I'm 67 and have been very active, going up Scottish Munros (mountains over 3000ft) most weeks, sometimes several Munros at a time and often walking over 20 miles a day. I go with the dog and walk her 3 times a day at other times, maybe 2 hours in an afternoon.
Over recent months I've sometimes felt myself 'grinding to a halt' on hills, not tired or breathless but kind of struggling to put one foot in front of the other. After a brief break of a couple of minutes I could carry on and this would happen repeatedly. On the level or downhill was no bother though I did sometimes feel unnaturally fatigued towards the end of a hill-walk.
About 4 weeks ago I was up a hill one day but the next morning, intending to go up another hill, I felt quite unwell; leaden-footed, light-headed, my heart was pounding and pulse was all over the place. I knew I had arrythmia (for a few years) but had never felt unwell with it. Anyway I ended up in A&E and was told I have AF. Overnight stay until they got my pulse below 100.
I'm on Bisoprolol (2.5mg) and Apixaban and waiting for an echocardiogram and cardio consultation (sadly just on the telephone and before the echo!). I mostly feel quite weak and light-headed, easily tired and my chest is frequently uncomfortable. Resting pulse is around 48 but regular unless I raise this with walking to around 80 when it sometimes goes irregular again.
I can't figure out what's happening to me and wonder if I'll be able to get back to the hills. Sorry for the long post but I'd welcome the benefit of your experience. Thanks.
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Meanddog
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Hi there, thankyou for your amazing post...I have the same problem as you, but iam not talking beta blockers anymore, I can't tolerate them. The heart is under alot of stress when walking up hills, bp starts to rise and heart rate because more blood oxygen is needed for the muscle to work harder. Have you had any test done for angina, I have been given a ctn spray from the cardiology consultant about 4weeks ago, I have never used it so far. I start to go lightheaded and start to feel a little out of breath after about 30mins for walking or any activity around the house and garden, once I have rested for about 15mins I can carry on...I would go to your doctors and explain what has been going on. All I can advise at the moment, keep to flat walking for now and not to adventure out to much above sea level. Take care
As a physician with a history of AF I also recommend you need a complete cardiac evaluation to rule out coronary vessel occlusion. If you are cleared then your attention might focus on the need to replenish Mg which has been scientifically proven to be deficient in heart cells of most individuals with AF. Mg is needed to improve the energy deficit in heart cells by making conformational changes in the energy containg molecule ( ATP) so that it can be broken down by enzymes to release energy needed for generation of sinus rhythm.
i had my magnesium levels checked in last bloods and i was at bottom of scale and have been on 130mg of MgTaurate and 200mg Mg Glycinate for 12 months and now am sitting closer to mid range. If your levels are high then you may not need to supplement
I am unable to offer specific medical advice but if you are interested it is part of a protocol that converted my AF of 2 years duration to sinus rhythm to date for 18 months. You can view it on Amazon with a book titled :
Atrial Fibrillation and has a cover of a physician holding binoculars.
If I had the answer I would win a Nobel prize. The following is my my hypothesis for the cause of AF based on scientific observations.Its more complicated so I will simplify as possible.
1.,All cardiology believes it is caused by chronic inflammation but no one has offered what causes it except everyone agrees unhealthy lifestyles cause it in many individuals ( not all as there are other factors especially genetics).
2. A relatively new recognized mechanism of innate immunity ( born with) was discovered about 22 years ago. It is made up of uniquely discovered proteins located in specialized immune cells and in heart cells. It is stimulated by metabolic products produced from aging dying cells, from cells losing blood supply , from crystals of cholesterol and more. This innate immune mechanism is called the NLRP-3 inflammasome. When stimulated it can overproduce small proteins called cytokines that are pro inflammatory and attract inflammation cells. Chronic inflammation causes abnormal anatomical changes causing scarring and alters electrical pathways that are associated with sinus rhythm. It will continue unchecked as long as a person continues unhealthy lifestyles.
3. One of these cytokines is called Interleukin -1 Beta. A well done research study demonstrated that it can inhibit the enzyme called ATPase which is needed to break down molecules called ATP that store energy to produce energy in heart cells for electrolyte pumps needed for sinus rhythm electrical impulse generation.
4. Magnesium(Mg ) is essential to combine with ATP to cause a conformational change in ATP so that ATPase enzyme can break down ATP for energy release in heart cells.
5. Combined all together there is an energy deficit in heart cells of individuals with AF.
6. AF individuals have been proven to have a Mg deficit in their heart cells. Hence unless unhealthy lifestyles change to healthy , the only option available to improve the energy deficit inAF heart cells is to replenish them with Mg. The problem is there are nuances in selecting ideal Mg supplements and being patient because Mg in humans has a half life of 6 weeks for some one in Mg balance but requires multiple 6 week half lives of Mg to replenish Mg in AF with pre-existing Mg deficiency .
