Afib without symptoms: I've been a super keen... - AF Association

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Afib without symptoms

whiteface
whiteface

I've been a super keen sportsman for the last 40 years and by most standards am extremely fit and healthy (I'm now 60).

I have also had odd bout of AF for about the same time. Over the least 10 years these bouts have become more frequent and it now happens once a week and for about 1 to 2 days. These are without symptoms -- for example there is no change to my heart rate and I've happily done a 15 mile mountain walk during an episode. But the episodes are emotionally very hard for me and I can get pretty down about it.

Over this time I haven't found anyone who can give me any advice so I thought I'd try here and also share my experiences.

I have found that the following are the key triggers that bring AF on: - 1) Getting dehydrated (so I now drink a lot); 2) Taking a cold drinks (never take an iced drink and NOT from the tap in winter -- it must be tepid. This is especially important if your hydration levels are getting low); 3) Low salt levels -- so I eat crisps and other salty snacks as well as using sports drink tablets and especially after exercise or in hot weather; 4) No sudden bursts of exercise (running hard without warming up -- and I now avoid flat out exercise too)

I have found that a long strenuous cycle ride (>30 Minutes and a lot of uphill) will usually induce a return to sinus rhythm

No-one told me any of this -- i Just found it out by experimentation. And some of this goes against the prevailing wisdom, so I wanted to share it in case it helps anyone else. And I would appreciate any other advice others can give.

(PS I only use medicine sparingly and as a last resort)

50 Replies
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I started with rare, then occasional, then frequent and now permanent AF. I have had 5 ablations, over 25 years, each worked for a while, the last was 18 months ago but now I am permanent with no ablation treatment to be offered as they think it is not likely to work anymore.

I spent years looking for triggers, both internal and external stimulus, but eventually gave up as apart from alcohol, I couldn't identify a pattern. I concluded for me that the stimulus must be so physiologically deep that I was unlikely to affect it.

I write this not to sound negative or to forecast gloom, but to illustrate that although I find it tires me a lot of the time (sleep disorder or irregular rhythm, who knows?) I live and work and cycle a lot.

Lat week I completed the Ride London 100 mile cycle event, and ride 2-3 times a week - as one cardiologist told me once, 'having AF means you will run the 100 metres in 11 seconds instead of 10' which I found encouraging.

AF scared me witless for years, led to health anxiety, depression and alcohol abuse to manage my fears.

Now, I am comfortable with it; AF lives with me, I don't live with it.

best wishes.

Hidden
Hidden in reply to clemothesweep

I love your attitude! Thanks for telling your story.

Yes, I love your attitude too. I think when we first discover we have AF it does scare us witless like you say. After having it for 13 years and having had three ablations I now accept it and never get the severe, debilitating attacks of the past. Whether it was my last ablation two years ago or my new accepting state of mind and not becoming anxious I really don't know.

Jean

You are a beast!!!! Thank you! That Ride London 100 mile cycle is not a walk-in-the-park! Wow!

the rain and wind didn't help :-)

Thanks so much for sharing. Your comments are really helpful. I expect my AF to gradually get worse but whilst I can I'll try to manage it.

And the triggers I identified still only explain around 2/3 occurrences -- so there is a large random element too.

Like the rest of your body, your heart is wearing out, and I've been encouraged to view it in that light -- just like needing glasses, or a hearing aid, or going bald, or having gray hair. It's normal -- just part of what happens.

Thank you for your informative and inspiring post, the things you have mentioned are all well known triggers. Though the salty crisps are a new one - hmm, yes think I'll say that's why I eat them! Having salt in our food used to be frowned on, but that way of thinking appears to be gradually changing. We had a member on here once who claimed that drinking Himalayan Mountain salt diluted in water would cure his AF. I did try it, but unfortunately it didn't work for me.

