Endurance Athletes with AF? - Atrial Fibrillati...

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Endurance Athletes with AF?

estrennen profile image
27 Replies

Hello, I am wondering if there are endurance athletes in this community that have experience with catheter ablation surgery? I was diagnosed with paroxysmal atrial fibrillation 3 months ago. I go into AF 1-2 times/week and they last for 24-36 hours. I tried a few drugs (diltiazem & flecainide) but did not get any relief. I met with an EP a few weeks ago and am now scheduled for catheter ablation surgery in late September. I plan to be very conservative with my running activity for at least 3 months after the procedure so the scar tissue can properly heal. If the procedure is successful, I will contemplate what level of running to return to. I had been running 2 marathons per year and training 4 months for each marathon, but am concerned that I may hasten the return of AF if I train at that level again. If there are other runners that have gone through this, I would like to hear from you. Thanks!

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estrennen profile image
estrennen
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27 Replies
CDreamer profile image
CDreamer

AF is a well known phenomenon for Endurance athletes but most tend not to linger on this site and find their own community. You may find this site useful as well as Dr M’s book called the Haywire Heart - written specifically for endurance athletes.

drjohnm.org/ Best wishes CD.

BobD profile image
BobDVolunteer

I am not an athlete but the phenomenon of endurance athletes getting AF is well understood and recognised as are the reasons for it. In fact there is a similar problem with fast jet pilots who over work their hearts fighting G forces in their fighter planes who have a similar disproportionate number of AF sufferers.

I understand that the professionals who retire in their thirties and de train do not suffer so much as those lower echelon runners who keep running against all odds. I also understand that no matter what anybody says to them many will continue to push their bodies regardless.

Ablation is not a cure for AF it merely removes symptoms. sometimes for a short while , very occasionally for life. My own has been in hiding for about eleven years now since my third ablation although I have other arrhythmias. Sometimes we just need to have a long think about what we want out of what is left of our lives.

dmjtanner profile image
dmjtanner in reply toBobD

BobD, can you tell me what other arrhythmias you are bothered with? Thank you.

bbnotrevealed profile image
bbnotrevealed in reply toBobD

Do you still take an anticoagulant since your AF has been gone for 11 years?

johnMiosh profile image
johnMiosh

I am a long time cyclist. I started having problems with energy levels in late 2015. I was diagnosed with AF in April 2016, and had ablations in April and October 2017. I am now permanently in NSR (on no medication) and have returned to a high level of activity, but no competition, no HIIT and no pushing lactate threshold HR. I am happy with this, it is far better than I expected in 2016, and dont want to return to that condition. Look back through my posts for details of my progress.

estrennen profile image
estrennen in reply tojohnMiosh

Thanks, johnMiosh. Assuming I have a successful ablation outcome, I suspect my lactate threshold training days are over. Although not ideal, I would give that up if I no longer went into afib rhythm. Still having a difficult time accepting this change in my life.

whiteface profile image
whiteface in reply toestrennen

I continue to life a very full and active life (I've cycled around 70 miles last week week most if it quite vigorous, plus I spent 3 hours on Tuesday and another 3 hours on Friday loading and unloading hay bales. My resting pulse is 55 and the time when AF is hardest to live with, is when sleeping and it can get a bit irregular as it can drop to 40bpm. When I'm exercising it feels great!

An active life is perfectly possible but be careful and learn your way. Happy to share more if it will help, and if you can, check out some of my previous posts too.

johnMiosh profile image
johnMiosh in reply toestrennen

I got over it by adjusting my goals. No more veterans competition. While in AF, I still cycled, but slowly along the canal paths. I also trained as a Commissaire (track judge) to maintain my involvement.

