Atrial fibrillation
 

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Atrial fibrillation

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I’ve had a bug the last couple of weeks; headaches, flu like symptoms & feeling generally unwell. Thinking back I think it may have been Covid as it was very similar to last time but without the loss of taste & smell (they’ve never really come back to pre-Covid).

Anyway, I now absolutely feel fine but noticed my resting heart rate was high. Suspecting a dodgy garmin reading I manually checked my pulse only to find it was high & all over the place.

Being unable to get a Dr’s appointment I took myself to the nearest walk in centre & following a load of blood tests & ECG I’ve been told I’ve got Atrial Fibrillation. I’ve been discharged to outpatients & that I will be asked to attend a further appointment for more tests. The Dr suspects it is related to whatever virus I had last few weeks. I was told that it might just go back to normal by itself but I might have to have an electric shock to put my pulse back to normal.

I’ve also been told that due to having no risk factors usually associated with this, I am ok to continue exercising & living life as usual. That’s fine except I’m now shitting myself as I don’t really know anything about AF & what it means for me long term, let alone over Christmas.

I’m feeling quite deflated by this, so does anyone have any experiences to share?


 
Posted : 22/12/2023 5:47 pm
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I wouldn't be worrying too much yet - AF is definitely one of the 'better' heart problems to have. In my case I'm pretty sure it was the booze - gave up and it hasn't happened since. Covid (and all flu-like viruses I believe) are known to affect the heart, so it's quite feasible that it will go back to normal.

https://singletrackworld.com/forum/topic/irregular-hear-rhythm-ablation-experience-to-share/#post-11931293


 
Posted : 22/12/2023 5:58 pm
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As i understand it there's several types of AF with varying solutions/outcomes. Some people live with it with no issues, others live with it but take anticlotting drugs to reduce the stroke risk, but quite often the op to put it back in normal rhythm is easy and effective. My type required an ablation to fix (for reasons i never understood the simpler shock operation wouldn't have worked). I had mine done in 2016 and (toucchwood) it's been fine since.

Personally, if the doc says you have no other risk factors, I'd try not to worry...i know,easier said than done.

There's several on here with varying experiences of it.


 
Posted : 22/12/2023 6:03 pm
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Short term: be particularly careful while gradually returning to exercise, back off at the least sign until you know the longer term likely prognosis and have been given specific advice.

Medium and longer term: should be fine, depending on which variety and causal effect you have.  Can't be more specific than that.

For info, lots of my many ultra runners who I look after have AF, it is indeed common and it doesn't stop them getting out and enjoying themselves.  If it has been triggered by a viral infection such as Covid, you do need to be extra cautious about your return to normal exercise, better to be too slow than too quick to get back up to big efforts.  Just make sure you have a very low tolerance for odd signs and head the warnings.


 
Posted : 22/12/2023 6:23 pm
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https://www.bbc.co.uk/sport/rugby-union/67797424


 
Posted : 22/12/2023 6:56 pm
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For info, lots of my many ultra runners who I look after have AF, it is indeed common

When i had my ablation, my surgeon said he was seeing more and more cyclists with AF, and he though it was cos cyclists can spend hours on a bike at a relatively low effort and this was somehow causing changes that triggered AF. Fits with it impacting ultra runners i guess.


 
Posted : 22/12/2023 7:46 pm
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My wife (HDU nurse) recommended this as a first port of call.

https://www.bhf.org.uk/informationsupport/conditions/atrial-fibrillation

Hope you're all healed and on the mend soon 👍🏻


 
Posted : 22/12/2023 7:54 pm
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Thanks all.

The BHF information is very good, just what needed.

The Dr say next steps are echocardiogram & Xray. My bloods came back normal.

I don’t actually feel any different, & had I not been wearing my Garmin I probably wouldn’t know about it.  Bizarrely the wife’s heart rate is now very high, but without any irregular beats. She was also ill over the last couple of weeks with the same symptoms as me. 


 
Posted : 22/12/2023 9:25 pm
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Both probably still post - viral, to a greater or lesser extent. It's the new normal.


 
Posted : 22/12/2023 9:35 pm
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😠


 
Posted : 22/12/2023 10:26 pm
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he was seeing more and more cyclists with AF, and he though it was cos cyclists can spend hours on a bike

Hard to say - but I reckon if I wasn't so generally aware of my heart from riding, HRMs etc I wouldn't have realised I had AF. My dad had it and didn't realise until he had a minor stroke.