Did you know that it's mostly we sporty types that end up with AF? Other cyclists on this forum have said the same about cycling up-hill bringing their hearts back into sinus rhythm. When I used to cycle with a group I could never understand why I became so breathless and lagged behind everyone else when going up hills, that was before I was diagnosed with AF. A cycling friend once told me that a member of his group raced up a hill way ahead of everyone else and when they got to the top they found him dead. Things like that story stick in my mind I'm afraid, so I would be reluctant to take up your cure as to me it's a bit like playing Russian roulette. Each to our own cures though, for me it's doing deep breathing for several minutes.

It sounds like you are enjoying life, which most would agree is another good way of avoiding attacks of AF. Long may that continue.

Jean

Two things...yes I find that deep breathing will ward off an attack

My Af was started originally by exesive exercise when i ran up a very steep hill...that one event brought on many years of trouble.

Remember that when I'm having an episode I have no symptoms.

To start with I used to rest and take it really easy and let it self revert which it usually did within 2-3 days. But on one occasion it went on for a week "tip-toeing around like walking on eggshells" and doing nothing was making my life an utter misery. So I decided I'd prefer to die active than live like a couch potato. So I went out on my bike (carefully) and lo and behold it reverted. (Originally walking had the same effect.) Since then I have VERY gradually pushed the boundaries and found out what works for me. And I'd encourage everyone to adopt a similar approach of careful trial and experimentation. What it has meant for me is that I can now keep the episodes down to <36 hours duration whereas previously they lasted for 48 - 60 hours when I just by rested. So exercise seems a much better thing to do! Hope this helps

I agree with you totally. Our hearts are much more likely to revert back into sinus rhythm if we keep as active as we can when AF strikes. Unfortunately, for some people they feel so ill with it they have no choice other than to sit. I've had episodes like that in the past where it was a struggle to keep conscious or walk at all and I'm so thankful that all appears to be behind me now.

AF has an effect on people in so many different ways and it's sometimes difficult for those who have no symptoms to realise just how awful an attack can be for others and how it can leave them worn out for days afterwards. I believe it's something you have to experience to understand. You are certainly one of the lucky people to be able to think of cycling up a hill while in AF, am pleased for you and hope your luck continues.

Jean

ASFA
ASFA in reply to whiteface

Whiteface - if you have no AF symptoms, how do you know when you have gone into AF? And also how do you know when you convert back to NSW?

whiteface
whiteface in reply to ASFA

A lot of people have asked this - it is simply because I can feel my heart most of the time. (I'm trying to learn to ignore it as then I can't tell).

I've been thinking about how to describe it here is what I have come up with. For most people their heart is like the engine in a modern car -- difficult to know what rev's it's doing as it is so well sound proofed. If you are like that you can get 'silent AF' which is where you have AF but are not aware of it. I'm more like a racing car where the engine is really loud and you can hear it all the time -- it's difficult NOT to be aware of it. Under these circumstances you are aware of 'silent AF'.

The hard thing for many people who have more obvious and serious symptoms (breathlessness being very tired for example) is to accept I don't have symptoms. I'm just about to go out on my bike (I have AF right now) and I'll feel better whilst cycling (when things get more regular and often the AF reverts) than I do when resting and the heart if much less regular.

I discovered the benefits of exercise when in AF very gradually and carefully over a period of around 7 or 8 years. Just as one example, one occasion when I was already aware that gentle walking helped, I was at the top of a Scottish Munro when the AF kicked in. It was a 15 mile 6-hour walk back to the car over 6 more Munros. What else to do but walk back? I was fine at all times, and at the end, so concluded that that level of exercise was perfectly OK.

Hi two day long AF episodes once a week is a lot of AF. As I understand it symptoms or not the main risk are clots and stroke. Depending on your other risk factors it may be worth speaking to your GP about possible anticoagulants to mitigate your stroke risk.

whiteface
whiteface in reply to Kfib

Thanks. FYI My cardiologist specifically told me NOT to take anticoagulants as the downsides outweighed any benefits.

Pleased you have an active life and live with bouts of AF. I do hope you take anticoagulants to reduce stroke risk. I have an active life cycling and walking so wear a MedID band with details of my anticoagulant apixaban due to the risk of bleeding.

