I am currently on a long distance walk in Sweden and had just finished 7 days of walking when I felt the jitters and realized I had started another AF episode. I am on Xarelto, bisoprolol and Irbesartan for BP. This episode is a little different in that my only real symptom is an irregular pulse rate but well within the guidelines. With the bisoprolol my heart rate at rest runs between 60-70 and now in this event it is jumping between 70 and 90 so an increase but nothing too terrible. The episode has lasted about 18 this far and I was able to sleep, albeit not very restfully. Most of my episodes resolve within 1 to 2 days and this is the first one in about a month.
my question is have any of you had “mild” AF (for lack of a better description) where the pulse rate doesn’t get too tachy? Is it just the bisoprolol doing its job?
I am taking an extra day off today to rest to see if I can knock it back into sinus before I do another 20 kms plus day.
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Longdistancewalker
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Yes I was on Bisoprolol. I have now been free from AF for 18 months. I have a very slow heart rate and for this reason my Bisoprolol medication was stopped about 5 years ago.
Following the first very fast attack of AF that I had after my ablation for atrial flutter in 2019, "mild" AF, as I also describe it, had always been the case with me, lasting for a few hours maximum. My last two, however, a few months ago now, were fast, 150-180bpm, sadly, which l could well do without, although I coped well enough.
Sweden? What a marvellous place to be. Keep an eye open for raptors like the gyrfalcon!
Hopefully, you realize that participating in this type of long distance endurance exercise is a known cause of atrial fibrillation and potentially will not only make your current afib episode worse, but may increase your afib burden in the future.
If not familiar, a good book on this is the "Haywire Heart" by John Mandrola, an afib specialist, atrial fibrillation patient and former endurance athlete.
To your question, you can have atrial fibrillation at any heart rate.
It's tricky isn't it, to balance exercise/enjoyment. I did a long walk this year overnight, basically on the theory that I ain't going to sit around and wait for AF, I'm going to enjoy life as much as I can.
Sure is tricky. And even trickier is balancing out exercise/enjoyment as I push toward 80. Yes, I do want to enjoy life as much as I can, but coming more and more to the realization that actions can have consequences, which might result in less enjoyment overall.
The long distance walking I do is a long way from the long distance running and endurance sports that you speak of. My heart rate is rarely high, I take plenty of breaks and usually rest for many hours a day before and after my walk. Perhaps it was the walking that triggered this latest episode or maybe it was something I ate. All I know is that life must be lived.
We are not in disagreement, I was just pointing out that actions can have consequences and while "moderate exercise" is recommended -- beyond that -- and especially something like a seven day walk -- may trigger or accelerate your afib situation. I can't say if that's the case with you or not.
Good for you. And if you're walking regularly as you imply then perhaps not necessarily a strain on your heart. I imagine you walk regularly or you wouldn't engage in this for pleasure. Are you able to do nose breathing while walking? This might help, even if you cannot manage it all the time.
thanks for your concern. Drugs were reviewed by GP recently. I’m 55 years of age. I’ve had two three day Holter monitors and an echocardiogram in the past. BP is controlled with meds. Travelling now (as indicated in my post) so all extra steps being proposed aren’t really practical whilst walking in northern Sweden.
Totally envy you. And you're mid fifties. Life to be lived as you say. Excellent healthcare in Sweden should you need it. I'm.guessing you're not high altitude? If so that could be a factor. Hope it soon clears up.
Definitely not high altitude. I believe the highest I will get on this hike is 650 metres. It the St. Olav Way from Sundsvall to Trondheim in Norway. I have walked the Camino in Spain and two routes in France in previous years. All of those with beer and wine. These days just water. 🫤
I had an ablation in 2021, my AFib has started to gradually come back over the last couple of months and I’m on the waiting list for another ablation. This time though my heart doesn’t race off, it stays at 60-70bpm but is very erratic. My resting heart rate is 40-50bpm so I can’t take bisoprolol regularly, I just take one if I can’t get back into sinus so I presume the ablation I’ve already had is doing something to keep my bpm down?
My permanent AF has always been low rate and bisoprolol brought my heart rate down to high 30's My normal heart rate in Af now is 54 resting and under 120 even when exercising normally 60 -70 during the day.
the AF episode lasted about 30 hours and ended yesterday evening. Was able to get a good night’s rest although my Garmin tells me it wasn’t as restful as it should have been. I am a bit of slave to these wearable tech devices when I should just ignore it and go by how I feel. Today is a scheduled rest day and tomorrow I have another moderately long walk on flat surface with the option to take a train after about 3 hours. Thanks for all the responses.
Just out of interest, what terrain were you walking in ?Were you walking at a higher altitude when the event was triggered?
Is the weather hot or very dry?
Have you been following any guidance about how much water you need per walk and if you require an adjustment to your intake of salts / electrolytes?
You could have got internal dehydration even if you didn't feel thirsty and may have been loosing more salts than normal even if you didn't notice any sweating. Although you may not be able to check your salt levels increasing your water intake as you are walking , especially on less even or steeper paths should help to keep your symptoms under control.
Do you use any particular breathing techniques while you walk?
It's good that you have a rest day but that may not be enough for you to prevent a further incident being triggered if you attempt a long walk the day afterwards no matter which terrain / environment you are walking in. Your body will still be quite sensitive to triggers because it will still be in recovery mode.
I know it will be disappointing but occasionally we do need to work within the limits an AFib event creates for us and I would suggest that you would be better taking the shorter walk and train ride.
It's probably the only option available to you to help prevent another attack and to allow you to make the most out of the rest of your trip without need for medical help.
Take care and enjoy , Sweden is so lovely I wish I was there with you, Bee
Thank you for your comments and questions. It hasn’t been terribly warm and in fact has been raining quite a bit on at least one of the days I was walking. I do sweat quite a bit and usually drink around 3 to 4 litres of water a day while walking and more when I have finished. I will supplement with an electrolyte on days I find myself sweating a lot.
I have now had 2 days off from walking since the episode and will try a walk tomorrow and see how it goes. There is a train station about 12 kilometres down the path which I can catch a train from if it proves too much.
This is not the first such hike I have done and in fact is much milder than other ones I have done past years. Perhaps though the Afib is telling me to slow down a bit.
Totally understand the frustration expressed by all in this post. Sometimes I feel good (not as strong as before this afib set in) and enjoy all aspects of getting out for a walk or cycle ride; at other times (today for instance) I struggle to do much at all. This seems to last just a day or two. Also so frustrating as it makes me so unreliable. I used to take pride in being reliable, now I get referred to as David question mark.Hope it goes well for the rest of your trip.
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