AF Association
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How to stay Afib free after a successful cardiac ablation.

Having had an ablation last October I am AFib free for now and want to stay that way for as long as I can. Are my old Afib triggers still to be avoided? Is high intensity exercise OK? Grateful for any comments or anecdotes!

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Hi Kevin,

I had my afib ablation almost exactly three months ago in Boston. I had some major palpitations for the first month but I've been clear since then except for occasional 5 to 10-second palpitation bursts. By the time I realize it's happening and take my pulse they are usually gone.

I began exercising about a month ago and have worked my way up to 10,000 steps most days walking. I even tried running a few times and got my heart up to about 125 bpm. After I passed a post-ablation nuclear stress, the cardiologist cleared me for exercise up to 140 bpm. But i find it hard to get there while taking a beta blocker.

My triggers are definitely spicy food, alcohol, stress and sometimes physical activity. I try to avoid the spicy food and keep my alcohol intake to no more than two glasses of wine in a day. Although I would probably be better with no alcohol at all.

I am still on a bunch of meds - sotalol, lisinopril, imdur and lipitor. They just took me off Eliquis because of some GI issues they are investigating. Hopefully I can begin to wean myself off the rest at the six-month mark.

But no afib since the ablation! Hope it stays that way for a good while. But the EP warns me "afib always comes back..."

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Thanks for the reply. I can now get up to 125 bpm for about 40min every 2nd day but it took a while to get there! Yes I know it comes back but my guess is some do better than others and i want to do the best I can. I stopped my NOAC after 3 months. Good luck!

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I can relate to the 'by the time I get to check my pulse, it has stopped'.

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Are you not worried about getting off eliquis? What kind of stomach issues did eliquis cause and are they sure it’s the eliquis?

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I have reflux and chest pain. Never had it before ablation. I had an ambdominal CT scan and my doctor's secretary called and and said stop Eliquis and have a colonoscopy. I am not sure about anything else. I am not too worried about stopping Eliquis for a few days. I am out of afib since my ablation Feb. 28. and my heart ejection function has gone from 40 to 70.

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I had a colonoscopy this week and they removed four benign polyps. Now I am back on Eliquis.

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Not to be skeptical but is there anything that "DOSEN'T' cause afib! Themore I research it the more disillusioned I get. Had a bad recovery from general anesthesia after having ablasion done one week ago so I am afraid to do or use anything that could cause me to activate afib again. It was a difficult recovery. I have read very few comments from people who have stayed in normal rhythm for any extended period of time. That is discouraging. And it so affects your quality of living when your init soas you can't ignore it.

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I had a tough time immediately after ablation with fatigue and felt pretty weak. But the heart rhythm has been solid up till now so it was really worth it all. The first few weeks are the worst! Good luck.

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Life style changes are essential to avoid AF but people do need to consider what may have helped cause it originally. Exercise junkies who do not re-assess their lives could easily undo all the hard work just as those who are obese and do nothing about it, have a high stress existence or drink excessively . Moderation in everything.

Many people who look hard at their lives and do something about it actually improve their morbidity prospects

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Thanks Bob. Not planning any marathons! I need as much exercise as I can get to keep on top of my Parkinson's but not so much as to trigger AFib - its knowing where the line is.

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I think it's more the type of exercise. As you say marathons are out, as are cycle trips up the Col de Torini, but a 3 mile walk every day is great exercise and keeps the heart beating healthily.

The other thing to avoid is flu-type viruses. Anything that causes the heart to swell can retrigger AF. The AF goes away once the heart goes back to its normal size but this can take long after other symptoms have gone away.

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Thanks! Yes I enjoy regular walks. Reminder to self - take 1 gm daily vit C !

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Bob have you read eliquis can cause stomach issues? I am on it along with placid (hopefully coming off plavix soon on it after the PV stenting) but I have always had a very sensitive stomach so this is a concern.

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Hi Kevin, I had a Hybrid Ablation in 2 stages (1) Nov 14 & (2) in June 15. Since then I’ve been AF free..............until last month, when my & I went on holiday to Tenerife. Our Appartment in the Hollywood Mirage, is on what is referred locally as Cardiac Hill. Although there’s a free bus down in town, and me really feeling free, we decided that we would walk back from town. The way we chose was up a series of steps. We did this every other day, but on the 3rd or 4th day , bearing in mind, it was hot, I noticed I got really breathless. Needless to say we didn’t do this again. When we got home, was getting breathless on exertion . I went to the GP , had a EGC, which showed I was in Atrial Flutter, and was to be referred to my Cardiologist. After speaking to the Arythmia Team, I’m back in Rivaroxaban, and my Bisoprolol has increased to 7.5 daily. When I’m really coagulated in 4 weeks they contemplating Cardio Version."..............................

....................I guess the point of this is ,to remember how 3 years I was given my life back, and I’ve blown it by being stupid in thinking myself that I’m free of AF forever ????????????

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Really sorry to hear about that. Hope they can sort it all out for you! I have noticed (I wear a fitbit all the time) that my heart rate can goes up to 160 walking up hills. But I need to get fit ... we could do with some detailed advice but because it is more health than illness its all a bit fluffy

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"I can now get up to 125 bpm for about 40min every 2nd day"

The recommendation for exercise is generally around the 30 minute mark 5 times a week! Why push another 30%, when all you need to do, is to keep the engine well oiled/ticking over - no need to thrash it, as Bob says "Moderation". If there is a key to life - that one word seems to fit the bill.