That said.... this  https://velo.outsideonline.com/cycling-to-extremes-heart-health-and-endurance-sports/


 
Posted : 22/12/2023 11:05 pm
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Fellow heart arrhythmia sufferer here. Not AF but really strong premature ventricular contractions started in 2021. Felt awful and very very scary, brought on by exercise or lack of sleep, being run down and/or too much alcohol.

Speaking to cardiologists all sorts of things can trigger AF or other arrythmia. Virus being one of them so it might just be that.

For me, I had an ablation to sort it out - can be used for lots of AF cases also. That mainly fixed it but I still had a few less severe palpitations.

Then about 4 months ago they just suddenly stopped. I can't fathom a reason. Touch wood they don't come back.

You have my sympathy its a mind****. Try not to worry.
That's easier said than done though...
The negative affects on my mental health were probably more severe than the heart issue itself (which was never life threatening just felt awful)

Would recommend the book 'haywire heart' for a better understanding. Try to avoid self diagnosis though, and see what the cardiologist says.


 
Posted : 22/12/2023 11:16 pm
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Weird. Was going to start a similar thread today. Think I might still as my symptoms are not quite the same.

Bloody scary when anything odd with your heart  kicks off though.


 
Posted : 22/12/2023 11:24 pm
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The worst bit for me so far was that moment when the nurse who did the initial ECG seemed to double take at the printout look at me, look at the printout again & walked out saying, erm… I just need to have a word with one of the Dr’s. She returned about 5 minutes later, & walked me down the corridor whilst holding my arm, as though I would keel over at any point, to the emergency care unit… that moment right there & then shit me right up..!


 
Posted : 23/12/2023 12:45 am
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Fellow heart arrhythmia sufferer here. Not AF but really strong premature ventricular contractions started in 2021. Felt awful and very very scary, brought on by exercise or lack of sleep, being run down and/or too much alcohol.

I also have this, brought on by lack of sleep. The PVCs have shown on ECGs for more than a decade, but from time to time I suddenly become aware that they’re happening.

Need to have ECGs every other year for work and my old doctor was brilliant. Retired cardiologist who just kept hitting the button on the machine to do a new scan every time he saw something he thought the CAA wouldn’t like, while at the same time complaining about cyclists and runners confusing the automated diagnosis.

Ironically he died in October from a ruptured aorta. He was a lovely chap and sorely missed. The replacement is very thorough but has sent my latest ECG off for a second opinion. FWIW COVID and the flu mess with the heart, so don’t rely on a single ECG if you’ve got either at the time of the first test.


 
Posted : 23/12/2023 3:12 am
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Not AF but really strong premature ventricular contractions started in 2021. Felt awful and very very scary, brought on by exercise or lack of sleep, being run down and/or too much alcohol.

After a recent second opinion this is me too. Not alcohol as I don't drink, but I've gone decaf on tea and coffee (not a massive coffee drinker, mainly tea) and it's seems to have made a massive difference. I also have terrible sleep and suffer with it. Though my recent, and first, bout of covid sent it seriously racing and all over the place for several days.

Was also a massive relief to be told I've actually not got microvascular heart disease and don't need to take all the medication they wanted me to. It really had me worried, and no amount of saying don't worry helped 🤣

Just need to lose a shit tonne of weight now and try to build my endurance cycling back up without triggering it, maybe even ditch the ebike. #NewYearPoject


 
Posted : 23/12/2023 6:54 am
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I had Covid over a year ago, followed by Pleurisy then developed AF. Had a number of tests and appointments with specialist who confirmed it was relatively common in distance runners (me) and cyclists. It hasn't gone away but I am on anti clotting drugs. Still running daily (around 30+ mpw) and I get "flutters" every day or so.

59 now but from my teenage years I probably averaged 40+ mpw running, up to 70-80 at my peak. Talking to a mate last week who also has it (he is 71 and ran 14:30 for 5k as a V40!) and we joked that if you didnt have you hadnt trained hard enough!!


 
Posted : 23/12/2023 8:16 am
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Welcome to the club! first things first: try not to worry too much. As has been said, there are much worse things to have. AF can be a range of things from annoying to making you miss exercise or take it easy for a couple of days, but just try not to worry.

mine was diagnosed in 1999 after an admission to ER at my local place. I got a nice all day stay in cardiology (pulse at about 70 bpm, HR up at about 200) and then they zapped me a few times to make sure it went back to normal sinus rhythm. That was hilarious. I had ablation on in 2008 to fix it and, despite the odd episode even today, it is pretty much gone. Certain things will trigger it again, usually extremes stress, combined with exercise or cold, or really, really needing to pee (for some reason), but otherwise my life is normal or better than it was/has been since diagnosis.