All of this is detailed with scientific citations in my protocol. Anyone interested in more detail can contact me by PM.
Agree with that sentiment but we all know that is easier said then done. However Mg deficit still needs to be addressed , as in some individuals, they still get AF after changing to healthy lifestyles , I ask myself why athletes and individuals with healthy lifestyles get AF? Mg is an essential element and when deficient reduces energy production in heart cells.
What type magnesium is preferable? I've currently began 200 mg. Citrate -- which was recently okay'd by my EP. (You and I discussed this before my EP visit.) Would Taurate or Glycinate be better?
I read that Mag taurate was a specific heart magnesium, so I take that, plus mag glycinate at nightvto help me sleep. I get my mag taurate from Cardiovascular Research in the USA. I have PAF, diagnosed last April and I know it was first triggered by covid when I know there was inflammation going on, and triggered again by lifestyle - not enough sleeep with the arrival of two grandbabies. M heart stays in sinus rhythm with good sleep, plenty of water and my magnesium supplements. Plus I take Nattokinase which is a cardiovadcular supplement, plus Ubiquinol which is a product within Coq10 - good for the heart.
Thanks so much for your reply. I got the okay from my EP about the mag. citrate, and will look into those you mentioned as well. I'm glad they're working so well for you -- and congratulations on your grandchildren!
You are correct that the blood Mg level can be normal and you can still have deficiency of Mg., The best test is no longer available to my chagrin.The rbc test may be helpful but in my opinion there is enough evidence if you have AF, you are likely deficient in Mg.
Ye, my issue is I can't raise my Mg level easily, this may be due to my addction to a calcium high diet, which I believe may block Mg absorption or it may just be my body.
You are correct about calcium interfering in Mg absorption. Try separating supplements one in morning and one in evening. Also eat foods fortified with Mg. One of the highest are roasted pumpkin seeds . I add them to cereal every day.
Thank you I must at least try to reduce my consumption of cheese, milk, cream, kefir, butter, yoghurt -almost always organic and often raw, ironically the better the quality the more it probably blocks Mg absorption.
I have had af for years now but it used to start for no known reason. At first I found I could exercise myself back to sinus rhythm by doing a long run, bike ride or mountain walk. My AF is now persistent and I have no causes for the AFIB but I still walk and run, just a bit slower than I used to. Main thing is to get a doctor to find if there are any reasons for the AF and get you on the correct medication.
I have mentioned to many who inquire the evidence is compelling that having AF u likely are deficient in magnesium. There may be other answers but that is one direction you might consider. My BIO mentions more information.
Thanks Hugheart. I do take magnesium which I find helps with sleep but AFIB is still permanent. Although in afib I am leading a normal life with no symptoms. I will check out your BIO.
Suggest 1) early private cardiologist appointment 2) request a 48 hr monitor 3) discuss the right dose of Flecainide & whether Bisoprolol is essential (I have never taken the latter) 4) scale back hill climbing.
That's tough when you've enjoyed such an active life. People here will tell you you may not be able to sustain that same level post AF but you'll definitely still be able to enjoy walking. In the UK Bisoprolol is the first port of call. It doesn't suit everyone. I hated it because it slowed me down, made me feel low and - crucially - out of breath with leaden legs walking up a flight of stairs. That all improved when I went onto an anti arrhythmic. Obviously I'm not a medic but if you feel that your current meds are compromising your QOL then this would be something to discuss in your cardiology appointment. Hang in there - I'm 68 and while I've never been as active as you I walk most days here in mid Wales, can happily mow and strim, and recently took up some resistance training.
Hi MeanddogAs someone with PAF and an inclination to climb mountains, I understand your frustration. After 18 years of it, I still climb mountains (I climbed a 1780m peak in the Anti Atlas of Morocco yesterday) - no AF. BUT, I have never experienced your other symptoms and think Hugheart is right- you need to get checkrd out for other heart problems. I had a full battery of tests and my PAF was described as idiopathic- no identifiable cause. My theory is - not Mg or unhealthy lifestyle in the normal sense - but an extremely overactive lifestyle (resting hr used to be mid to high 40s) coupled with a bit of genetics.
So, if you 'only' have PAF, then there is a possibility of you getting back in the hills. My cardiologist advised against big days out and so I confine myself to (say) max of 12 miles, and 3000ft ascent. Still leaves plenty scope. That said, we are all different.
PS I take 100mg flecainide twice a day. I stopped taking bisoprolol - my hr in AF is never very high.
2.5mg Bisoprolol is the automatic response to an initial AF diagnosis until you have an echocardiogram to establish whether or not your heart is in good physical shape. Many of us don’t tolerate betablockers very well so once you get the echo results do question whether you really need any rate control medication (as opposed to rhythm control). You can read up on strict rate control vs. lenient rate control if you Google them. There are other ways of tackling blood pressure if you need to. Hope you get back soon to bagging those Munros, just don’t overdo it. I found it helpful to monitor my heart rate during exercise and easing up if I risked pushing it over the ‘fat burn’ zone.
