Just found this forum as I'm currently at home recovering from a catheter ablation. I'm 51 and would class myself as pretty fit, I've done various sports all my life, field hockey, and various other sports in gym classes etc.
About 5 years ago I started doing more serious cycling and longer and longer distances even doing the UK Coast to Coast in a day 250km ride in 2014. All was good, if I look back at that ride my max HR was 186bpm at the top of a renowned climb called Hardknotts Pass.
However during 2018 I noticed my monitor sometimes reading HR over 200. Despite no other symptoms something wasn't right so I got checked out, inc a day with an ECG. That diagnosed Atrial Fibrillation but only under extremes of exercise, and with no other symptoms and no discomfort the agreement was to do nothing, but keep an eye on it.
Over time it got worse and I noticed myself out of breath when simply walking my dogs, an elevated HR of 165 bpm at the easiest of jogs, and went back for further tests. I wore the ECG for 3 days and concluded I was now in permanent A Fib. I'd continued to train, but trained wisely with a coach, so easy days were easy and I'd perhaps do 3 hours of very hard work spread over a week.
I also started doing triathlon at the age of 50, so I was no longer doing the long 6 hour bike rides, more shorter stuff, and adding in running and swimming.
Due to my age and my low resting HR, we decided an ablation was best. I had the op on Thurs 7th Feb, it took longer than expected, the consultant had to cardiovert me 6 times and after he'd fixed the A Fib on the left he found flutter in the right so also fixed that.
All was good, stayed in sinus all night in the hospital and I tested at home the day I was discharged and was still in sinus. Then I started shivering uncontrollably around 9pm, rang the hospital who told me to ring 999 and get to A&E! I was tested by the ambulance who said I was back in A Fib and had a fever with a temp of 38.3
I stayed 2 nights back in hospital and was discharged again on Sunday, a phone call yesterday said they'd found signs of an infection on the chest X Ray so I am now on antibiotics. My temp appears normal.
Now I've read the Haywire Heart book and done plenty of googling, it's clear that there is mounting evidence that endurance sports do seem to enlarge the heart which could potentially cause these electrical issues that lead to A Fib. I wouldn't say I'm 100% convinced that it is purely down to that, and would like to see and read more research.
I'm back to see the consultant next week to agree my next steps.
However I do enjoy exercise, I intend to carry on playing competitive hockey, that doesn't seem to make my HR peak even with A Fib.
The reading and research I've done says I can continue to exercise once the heart is sorted, but I should cut back, which I am fine with doing. Exercise for me is important, but a gentle ride or jog in the countryside is going to be fine.
What I'm not clear on is it "long" endurance work that stresses the heart and causes the long term issues or would short high intensity workouts cause similiar issues?
The consultants I speak to say they see this a lot in marathon runners as an example.
Sorry for the long winded post, but I'm keen to hear from others who have had similiar and returned to regular exercise.
What did you do before, and what did you do after?
Did you change anything?
Is anyone out there still competing, ie 10km runs, Triathlon etc?
Finally some things I've found useful.
I bought the Kardia ECG monitor and that has been very useful in keeping an eye on if I am in or out of A Fib, and my consultant and another one has said they agree with it's accuracy.
This is the book I referred to: The Haywire Heart: How too much exercise can kill you, and what you can do to protect your heart
Thanks, the research list would be very useful! I'm 99.9% sure I didn't over train, that was why I quit paying for a gym and got a coach who kept a very careful eye on everything week by week.
It is interesting to note that professional athletes who retire gracefully around 40 do not seem to suffer quite so much as the adrenaline junkies who continue regardless. Also interesting that few seem willing to reduce their sport to a level which may prevent complications. We are what we are and in my mid seventies I still stress myself by building and testing race engines which probably doesn't greatly help my condition.
We all have to make life choices and for many this greatly improves QOL and long term health. In non athletic people weight loss for example has been shown to be highly beneficial as has reduction of meat intake and a move to more plant based diet and away from processed foods. We all need to take some respsonsibility for our conditons and do whatever we can to improve our lot.
I was about to say I've been told I can exercise, but perhaps cut back a little? All the consultants say exercise is good for you and the heart. I don't think I ever over trained Hidden , so is it fatigue, time doing exercise per session or overall or the intensity that causes the issues?? Does any of the research you've linked to explain that at all? Now trying to clarify what I should do next to "cut back a little" Less time per exercise, ie do a 1 hour bike ride not a 2, less time per week, take an extra days rest or what?
BobD The problem I have listening to my body is I don't get symptoms when exercising! An example last year I did a 40 km/25 mile bike TT race in just under 64 mins, then my body was fine, no fast HR, no pain, no palpitations, so I did a 5km run off the bike in just under 23 mins, and all felt fine, max HR of 172bpm. The next day I did a really easy swim, all felt fine. So what I really don't understand is was that "too" much and did it contribute to the AF, or were the 6 hours bike rides I did a few years earlier the kind of thing that enlarged the heart and caused the issues??
