Hi All
Mid 40s male runner / athlete .
Noticed Afib occurring more frequently ( once a week ) .
I can get rid of it by spending 5-10 mins at low intensity on a exercise bike .
However every night now I’m like will it be during tonight’s sleep my heart throws a wobbler ...
Hence , here I am on this forum hoping to share / help / discuss .
Dave
Hello Dave.
Quite a few people on here have said exercise can help when a-fib kicks in. I fully understand your concern about an attack happening in the night. There's nothing worse than waking up from your sleep with a pounding heart.
Anxiety and a-fib go hand in hand. If you wake up with it then you panic - I know I do. This in turn makes it worse. If it's happening a lot at night then maybe change your sleeping position - it might not make any difference but worth a try. It might be also be worth asking your doctor about sleep apnea too.
Paul
Thanks Paul
I’ve been reading the messages etc and am feeling a little faint at present ( like - oh dear I might have to give up my training and accept I can only do easy stuff ).
Like others I’ve created an identity with my running and still improving ... to quit competing would be a major thing for me ,but maybe I’m going to have to accept it ..
I’ve got used to getting rid of it - and it quickly goes ,but I’m thinking it may become more frequent and even permanent ...
Awaiting an appointment with a cardiologist at present .
I’m not sure it’s the sleep apnea as it occurred once when I was about to go to sleep ( was fine , lying in bed for a hour or so watching tv ,got up , went to toilet , had a drink of water , lied down and there it was !).
Is it normal for it to become more frequent then permanent without changes ?...
It's hard to say to say if it will become more frequent or permanment Dave - we are all different.
However help is at hand and your cardiologist will be able to advise on treatments. A CV worked for me after I started on 200 mg of flecainide a day. I've had two bouts since then (must be about 10 months now) and all is looking good. Your case sounds promising for the simple reason it sounds like you can convert to normal rhythm quite easily. This is a good sign and suggests treatments like ablation (might not be needed) stand a better chance of being successful.
I'm sure your cardio will be able to help out - he / she is the person in the know. If you enjoy running maybe do it in moderation until after your appointment when you have talked to the doctor.
Paul
Thanks again Paul .
Ultimately i need to avoid having surgery as I work for myself and that would be disaster for my work / company / income.
So if it’s a choice between risking that or just taking it easier then as much as I will be really gutted by it ,there is only one answer .
I guess I am in an “ early “ stage of getting Afib and that if I just continue without changing anything then it will progress to becoming permanent .
The heart doesn’t want to be on this forum but the head brought me here.
As Paul says, we are all different but there is quite a bit of evidence as to how AF is likely to develop because, unfortunately, it is generally a progressive condition. Some lucky people may have the very occasional episode which might last for a short period whilst others find over time, the episodes last longer and eventually could become persistent which sounds bad, but provided the rate is controlled and symptoms not too troublesome, folk often go on to lead relatively normal lives. They also don’t get the anxiety of wondering if or when the next episode is likely to occur. That said, a lifetime of taking fairly potent medication is also less appealing. I’m sure your Cardiologist will go through this with you but it is a good idea to find out everything you can by reading the AF Association webpages as mentioned before. I understand your concerns about ablation but it is not surgery, it’s a procedure so no scalpels or zips! If your Doctor thinks it might be the best option for you, it’s best to avoid any activity for 2 weeks and then gradually progress to normal activities avoiding heavy lifting, so obviously it depends what your job involves. It is generally accepted that ablations are more successful sooner rather than later but there are risks albeit small, so it does require careful thought.
Thanks FJ.
I have been reading up for the last few hours now — not great before sleep time 😀.. but i am learning quickly ...
Great to have people like yourself responding so quickly on here .
It will be a while before I see the cardiologist ( unless I can see one privately - I’m in Swansea )....
“Progressive “was the word I was kind of expecting ,yet hoping I would not see it during reading up ... ( reading up with one eye closed and desperately squinting with the other ,in a child like manner so as to avoid what one does not want to see ).
I’m thinking once a week is now becoming too frequent ?...
For anyone else’s temporary benefit maybe :-
I now start timing how long it takes to knock myself out of Afib into normal sinus.
I use a watt bike , my Garmin watch etc , and cycle -hold at a wattage output ,at what a normal sinus heart rate would give approx 110bpm.
The last few times have taken 9 minutes most recent , and 3-4 minutes for normal rythym to be restored .