As others have said, get a full check out. It could be that the effort is tipping you into AF. Effort while in AF will make you out of breath and lose the power in your legs. But until you are checked out properly, for example a stress test so the medics can see what is happening under effort. You may very well be able to climb again. I have PAF and climbed all the way through until my ablation but tried to keep my heart rate low. I climbed slowly! I have had an ablation (3 months ago) and been advised to ‘test myself out’ and I am planning to do the 3 Yorkshire Peaks in May. So don’t despair yet, but do investigate and learn.
I’m 78 now and like you, up until the end of my sixties I was regularly walking ten mile walks and also climbed up several of the Lake Districts peaks. Each time in my seventh heaven. Then I had similar symptoms to you.
I modified my walking, not wanting to be indoors most of the time. I now walk between the hills and look up at them remembering the old days but I am perfectly happy doing so. Don’t despair….just remodel what you’ve been doing to an easier way but still just as enjoyable.
The past year I’ve had to invest in a four wheeled ALL TERRAIN Rollator that has a seat on it and fold up for carrying. It’s been wonderful. I can go over sand, grass, and through the woods perfectly well. Just DO NOT GIVE UP. Just alter your lifestyle a bit and get out there and enjoy yourself. Take a flask of coffee or soup and enjoy your life, best of luck.
Meandog you just some amazing with all that you have been doing, but please, as you are seeing on here, get the full work up before you do anything like that again. Things change I was OK until I wasn’t. Briefly for a change lol I was walking 5 miles a day and I love to swim I could be in the pool for hours and I had to walk those 5 miles round-trip to be able to get to the closest for me. I never felt so good.
when it hit, I don’t know where it came from. I know anything until I woke up on the floor It wasn’t pretty. I also blacked out a second time during that then finally got myself to bed and went to sleep. Anyway, that was almost 5 years ago now two years ago I got my pacemaker a very special one. Something obviously changes in our body. I was thankful I had no blockages along the way they found other crazy things in there, but then I was blessed with an incredible PE. I was very blessed from the beginning with all of my doctors, including my who was the first one I saw and rushed quickly to a. I also had the hospital and all of these doctors almost across the street from where I lived. I guess it was not my time to go.
six months before my pacemaker and my new PE I was unable to walk to stand brought tears. It bad and trying to scuffle to the bathroom. I was borderline passing out. If you saw the woman that left the hospital with her new pacemaker you would think they were different people. I am a great especially about doctors. In I waited two days after I blacked out and hit my face, don’t even want to know what that looked like having fallen face down on concrete. It can look pretty on the floor not so pretty on your face. I think my next flooring is going to be made of bubble wrap lol
last week I took an extremely bad fall. I’m waiting for results now in the meantimehere I go again I cannot put pressure on my right foot leg or anything and barely lift my arm. I ran my face into a wall made of metal and wood. I have no idea what happened, but I heard the crunch when I hit the wall with my face and shoulder. Monday, I see the GP and I also need more x-rays. They tell me, including a CAT scan on my head. That was my fourth fall in about two months.
I want you to know since my pacemaker except catching some type of viral thing I have felt amazing for the last two years. I felt normal as though I did not have anything wrong with me. Oh, I’m not as fast as I used to be I’m also five years older. My problem is I keep thinking I’m still 35 and the age is confusing me lol
again something has changed in me. I think it’s been since that virus but this is why when you have had a norm especially like you that is just incredible and then you’ll land in the hospital you need you owe it to yourself to get completely checked.
I am fighting myself about it including going Monday, but as I lay here throbbing from head to toe, I know I must do it
please be careful if you are lucky enough like I was you’ll be back in your hills soon every day they are working on amazing things for you. Who knows maybe just a medication will help. Life changes in a heartbeat for real.
With all the talk above about supporting Mg levels, I'd suggest ensuring a generous eating of cooked and raw leafy greens. The darker the better as at the center of every green chlorophyll molecule is a Mg²+ ion.
In the interest of full disclosure, I'm a follower of Dr Esselstyn's vegan no-oil regimen as it's done wonders for me after a MI 13 years ago and a successful cardioäblation 3 yrs ago. As I've tangled with my heart disease, my touchstone is that my disease was the result of my diet and so my recovery and life going forward has to involve eating the healthiest diet I can craft. I credit my heart attack for giving me the wake-up call to force me to adopt a lifestyle which I'm hopeful will carry me *healthfully* into my 90s, and even possibly beyond.
If you are still in afib you will struggle however if they get you back into normal rhythm there is no reason why you cannot resume your healthy lifestyle (cardiologist permitting, of course, though in my experience they are very keen for you to keep fit.). I run, cycle, hike and weight train with no problems. Bisoprolol affects some people, if so you may be able to change to another type of beta blocker if necc. Best wishes 🙏
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