65 yo, was doing triathlons <3 hours until AFib. Ablation 3 Aug. No AFib since. Resting HR was 60, 70 since ablation. HR would reach high 160s when exercising, before ablation - HR peaked at 168 doing the treadmill ramp stress ecg at which point AFib was imminent (pre stage). Since ablation I have limited myself to exercise at 130 HR max - slow cycling & jog walk. After jog walk my Kardia usually shows ectopics at a frequency of about 5 per minute for a day or two.
I plan to quit running for now as at 130 bpm I can barely manage 9 min KMs and I can fast walk at that speed.
Medium term aim is to do a triathlon again next year, longer term aim is do a World Champs age group triathlon in 2023 (luckily my qualification had rolled over due to Covid). But I am realistic and realise that family tree research and nice walks might have to be my new leisure mix.
Does anyone have any thoughts or sports rehab/training advice? Cardiologist review later this year will be key.
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splashrollandplod
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As I am sure you already know , AF is common amongst athletes, the more so non professional ones who keep on going into dotage. The professional ones who retire and de train do not seem to suffer quite so much.
Experience has told me that trying to stop people who love the buzz is a waste of all our time but maybe you have already got some ideas that will help you. Life is all abut choices, risk assessment and acceptance.
Thanks. I do get the buzz but have only ever been semi serious. I got more serious from about 58 for some reason. My policy since getting it has been and still is “I’ll do what the Drs say”. I consulted Graeme Stuart, sports cardiologist and probably will do again. I’m ready for any adjustments - if the electric buggy period of my life comes sooner than hoped for, so be it, bring it on. But some athletic folk seem to return to the sport post ablation.
It is your life and your choice. And no one here would ever say "We told you so".
We have 1000s of members here and most went through the same journey. Of course there are also some endurance athletes among us, they might share some experience. And you are right, some athletes made it back to competitive sports after ablation. We all wish you that.
You body and your EP will most likely tell you if you pushed it too far.
Had ablation in July took it easy for 2months, only 20 mins light exercise.Last week had a go on the treadmill after 10 mins had to stop hr 95. Pre ablation could manage 30 mins hr at80 bpm . I have been told that ablation is a serious procedure and needs time six months or more. Having said , that I think strenuous exercise is on the back burner for a while.
Yeah ablation must be quite quite significant to raise Resting HR from 60 to 70, 12 weeks after (still). Treadmill at 80 or 95 would be great for me!!! Slowest possible run speed (slower than fast walking) gets mine to 125 plus (before AF) but hearts all different. Good luck.
A raised HR can often be a result of ablation, but perversely some studies have shown that the ones with the raised HR after are often the more successful ones.
Thanks, I realised RHR is expected after ablation. But it being indicative of success is very interesting. Hopefully AF is gone, RHR will drop and more intense exercise will be possible. I’d settle for 2 out of 3.
Good luck with your triathlons. I think seeing your sports cardiologist is a brilliant idea. You might also like to check out the Facebook page Cardiac Athletes which is very inspiring.Be reassured that the link between Afib and sports is not as clear cut as many make it sound. My EP said it's Tour de France eyeballs out six hours per day type stuff that can cause it , not amateur level stuff, otherwise it's genetics. In fact the single biggest risk factors are a sedentary lifestyle and ageing.
Thanks. Interesting. It’s not very clear is it. I wonder how most people who get AF first find out - breathless/dizzy I guess. For me it was mid Triathlon but I wonder if I’d always had it but only discovered it because of the intense exercise.
Yes, some people don't know they've got it so I suppose they would notice if they did exercise. Mine floors me so I can barely walk so no chance of missing that!Hope you get sorted out soon x
I'm a bit behind you at 2.5 weeks post ablation,...feeling along to see what I can and can't/shouldn't do. I started walking the day after (1km) at a very slow pace. Have worked up to 3.5 miles in a bit over an hour at this point. My heart rate runs to 100 but stops there and or I back off, or sit to rest on a park bench for a minute. I'm on 50mg Flecainide and 25mg Atenolol, as well as all the post ablation pharmacy cocktail. Recent walks have tested me with stairs or longer gradients, simply due to me squeezing in the walks on family outings to unknown areas. It actually feels better to me once the HR stretches and begins a light gallup.
I picked up a couple light dumbbells and did a quick 15 set run through of a workout after two weeks. Can't say I loved how I felt for that one, so I am putting that off for another week. I've read the quick transient changes to HR as in sprinting or lifting is tougher on our challenged hearts.