As I had what appears to be a full recovery, I did not want to jeapardise what I had regained, so maintained lower goals. Its good.

dmjtanner profile image
dmjtanner in reply tojohnMiosh

Sounds smart!

whiteface profile image
whiteface in reply tojohnMiosh

Refreshing to finally meet someone else who has permanent AF, and is fit, healthy and not on medication. Me too. Enjoy!

johnMiosh profile image
johnMiosh in reply towhiteface

To clarify, I didn't have permanent AF. I had paroxysmal AF which was undiagnosed for about a year or so, which was eventually diagnosed as AF when it became persistent. After six months in persistent AF i had a successful cardioversion which lasted two weeks and after another six months in persistent AF I had an ablation. I have been pretty much AF free since then, but did have a second ablation for flutter, PVI reconnection and completion of the maze set on the anterior wall another six months later.

I was not feeling very healthy in AF, but admittedly the Bisoprolol made me feel even worse.

jwsonoma profile image
jwsonoma

I used to train hard all year so I could go from sea level up to the mountains and ski moguls at 10,000 feet elv for a day. I have never gotten on a bike or stair master without trying to max out my HR. Since I developed AF I have cut it way back and have been lucky to not have had an event for 3+years.

This Ted Talk also made up my mind. Run for your life! At a comfortable pace, and not too far: James O'Keefe at TEDxUMKC

youtube.com/watch?v=Y6U728A...

I do not want to eventually end up with constant AF

dmjtanner profile image
dmjtanner in reply tojwsonoma

Excellent video! Makes so much sense....I just forwarded it to my family. Moderation in all things. Thanks for posting!

in reply tojwsonoma

I'm not discounting the message in this video but found another take upon it newyorker.com/tech/annals-o...

might make for some interesting reading.

estrennen profile image
estrennen in reply to

Agreed, this is an interesting read - thank you! Good to collect different perspectives on this topic. I have read the 'Haywire Heart' which was co-authored by Dr. John Mandrola. Lot of good information in that book but he is definitely in O'Keefe's camp about tempering endurance training.

in reply toestrennen

Yes, from my experiance less would seem to be more. I still train 5 to 6 days a week but these days I keep it around the hour mark in duration and watch my heartrate, for me that typically means no higher than 130bpm and often well below, training mostly indoors makes it easier to monitor my heartrate and rhythms and the non jarring also seems to reduce the likley hood of Afib. I mix things up to, cycling, rowing, run/walking and some skierg. This link profgrant.com/2019/07/19/wh... is a direction I'm exploring , and the principles of "the Maffetone Method" by Dr Phillip Maffetone. The Haywire Heart is indeed a good read. Good luck on your journey.

estrennen profile image
estrennen in reply to

Thanks for the feedback and advice. I'm in the early stages of this process. First goal is to get this damn afib resolved. Hoping the ablation procedure does the trick (surgery date is Sep 26). I know there's a possibility it may take more than one time, but hoping it's resolved on the first attempt. Then I plan to do no running/training for 3 months to let the scar tissue get established. Then slowly start getting back to conversational pace running and cross training with a bicycle. If everything goes well to that point, I will try some light training for 5 or 10K races. Plan to keep runs limited to an hour and no speed work. There's a lot of 'IFs' along the way, but I think if I'm conservative and patient I can get there.

MS444 profile image
MS444

I am 63. I used to surf a lot and have always run. But never more than 5km 3 times a week. I also do 20 minute sessions doing laps in a swimming pool. I’ve never done a marathon. Want to preserve my joints for snow skiing.

I had an ablation in 2016 and a touch up 3 months ago to stop a recurrence. I think it takes 3-4 months to settle down after an ablation. So I’d take it easy over that entire time. Don’t do much other than walk for the first 2 weeks.

I would ask whether the latest catheters (with pressure control for optimised scarring) and 3D heart imaging technology without flouroscene (which is radioactive) are being used. They are state of the art and seem to be the highest quality and lowest risk methods.

Ridley60 profile image
Ridley60 in reply toMS444

A bit like yourself MS444 I had an ablation in 2014 followed by a touch up 6 weeks ago.

The Cath Lab and tech had come on leaps and bounds for imaging and safety.

Rode my bike for this weekend with no I’ll effect.