Anyway, long story without a real point to it. The big thing I wanted to say is that this is both controllable and treatable, but it is also something that pretty much exists in a mild form when people are run down as well. Something like a cold or recovery from one will for sure see me avoid super-heavy exercise because I know that is a trigger for me. For you, this could just be exactly that… a one off brought on by something as simple as running up the stairs to pee whilst stressed from a Zoom call and recovering from a virus. Just rest up for a bit. And try not to worry about it.


 
Posted : 23/12/2023 8:23 am
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Thanks for that link, Branes...interesting read.


 
Posted : 23/12/2023 8:59 am
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Incidentally I get very strong palpitations periodically when I'm stressed. I was worried that it was my AF returning, but happily not. Had a long talk with a GP who had a personal interest in palpitations, and he put my mind at rest....they're almost always harmless and not related to AF in any way.


 
Posted : 23/12/2023 9:02 am
 ton
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14 years in and out of AF.

3 x cardion version. failed.

2 x ablation. both worked, then reverted.

1 x surgical ablation. open heart surgery. worked for 7 years, then reverted.

currently in permanent AF.  but not as acute as previously.   more like a very erratic heart beat.

sometimes, your heart can prefer to be in AF. my consultant told me that mine must do, has it does not hold me back in any way really now.

good luck.


 
Posted : 23/12/2023 11:59 am
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Not AF (hopefully) but does anyone get a racing heartbeat occasionally for no reasons? I had an episode this morning, came in from a dog walk and my pulse was showing around 125. Pulse was steady (confirmed by an app I have on my phone), just about 20 beats per min higher than I’d expect it to be. I’m thinking too much alcohol over past few days and not enough water maybe the cause. Went down fairly quickly after a sit down


 
Posted : 23/12/2023 3:26 pm
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When I was diagnosed at a drop in center, they wouldn't even let me walk to the ambulance, insisted on wheeling me out. Although to be fair my main symptom was difficulty breathing the afib meant fluid was building up in my lungs.

Apparently most people can feel the irregular heartbeat, I think my only notable symptom before the difficulty breathing was what felt like bonking while exercising, which became more and more frequent but I just dismissed the effects of aging. But in the end I was in permanent afib and atrial flutter.

I had 5 or 6 cardioversions, and 3 ablation surgeries. Been ok for 3 or 4 years now but probably on bisoprolol for the rest of my life. 

I have massively cut down my alcohol and caffeine intake now, they are both well known triggers. And there does seem to be a link to endurance sports.


 
Posted : 23/12/2023 3:51 pm
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I point all my patients towards patient.info, tells you what you need to know about pretty much everything:

https://patient.info/heart-health/atrial-fibrillation-leaflet


 
Posted : 24/12/2023 10:11 am
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@Ton you recounted your experience with AF on here some time ago which coincided with me experiencing it. Sounds like you have had a tough time and I feel for you. I am glad to hear it is not holding you back to much.

Apparently most people can feel the irregular heartbeat

Yes mine is unmistakable and unnerving. Not sure it will be picked up by a HRM as that only takes samples so in my case I had an extra beat then a missed beat every 10-20 seconds so over a minute it looked pretty normal. When hooked up to an ECG however it was concerning and bouncing between 50 and 153!!


 
Posted : 24/12/2023 10:29 am
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Reading this with interest.

I was diagnosed with paroxysmal Afib in August and almost the worst thing about it for me is the psychological effect of making me feel older and less "robust" ( I'm 59 and have enjoyed very good health).

All this conversation and the links are so helpful for me - I've cut down on caffeine (I love good coffee...) and alcohol (not so fussed, not a big drinker anyway), and have noticed it seems to come on more when I'm tired and often a day or two after strenuous exercise. Generally lasts for a day or sometimes two and them resets on its own, after which I can be fine for a week or two.

I'm starting to understand that the best thing for it is to actually exercise more and get fitter, rather let yourself give in to it, but any talk of an increased risk of stroke is quite scary, even if it's not greatly increased.