Rebma
Rebma in reply to Gincalpe

Do you get your MedID band on line? I am on Blood thinner Eliquis. Does your say Afib or just blood thinner? Thank you

Gincalpe
Gincalpe in reply to Rebma

I got mine online. It has a weather proof label on the inside with my name, date of birth, Taking anticoagulant apixaban for AF, my ICE phone no. (contact in case of emergency), Doctor name and doctor phone number.

rocketritch
rocketritch in reply to Gincalpe

I have a Road ID bracelet. Has my name and where I live. 2 emergency contacts and that I am on anticoagulants. Even had enough room to list elequis.

whiteface
whiteface in reply to Gincalpe

Thanks. FYI My cardiologist specifically told me NOT to take anticoagulants as the downsides outweighed any benefits.

For me too actually, long term antiC at my age (56) as you say was described as carrying a greater risk of bleed than stroke, so I guess it is profile specific

Kaz747
Kaz747 in reply to clemothesweep

I’m 54 and only recently diagnosed. Initially I wasn’t deemed to be a high risk but after a few hospitalisations my specialist put me on anticoagulants which I was told to stop 2 days before my ablation procedure. My procedure was abandoned because they found a clot in my left atrium which must have formed very quickly. I guess my risk profile is now a lot higher. I was told the clot will take 4 weeks to dissolve - I’m 9 days in and I’m a bit on edge. I’m only allowed low impact exercise like gentle walking for now 😳

whiteface
whiteface in reply to Kaz747

Very best wishes for a speed recovery back to 'normal'

If there is no change to your heart rate then how do you know that you are in AF? I have am episode nearly every other day for 3-4 hours and my heart rate goes up and down continually between low 50's to over 100. I can feel the thumps when each episode begins. So how are you made aware that you are in afib? Interesting.

whiteface
whiteface in reply to rothwell

I'm aware of when my heart beats most of the time -- maybe because I was and athlete -- so I can often tell you my pulse without having to put a finger on an artery. What happens is that it becomes arrhythmic so over a minute period I still get 55 to 60 beats. These are distributed randomly -- sometimes two in a single second, sometimes up to 2 seconds between beats. Hope that answers your question.

Staffsgirl
Staffsgirl in reply to whiteface

Surely that is, in itself, a symptom, since you are aware of it.

Try reading 'The Haywire Heart' by a cardiologist and cyclist, about sport and AF.

whiteface
whiteface in reply to Polski

Thanks very much. I joined this forum in the hope of finding useful advice like this and this tip has exceeded my expectations. Thanks so much

Thank you so much for sharing. Your experiences mirrors mine very closely. I too am a fit sportsman a bit older than you. It was a bombshell to experience my first episode 3 years ago. Woken from sleep and convinced it was a heart attack. Had very little support until I found this wonderful forum. Agree absolutely with all your triggers which I too found out myself. The hardest part has been the psychological impact. Have been very down and depressed with insomnia thinking my active life was over and my gp was not encouraging saying only very gentle exercise. Now I am coming to terms with it and back to mountain walking and cycling. I too find salt (crisps) and potassium (fruit,bananas) and especially magnesium are important. I take flecainide when an episode occurs ( like you not a fast heart rate) but also like you exercise seems more effective in getting back into sinus rhythm.

whiteface
whiteface in reply to MyCloud

Likewise thanks for your reply.

I'm enjoying connecting with people who have had similar background and experiences. I agree 100% the hard part is the psychological part. I shared that with my doctor recently and he suggest I go find a forum for athletes (like this one -- art there others?). He said that most of the advice and knowledge relates to people who are ill, or have a poor lifestyle which is of no interest or relevance to me!

whiteface
whiteface in reply to MyCloud

BTW do you know a good natural source for Magnesium? I regularly use SIS Go Hydro or High Five tablets in water to keep mineral levels right but appreciate natural sources too.