Jamila123 profile image
Jamila123

This is not going to be easy to say

But if u want to stop afib u need to stop running

In my opinion

Afib is a symptom of the body telling u something it needs

I would say going from my own experience that afib is caused by oxidative stress - inflammation

And nutrition deficiency for magnesium CQ10 vit C

It makes sense in a otherwise healthy heart

People who often develop afib and get this awful condition 1/2 month

And athletics have one thing in common

They have pushed their body to a point that has damaged the body could be high levels of stress working to hard at any age

It’s called BURNT OUT

Basically you have pushed out of the cellls much needed energy and nutritional vitamins

And what is needed in stead of tablets ablation that cause the body more inflammation and damage to the injured cells

Is too out back into the cell vital nutrition

This is vital for healthy cells

This happened to me I knew if I was to get rid of this afib I had to put back and heal the body

Detox for a year

I completely stopped all sport because the heart is aggravated and needs cooling

My theory has work as soon as I applied everything

I have not had afib for 3 years

Now I have started back to light weight training and very light carbs 30 minutes on trend mill

So it’s about sorry to say changing everything if u don’t want it back

You cannot run if u do u will be on tablets and I think it will progress and become permanent

🌸

MarkS profile image
MarkS

I used to play hockey, go on long cycle rides and before that row competitively. I think I must have had AF for quite a long time, I was in AF for about 24 hours every 3 days. Then I had an ablation in 2010. I stopped the hockey and cut back on the cycling but still do around 180 mins of exercise a week of moderate-intense level. I've been in NSR since then. I think I was overdoing it and that contributed to my AF (plus a genetic component).

jondeanp profile image
jondeanp

I’d never class myself as an endurance athlete. More of a casual runner that sometimes runs long distances.

I don’t run anywhere near the pace that I used to but that’s probably because I had a break from running for a number of years due to injuries, kids and the onset of AF/ flutter.

After my flutter ablation I did some low intensity stuff including easy treadmill running.

After 6 months (a bit of nerves) I went out on the road again and also did more HIIT training.

I find now if I have a period of not training I feel like my heart is craving the exercise.

Whenever I train I always ensure I rehydrate using rehydration tabs (not the caffeinated ones) and also I take daily doses of magnesium taurate.

I don’t think AF necessarily means the end of training but it may mean that you have to make changes

All the best

CliveP profile image
CliveP

TL;DR: Yes you can continue to run. Maybe. It depends. I did.

Well, we all have an opinion based on our own experiences/prejudices. There is no 100% right or 100% wrong.

Do not listen to people who tell you you have to stop running. The chances of that are vanishingly small.

You may well be able to continue running competitively. I have. Equally, you might have to modify your training and run less. Everyones situation is different and peoples response to treatment varies so much that it's impossible to assume anyones advice will work for you.

My story is that I was a modestly keen runner as a teenager and ran for periods of time throughout my life (mainly to get fit for motorcycle racing) . I didn't compete in running races, just ran for fitness/fun.

Fast forward to 2014, I hadn't run for several years and, at the age of 52, was quite badly out of shape. I decided to get back to running and eating better.

I discovered that I lived literally across the road from my local Parkrun so, after precisely one run on the wednesday, I jogged over and had a go. Close to 35 mins later I discovered just how out of shape I was!

Over the next few months I continued running. Never a long way, just 5-8k, 3-4 times a week. I never did anything longer than 12k but I did do a few hill sessions and fartleks. My times gradually improved until 2015 when I had a calf injury that stopped me for 2 months or so. When I returned I expected to be a bit slower and I was. The problem was, I continued being slower, my fitness didn't return and running seemed much harder.

One evening I was out doing a hill sprint session when I decided to check my pulse while recovering between efforts. I noticed straight away that there was something amis with my heart rhythm. I stopped and returned home expecting it to return to normal. It didn't, not later that evening, not the next day, not the next week, not at all!

By this point I suspected what the problem was. Both my parents have AF so I was familiar with the condition.

Turned out that I had persistent AF. Apart from the reduced exercise capacity I was pretty much symptom free. Day to day I felt completely normal. I started on the treatment pathway. No medication apart from anticoagulants.

Throughout this I continued running, just slower than before. Running has so many benefits for me that I was keen to continue.