 
Posted : 24/12/2023 10:57 am
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Well, alcohol definitely seems to be playing a part; I had 3 bottles of IPA & a brandy last night & looking at my Garmin this morning, my heart rate didn’t drop below 100bpm all night.
In fact my Garmin reckons I was awake most of the night 😳
I do like a drink but I’m not a massive drinker, & due to being on call every few weeks I often don’t have a drink for weeks at a time.
As part of a weight loss diet leading up to the Megavalanche earlier this year didn’t drink any alcohol at all between March & July so cutting it out again isn’t particularly daunting; I think I’ll be more upset at giving up coffee..!
Thanks all for your input. I definitely had an Oh Shit! Moment when I realised something wasn’t quite right.
Again, referring to my Garmin data I can actually pinpoint the day it went funny. Saturday 9th December I did a 15 mile walk then went out for Chinese buffet meal with the family. I remember thinking at the time that everything tasted mega salty & I would’ve definitely been dehydrated from the walk. I drank orange & soda throughout this meal.
Anyway, I remember that I felt shocking the next day but put it down to a night of poor sleep & salty food hangover. That week I never really felt much better, with the main symptoms being sore throat, wheezing chest, blocked/inflames sinuses & a weird feeling like my head at too much pressure in it, causing a stalking headache all week.
I didn’t wear my Garmin much that week or last week, so I only have periodic snapshots, but it appears it all started weekend of the 9th.
To those who’ve identified some sort of a trigger, do you find that if you remove the trigger, your heart goes back to normal after a while ?


 
Posted : 24/12/2023 12:02 pm
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my heart rate didn’t drop below 100bpm all night.

Not surprised after 3 bottles of brandy 😂


 
Posted : 24/12/2023 12:09 pm
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Along with all the other stuff noted above, MSG is definitely one of my stronger triggers, had a Chinese takeaway last night and a can of beer, hardly slept due to the irregular pounding in my chest, I’ve had it for going on twenty years now and finally agreed to beta blockers about two years ago, they definitely work for me unless I drink too much, coffee is a trigger but also kicks off my IBS, the downside of the beta blockers is that these days a thirty mile ride wipes me out, that’s hard to take after many years of riding long days but at least I’m still able to get out and ride every day and am slowly accepting that a twenty mile ride is as enjoyable as a hundred mile ride, just a different type of enjoyable

To answer your last question, yes removing all the triggers does result in a normal regular heartbeat for me, but where’s the fun in that 😉


 
Posted : 24/12/2023 12:15 pm
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I point all my patients towards patient.info, tells you what you need to know about pretty much everything

I wish I hadn't read that! I don't have AF but I did have an ECG about 3 weeks ago because my GP was worried that I had an irregular heart beat, plus a much higher than normal resting HR and higher than expected BP.

Everything turned out normal as did by then my HR and BP (had been issues for a couple of weeks).

Things seemed to kickoff after a covid booster jab, I don't know if there was a connection with that.

Edit: My brother has been plagued with AF for many years, we have similar health backgrounds in terms of ex heavy smokers and he does a fair (but less) amount of exercise, and genetics obviously. The big difference I guess is that he drinks alcohol and I don't. He has had loads of treatment for AF and yet he has told me that it has been triggered by just one alcoholic drink. I have no idea how anyone could enjoy a drink of alcohol knowing that.


 
Posted : 24/12/2023 12:25 pm
 rone
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Mum got close to death with this - this year. A last minute desperate rush to Hospital (because she would not get it checked out earlier) turned everything around with pretty amazing treatment.

Now back to 'normal' but lots of tabs.

It seems fairly common.


 
Posted : 24/12/2023 2:13 pm
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I developed AF as side effects to my second covid jab (phizer). After lots of tests etc. it disappeared after about 6 months. Was a bit worrying but nothing bad happened.

The conversation with the GP was hilarious. "Do you think i should have the booster jab?"

"I can't really advise you either way. You might be fine, you might die!"


 
Posted : 24/12/2023 6:33 pm
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I developed AF as side effects to my second covid jab (phizer).

Interesting, so perhaps my issues were caused by my last covid jab then. I will probably still have next year's covid jab though, I can't imagine that a bad dose of covid has any less risk of causing a high resting HR or palpitations.

“I can’t really advise you either way. You might be fine, you might die!”

The same can be said concerning covid.


 
Posted : 24/12/2023 8:28 pm
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I point all my patients towards patient.info, tells you what you need to know about pretty much everything:

Interestingly that doesn't mention sleep apnoea as a cause, which I discovered I had while in hospital getting treatment for my afib, and the specialist said was probably a significant factor in me developing afib.