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Thanks - I am carefully pushing it as intense exercise is neuroprotective for Parkinsons (published results of a clinical trial and now generally accepted that you can't exercise too much for this and some other neurological disorders). Can't afford another ablation as the GA was really detrimental. So need to get as close to the line as I can!

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Hi Kevin

I’m female, 43 years old and I also had an ablation last October for exercise induced AFib. I’m on no meds since post 3 months of the procedure. I’ve had one mild afib episode during CrossFit which was on the cusp of the 12 week mark. I am now managing between 4-5 CrossFit sessions a week with my heart rate reaching 210 at times. I use my Apple watch and Cardiogram app to monitor this during a workout and my recovery. Rate often drops to the low 40’s in the afternoon after a hard session but otherwise all is well. My EP cardiologist has no concerns with my range of heart rate and the AFib remains at bay.

My resting heart rate was quite high for some months after the ablation and in the 80’s-90’s with a spike into the 130’s if getting up and walking about. This has finally dropped over the last couple of months into the 60’s/70’s.

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I would be happy to average 140 on my waterrower! My resting heart rate is around 70 since I began to monitor in January. I get up to 160 when walking the local hills - loadbearing exercise on the legs seems to do that to me. I am 67 and also have Parkinsons so need to push the exercise up, slowly. Thanks for the encouragement!

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I had an ablation in Oct and have been AF-free save for one brief episode which Flecanide brought me out of quickly. I like to stay fit and find cycling (2-3 hour rides, fairly hilly, HR up to 150-160 on steep hills) not only makes me feel good, and keeps my blood pressure/resting HR low, but actually helps reduce occasional runs of ectopic beats. I do some light resistance work at the gym but I am going to review this as my EP thought it could possibly have been a factor in the single AF episode. His advice was to experiment with my exercise regime, and modify it as necessary to retain all the protective benefits without the AF risk. I chose to give up alcohol after the ablation and he said he would have done the same in my position.

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Thanks for sharing. I would be reluctant to give up alcohol entirely - I just have a couple of small glasses of organic wine. AFAIK I have been completely AF free since my ablation (check my fitbit data each night). Agree about cycling but I am cheating with an ebike as it is really hilly round here :-). I do resistance exercises too but with light hand weights - I still need to gain weight after losing half a stone while in hospital for the ablation - did not touch the hospital food!

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Coming up to 4 months since my ablation. Barely an ectopic felt since it happened.

I'm a believer in moderation, rather than abstinence, these days. I'm 41; I don't want to have to give up things I enjoy - alcohol, exercise, occasional moments of food gluttony, for the rest of my life.

It would be ridiculous to go through an ablation and then spend weekends running marathons, or going on alcoholic benders. But I allow myself a couple of glasses of wine most weekends. I'll probably have a couple too many on less common occasions like weddings or christmas. I go to the gym a few times a week, and I've started playing in a 5 aside football team - albeit in an over 35 year olds league - I'm only a short step away from walking football!

Good luck, hope you find the right balance.

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You guys that drink some are tempting fate perhaps? All the docs I have seen advise against it. If I take 2 sips of wine I think I’m living on the edge. Life is so different now watching so called triggers and exercise and doing strength training. It’s a bad dream.

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My cardiologist told me it was ok.

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I stick to one glass of good organic wine a couple of times a week. Yes it does change your life - but I ran through a mown hayfield this afternoon with my 4 yr old goddaughter and that was worth the ablation!

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Cheers! I never made any football team - not even my maths dept! Good luck on the next match.

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Had ablation in 2009. Was an endurance cyclist and racer up to that point. About 3 months after the ablation I started back to spin class (eased into it) then when spring came back on the bike.

Did my first centuy ride 6 months post ablation while wearing the event monitor I had just received from the doctors office.

Following that I was taken off all meds and returned to normal life. I only did a couple races after this but continued to do long distance and still pushed myself on shorter group rides.

From 2009-2017 I had a pretty normal life. For the first five years I was affib free. After that I would experience anywhy from 0-3 episodes a year and would either convert on my own or use a PIP.

2017 was probably the best year I had on the bike in years but the affib seemed to be getting worse. However, it wasn't debilitating as it used to be and my heart rate didn't seem to go off the rails as before.

Ended up having second ablation done in January which failed. Actually I feel I am worse off now than before. My EP then suggested the next step would be hybrid Ablation which I would consider but I had also been pursuing having another ablation done by a different, more experienced EP before taking that step. When I discussed this with my EP and cardiologist they both agreed that this was a viable choice.

My first ablation was RF the second was Chryo. I can't help but think that this is the reason for the ablation not taking this time. Though in studies the success rate is pretty much equal irregular shapes inside the heart can create shallow burns that will not fully isolate electrical pathways.

And before anyone says that my continued excercise led to this I would argue against that. Prior to my ablation I always experienced affib in the winter months when I was less active. As I would regain a level of fitness in the warmer months my affib would dissapear. When things got worse affib only showed itself after a ride or during recovery at lower heart rates. Following my ablation when affib made it's return I experienced the exact same thing. Worse in the off season nonexistent in season. I could almost mark the calendar as to when I would most likely have an event.

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Hi rocket I went with 3 ablations rather than the hybrid which was suggested early on by one EP during a consultation only. My other EPS and cardiologist thought it was a drastic move before going ablation route. My afib is basically gone although I get short bouts of tachycardia and did get 2 complications from having 3 ablations but I believe I would do it again even so. Do you live in states and where would you go for 3rd?

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Thanks for sharing and sorry to hear about the failed ablation. Mine was RF. I am sure you are correct about Afib and exercise being a complex picture.

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