Some questions

[Sheldork]

I am a 68 year old marathon runner. I have been running for 50 years.

Per Kardia and a heart monitor, I am in AFIB about 30% of the time

My BPM when in AFIB is between 70-85

When not in AFIB it is between 48-54

When I run my BPM usually goes up to 175 (even when not in AFIB) but goes down quickly.

I have no comorbities

1. Given the frequency of fib but the minimal impact on BPM should i consider an anti-coagulant

2. I assume that because my BPM never is high, that is a good sign

I rarely feel symptoms other than running a bit slower when I am in AFIB

[gilreid1]

Sorry I really don’t understand your post. Are you asking a specific question. Only your gp can answer any of your points raised. And after running for fifty years you must be close to where your going 😂

[Heather1957 in reply to gilreid1]

I have to admit I thought the post was a bit technical especially for me! If anyone needs specific info then IMHO they really need to get medical advice.

[Hidden]

My understanding is that anticoagulants are required for proper management of Afib: it’s not heart rate that increases the clot risk, it’s the manner in which the heart fails to contract correctly that leads to blood pooling in the chambers of the heart. Anticoagulants are given to counteract this and prevent resultant heart attacks and strokes. Have you not been prescribed one?

Whilst your heart rate isn’t high, ultimately you still have an arrhythmia effecting the way your heart physically beats. Unlike something like SVT where the rhythm is regular but fast, afib is not just about the rate but also that the rhythm itself is irregular.

[Chappychap in reply to Hidden]

My understanding is exactly the same as Charlie G's, AF increases stroke risk, therefore an anti-coagulant is a smart precaution.

However, we're all just armchair cardiologists...where as you need advice from the real deal, so speak to your GP!

[Ducky2003]

I have AF. As others have mentioned, your heart rate is not the issue regarding anticoagulants. Drs use the HAS-BLED score to assess your likely stroke risk. You have 5x more likelihood of having a stroke than someone without AF. If you are seeing your GP or a cardiologist, I'm surprised that they have not discussed this with you. If you haven't seen anyone, I think its best if you do.

😊

[Barle]

Hi Sheldork,

Rather than asking this forum, you should see a cardiologist who will run some tests - reach a diagnosis - and recommend suitable treatment.

BTW, if you really do have AF, treatment should involve reducing the frequency of occurrences. My understanding is (NB I'm not medically qualified) that anticoagulants do not reduce the frequency of AF: they simply mitigate the potential impact of AF. They are also double edged, whilst they significantly reduce the liklihood of strokes, they increase the risk of bleeds. So, they should only be prescribed by someone medically qualified.

[Hidden]

In summary, all the replies advise you see a health professional, e.g your GP, which is the only advice there is to give imo.

[Afibflipper]

I have AFib and take Apixaban (Eliquis) anticoagulant I’m not a medic so so don’t quote me but, I would have thought AFib is AFib for anyone! Therefore you’re still at risk of stroke I’d have thought so get checked out professionally please ( well done on the marathon runs - AFib just gets me going up stairs!)

[Hidden]

"When I run my BPM usually goes up to 175 (even when not in AFIB) but goes down quickly."

That would seem to be quite high. I would check what your doctor's opinion on this is. The other thing to check would be whether it's advisable to run marathons; these, presumably, put a lot of pressure on your heart and may worsen AF.

"1. Given the frequency of fib but the minimal impact on BPM should i consider an anti-coagulant"

Whether an anticoagulant is required depends on your CHADSVASK score not on how frequent your AF is. I was told this quite categorically by an EP; even if the interval between episodes of PAF is several months, the stroke risk is the same for a given CHADSVASC score.

"2. I assume that because my BPM never is high, that is a good sign"

I was told there was less risk of stroke at, say, 85 bpm as opposed to 130 bpm when in AF, but that a bpm in the normal range when in AF wouldn't obviate the need for an anticoagulant if the CHADSVASK score indicated one was required,

" I rarely feel symptoms other than running a bit slower when I am in AFIB"

That's good, but not necessarily a crucial consideration when considering medication. I would advise discussing with a doctor, particularly the advisability of marathon running. It's known that very strenuous exercise correlates with AF. Mark Spitz, the former Olympic swimmer, has it for example.