Staffsgirl
Staffsgirl in reply to whiteface

Whole grains, bananas, almonds, quinoa, edamame beans, cashews, spinach, black beans, tofu, sesame seeds.

MyCloud
MyCloud in reply to whiteface

Yes I use sis electrolyte when I’m out but have become convinced of the benefits of magnesium that I would not rely on natural sources. I use mag citrate tablets and take a 200mg tablet in the morning and one at night with a meal. Maybe it,s a placebo effect but since taking them I definitely have had fewer episodes and since 400mg is the daily mag requirement with no side effects - bowels are a bit looser!- I will carry on.

I am going to try Mag C tabs, seems sensible

There’s good evidence. Are you familiar with Dr Sanjay Gupta,York cardiologist. If not have a look at his blogs/you tube videos on af. Very enlightening.

whiteface
whiteface in reply to MyCloud

Thanks -- I really appreciate good information so that I can make my own informed decisions. The only person who really knows me.... is me!

Staffsgirl
Staffsgirl in reply to MyCloud

I agree that it’s worth taking mag as a supplement as well as in diet.

This may be a naïve question: if you have no symptoms, how do you know you are in AF? I have never had symptoms...simply been told by doctor I was in AF when under anaesthetic.

whiteface
whiteface in reply to Staffsgirl

I'm aware of when my heart beats most of the time -- maybe because I was and athlete -- so I can often tell you my pulse without having to put a finger on an artery. What happens is that it becomes arrhythmic so over a minute period I still get 55 to 60 beats. These are distributed randomly -- sometimes two in a single second, sometimes up to 2 seconds between beats. Hope that answers your question.

Are you taking a coagulation? If you are having AF events you definitely need to be on coagulants.

whiteface
whiteface in reply to Vscherer

My cardiac doctor specifically advised me NOT to take them as the risks outweighed the benefits.

For me Whiteface I had to find Acceptance, I knew i had the problem but couldn't Accept it...I was full of 'why me?' and 'what's the explanation/cause/trigger?' I fought it and hated it and thought every episode was catastrophic.

I learned after a very long time to say instead of 'why me?'...... 'why not me?' and began to turn my thinking around, to Acceptance.

This is just my experience, and won't be a fit for everyone; my story is very long, and full of ups and downs, with every type of therapy from CBT to Hypnosis to Reiki.......I have always wanted to write about it all one day!

It's great to read of others in the same boat. Thanks so much for sharing.

I thoroughly enjoyed reading all of your posts, replies, and responses. I’ve had AF for over 30 years, and I also had triple bypass surgery in February of 2002. I do a lot of walking (5,000 miles over the past 4 years) and I never really know when I’m in AF. I take Verapamil to regulate rate and I’ve recently started taking Eliquis to lower stroke risk. I also take Lipitor and atenolol at night. Alcohol was the trigger that took me to the emergency room with AF 30 years ago, and so that was eliminated from my diet right away. I’ve found that high stress combined with poor quality sleep almost always triggers a 24-hr AF episode. Frankly, I’d rather just take my 325 mg enteric aspirin and stay away from Eliquis, but my primary care doctor really pushed me to give Eliquis a shot. I think you should keep doing whatever feels right and makes sense to you. Every new day is a gift and a blessing, right? Thanks so much for sharing.

whiteface
whiteface in reply to TonyStrad

Thanks so much Tony, Yes chill and enjoy your life for a long as this one lasts...

I too regularly stop my AF by getting on my bike and cycling up a hill. Have had AF for 10 years but have learned to live with the pesky nuisance. I still cycle regularly but modify things to help myself like use a heart rate monitor to keep it below 120bpm. Things are now slightly better. I found alcohol a trigger so have stopped totally. Do not be beaten. Haywire Heart definitely worth a read.

whiteface
whiteface in reply to AFCyclist

Thanks -- ordered the book and look forward to reading it. Best wishes

I agree with all of your solutions to deal withAF except the strenuous bike ride. Im a 63 former extreme cyclist and AF sufferer (albeit well controlled) and for many AF sufferers extreme exercises makes symptoms worse. I still ride but now more moderately- less miles less intensity. While a big hill and pushing the envelope may seem to benefit you now, eventually it will likely make your AF worse, which appears to be happening now