Prior to normal rythym being achieved the watch HR reading is wild and I’ve seen it up to around 160 then just like magic it drops off very quickly to 110 and I feel relieved again ...
I did try walking up and down stairs for a while but this didn’t work .
Other times it’s taken 3-4 minutes to reset when I have tried by running .
The key seems to be holding a low set speed / rythym ( I dare not try anything hard when in Afib ).
Last summer when I first noticed I had it , I did nothing and it took 1-2 days to revert to normal .
Another recent time was just before sleep — I got up , spent a few mins on the bike and cleared it , but it came back again later that night ... so now if it occurs around sleep time I do nothing until the morning ..
Based on my own findings ,it would appear that normal day to day activity is required once resetting it .... whereas complete rest ( ie sleep ) after resetting it doesn’t help ...
The last 4 episodes have occurred in the evening ( within a few hours of falling asleep ) following either a long run or a hard ( effort ) training session earlier that day .
Hello Dave and welcome to the place you would rather not be. I think we need to face the main problem head on and that is that intense, excessive and or extreme sporting activity does not mix well with Atrial Fibrillation as you will see if you take a look at Easygoers13 post about 2 before yours. Initially, I suggest you take a look at the replies he received earlier today an follow some of the suggestions we gave him. I know it’s not easy, but although I am not medically trained, all the medics I have heard talk about exercise and AF say much the same thing. Extreme exercise is the main cause of AF in young athletes in the same way that exposure to high levels of g-force has a similar effect on fighter pilots,
Once you have taken a look pinned post for Newbies and Oldies to the right of this page, click on the link below. It’s about Dr John Mandrola who is an American Cardiologist/Electrophysiologist who is also a keen athletic and competitive cyclist. Also take a look at the details about his book, “The Haywire Heart” as this tells it as it is......
Thanks FJ , yes I’d rather not be here but here I am 
Will read this book shortly .
Hi Dave, a lot has been said here already. The AF journey is about getting up to speed on knowledge, here and elsewhere, and then gradually introducing lifestyle changes to find out what works and what doesn't for you as the individual. I would start if you can manage it (and there is not much more important) to book a private cardiologist visit and to an experienced Naturopath. I would drastically reduce the intensity of exercise and not sleep on your left side and look at reducing work & personal stress levels - which takes a long time so start now! As much as I like black & white I learned to accept that a combination of pills and lifestyle changes stopped AF and improved QOL. I hope something there helps, Good Luck.
Booked in to see cardiologist Monday morning .
Surprised how quick I managed to get that appointment , but got it done and looking forward to a few answers ...
This year I started on a coached running plan which is already producing results ...
Before this I thought I knew what I was doing , but I guess like many others i was just putting in too many hard efforts ... and it’s possible that this has led me to where I am now .
Cut back a lot on the overall volume of training to focus only on running ( was triathlon training ) ... I still use swimming but only as easy cross training now ...
I think once you know the facts then a decision can be made .
I will be really really gutted to give up the hard stuff and trying to compete ,but as I say to others .. the most important thing you have is your health ... so to follow my own advice then I’m thinking this is where I will end up .
Retrain the mind to enjoy easy jogs , maybe do a longer run but only light intensity — so can still take part but just cannot move out of lower zones ...
So ... to Monday ..
Good stuff, you sound on it to me. I gave up running, tennis & skiing and found it helpful to start something completely different, which was walking basketball. Still thrilled by scoring a basket from way in my own half on the buzzer!
At the moment I am talking the talk , but can I really ease off ... walking basketball no thanks 😊 but I know what you mean ...
This is going to be a difficult thing to replace , but for me it’s essential to have a competitive type of focus ....
Maybe the 120bpm max running club .... disqualified if you go over 120 - oh dear I’m floundering here ....
My Cardiologist friend informs me that athletes like you and me for that matter can develop Afib. It seems that when you normally have a slower heart beat can be a precursor. Whst to do is the question. My own thoughts, still exercise, but spend more time warming up and cooling down. Keep a log of what you feel could be triggers, alcohol stress, sleep issues. Try and modify. Eat well, stay calm and carry on. Best wishes.
I have tried to find specific triggers — initially I was convinced it was chlorine related from swimming at high intensity / whilst breathing the air just above the water surface ( more so in a busier pool )... then it occurred at other times so my theory was incorrect ..
I think it is to do with interval training, it that is a big factor - ramping the heart up / down / up / down — poor heart is kept guessing — no wonder it decides “enough is enough , take that host “
Maybe it’s not recovering well or replenishing nutrients - eating hydrating in general associated with exercise ...
