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High heart rate during workout

Hi All

I was diagnosed with AF 2 years ago - im not on any related medication other than statins. I was told that as long as the AF does not affect my daily living then no action is required. I am 53.

I have since continued to go to the gym 5 days per week doing fitness classes. Recently while on the x trainer while experiencing AF I have recorded my heart rate during the workout racing up to and beyond 200. I can sometimes control this somewhat by reducing my work rate to walking pace. It seems to be happening more often, is this something to be concerned about? should I be going back to see my GP?

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In my opinion a GP is not the correct type of doctor to be discussing this with. They seldom have the full training available to give you the best advice and ordinary cardiologists whilst understanding the plumbing of the heart are not usually trained in the electrics so you should ask to see an electrophysiologist.

Pushing your body like you are is not a great idea and could lead to serious cardiac issue in the future so please ease off until you have spoken to an expert and worked out a suitable treatment plan..

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Hi Anotherun :-) I am not a doctor but was lead to believe that the maximum heart rate during exercises should be around 220 minus your age .

A heart in AF is 'labouring', it is not pushing blood around the body efficiently in order to supply our vital organs (one reason some of us with P-AF feel so ill during episode ) Logic tells me it is asking for trouble to push the heart too hard when in AF even more so if you do it not once but continually.

The person to discuss this with is your Doctor.

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This sounds like a high risk activity for you. In your position, I would stick to light cardio sessions until you have seen an electrophysiologist. I doubt it was an EP who gave you the advice you describe.

A cardiac stress test on the treadmill should identify the problem as well as screen for ischaemic heart disease, but surely an ablation should be considered.

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Ditto all the above - may I suggest you look at the book the Haywire Heart - written by a cardiologist and athelete with AF. I haven’t read it myself but understand it very clearly outlines the risks as to what and when exercise is helpful and when to 🛑

google.co.uk/search?q=the+h...

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Mmmmm …. I'd listen to all the advice given above if I were in your shoes. The one and only time I knowingly had a HR of 200+ I felt like death and the GP called an ambulance and packed me off to A&E. It makes me feel ill just thinking of doing any exercise with a HR that high!

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Yes, Anotherun, you should be concerned about it. I assume you are in great shape and excellent health which is probably why you aren’t on anyone’s radar. You need a referral to an electro physicist since you have already been diagnosed with A-Fib. Don’t put it off. I bet you have put it off, haven’t you?....but don’t. You are not going to fix it the way you say that you have been trying to fix it because it is an electrical issue. Eventually, if you wait too long -it may not respond to anything but medication. The sooner you can get help from the EP, the easier it will be to correct/manage the problem. I wish you the best! Welcome to the forum. Knowledgeable and kind folks on here. 🙂

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Yes I was told by my electrical cardiologist the earlier you get help and have treatment the better the outcome,eg. Ablation .

I asked him how long ago was it when my afib was beginning to occur, when it was minor and not effecting my life. Use to scuba dive every fortnight. He said 10 years. My heart use to race and I would feel exhausted going up the slope with heavy gear on after the dive. Thought everyone felt that way.

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If you were relying on the monitor built into the x trainer, be aware they are not always very accurate. A couple of months ago, I was on a treadmill that showed my heart rate going up to something like 200 while my fitbit showed a heart rate of under 100. Now, I know my fitbit is not entirely accurate (it usually reads about 10% low) but I was pretty confident my heart rate wasn't anywhere near 200 but that's what the treadmill told me. I stopped anyway just in case.

So, overall, what do you believe? I'd say believe in how you feel and get used to assessing your own heart rate that way.

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I think I'd still see an EP though - think Andrew Marr..........

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To all that have taken time to reply, many thanks it's much appreciated.

Having lived with this for 2 years without any advice or I admit not seeking advice, I realise I can nolonger rely on my ignorance!

I feel very fit and well and don't have any other symptoms. I have experienced this high heart rate many times and checked on 2 different devices to check the correct readings. When at high levels the worst case is I need to stop catch my breath wait for my heart rate to fall into line then carryon. However from listening to your replies this will no longer be the case.

Thank you Aprilbday as you seem to have just about summed it up! I will book a visit to GP and ask for a referral to the electro physcist.

Not before time!

Thanks to you all, this has been extremely helpful

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If the GP won't refer you directly to an EP (mine wouldn't - only to a cardiologist) then you might wish to consider seeing an EP privately if that's 'do-able' for you. I'm not sure of current EP rates, but I'd have thought £250/300 for a consultation + extra for any tests.

Good to know that you are willing to take the advice given here on board :-) We are a kind, supportive lot here so do let us know how you get on, won't you?

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Thanks & will do

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Before you ask for a referral, do your research on electrophysiologists locally, regionally and nationally. You can request an out of area referral with the NHS. Members here can give you recommendations (suggest you do a separate post for that).

I agree about a one off private EP appointment, but be careful about private tests, they cost a fortune. I was charged £400 for a 48 hour Holter monitor. You can revert to the NHS for tests. This way you avoid NHS delays of up to a year for a first appointment.

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I paid £180 for initial appt with Cardiologist, £140 for follow up. There was an additional charge of £60 each time for ECG. 24 hour Holter just under £300 & Echo just over £300. Back in NHS now but expense worth it as I avoided 6 week delay for initial NHS appointment. Haven’t seen EP but Cardiologist has made recommendation for ablation if drugs (Flecainide & Apixaban) don’t work. So far, so good - no more episodes after a month’s treatment. Some side-effects, but lessening. Take care everyone.

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This reminds me of my AF history. It started with occasional spikes in HR during exercise; I ignored them because I thought they were impossible and must have been caused by a faulty heart strap. My AF progressed until it became more regular and actually affected my performance. During exercise, my heart would beat faster in response to adrenaline, but because of the AF less blood was pumped so my heart would beat faster but less efficiently. Eventually my heart would pump at 250, but I would come to a stand still. The haywire heart book give a very good explanation of why this happens to fit people.

Wrist based HR meters dont work in AF because they measure blood flow, not beats. An electrical chest strap or the hand contacts on a xtrainer will give relatively correct reading.

You are the same age as I was when I developed symptoms. You need to see an EP, to arrange a treatment plan, and you should probably be on anticoagulents.

Search back through some of my posts, there is a full history of my treatment. There is also my blog, which may be a little self-indulgent, but has a lot of detail on my treatment.

afibandcycling.wordpress.com

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Many thanks, I've just started reading Haywire.

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hello there from Los Angeles. First of all, go to a specialist. Secondly, do not work out as much as you are doing. Heart rate @ 200 (and this may perhaps be inaccurate on a machine in a gym) is far too high. It seems your workouts are aggravating your problem. I repeat, go to a Specialist, someone who only deals with heart and AFib. Ive had one or two wrong diagnoses in my life, one nearly took it!!! Second options also. You can never be too sure. Good luck and GO TO A SPECIALIST. Statins (I believe) are for high blood pressure? All of the above just my opinion as an AFibber. Been so for many years now. On meds that control it very well. As far as ablation, a Specialist will advise on that. Ive heard many reports, especially here in US, re this procedure. It can be - sorry for the pun - hit or miss. In other words, it might have to be repeated. Again, it also depends upon the doctor, especially his qualifications and experience. I saw Dr. Andrea Natali, here in US, renowned EP. However, I chose not to go forward with the ablation until absolutely necessary. Sooner than later does not always work out. In other words, more than one ablation. A patient Dr. Natali operated on had had four ablations with other doctors before the fifth from him - which was successful. I hasten to add, this woman was 73 at the time, and has been out of AFib now for three years. Again, all of the above, just my opinion. Be well AND go to the right person.

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