 
Posted : 24/12/2023 8:42 pm
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Bit of an update to this thread.

because I was whittling myself half to death, & because i was told the waiting list for an NHS cardiology appointment is up 18 months I ended up paying for a private consultation; I had an echo & they found that there is nothing wrong mechanically with my heart, which was reassuring, & I was given the thumbs up to exercise, with the caveat that I should listen to my body. Says I should respond well to  cardioversion. I can’t afford that privately so I’m still awaiting an NHS appointment.

I was also put on anticoagulant’s & Bisoprolol beta blockers. These I do not like… I seem to have quite a few side effect from the BB’s, though some of these also match AF symptoms, so it’s difficult to say what’s causing what.

in the meantime I’ve also been diagnosed as having hereditary haemochromatosis; given that AF & arrhythmias are one of the symptoms of this it may be an explanation of why I’ve developed it. Trouble is, without an appointment I can’t get anyone to apply a bit of joined up thinking; I’ve been told over the phone that I’ll be having venesection, but due to staff shortages it won’t be for a couple of months. I’ve also been told over the phone that due to the echo results from the private clinic I’m on a cardioversion shortlist.

My ideal scenario would be to start the venesection before the cardioversion, just in case it is the iron overload that’s causing it, which should increase the chances of cardioversion working, but it appears that hospital departments don’t particularly talk to one another 🤷‍♂️.


 
Posted : 01/07/2024 10:42 am
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I had a heart scare (it was nothing but blue lights to hospital) post covid.

Then at Christmas I was getting tight chest, anxiety, fluttery feeling unable to sleep.

Quit drinking and it's gone.


 
Posted : 01/07/2024 10:51 am
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Also, and this is the reason for the update, I’ve noticed something a little odd recently.

A question to fellow AF sufferers; when I exercise I can nimble along nicely but have no top end whatsoever. It’s like hitting a brick wall. I’ve also noticed I have zero lactate tolerance; even the slightest hillock such as a hump back bridge or gently rise has me struggling with lactic acid. I assumed that this is because the pump isn’t efficient enough to clear it out. However, I’ve recently noticed my heart rate seems to “behaving itself” whilst exercising. What I mean is that the BPM is much more normal (more akin to pre - AF heart rate) whilst exercising. In fact I did a 2 hr off road ride yesterday, & though I could feel that my heart rate wouldn’t go high, which I’m assuming is the effect of the BBs, the heart rate was exactly how I’d expect it to be when compared to perceived exertion.

This was also the case on Friday on my commute home - all fairly normal feeling on the ride home. On both rides I also had negligible lactic acid build up. I felt absolutely normal.

So my question is, does anyone else have AF at rest but feels normal whilst exercising?

My Garmin graphs have a much smoother profile to them as well, similar to pre AF, and my average heart rate per ride is much lower. I know that I haven’t suddenly gotten loads fitter.


 
Posted : 01/07/2024 10:56 am
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“ Quit drinking and it’s gone”

I don’t particularly drink much and can go weeks without touching a drop. I gave up caffeine entirely for a while & nothing changed, though I only have one cup of caffeinated coffee per day now with the rest of it being decaf’ tea & coffee.

I certainly sleep better but it had no effect on my AF.


 
Posted : 01/07/2024 11:00 am
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I don’t have AF but do have a CRT-P pacemaker and feel exactly like you do on the bike.
Can be flowing along just fine with no issues but as soon as I need to exert myself I feel like I have no legs. I.e feel hollow and full of lactic acid.

Horrible feeling as I feel like I’m going backwards in fitness and always feel like I’m holding people up on a group ride.


 
Posted : 01/07/2024 11:20 am
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On exercise... When I am in AF (paroxysmal, no immediately known cause), I have very little ability to exercise at my peak. I've done it when i have had to, but with the top part of the heart maxing out and the lower part struggling to fill effectively, it's not a good thing and probably will result in me passing out. Hence, if I do get AF, I stop and have a sit down until it goes away.

For me, normal rhythm == normal exercise. 21min 5k, half marathons, long bike rides, Crossfit, etc. But... I can _never_ got to 100% because my brain is always concerned that I will jump into AF. It's held me back for a long time and was a big factor in several recent issues I have had with my mental health.

AF and alcohol are linked, but I am not sure how. Certainly a large number of chronic alcoholics have/can have AF, but is the correlation or causation? IANAD. I know that my fitness improved a tonne when I stopped smoking and cut down on alcohol, but that was also at a time when I had the RF ablation and could actually exercise more, so maybe there is a general link between fitness and AF.