Keeping detailed logs now ..yet my underlying thoughts are that i think I know what I will need to do soon , and that is just to back off .... 😬😬😬 yikes
What is your resting HR?
Resting HR is 40 average ... though when we’ll rested ive seen it as low as 36-37.
When in AFIB the watch can’t properly record but it shows average 55-60 when asleep ( so it’s wayyyy up - To make things worse ,Garmin then decides to tell me i have had no restful moments and am completely stressed out !)
In AFIB when just walking up the stairs it shoots well over 100 ... I can’t imagine how scary this would be if I was very unhealthy ...then again I probably wouldn’t know as I wouldn’t be wearing a sport watch ..
Even allowing for your fitness 40 is too low and may explain the AF and the 'cure' you have found, which is why I asked the question. The slow heartbeat can allow rogue signals through I believe. Unfortunately no easy answer to that as you can slow your HR with drugs but not speed it up (with legal ones). Anything less than 60bpm is officially bradycardia but some people can feel fine at a lower rate unless......
I have had all your symptoms and more for the past 7 years. I have a low heart rate and beta blockers slow the heart more, to the point where I ended up in ICU. So you may wish to avoid these. Next the drugs I was given made AF much worse, which drugs can do. I stopped taking all the drugs and my AF was much better for awhile but then gradually got worse. Most of the time I could stop it by different postures, exercise, etc. I have not taken any drugs since. Giving drugs to a healthy heart may not be a good thing but heart doctors will not tell you this.
What I found, after messing around for a year or two paying attention to various triggers, is that my AF is triggered by nerve issues in my back. Even though I have EKG charts verifying this, my cardiologist, or any other that I asked, including Sanja Gupta, don't think this is possible. Chiropractic treatments for three years helped a bit but did not fix my back. Gradually, I learned that this is likely because the nerves feeding the heart are continually being re-injured and do not heal. Just in the last month I found out that a 2 Hz frequency is needed to heal nerves, if they are getting the correct blood supply. I know of only two devices that can generate the 2 Hz frequency to heal the nerves. I suspect the brain is somehow involved. In my quest to fix AF, I happen to have purchased both devices. I am travelling right now and only have one with me. For the past two weeks, I have been using it and my AF symptoms have improved immensely. Right now, I am not having AF when previously, I would have it pretty much every day. Gradually, the AF began to come and go during the day. Moving my back, I could usually stop it. (Like you, exercising would often stop it before.) Now AF is not happening during the last three days and that is a big deal to me.
After many years of seeing AF symptoms change, as I tried different back treatments, I am hesitant to say I may have fixed it this time. Time will tell. I would have preferred not to make this post until my AF does not happen for several months, (if it does not) but your post prompted me to make you aware that you may have back issues.
If you want to know more about the devices, message me.
I don't think you will find anyone else who knows about this or believes this can happen. My advice is to try some of what I have done before taking drugs or having an ablation. Unfortunately, there are no guarantees no matter what you choose to do. If you only have this heart health issue, according to my cardiologist, you likely have a 1% chance of stroke. Taking an anticoagulant may reduce this to about 0.3% but will increase your bleeding risk by maybe 3 %. Heart doctors are good at emphasizing risk to get you to do as they suggest. You actually experience much higher risks every day; having a car accident, etc. The approach to the Corona virus is an example of how overblown risk is upsetting the whole world.
I apologize for being blunt. Think very carefully about what you choose to do.
That’s great , I like people saying it how it is as that’s how we - I become more informed.
New on this forum but I will message you - when I find out how to ....
I certainly won’t discount anything , as in other fields I have learnt that even the people you think should really know everything ,are good but often lack in certain areas of expertise ...
Thanks again .
Click on the icon by my name and then you will see where to compose a message.
Hi David, I'm a bit older (59), but also an avid runner for the past 8 years. I trained for 6 marathons as well as several half-marathons, 10Ks and 5Ks. About 2 years ago, I experienced my first Afib episode during a 20K race. Then nothing for a few months, then once/month for about 6 months, then once/week for a few months until they finally captured it on an ECG and figured out that it was Afib. Like you, I also had a low resting heart rate (in low 40s). Unlike you, I found that any aerobic activity above zone 1 HR levels could trigger my Afib. The frequency of my Afib episodes increased to every 3 days and lasted for a 24+ hours each time. I tried several medications with no success and opted to do an RF ablation procedure last September. The recovery time is painstakingly slow, but I have not had Afib since then.