Eventually, in sept 2016, I had a catheter ablation which so far has been a complete success. I've had no AF at all, none. I take no medication at all.

I was obviously keen to return to running. My EP said I could return much quicker than I did. I had read so much on here about letting the heart heal fully which sounded like sound, logical advice that I decided to take an ultra conservative approach.

I did literally nothing but sit for a week, no more than walking to the kitchen to make a decaff tea for another week. After 2 weeks I returned to work, slowly, carefully, with lots of rest. No more than a ridiculously slow dog walk (shuffle really) twice a week. I gradually walked a little more over the next few months

I didn't do any running at all for 3 months. when I returned, I was again super cautious, kept my heart rate low (below 130) and for really short distances.. Again, I increased really slowly.

FF to today. I continue to run completely normally. Performance wise I've improved all my times. My Parkrun time at the same event is now sub 21 mins. I've run several half marathons with a pb of 1:37 so not terrible for a 56 year old :) I'm currently planning my next traning block. I want to run sub 1:35 at the Gosport half in November. By far the biggest impediment to this is blinkin" Plantar Fasciitis! That's a real pain :)

Will my AF return? Maybe. but it also might return if I dont run. plenty of non runners hereabouts have much worse outcomes.

My point is that, you might well be able to continue. With a good EP, a sensible approach to returning to running and some good luck then it certainly has happened.

If I can be of any help I'm happy to talk in person. send me a message and I'll give you my number.

Good luck!

Turquoise19 profile image
Turquoise19 in reply toCliveP

Wow this is so inspiring. I am just 3 weeks now post ablation n taking it slow. Went for a very slow walk on Sunday tho 3 miles, that needed a long nap to recover. Think the pump function is still recovering.

I would like my recovery to match yours. I have been an endurance cyclist only in past 5/6 yrs, 54 now.

Even a bit of gardening the other day was a challenge and suggested on my HR watch that I'd climbed a set of stairs N HR 130, so suggestions very well heeded. Hopefully I can report your progress in a few months time, if poss. Mine was also persistent. Came on since Dec/Jan

Thx v much Wendy

goldfinger88 profile image
goldfinger88

I've not had this myself. But Billie Jean King, retired athlete. had afib and had this procedure. She says she is now cured and feeling fine. Not sure how long it's been since she had it. Quite a number of years I think. I'm sure she had the very best doctors and hospitals, however and that is always a consideration.

It is a very personal decision and needs to offer you a far improved lifestyle. It is not without risk. But I guess nothing is.

Rbyy profile image
Rbyy

I am a runner since 20 yrs old now 63 and was training for a tri last nov when my afib put me in the ER. Never ran the race but decided to have an ablation which was done Jan 2019. Now july and i am back to casual running no races yet. Like u i did not want to use meds and with low heart rate i was limited on med options. I have had no afib issues but still deal with pacs and pvcs on occasion. My cardiologists says i can do another triathlon but “ its not good for your health”. I have another long time runner friend who also just had an ablation. Def a link with endurance training and afib. My training times have come down but one to two mins per mile. . I am hoping that improves over time. I am not training everyday as i am trying to be more cautious with it. Frustrating but i have replace sone running training with weight lifting and swimming. So I think we can continue to train but check with your doc on how intensely and long you can train. Good luck!

rvotvtlady profile image
rvotvtlady

Hi, I have had two ablations, both in 2018,first one was unsuccessful. I was a regular runner since my early 30s. I ran regularly, had regular races and always pushed myself on races and in training. In 2016 I started upping my training at the age of 45! I then developed ventricular tachycardia which is different from af but I do believe mine developed due to all the running and the increase in intensity as I was getting older. I was regularly running half marathons in training. Running was part of my identity and I found it so hard to. Come to terms with. Esp as my husband ran with me too and is also an avid exerciser. My last race was 2017 jyst before I got my diagnosis. I now jog and walk. I also cycle but no more competitive running for me. It was hard and I still feel a bit sad but at the end of the day I'm getting older do chasing pbs was getting harder and harder. Good luck with whatever you decide to do!

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