Also, if you are having no symptoms, how do you know you have AF unless you have a cardiac monitor or are getting an EKG? Just an FYI, some folks with AF have a normal HR in terms of beats per minute, but have the irregular symptoms, heart bears tha are consistent and scattered , Regardless, if you are indeed experiencing AF that frequently and had it for 10 years, please see a doctor immediately. AF progresses does not regress unless properly treated. You are at risk for stroke as many of us are on this site and you may need to be on an anti coagulant...I’ve been there, trying to stay off drugs and experiment with different things, and AF usually ends up winning. It is nefarious but can be managed with many of the techniques you note (except the extreme cycling) and drug management or ablation.

Don’t fool around with this. Best of luck.

whiteface
whiteface in reply to Jhcoop55

Don't worry -- firstly I've fully involved the medical profession at all stages and who specifically advised against anticoagulants. I've had an ultrasound done and am due another shortly. All was fine last time...

Secondly I have also stopped "extreme" exercise, but that doesn't preclude any exercise. It's difficult to define what extreme exercise is but the comment someone else made about a heart monitor and keeping BPM below 120 seems a good idea. For me AF happens when at rest and never during exercise which is maybe worth sharing.

On a separate point there seems to be some confusion generally in the comments I've received about what a "symptom" is. Many people will catch the 'flu but some won't have any symptoms (symptoms include high temperature, feeling tired, sweating etc.) When people don't get the flu but all around them do, then they most likely have it, but don't show any symptoms.

And so it is with AF for me. I have episodes of AF but no symptoms -- nothing to distinguish when it is happening from when it isn't other than irregular heartbeat with unchanged BPM. I explained this to my doctor and told him that the problem is not physical but emotional (dealing with it) and he recommended my finding a site to help me share with other athletes our experiences. That's why I'm here.

Most of the awareness about AF comes from seeing it in unhealthy people. People who were already "ill" with a poor lifestyle and hence already more likely to die early of a stroke. So the situation is actually not at all clear for fit healthy people like us. I'll post (separately) a link to a study which concludes that people with lone AF do not die any earlier than people without.

I've got the book "the haywire heart" on order and look forward to reading that.

Hope this helps.

I love your attitude! I am not an athlete but like you struggled emotionally and psychologically with AF. I have a friend who was an Olympic rower then a sports teacher...and now she has it. She wakes at night with a crazily thumping heartbeat. Athletes have a high incidence of AF.

Two things: magnesium oil rubbed into the skin -10 sprays twice a day is a good way of absorbing magnesium without stomach upset. (According to Dr Carolyn Dean in her book "The Magnesium Miracle")

Secondly: I had hypnosis with a psychologist. Amazingly helpful! As well other techniques she taught me, I now find 5 mins deep slow breathing - in for 7 and out for 11 can calm me enough to ward off an attack and certainly helps cope with it calmly. Onward and upward.

whiteface
whiteface in reply to Coco51

Thanks for the tips.

I've been dealing with this on and off for 10 years now (although I had episodes before that) and found the medical profession good at diagnosis but unable to help with prevention or management or emotional support. And for me the challenges are 100% emotional. Sadly it took me 9 of these years to work out the triggers for me, and how to manage it, so I feel I've only been fully informed for a year or so.....

Not only that in some cases I've been fighting against established wisdom. You'll see in this thread many who think exercise is dangerous. And I have found the rush to immediately label me a "stroke risk" (without taking into account any other aspects of lifestyle or age) gets me particularly upset -- and there are plenty here who want to do the same.

I wish there was better information for fit and healthy people who have "silent AF" -- but hopefully that is changing now as we learn more about it.

There is data to show that (some types of )AF does not change life expectancy -- I'll post that separately.

Thanks again for your post (PS I'm an ex Olympic oarsman too)

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