I am new to the group. Some very good posts with lots of living experiences with AFib.
I was diagnosed with AFib approximately 3 years ago but suspect I had it a lot longer not knowing the symptoms putting it down to fatigue. It was an Apple Watch that alerted me to AFib and after a hospital stay I have been on medication with limited success.
I am at the point now of getting an abalation. I was wondering whether anyone else has been able to return to an endurance sport following an abalation? I am very active swimming and mountain bike riding but perhaps it is time to realise that I cannot do these activities at a competitive level again.
Would be interested on any abalation results and whether there is someone that had a successful return to an endurance sport?
Cheers
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Murphy10
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It is well known and documented that endurance athletes are more likely to get AF than the average person. Interestingly this also applies to fast jet pilots so the link here is over straining their hearts.(Fighting g forces).
Whilst ablation does not preclude exercise it would be wise to a) leave things for some months before even thinking about return and b) moderating that excercise to a more reasonable level.
Thanks BobD and mjames1 for your response. Funny enough I have not had an episode of Afib while performing endurance activities. My Afib episodes have mostly occurred at night waking me up sleeping. Not too sure whether it is a delayed reaction from endurance activities.
my cardiologist has changed my medication from Sotolol to Flecaiinde 100mg twice a day and 180mg of Diltizem and said I should try them first before jumping into Abalation.
I am a bit nervous taking this medication but I guess I will try as my episodes of AF have become more frequent and see how it goes. Would be interested if any members have tried this medication with any success?
In July 2022 and July 2023, I went on an organized 7-day bike ride where I ride hard between 55 and 70 miles each day with 25000+ elevation gain for the 7 days . I noticed that during June July August and September of both years, I did not have afib episodes. Seems to me the heavy training I do in May, June and July pay dividends. After the event my training falls off big time (as I play catch up with work, etc), and I start having afib episodes again around October. Just my observations and I am not an endurance athlete.
Exercise and a good stable diet are very important for AFib. It does not mean you need to be an endurance athlete but by making it a habit it becomes part of your routine. It is important to get that work life balance and when you are tied it is easy not to exercise. The ride sounds great you should book another ride and then you have yourself a training goal to aim for.
The biggest challenge for me is sleep. Especially when having AFib episodes at night keeping me awake hoping they will stop.😴
With so many variables, it's case by case. Certainly many are capable of returning full bore to previous endurance sports, the question is if it will make their ablation less durable and really not too many studies on this. And then there's the question of what threshold is safe and what isn't and even the author of "Haywire Heart", Dr. John Mandrola (he's an ep, afib patient and endurance athlete) can't quantify that. Probably we can rule out ultra-marathons and rule in mountain biking for the afternoon and lap swimming, but the in between is the tricky part.
I am currently taking Flec daily with great success. Previously I was getting frequent Afib episodes, probably averaging once a month, with each episode lasting from 1 - 3 days. Then I had an episode that lasted 2 weeks which was what got me onto Flec.
Initially I was only taking 100mg of Flec when I had an episode and then another 3 hours later if it was still ongoing. But now I take it daily to prevent afib episodes from happening in the first place and it has been very effective at doing that. I also was advised I could take 100mg in the morning and again in the evening, but I prefer to take the minimum dosage that still does the job and so tested out taking 25mg in the morning and 25mg in the evening. At that dose I did still have an occasional episode so changed to 25mg in the morning and 50mg in the evening. That dosage has been working great at preventing afib episodes for me up to now. I do have an ablation scheduled for May.
Thanks for sharing. I have decided to reduce the Flec. To 50mg in the morning and 50mg in the morning. My cardiologist is on holidays so will discuss with him when he returns.
I have PAF and have done endurance running. My episodes have been triggered by sustained high intensity running, sprinting after a late night of heavy eating and drinking, interval training plus flu vaccine, cold plus exercise. I have dialled back the exercise to low HR running under 120, but also do weights and a swim session that take my HR higher but whilst that does provoke a few ectopics my heart returns to normal after. Following the Afib cure by John Mandrola, I am following Zoe diet, no alcohol, caffeine, sleep well, take magnesium. In terms of bio markers the biggest difference has been to HS CRP which has reduced from 1.97 to 0.266. (I use Thriva service) This is an inflammation marker which Mandrola suggests getting under 1 and I would say that this time last year when my AF started to deteriorate I was also having problems with my arthritic hip. Now this and my excema are much better along with reduced ectopics. This could be due to reduced inflammation.