Since the procedure, I do have ectopic beats but they are short in duration and rarely occur when I'm running. I'm still not back to my pre-ablation fitness level, but it does seem to be still improving. I do easy paced runs 4 times/week that total about 20-25 miles. I don't know that I'll be able to train for marathons like I used to, but if I can continue to run several days/week I consider that a victory and much better than my almost daily struggle with Afib. Good luck to you!
thanks for your reply ...
Did you try any activity to get back into synch when you went into AF ?
Interesting to note yours occurred during activity —- did it ever come on during rest ?
When the frequency increased were you still training at the same level throughout ?.
Dave
I tried running through AF (at slow pace) several times and had no luck at all. When I was in AF my heart rate would spike up, around 90-100 when I was sedentary and sometimes as high as 190 while running.
My AF would come on at rest at all times of the day or night. Sometimes it was triggered during a run. I kept logs of activity and food and work. Never could identify a specific trigger for it.
No, the frequency increased even as I decreased my level of running. For most of last year I did not train for a race. I just wanted to be able to do runs without battling AF. The last month or two I was lucky to get in 2 runs/week.
Interesting .
Afib ,but different to myself ...
Shows how complex this really is .
Seeing a cardiologist on Monday and then I shall decide if it’s time to give up chasing pbs etc ...
The sensible part of me I’m wanting to silence is telling me - your time is up—
Also I know that once I get a pb or maybe win or do well in an event ,that I will just want to do it even more ... and ultimately I’m now questioning ,why and whats the point Dave ...
Dave, you only live once. If you have a shot at a PB, go for it. I trained really hard and made it into Boston. That level of training probably contributed to my AF. I love running and I loved marathon training. Bad luck that I ended up with AF as a result. But, I don't regret it one bit. I'd do the same thing again if I knew the result.
To your other point, AF affects everyone differently. It takes time and guess work to figure out what's best for you.
Do you drink about 2.2 to
2.5 litres of water? (Not coffee) throughout the day?
I have tried to drink a bit more recently and over the last month cut down on coffee - reducing from 2 large doses a day down to 1 then less and less on the (tablespoon ).. to today where I have been caffeine free for the first time ( and not really missing it )....
Oh man, I feel your pain. Eighteen months ago, at age 51, I was in terrific shape. Cycled, hiked, occasional tennis, but mainly running - a competitive 400 m and 800 m runner at masters level. Then one morning I had a stroke. Initially, no explanation could be found for it (same as Michael Johnson, the great American 400 m champion!). After a month, heart monitors detected occasional AF, even though I had no symptoms. Then the arrhythmia became symptomatic. Within 2 months, it was out of control. Diagnosis was changed to sinus node dysfunction, a more complex condition (it includes AF and other arrhythmias).
For various reasons, I have chosen not to have an ablation procedure (at this stage, anyway). My condition is managed by medication, to the extent it can be. It is highly symptomatic at times, but tolerable. But I can't run fast on the meds. Flecainide (one of my meds) impedes VO2 capacity so you feel like you don't have enough air in your lungs. And there is a noticeable drop in energy levels - for the first time in my life, I don't feel like running fast.
FlapJack wisely suggested that you look at the work of Dr John Mandrola in the US. I urge you to follow Mandrola on Twitter. He's a sensible guy and an athlete himself (cyclist, but apparently now doing marathons). He is an electrophysiologist - that is, the sort of cardiologist who handles arrhythmias. As veteran posters on this website will tell you, you need a cardiologist who is an electrician, not one who is a plumber. (Some cardiologists focus more on stuff like heart blockages - not on the heart's electrical system.)
If you read the posts on this splendid forum, you will get a sense of how complex cardiac arrhythmias are - different frequency, different levels of symptoms, different triggers, different treatments. You might need to get yourself a device called a Kardia - there are loads of posts about it here on this forum. These are little devices that sync to your smart phone and detect arrhythmias (I'm in Australia and they cost about $A200, worth every cent).
So talk to your doctors and see what they recommend. From my own experience, the main thing is to be conscious of your stroke risk. This is the greatest danger of AF. Strokes can happen, regardless of age or fitness level. I was incredibly lucky - mine was minor and I recovered quickly. I will be taking anticoagulants for life now - even if I had a successful ablation procedure for the various arrhythmias. But that is a small price to pay for being alive.
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