Extrasystoles (PACs) and bike - Atrial Fibrillati...

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Extrasystoles (PACs) and bike

lapetto profile image
17 Replies

Hallo i am 49 years man 1,91 cm tall

I am new here

I have been experiencing increasing PACs (atrial simple extrasystoles) especially in the last year moving form 7/day (12 month ago) to 200/day (6 months ago) to 2000/day (now). In the last years i felt extrasystoles but the frequency was different and tolerable. Now it is a nightmare

Phisical activity like bike is the first source of extrasystole.

I used to go to Mountain bike for ca. 7 hours /week (10 years) ; now it seems impossible for me to do MTB more than 2-3 hours per week

If i do 1 hour of bike the same day and the day after i experience tons of PACs / extrasystole. Furthermore, situation after meals worsen like 1 extra every 5-6 beats

I feel every single ectopic so this situation is creating anxiety more and more ; now i am in a tunnel where i don't see a solution

I did stress test, ECG, blood analysis and all seem ok. Cardiologists said to me that this should depend to burning heart cells. Take flecaineide 100mg / day didn't help me so i stopped them. Beta-Blockers are not siutable for me since i have 35BPM during night

I am going to do an MRI in the next week; i don't see a solution - ablation cannot be done since PACs are not so frequent, on the same hand drugs are not helping me.

If a stop phisical activity the extrasystole will decrease a lot but this should be the very last option for me;

need help to understand how to manage the situation

many thanks

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lapetto
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17 Replies
Physalis profile image
Physalis

Do you actually go out on your bike or is this an exercise or spin bike? If I was your mother I would tell you to give up your mountain biking for a time until this gets sorted.

One of my sons is older than you and he has PACs and I have been trying to get him to buy an exercise bike. I thought it would reduce his stress levels. Maybe, in view of your experience, I should tell him not to even think about it.

Why do something that you know is making you ill? What is your mountain biking to you? Does it reduce stress, if so what else could you do instead?

I don't suppose yoga appeals to you, or meditation!!! No, probably not!

Physalis profile image
Physalis

You say they are PACs which stands for premature atrial contractions. You call them atrial simple extrasystoles. I don't think they are actually extra. When I saw a cardiologist twenty five years ago he told me that what happens is that an extra signal comes from a different part of the heart and it's premature so you don't feel it. The next one is then heavier and that's what you feel.

lapetto profile image
lapetto in reply to Physalis

Thanks for the reply

Substitute the mountain bike is not simple for me ...... otherwise i had already did

But it is a a trigger of PACs (premature atrial contractions). I think that all the aerobic sports (swimming, run,..) would have the same result to my beats incresasing the extra

I am very sad since i don't see at the moment any real solution to this problem other than stop the exercise or limiting it a lot

Someone has experienced good effective medications to lower the PACs / extrasystoles ? which types?

Thanks

Physalis profile image
Physalis in reply to lapetto

Do you have a Polar heart band or something like it? Could it be that your heart rate doesn't go up quite as much when swimming or running.

I have got quite old without any exercise since I was at school. Looking after a home and three children kept me busy but rarely anything to make me out of breath.

These days a lot of people are hooked on exercise. My daughter tells me she aims to do 10,000 steps a day. A friend of mine is the same, she's underweight and her doctor tells her she must eat more but she's still determined to do her 10,000 steps. I think she's mad!

One of my grandsons took up running marathons. Now he's an instructor at a spin class. Got this from Google "So “what is Spinning class” you ask? It’s an amazing, challenging way to get incredibly fit. All it takes is pushing through those first sessions as they are always the hardest. Once you do, don’t be surprised if you find yourself addicted."

Are people becoming addicted? Will exercise addiction classes be next!

Auriculaire profile image
Auriculaire in reply to Physalis

I agree with you. Exercise addiction can result in people exercising excessively which is actually bad for you and puts a strain on your system. The problem can be addiction to the endorphins provoked by exercise- these are actually a sort of "home made " opiate. Our parents generation rarely "exercised" . They were more active in their daily lives . My gran lived to 98 and apart from walking to the shops and doing her housework was fairly sedentary. And she baked every week and ate cake or scones every day! The only forms of exercise I have ever liked are dancing and gardening. Anything else I find boring. Swimming is ok but chlorine makes me feel ill. Any form of keep fit class I found torture and I watched the clock constantly just wanting it to be over. I have an exercise bike but I can't use it till I get my hip fixed. Even then I will have to force myself to do it!

Physalis profile image
Physalis in reply to Auriculaire

My mother lived to 92 and never did any exercise apart from gardening.

I suppose your name comes from auricula the plant. Mine, well, I bought some fuchsia seeds and sowed half the packet, they all came up and I lovingly potted them on. I had 58 little plants which I was very pleased with. My daughter came over and took one look at them and said 'they're not fuchsias' and pointed to a little white flower which I had not noticed. They turned out to be chinese lantern plants, physalis alkekengi and met a sticky end. Still, one less thing to worry about after my ablation!

Auriculaire profile image
Auriculaire in reply to Physalis

No it comes from the French term for afib "fibrillation auriculaire" . They call the atria "little ears". Medical terms can be confusing here as everything is francicised. The latin terms are not used much as in English speaking countries but most docs understand them. I grew Physalis when I lived in Brum but was not much impressed with it. Hope all goes well with the ablation. Nobody has ever suggested one to me as my afib attacks are at the moment fairly infrequent. I have to have an echo tomorrow so the cardiologist can complete his report to the anaesthetist for a hip replacement op . It will be the first since my first confirmed attack of afib 5 years ago so I am hoping it's ok.