FWIW, on my first episode, I walked into A&E as told the reception "there is something wrong with my heart" and. got seen by nurses before I had filled out the paperwork. Cardioversion happened a few hours later. Now I am in Sweden (and would like to actually have access to Flecainide or the modern equivalent) I tried calling the care phone lie to get a referral and never got a call back, despite registering the call as AF/arrhythmia. No idea if that is lower priority here, or just poor service.


 
Posted : 01/07/2024 11:30 am
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A question to fellow AF sufferers; when I exercise I can nimble along nicely but have no top end whatsoever. It’s like hitting a brick wall. I’ve also noticed I have zero lactate tolerance; even the slightest hillock such as a hump back bridge or gently rise has me struggling with lactic acid. I assumed that this is because the pump isn’t efficient enough to clear it out.

Assuming you are not in permanent afib, that is probably the bisoprolol, I just came off it 2 months ago, and it was like having a rev limiter removed when going cycling afterwards.


 
Posted : 01/07/2024 11:37 am
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Quit drinking and it’s gone

Should be I quit drinking.

Not saying it was AF but certainly a fluttery anxiety tight chest.


 
Posted : 01/07/2024 12:56 pm
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I was also put on anticoagulant’s & Bisoprolol beta blockers. These I do not like… I seem to have quite a few side effect from the BB’s, though some of these also match AF symptoms, so it’s difficult to say what’s causing what.

I was on Bisoprolol for a few years after AF was diagnosed and it wrecked my mtbing. Just didn't have any energy beyond an hour's ride and the struggle to get up hills took all the enjoyment out of it. I thought it was the new normal - now in AF, stamina wrecked (I even bought an Ebike! The horror!). Wasn't til I started dating a doctor and she told me I didn't need to put up with it and got me a private appointment to be re-assessed, it turned out to be the drugs mainly at fault. Bisoprolol has been changed to Viazem XL and fitness has improved a lot. I wouldn't say it's night and day (I mean even at rest my heartrate can be at a ridiculous high), but I can enjoy normal MTB rides much more now. (eBike rides are better though tbh)


 
Posted : 01/07/2024 2:24 pm
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Yes I’m in permanent Afib.

What I’ve noticed in the last week is that when exercising I suddenly seem to have good lactate tolerance, more energy, breathing is regular - dare I say, it feels normal.

The only difference between how I feel now & how I felt before Afib is my heart rate won’t go up much beyond my old threshold levels (155 ish).

I feel like I’ve got a lot more to give - that is, my legs and energy aren’t holding me back like they were a couple of weeks ago.

Up until now my heart rate would be all over the place with zero lactate tolerance meaning anything above level 2 type exercise was horrific. But I firstly noticed it was fairly stable on the turbo trainer unless I did an extended session (1.5-2hrs). It also went down fairly quickly, whereas for the past few months it would go up & stay up even some time after the exercise had finished. So biking to work and back last week - Monday & Tuesday felt crappy, Weds & Thursday just felt tired, then Friday - felt virtually normal. My 20 minute bimble yesterday turned into a 2hr woodsy ride. I didn’t particularly push myself, but felt like I could’ve given more except for the heart rate brick wall, which I assume were the beta blockers in action.

Once I’d finished my heart rate stayed mildly elevated (still erratic) for a few hours but I didn’t have the feeling of being utterly drained like normal.

Is it possible for your heart rate to return to normal during exercise but revert to Afib at rest? I’m only guessing that’s what’s happening & there’s no ecg facility on my Garmin, but I can’t find anything on google.


 
Posted : 01/07/2024 2:28 pm
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This is interesting about the bisoprolol as I’m on 5mg a day.

I just have no energy to do anything.

I can manage a 20 ish miles ebike ride on a Saturday and then feel like a zombie the day after.

lack of motivation to even walk the dog.


 
Posted : 01/07/2024 3:12 pm
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I did wonder if it was working at all, but due to the unpleasant side effects I didn’t want to mention it to my Doctor in case he increases the dose. I don’t want any more of that..!


 
Posted : 01/07/2024 3:39 pm
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I’m happy to say that I had a successful cardioversion in November and I’m still in Sinus rhythm. I’m still on Bisoprolol at a very low 1.25mg dose. I tried coming off it & had a rebound whereby my heart felt like it was beating particularly hard. I’m told this is normal and goes away after a few days but it was pretty alarming so I decided to wait until my follow up appointment.

