Atrial Fibrillation Support

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Back in AF?

37 Replies

My other half had his second abalation in September, he stopped all sports for the 3-4 months after the op and when we saw the surgeon in December it looked like it was all good news and he was back in rhythm with no sign of AF. He started cycling and running slowly and building up gradually, constantly wearing a heart monitor and had it set up to 125 bpm to ensure he could slow down if necessary. 6 weeks ago after a ride he said his heart felt like it was missing beats, over the last few weeks this sensation has become more regular and what he describes as “big beat then a little beat”. We saw his surgeon a couple of weeks ago who did an ecg and nothing was apparent and ordered a Holyer test for last weekend ( we are awaited by results). Three nights ago he took his beats per minute and it was 38.Tonight he has gone for a run after a weights session and as he was walking to start the run it went up to 160bpm but dropped back down within minutes. Anyone got any thoughts about what’s going on? Is his AF back in people’s opinions? Any advice? As a non AF person I feel I’m constantly says no the wrong thing. Many thanks in advance, Gem

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37 Replies

Gem, really feel sorry for you....clearly you are between a rock and a hard place. Obviously we are unable to offer any meaningful advice because the change in his condition could be caused by so many different factors. Clearly he did all the right things after his ablation and I suspect, but obviously don’t know, that he asked the Consultant if it was OK to return to normal exercise, the problem is what is “normal” is subject to debate. Given the care he took earlier, I’m surprised that he has not stopped training immediately the changes started to occur. He is having all the necessary checks, but still pushing the envelope which to an old codger like me does not make a lot of sense. Everyone talks about the “blanking period” of 3 to 6 months, but it can take longer for some, 9 months is not unusual.

I know you will be telling him things he won’t want to hear, but assuming he is a youngish, fit guy who has followed a healthy lifestyle, the extreme sporting activity may well have caused his AF in the first place.....let’s hope you can encourage him to slow down a bit before it’s too late.....sorry, but that’s my personal view, but I am not medically trained.....good luck.

in reply to

Hi FlapJack (I’ve found the message) we have had a long chat tonight and he has come to the conclusion that the rate of excercise and how long he cycles for is probably having quite an effect. for the next week he is going to take it considerable easier and then the following few weeks just concentrate on small runs and leaving the cycling for now. It’s hard to know what to do for the best.thanks again Gem

I would suggest that the high HR result he saw on his HRM was because it wasnt picking up correctly at 1st - as you say it dropped back within minutes. I’ve seen this myself with HRMs many times - my current one is a wrist based TomTom sports watch and I have seen that if it’s not quite sitting correctly on my wrist it can show abnormally high readings until I shift it. if it happens again, suggest he compares what the HRM is showing against a manual count. if they compare, stop the exercise and discuss with the medic. if they dont compare, it’s the HRM throwing a wobbler!

in reply to

We hadn’t thought about this! Thank you clearly one to watch!

perkman profile image
perkman in reply to

I have a Garmin HRM that goes on the wrist and it is not accurate a lot. Sometimes by 30%. These monitors use light to read blood flow and algorithms to give reading.

I switched to the chest strap monitor which uses ecg and it is spot on.

Polski profile image
Polski

You could suggest he reads 'The Haywire Heart' by Dr John Mandrola. He is a cyclist and cardiologist, with some personal experience of AF.

in reply to Polski

I’ve read it, it’s now on his bed side table to start this weekend! Many thanks.

Thanks john6. Surgeon couldn’t find anything wrong was badly worded by me, In the snapshot of a couple of minute ecg the heart was in rhythm. My other half is laying off the excercise to see if that will settle. we will wait for he results and take it from there.Thank you for replying John I appreciate it.

Buffafly profile image
Buffafly

I'm just curious, what is the purpose of this training? My son-in-law cycles to keep fit and socialise as he has a desk job but weights + cycling + running sounds heavy!

in reply to Buffafly

That’s what he loves to do! He has been a runner since he was 15 to quite a high level, he got injured so started cycling. He likes the social side of cycling. The weights he started gentle sessions after the 3 month blanking period (I do the same session on a Sunday with just lower weightsso not hard core!). Since the op he has slowly built up his cycling and the running even now is a couple of miles twice a week.

in reply to Buffafly

keeping fit and competing in a sport can be different. as a triathlete, weights + biking, or weights+ running is no big deal

Mike11 profile image
Mike11

Only a guess, but given the time of year and the fact he's cycling so is in the open air, is he prone to hay fever ? I've had two reoccurances since my ablation, both due to flu viruses, but I imagine anything that causes swelling could make the heart grow a little which creates the extra pathways needed for AF.

in reply to Mike11

Yes he suffers badly with hay fever. We hadnt thoughts of that. Thank you.