I tried Zwifting (online stationary bike) once and the heart rate hit 100 after 10 mins at .5 watts/kg and as slow as I could pedal in the easiest gear. I haven't been given guidance on where to keep the max HR but I'm comfortable with 100 for now. I suspect I will soon 'test' out 110. I have the same concerns relative to resting HR, etc. Mine is 57 overnight, or in high 60's by evening on the couch,...or mid 70's-80's through the day. So, a full 20 bpm or more over pre-ablation level. I also read that study about it being good news that HR was higher. Read the same thing is true for HRV (except here, it's 'better' to have a lower reading post ablation). Mine is flat at 6-9 (rppm?)
Overall, I think a return to healthy living includes a moderate active lifestyle. Getting there shouldn't be rushed, but we only know when it is time by treading the water for a minute to see if the temps suit us. I don't know your medical situation but as you approach the magical 3 month blanking period (Sure your healing will continue no doubt) would a modest challenge under 'safe' conditions be appropriate to up titrate to 145 bpm,....I've spent many miles in the saddle at beta blocker constrained heart rates that were much to low for the effort I was expending. The fact that it's running higher now has actually got me feeling much better....not getting woozy when I jump up to answer the door...
Please keep us up to speed on your journey and any wisdom you gain as you chart your return to a more moderated exercise regimen.
10 weeks behind me and 12 years too! Thanks for a very interesting reply, it’s good to hear of someone else thinking about good HR for the recovery period. And your walking HR sounds similar to mine, although your pre ablation HR sounds very low (like my ex? Running club mates). Btw I was getting PACs and ectopics in first 8 weeks after ablation but very few in the last 4 weeks. If you’re out walking near Morayshire we can compare hearts on a stroll!!
A walk in Morayshire sounds lovely. Alas, Portland, Oregon in the wet season is my current go-to. I appreciate the comments on PAC's. My biggest QOL concern over the past 20 years had been my benign ectopics which got much worse over the past 6 years. Afib was the cherry on top 3 years ago. Still, from a quality of life perspective, the PAC's had been the troublemakers. Ablation stirred up those suckers in a big way (guessing 1-2 thousand on a bad day). At two weeks post ablation I've seen a couple days where that number dives to 2-5 hundred (glorious). I remain hopeful that they will diminish going forward which is the main reason I proceed with caution in these early days. So far, activity in that 100bpm range seems to suppress them but Flecainide may be playing a role there. Enjoy the walks and I bet you will at one point spontaneously launch into a trot without concern for what the heart is doing via a device, but for how good you feel. Oh, to be a luddite!
I was thinking … your PACs, up to 2,000 a day is still only about 2%? How do you know how many? Have you got some tech that tells you (I have Kardia 6L, Garmin 735XT, HR strap)? Or are you scaling up? And how do know they are PACs? I think you said somewhere you had PVCs at one stage, how do you detect the difference? From the Dr? Or from a Kardia diagnosis? Or from self interpretation of Kardia ecg eg ectopic with no/poor P Wave = PAC?Lots of questions sorry.
PS my power walk went well, average HR was 114 and pace at 4.12 mph was seconds faster than last slow run (average HR 130). 114 is my ‘MAF’ HR - have you seen that theory, that you should train at HR of 180 minus your age (less if not in good health), and result should be get gradually faster at that HR. Also I’ve felt great since & zero ectopics after. Another theory that will probably disintegrate but I’ll try it.
Would have responded earlier but issues with website. You ask a very good question. I loosely extrapolate the 2k number. I do have a Kardia 2L and iWatch but generally see that I might be in atrial bigeminy or throwing 24 pac's in a minute. I'll look at how many hours that goes on and do some math. In reality I'm likely not having that many total in a day as I don't have reason to believe I have them at night while sleeping and I do get respite at points during the day. I am sure I'm overstating. It's tough to know exactly how many without doing a holter. Last time we did that I had the Zio patch but it came off after 2 days with too much sweating on the bike. I did not register much in that timeframe.
As for knowing that they are PAC's, I have sent multiple strips into EP who confirms....Also Kardia corroborates. And I've done a little EKG sleuthing to get familiar with how I manifest. Sometimes I can actually feel the difference, but not always. Biggest difference indicating PVC is the width/morphology of the QRS as apparently the bundle branch system has further to travel when the impulse is not coming from AV node.
The really good news is the incessant PAC's broke up a bit over the weekend. I've had 3 days where they have gone into hiding. They still come back at odd times or for a day, but it's not as constant as it was. I'm at 3 weeks post ablation tomorrow. So, seems to be a good harbinger of things beginning to settle down or remodel....?