I am going on about all this as Mandrola suggests you need to make all the changes to improve the chance of ablation success. I am waiting for an ablation but my cardiologist was a bit cagey about the extent to which I could go back to where I was. As others have said, the studies haven’t been done and certainly not on athletes. Applying the rule that if you do the same things that led to the AF then the same things will recur, probably not a good idea. So I definitely wont be doing any more marathons but don’t know whether a faster 5k is possible or not…
Thanks for all of the information. I do suffer from a bit of early arthritis and will see what my HS CRP levels are. It would be hard for me to give up the 1 coffee a day that I have. I may have a beer on the weekend but don’t drink that much. Strict diets I have found difficult to commit. It seems you have been very diligent staying the course and the lifestyle changes have made a big difference. Well done!
I found that exercising hard while not having enough sleep brought on both of PAF, so I no exercise only after I’ve rested well just remember there’s a difference between a long bike ride and racing so as sometimes it can be a matter of just taking it slightly easier rather than putting in that little bit of extra effort that you would have racing. Three hours of riding and three hours of racing are two completely different animals
Good advice. I managed to go 12 months without an episode however in the last four weeks I have had episodes every couple of days with no change in lifestyle. I did hear that PAF tends to progress. Hence the change in meds and then go talk to a electrophysiology specialist re an abalation.
I have been in permanent AF since November with just a months break the medication doesn’t seem to be working and I’m under investigation of what to do next but not letting it stop me doing my exercise routine. I might not be doing it as hard or as often as I want, but I’m still doing it and that’s the main thing
For me, there is a very close relationship between HR during exercise and setting off PAF. During running, if I exceed 145 bpm , I can generally expect to flip into AF which requires PIP flecainide to resolve, usually within 12 hrs. Keep below 140 and I generally avoid. I’m also of the view that dehydration post exercise (or anything else such as alcohol and maybe caffeine / hot weather?) is more likely to trigger a post exercise related episode. For me, run slow and drink lots. I’m waiting on an ablation but in agreement with EP, will decide if appropriate when date offered. I’m gradually increasing my running distance with the potential to do the London Marathon in late April. After 7 failed attempts, I get a ballot place just as AF is ramping up! If I do it, it will be my final fling but I will reduce but not stop exercising.
Wow good luck with the marathon. I guess I may need to retire from competition riding for now if I am going to try and rid this PAF. I know I am not riding the way I used to and it has become a psychological barrier more than anything else.
I've always been a keen runner and cyclist and I was diagnosed after a fall and probably had had it for years. I found that hard running and cycling actually put me back in sinus rhythm and never experienced an attack when exercising. The problem I have now is at 70 although still running and cycling it does not seem to work any more. I have been through a heart test at the hospital where the heart is monitored during hard exercise and they found no problems. Here it's called an exercise tolerance test. It may be worth getting such a test. Good luck
Great to hear you are still riding and running. I sometimes ride with a retired tour rider who has become a bit of a mentor. He is 75 and still riding great times and like age has no barrier.
I have had a couple of those tests and neither provoked anything other than a few ectopics. I suppose this is still information. I think it’s more about understanding our own triggers and avoiding them.
All the EPs I have seen, plus all the cardiologists too, have been desperate for me to keep exercising (walking, running, cycling, weights)!! My EP said it's eyeballs out, tour de France high intensity, high volume stuff that can cause arrhythmias. I wrote about the evidence /lack of evidence between exercise and AF in my blog "HHT and afib athlete". You need the speech marks if you search. It's based on 35+ scientific papers I researched. Hope it's helpful
Thanks I will have a read. From what I have read there appears to be a strong correlation between endurance athletes and PAF. Not too sure whether any have successfully eliminated this pain in the backside condition.
Over exercise or being over stressed mentally can often result in AF when you enter a quieter relaxing time later on. I have experienced this and I think it relates to the Vagus Nerve.
I would say not unexpected as soon as 'you let your guard down' it can strike if your AF is vagally mediated.
I have found the route to AF success includes moderation in all things and if this can't be achieved make a conscious effort to wind down slowly (by planning or doing another light activity) rather than go from full stress to full relax.
Hi, my journey sounds similar to yours in many ways..I think i had occurrences of afib years before i knew what it was. It seemed to get worse one summer where I did more than my usual mileage of trail running in preparation for a 30k race. Within the year and who knows what combination of things, I went into Afib rather steadily and was cardioverted. Was on the same Flec and Dilitiazem though in higher doses than you. Do you tolerate them ok? Some don't but I did ok in them. They worked for about a year, then afib broke through. Fast forward i am now 5 months post Ablation #2. I am 2 months being off the heart drugs and had been doing ok but recently am having what appears to be Sinus Tachycardia.. basically I'm calling it afib lite...my HR goes up far faster and higher than it should with the amt of activity. Like just moderate elliptical machine and I'm approaching 150! Often approaching 120 just clunking around the house. But not in afib. So that's new. Like you, and I think a lot of folk, my afib bouts would often come on overnight. Like the laying down or at prone rest set it off. Makes for stressful sleep. I would say my longer trail running days are past..but before this latest squirrelly business, I would still run 3 to 5 miles fine enough when i wanted. I turned 54 not long ago, for reference. Been on the afib conveyor belt for 4 or 5 yrs now. I've had two RF ablations..the second one was very quick as they found just a spot or two where the signals had reformed (pretty common)..but honestly it's all a mystery, and good EPs admit that. As others have mentioned, The Haywire Heart would be a good read for you. Sorry for the long post. It is a scary and frustrating condition, especially when you think you're nailing all the lifestyle factors and there it is!