Fast forward to my appointment yesterday & I expressed the desire to come off the Bisoprolol. the cardio nurse discussed the risk of going back into fibrillation if I come off it but suggested a try a different drug. He’s prescribed Flecainide. He said this would effectively do the same as the beta blocker but without the associated side effects of no energy, no ability to lift my heart rate & reduced exercise capacity.

That all sounded good (though I’d rather not take anything…). I read the enclosed paperwork & I’m now concerned that I’ve been prescribed the wrong drug.

Flecainide seems to be for supraventricular arrhythmia, ventricular arrhythmia & paroxsymal atrial fibrillation. I was in permanent atrial fibrillation but now in normal sinus rhythm. The leaflet, nor a scan of the internet says anything about using it in these circumstances. In fact nearly everything I can find talks about it being for serious heart conditions, which I’ve been told I only had AF without any other complications.

Has anyone else been prescribed daily Flecainide whilst in normal rhythm, or following a successful cardioversion?


 
Posted : 24/01/2025 7:48 am
 beej
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I was on it for 5 years with 1.25mg Bishop as well, as a preventative against atrial flutter (rather than aFib). Was ok until dose went up to 100mg from 50mg after a flutter recurrence. Then 2.5 years of feeling crap after exercise and increasingly frequent flutter episodes Then got stuck in flutter, had another ablation which seems to have fixed me. Came off all meds post ablation.

So it's definitely used as a arrhythmia preventative. Talk to your consultant if you can, or see how you get in with it.


 
Posted : 24/01/2025 8:17 am
 beej
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Oh, and I first went on it after a successful cardioversion


 
Posted : 24/01/2025 8:19 am
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Thanks Beej


 
Posted : 24/01/2025 8:25 am
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@renton

This is interesting about the bisoprolol as I’m on 5mg a day.

I just have no energy to do anything.

I can manage a 20 ish miles ebike ride on a Saturday and then feel like a zombie the day after.

lack of motivation to even walk the dog.

That's happened to me as well.

Can't ride up hills, no energy, no motivation.

Had to be a nonstarter in the Strathpuffer because I doubted I would have managed to get up the first hill even walking.

I've stacked on 7kg and I'm starting to think the cure/treatment is worse than the problem.


 
Posted : 24/01/2025 12:27 pm
mildred and mildred reacted
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Question re effects of Bisoprolol: What happens if I try to ignore the breathlessness and lack of power and push on climbing a hill?
I've been getting off because that feels like a warning, so is there a risk, eg fainting or worse, or will I just feel more crap?


 
Posted : 24/01/2025 12:49 pm
 ton
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i was on Bisoprolol early in my AF.   it made me pass out a couple of times when riding. walking up stairs was almost impossible.left me worn out constantly.

cardiologist changed my meds to Tildiem, which works fine for me. riding 100 miles most weeks. walks of up to 10 miles no longer a problem.  still in AF.


 
Posted : 24/01/2025 1:32 pm
 jako
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Bit of a thread resurrection, but looks like I am the latest STW victim of AF.  Started about a month ago now where suddenly over night I noticed my RHR was about 20 bpm higher than what it normally was.  Over the coming days it stayed like that and I had a general feeling not feeling quite myself.  Saw a GP later that week, who was not overly concerned and put it down to a post viral reaction.  Give it a couple of weeks and come back.

It stayed persistent so saw a GP again week before last who also took my BP, which was elevated.  Well it was very high - as I have white coat syndrome - but even taking it at home it was higher than it should be.  So went to see a cardiologist last week, to EKG which confirmed AF. ☹️   Blood test taken to try to figure out what may cause it and will also go in for an echocardiogram this week.  I am on a diet of blood thinner, beta blocker and something for the rhythm.   I am lucky in that I have private health insurance through work - so getting appointments is fairly quick.

I am not going to lie, it is a massive kick in the nuts as it has come out of the blue with no prior warning - and being on my own with own thoughts and access to google is not necessarily doing me well.  Although it does run in the family.  My mum was diagnosed almost same age as me (53).  That said I am sure I am in good care - and reading this and other threads is comforting in that it is treatable and manageable and will hopefully mean that eventually i can carry on more or less as I have. I am determined to beat this so will make sure I make the life style changes which can help as well as losing some timber.  

One question which occurred to me reading the BHF website is around driving. Has any of you fellow AF’ers been told anything about not being able to drive?