Interesting approach. I'll have to read up on MAF. I seem to be 'stuck' at 100 bpm currently (perhaps due to current meds). If I get a little winded on walks I tend to stop and every time it's at about 97. I am getting lots faster, however so there's something to it. I can say that the current workload of a daily walk (1.5 - 3 miles) seems to fit the bill. Fatigue level tells me it's not yet time to increase any parameters just yet. Cross training, however,......perhaps time to toss in some yoga and/or tai-chi or mobility work to keep things limber while the ticker continues to innervate. Keep me updated on your progress.
My experience is that it’s certainly possible for some people to return to a decent level of training and racing.I’ve run further and faster than I did pre ablation in 2016.
I agree that much of the oft stated link between exercise and AF is overstated. Most amateur athletes don’t do anything near the amount of training that elite athletes do and very few of those get AF. Personally, I was running about 25-30 miles a week when I developed AF. Much less than many people I know. However, both my parents have it. I’m convinced that the genetic influence is much greater.
The good news is that I’ve been able to return to my previous level of training and increase it with no problems. I put this down to an extremely cautious return to training. Reading some of the posts above, I can’t help but think that’s much too much too soon.
You really need to give your heart time to heal before putting any extra stress on it!
I did nothing at all for 2 weeks. Literally nothing. After 2 weeks I did a few short walks with the dog. These were so incredibly slow. Really, really really slow! Nothing to raise my heart rate at all.
I increased my walking really slowly. At least one rest day after every walk.
Eventually after 3 months I started introducing some jogging into my walks. It took several more months before I even ran 5k. I used a heart rate monitor and kept my rate low.
It probably took a year before I was back to anywhere near a regular level of training.
This might sound terribly cautious but it’s worked. I know a few people who have been less patient for whom it hasn’t!
I’m now 59 and I’ve run a 20 min 5k, 42 min 10k and a 1:37 half all since my ablation. Not super fast but not slow and faster than I was before AF so not too bad.
I’m currently coming back from a series of injuries so my mileage is low and slow but I’ll soon be back to training for next years London Marathon (where I’ll be raising money for the AF A)
That’s another really encouraging reply for me thanks. When you say you kept your HR low, how low? And what was your RHR and typical 5km run HR before & after? I’m 66 in 6 weeks - I think your 6 years younger? If so I’ll need to factor that in. I’m just off for a power (ish) 5km walk aiming at max HR 120 and ave HR 110.
Splash roll and plod - I am in a situation very similar to yours including age. I was wondering if you got any info on what a 30 or 60 minute HIT workout should look like for you….which zones and duration at these zones etc.
My cardio told to keep my HR max at 155 and to keep my average BPM to 140 for anything activity lasting from one to two hours…no more specificity.
HIT session no not really. Most training theories seem to recommend 80:20 type approach ie 80% zone 2, 20% at higher intensity. Difficult to know where the zones are with confidence, I think of zone 2 as around 115-135 bpm. Yesterdays ride was ave HR 135, max 159, 90 mins flat. Garmin tells me 2/3s in Z2.
I wouldn’t do 1 hour HIT as part of regular training, I might do an FTP test at some stage, to see where I am (probs the 20 mins flat out version). My understanding is that HIT is good for developing speed but that intervals are better. I am influenced by two advisors on intervals:
1/ Joe Friel. His Fast After 50 book is good. In that he states how strength and intervals are critical for us old guys, without them our muscles will waste away more. But he says they also present a much bigger risk to us - of injury and burn out. This fits with the 80:20 theory which says that too much high zone training requires more recovery time (greater when we are older). When I do a 10k run, even when fit, recovery is 3 days or more. If I do a 10k Z2 run, there’s hardly any recovery need, I could go again in the morning (eg 70 min 10k, fastest I could do these days is about 52 min). So Joe says do short intervals at 90-95% lactate threshold (I guess at 160bpm so for me 150ish. So yesterdays ride had 2x 6 mins at average 150, with 5 mins rest between. But very important to avoid injury when doing these - more likely running.
2/ My friend Stuart. Swim coach, very strong medical knowledge and interest, trains friends for marathons etc. His interval theory: work out your objective eg run 5k in 25 mins, set interval according to race length eg 250m for 5k. Run 250m at target pace ie 1m 25s. Rest 10 secs repeat. If you miss the time once, no probs carry on. If you miss the target twice consecutively, you take an extended rest eg 2 minutes. Go again. When you miss twice consecutively next time, you stop. This method stretches you but prevents overload and so recovery times are not excessive. I tried this and it worked - improved speed over a short period of time. But I stopped because I felt I was getting my HR over 150 for too long with my AFib.
I’m currently building base fitness so not focussed on intervals much. If all goes well I’ll add some short intervals into my runs, Joe Friel style.
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