Mike11 profile image
Mike11 in reply to

Best thing to do then is ask your GP to refer you for a chest X-ray and echo-cardiogram. That will show if the heart is swollen or not.

Alternatively go to a gym and see if the same amount of cycling brings on the AF or not.

in reply to Mike11

Good idea thank you.

jondeanp profile image
jondeanp

My HR (according to my chest strap HRM) seems to fluctuate at the beginning of exercise for a up to approx 10 mins on some occasions.

My running has been limited since the onset of AF/ flutter, but before my flutter ablation in February my HR used to be high (in the 160's) at the beginning before settling to "expected" rates

Since the flutter ablation and since my return to running i have noticed my HR fluctuating more ie into the 160's but then dropping into the 70's.

As someone else mentioned in the post i am aware that it could be the HRM not reporting correctly, but i find it difficult to prove manually

I mentioned this at my post ablation review and i had to push a little before they agreed on a 48 holter monitor. I have this booked in for next month. When it is connected i plan to do some running as normal to hopefully see if they can spot any anomalies.

I did ask if i could have a treadmill/ stress test done at the hospital, but they didn't want to go down this route (financial reasons i believe)

Hopefully i can be reassured by the holder monitor results

in reply to jondeanp

He did the usual excercise routine with the Holter test on so hopefully if there is anything it would have picked it up. Thank you.

Mike11 profile image
Mike11 in reply to jondeanp

"I did ask if i could have a treadmill/ stress test done at the hospital, but they didn't want to go down this route (financial reasons i believe)"

Sorry but this is outrageous. Insist a little harder as this test is one of the best ways of determining whether you are getting worse over time or remaining stable. I do it every three years.

in reply to Mike11

I didn’t know hospitals do this, so it is something we can ask about.

jondeanp profile image
jondeanp in reply to Mike11

Thanks Mike. The first person i spoke to mentioned cost, but then said that they only do the treadmill test when investigating other issues.

I have had a test done a few years ago after a previous cardioversion. This was at a different hospital however via a GP referral.

I will see what comes from the holter monitor test and progress it if i'm still not happy

Cheers

Mike11 profile image
Mike11 in reply to jondeanp

They first found I had AF on a treadmill. I had noticed I was sometimes breathless but hadn't worked out what it was. Wore a Holter monitor twice and although I pressed the button a few times, nothing significant was found but on the treadmill I got to about 8 minutes in and they suddenly shouted stop as my heart suddenly went haywire. After the drugs didn't help I had an ablation and now I get to near 10 minutes.

dmac4646 profile image
dmac4646

Weights are generally not a greta idea if you want to avoid af.

in reply to dmac4646

Ok thank you.

Dodie117 profile image
Dodie117

Has he considered getting a kardia machine. When he feels odd heartbeats he can do a home “ mini” ecg. This will tell him if it is af. It will not diagnose other arrhythmias but his doctor will be able to use the tracings for diagnosis. Very useful.

in reply to Dodie117

We were looking at one last night, we are in the last couple of months of planning our wedding so financially is a lot of money for us at this point, although I think it’s one of those things that we just need to prioritise and buy. It’s good to hear it’s worth the money. Thank you.

jondeanp profile image
jondeanp in reply to

Ive not found the Kardia device to be very helpful whilst exercising. I have tried to run on a treadmill while holding it with both hands (not very easy anyway). It seems to me to be only able to capture a clean reading once you are still, by which point HR may have changed anyway.

I used to use it daily after my ablation, but got fed up eventually. I use it now and again if i'm resting and feel odd bumps just for reassurance.

Further to my previous post ref HRM's reporting correctly, not only was i referring to potential connectivity issues, but also the ability for the HRM to read the electrical activity of someone with arrhythmia issues

From the Polar HRM website: "In most cases the Polar training computers work fine for persons with cardiac arrhythmia, but in some cases (many abnormal heart beat intervals) arrhythmia may cause incorrect heart rate readings. Having many abnormal heart beat intervals may also cause failure of the Polar Fitness Test."

mjames1 profile image
mjames1

Hi. It could be afib, but it also could be something else like SVT or sinus tachycardia. Very hard to tell unless he's either on a holter type monitor or has a portable device like the Kardia Mobile or Kardia watch. Wih SVT's the HR tends to snap back immediately, meaning the HR would go from 160 back to normal in one beat while in sinus tach it would come down gradually in minutes. But again it also could be afib. I'm having similar very short episodes but I was able to catch some of them with the Kardia Mobile. For someone as active as your partner, the Kardia Watch might make more sense because it's already on your wrist and you just push a button for an ekg. That said, one can start getting obsessive about this, so best to discuss with your doctor how much monitoring he feels is necesssary.