Physalis profile image
Physalis in reply to Auriculaire

I have a problem with my hip. Twenty years ago I asked the doctor at the hospital if I should put my name down for a hip replacement - the waiting time then was seven years. He said that I looked pretty fit so if I had one then I would need it done again in ten years and then again ten years later. I started to bring it up with my doctor last year but I had had my ten minutes so would need to make another appointment. Maybe next year I will try to get referred to the hospital again. It's got possibilities!

I've had the ablation and overall it has gone very well, only one brief episode of AFib in six weeks or so.

Auriculaire profile image
Auriculaire in reply to Physalis

Appalling! Thank goodness we moved here. I have had to wait 3 months for my appointment to see the surgeon because of covid. I don't know how long the wait for the op will be ( my GP took one look at my xrays and said I had no cartilage left in my right hip and a replacement was the only solution) as there is bound to be a covid backlog. With our GP you get as long as it takes and there is none of this one complaint at a time nonsense. This is very unscientific as to make a proper diagnosis several seemingly unconnected symptoms might have to be taken into account. Most of what I hear of GP services in the UK from friends and family is that they are pretty poor.

Physalis profile image
Physalis

Emailed your message to my son who said "Interesting that they talk about anxiety - I think mine are linked to that - they got worse and worse until the cardiologist did a week long recording and confirmed they were normal - since then they have been a rare event!"

Maybe the MRI scan and the other tests will put your mind at rest. When you say your heart rate is 35 bpm at night, is that when you take the beta blockers? What is it normally? How do you test it?

lapetto profile image
lapetto in reply to Physalis

Hi,

35 PBM without Beta-blocker it is my normal beats in the night - probably i am exercised (7 hours bike for week).

I don't have any PACs / extrasystoles in the night or very few. My problem is during the day

I know since i did 4 holter 24hh :-)

MarkS profile image
MarkS

You could take a magnesium supplement to see if it helps with the ectopics.

I used to over-exercise, that is around 3 hours a week of intensive exercise and 6-7 hours of cycling/swimming, etc. After my ablation for AF 10 years ago, I moderated that quite a bit and now do around 30 mins of intensive exercise (HIIT on bike or swimming) and 3-4 hours of moderate (walking, exercise classes) per week. That seems better. I get occasional AF now but it's a lot less frequent than before the ablation. You could consider moderating the exercise a bit and maybe do fewer hills?

You might also try a calcium channel blocker (e.g. diltiazem) rather than beta blocker. I got on very well with it before my ablation.

lapetto profile image
lapetto in reply to MarkS

My Beats per minutes when i ride the mountain bike are close to 120-130 per minutes on average. I am 49 years man 1,91 cm tall

I tried magnesium without any tangible benefits. I used to take Co10 and Omega 3 as well every day

do you think that moderation of exercise can reduce the syntoms? i can be ok with you. I don't understand well the correlation between exercise and extrasystole.. which is the relation? why intense exercise can improve the number of extrasystoles? I didn't find any scientific explanation of this. are you able to explain to me?

Thanks for the sugestion of diltiazem. I will explore this possibility

My dream is to find some workaround / drugs or something that enable me to continue to do the same bike work-outs since i really love the tours, the fatigue, ....

MarkS profile image
MarkS in reply to lapetto

I don't have a magic answer to ending extrasystoles unfortunately. With a low heart rate of 35 at rest, I think part of the system gets fed up hanging around and fires prematurely. It might be worth trying diltiazem. My symptoms disappeared on it and I was very surprised when told after many years if was 80% in AF. But it is very individual. You might consider seeing an EP privately. The early firing triggers must be coming from somewhere, perhaps the pulmonary veins which might be more easily treated?

lapetto profile image
lapetto in reply to MarkS

Many thanks for the reply

On top of what already shared, last ECG showed also a right branch bundle block that never cardiologists have identified during the ECGs done

Regarding the ablation, 100% of cardioligists said to me that in my case (since the PACs are 1000-3000 / day) ablation is not indicated since 99% fails due to impossibility to find the source of extra beats...

Do you have any experience of ablation ?

Regarding drug -> flecaineide didn't interrupt my ectopic beats. I tried to do the same things like bike and verifying if the flecaineide can help but unfortunaltly the results have not been very good

I feel many ectopics prior and post the meals; if i do exercise and then eat then the ectopics multiply becoming 1 ectopic out of 5 beats (for 1-2 hours).

I tried also to take some stomach medicine after gastro analysis but no results as well

My story is that i started ca. 1,5 years ago do feel some strange beats but the frequency of those was different from today... then these beats have improved during the last year moving from 200 / day to 2000 / day .....

If i do not do any exercise / sport the ectopics decrease a lot

The point is that i would like to do some exercise as well !!!! I don't understand why sport can increase the number of ectopics

Physalis profile image
Physalis

Here's a video that will, I hope, help you.

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

dmjtanner profile image
dmjtanner

Hi, my extra beats sometimes occur when I am using my arms a lot or the day after. If I am leaning forward on my bike too much that can bother me. Maybe you can check out raising the handlebars just a bit and loosening the shoulders and arms slightly as you bike, so that less weight is in the arms? Just a suggestion. 😊

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