It might interest you to know that a second group of people are prime cadidates for AF. They are fast jet pilots. It is the accumulation of the hight levels of work needed by the heart to fight high G levels (up to 9 G for Typhoon pilots) which causes enlargement of the left atrium. In simple terms this can stretch the natural pathways leading to breakdown and chaos . Once you have reached that point then you are into the AF begets AF syndrome in that the more you have the more you will get.
thanks for that list, flicking thru all your notes it seems very conclusive from the majority of those studies that excessive endurance sport does seem to contribute. I've not done as much as your 15 hours a week, flicking back thru last year I was doing 6-12 hours a week.
What I can't find is advice on what to scale that down to, assuming I can get back into sinus rhythm for a decent time!
Aged 45 now. Have had 2 episodes of AF. 2012 aged 40 and 2014. Electro Cardio Version required both times as drugs failed to work. Both whilst cycling. 1st in winter at one degree and 2nd in summer at 20 degrees. HR peaked at 255 which I could tell as was using Garmin with HR monitor. What I worked out after analysing Garmin output was HR increased greatly exactly the time I had a cold drink on both occasions . I am positive my triggers are drinking cold fluid whilst exercising. Cold drinks or ice cream don’t cause problems during normal activities. So now I tend to stay away from drinking when cycling which is very difficult ! Would love to see more research in this area.
It is very hard to accept but it is likely that just doing moderate exercise is best. With AF the heart rate fluctuates too much to be a helpful monitor. Check you can still talk comfortably during exercise is a good measure of moderate exercise. The duration of the exercise is also important so shorten the time.
A successful ablation or cardioversion may enable you to do more but it that will increase the chances of AF returning.
Hi Kitenski. I was 51 when diagnosed with permanent Afib. I would ride the bike for regular 30 mile sessions with the odd longer ride 70+ miles and would run half marathons. I take the exercise a lot easier now, as the Drs say listen to your body. Last Nov I ran for the first time since Afib a 10 k. It was slower but I enjoyed it, as I had mentally come to terms with the right balance. I wrestle with what caused my Afib but know I will never know definitively, hereditary, exercise drinking a Virus. In the end you will find your way with what feels okay for you. Good luck with your Journey.
Hi yes. I am more mindful of when my heart is at its peak. I back off up a hill. I go to spin classes I just do not bury myself anymore. For me it’s about a balance of what makes me happy and what I am mentally comfortable with regarding my heart. It took me a while to find this level, but it seems to work for me. I own 5 bikes what would I have done with them? 😀 I am sure you will adjust it takes time. My Heart surgeon says listen to your body, at first this was annoying as what does it actually mean? Now I know what it means, only I can tell what is right for me. I hope this helps you.
thank you for the detailed reply, step 1 is to get myself back to sinus, then we'll see what happens next! Worst case a gentle spin in the Yorkshire Dales on a lovely sunny day doesn't sound bad at all
Our son-in-law live sports like yourself and a very fit man. He did the triathlon and had AF after that and was hospitalised for monitoring. I am not sure exactly what treatment he had or maybe nothing. However they told him to take moderate exercising and nothing strenuous. He is still active, goes for walks, light running sessions and it seems AF is not an issue now. This goes to show people should not force themselves to do very strenuous exercises.
Thanks for your reply and sorry to hear about your son in law. There are plenty of people who are 100% healthy doing strenuous exercise.
There seems to mounting evidence that continuing to push yourself into middle age may increase the risk of a fib. However there are also plenty of fit and healthy middle aged triatheltes, marathon runners etc etc
Hi my first post on here but it strikes a cord with my experiences. I'm a fit 53-yr old and fell running and cycling are my sports (I live in the Lake District). The fell running world (running up hills for those that don't know what this is!) is littered with cases of AF and could probably justify a Research project in itself due to it's combination of endurance and intensity during exercise.
I had my first bout of AF + Heart Flutter during a fell race in Nov which was put into normal Synus rhythm by cardioversion in A&E. I then did very steady just keep fit training at low intensity for the next 2 months before trying a Park Run in Jan just to see how things went. Boom.....into AF + Atrial Flutter again. No cardioversion this time (they missed the 48-hr window) so I'm still in permanant AF + Atrial Flutter as I write, and on Anti-coags awaiting a Cardioversion at Blackpool in March, before a 6-7 month wait for an ablation with Dr Gall.
I think I'm coming to terms with the fact my racing days may be over as there seem to be many cases of AF that return after a few years, even after ablation, if you continue to push yourself to extremes. AF begets AF. I've no doubt that intensity in racing has caused the on-set in both my cases, but it could have happened cycling up one of our many local passes or in speed training sessions. It's interesting that one of the leading Endurance Coaches Joe Friel advocates the way to keep competitive in middle-age and beyond is to do interval training yet this could well be one of the main triggers of AF! I too read the Haywire Heart book and found it excellent at understanding what was happening and the likely prognosis.
So good luck with your own journey and let's continue to share experiences and tips, though the one thing I've already learned with this condition is that everybody's own experience is unique.
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