Jim

in reply to mjames1

Thanks Jim. He is constantly taking his pulse at the minute so I would worry if he had a Kardia watch. As I have just said in the previous post we were looking at the Kardia machine that you can attach to your phone. I think this is the way forward for monitoring.

I will have a look into SVT and Sinus tachycardia as this is something I have not heard of before.

Thanks again Jim for replying.

mjames1 profile image
mjames1

That's what I have, the one that attaches to your phone. It's called Kardia Mobile. You really don't have to attach it to the phone, just have it nearby when you take the ekg. Warning -- you can get obsessive with the Kardia, but sounds like he's already obsessive wearing the chest strap which is a type of monitoring, so at least he will know what the fast beats are. I don't know how clinically relevant that is, however, and that is one of the questions I will ask my ep later today.

Jim

in reply to mjames1

He wears his heart monitor when he is excercising but constantly feeling his pulse in the evenings if his heart “feels funny”. At least with the Kardia machine I can monitor how often he is using it! I think it’s time to invest in one!

mjames1 profile image
mjames1

Haha. I'm even worse lately. After my first short episode last week, started wearing my chest strap monitor even around the house! I plan to wean myself from that! But yes, the mobile is better than the watch in that regard. I think the watch would drive me nuts as it has an alert feature when to take your ekg. Sometimes a little less is better. Let us know how it works out.

Jim

in reply to mjames1

I guess you have to find what works for you. I know with my partner a constant reminder will make him a nervous wreck. I’ll let you know how it all goes once we have the Holter results.

Many thanks mjames1.

KMRobbo profile image
KMRobbo

I have slept with my garmin chest step on with a watch next to me plugged I to the mains! So i could see what is happening in the night!( AF gets you like this)

I have in the last month also starrted cycling and running . 6 cycles 16 to 25 miles but I initially low intensity no problem. Only w 3 miles runs the first my HR rocketed to 188 in 300 yards. I kept stopping and starting and it eventually came down to 145 to 150. A week later I ran again HR up again in a few hundred yards but only to 160 something then back down to 145/150. I ran quite a bit faster without really pushing.

I had no problems after so I think my heart and I am just unfit having done no cardio for 3 months and little for 6 months. I am getting the odd extra or missed beat but was getting them any way not running and my EP was not concerned at my 3 months meeting.

I don't count running a five miles every few days to keep fit as " endurance " events (certainly not at the speed I run now)

I hope I am right!

Hopefully the investigation will resolve/identify if there is an issue or not.

in reply to KMRobbo

Fingers crossed you continue to be able to run and cycle with no problems. Thanks for your respond KMRobbo.

rocketritch profile image
rocketritch

A change in min/max heart rate is normal after ablation. Also, being an athlete also lends to being more in tune with your body and it's mechanics, so the least little blip in the system is imediatly noticed.

After my first ablation in 2009 I noticed a huge difference in how my heart responded to excercise. I also had allot of eptopic and pcv's. However when in the doctors office there was never any sign of these. Also, about 8 months following the ablation I was given a 5 lead event recorder to wear for 2 weeks before I was released to stop all anticoagulants and antirhythmic drugs. I actually did a 100 mile bike ride with some friends during that time period and nothing resembling affib showed up although the other non issue heart beats did.

I'm not a doctor, and everyone is different, but what your husband is doing does not sound too extreme to me so Ong as he is doing it in moderation. Especially if he is fit. There are no hard numbers as to how much is too much. Even Dr John conceeds to that.

BTW, brief runs of eptopic or pvc's will record as much higher rates in the short term. IMHO, this is probably what he was seeing on his HRM. Especially since it returned to normal levels so quickly.

in reply to rocketritch

Many thanks.

Thought I would give you an update. The three day Holter has said there is mainly in normal rhythm with episode of heart not being in rhythm and brief episodes of extra beats but there was a lot of noise in the Holter test. so my partner has to have another 7 day Holter to get a better picture.which is fair enough. Many thanks for all your replies.

Gem

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