Thanks. I have just started the Flec. and Diltizam and so far it has been good with no side affects or AF. Sotalol was not good and my Vo2 max . when from well above average to below average and seemed to work for about 12 months.
I am booked into discuss an abalation next week. Would you recommend having this done as most people seem to have limited success with medication and it seems abalation may not always be successful. Was the procedure painful?
It looks like I will need to at least tone down my bike riding and will discuss with the Electrophysiologist.
I hope all goes well following your second abalation and you have no more issues.
I personally would still carryon doing what you enjoy but at a steadier pace.? Nice bikes rides/ swimming etc but without the high top end heart rates.? I’m sure Any exercise is beneficial even without maxing out our heart.?👍
Afib for me progressed from once a year to weekly inside of three years. Anything that challenged my nervous system would set me off (big meals, stress, lack of sleep, work, exercise, even just sitting quiet at the computer). I'm a non-competitive cyclist and previous bodybuilder. I have not had an afib episode in 2 years since cryoballoon PVI ablation (Pulmonary Vein Isolation). Currently off all meds (Flecanide and Beta Blockers and Blood Thinners). There are emerging studies that point to atrial stretching/scarring as a condition that can precipitate Afib. As an athletes' heart remodels the Atria substrate can be stretched. This substrate does not trigger afib in all people but some are predisposed. My echo cardiograms always showed dilated Atria. It took a long time after ablation for my heart rate to settle back down (Resting was 80, then 70 and now 60's). I was walking the first day, cycling after 3 months, without restriction after 6 months and challenging at one year. I currently can sprint as hard as I used to, BUT I limit my training to 1.5 hour moderate rides and 1 hour intense rides. No more all day 50-100 milers for me. And my echo indicates normal sized Atria. I think you most certainly would expect to continue your physical pursuits and should continue. Though it is likely wise to reset your expectations if you are a pedal to the metal, beat my PR's sort of personality. Also, I wish I'd done the ablation earlier. Good Luck!
Hi, I have no personal experience (yet) of ablation but on exercise, I have always asked myself, “how much is too much?”.
As already mentioned, the link between AF and high intensity/endurance exercise is well established, however, some research suggests some exercise’ does appear to suppress AF too.
It has been described to me as ‘J-curve’ with incidents of AF on the y-axis and amount/type of exercise on the x-axis. At either end of the x-axis, relatively, no exercise sees some incidents of AF occurring and extreme/endurance exercise sees more incidents. However, in the middle, there is a ‘sweet spot’ where it looks like ‘some exercise’ can reduce incidents.
The guidance I saw suggested the ‘sweet spot’ maybe around 75mins x vigorous exercise per week. Now, I don’t think there is really a lot of data about this but I needed a starting point and it tied up nicely with my cardio- rehab program. This I equate to my base ‘maintenance load’ and I try to do 80mins a week (2 x treadmill running sessions). This has also been backed up with a couple of CPETs too, I know I am running without any cardio respiratory difficulties and my limits are set (90% of maximal).
Do I do other stuff? absolutely. I am keen mountaineer, climber and cyclist. I don’t want to give this up until I have to. My gym sessions just give me a level of confidence, that I can do this but I just approach things more conservatively. I do not class these as extreme exercise but never the less, I take a more measured approach.
My Afib journey started nearly 5 years ago, it has also been kept ‘in check’ now for last 3.5+ years - no sustained episodes. I attribute this to medication - Flecainide (obviously) and also my exercise tolerance. This was emphasised recently at my latest review and was part of the criteria for me to begin reducing the medication to see if I can maintain NSR without it.
AF is such a complex condition and presentation is so diverse. You just have to discuss your individual circumstances with your medical team and find a path forward that is suitable for you
Finally, I will add that I have a friend who had AF and was successfully ablated in 2016. He is a keen cyclist (long distance) and has not had any reoccurrence of Afib. On his early retirement last year, he embarked on a trip to cycle around the world. He’s been cycling up to 100km a day for months on end and all is still fine.
Thanks. I have been riding about 8 hours a week with each ride approximately 2- 3 hours and doin gym 3 days and swim once a week in summer. As mentioned I have had no AF episodes while riding and they only started again a couple of weeks ago at night. I have decided to cut back my riding with 1-2 hour rides and not pushing myself. I will perhaps play some golf as it is my second passion and see whether my AF subides.
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