 
Posted : 08/09/2025 10:37 am
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My BIL has AF, and he hasn't been told not to drive. He's not a particularly 'fit' person but hasn't been told not to drive - he's even got a new motorbike recently.


 
Posted : 08/09/2025 11:33 am
jako reacted
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You only have to report the fitting of a mini defib, not AF itself.

https://www.gov.uk/driving-medical-conditions


 
Posted : 08/09/2025 12:12 pm
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 jako
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I dug a little deeper into DVLA

 

https://www.gov.uk/arrhythmia-and-driving

 

You must tell DVLA about your arrhythmia if one of the following applies:

  • you have distracting or disabling symptoms
  • your arrhythmia means you might not be able to safely stop or control a vehicle

Thankfully neither apply.


 
Posted : 08/09/2025 2:00 pm
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I had a pulmonary vein catheter cryo ablation seven weeks ago to 'fix' my persistent atrial fibrillation.  So far my heart is in a normal rhythm and I'm back on my bike and I've just started back at the gym.  I'm still on beta blockers and blood thinners but my cardiologist thinks I should be able to drop these in early December.  

Initially it happened to me in 2020 and I had a cardioversion done then which worked.  I then had 5 years of no symptoms then it returned in February this year.  This time the afib persisted.  The key is to get a cardiologist that specialises in this.  You want an electrophysiologist. My first cardiologist was decent but he preferred the drug solution but that didn't work for me.  I got a second opinion with an electrophysiologist.  He described my original cardiologist as an 'excellent plumber, but what you need is an excellent electrician'.


 
Posted : 08/09/2025 2:16 pm
 jako
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Thanks for that.  Was that private or via NHS?

 

I have my follow up in a couple of weeks where the blood samples and echocardiogram will be discussed.  I will then also discuss the next steps.  I have a clear presence to get to a no or very minimal drugs position.  From research, this seems to be the order of which things are done it - and that was also what the cardiologist said to me - seems in US they jump quicker to number 3.

 

  1. Drugs
  2. External DC Cardioversion
  3. Ablation catheter

There also seem to be a newer treatment called Pulse Field.  

And if at some point my cardiologist “stops” I will definitely go for second opinion. 


 
Posted : 08/09/2025 2:32 pm
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@dthom3uk

Right on the money. My local hospital cardiologist was, to be frank, pretty useless.

I resorted to a private consultation (because I could) and chose to see their best electrophysiologist based on his bio. The insight and advice he provided was like night and day compared to my local old boy.

 


 
Posted : 08/09/2025 2:52 pm
dthom3uk reacted
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FWIW I had a cryoablation followed a few years later by RF ablation. Mostly sorted now. Very occasional relapses (couple per year) due to various triggers. 


 
Posted : 08/09/2025 2:56 pm
 jako
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“My” cardiologist specialise electrophysiology as well so hopefully I am in the right hands.  Still early days - although I could be done with it already….


 
Posted : 08/09/2025 3:00 pm
bonni reacted
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I went private for my treatment as I was insured through Aviva.  

Good luck with everything, I hope you get sorted.


 
Posted : 09/09/2025 8:25 am
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 jako
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Thanks.  I am lucky to have private health too.

 

Must say this is a bit of a rollercoaster emotionally. It is amazing how your mind can find the worst case scenarios in these situation - sometimes I wish I did not have access to google 😀  There are days where I am struggling and shitting myself.  In some ways work is a relief - although in a paradox way I think the stress from there and the impact that has had on my me over a number of year is part of the reason for it all.  But who knows?

Tomorrow is echocardiogram day and return of the 7 day Holter monitor - and then week or week after next back to see the cardiologist.

I am keeping a list of an ever increasing number of questions for when I see the cardiologist - particularly around the drugs I am getting and the next steps (I am not a very patient patient).  This and some of the other threads has been a great help too. Although I would not wish this on anyone, it is nice to not be alone. 


 
Posted : 09/09/2025 6:26 pm
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I can appreciate how difficult it is. I wasn't allowed to exercise while my AF persisted so no gym or cycling for me for six months. I got pretty grumpy. Bear in mind though one of the cardio nurses said to me if you are going to have a heart problem this is the least serious. This is the worst phase while they try and figure it out.

One of my friends is in permanent AF and she racks up about 10000 miles a year on her roadbike.

Try not to over think stuff. Let the cardiologist guide you but don't be afraid to get a second opinion if you feel you aren't getting anywhere. 


 
Posted : 09/09/2025 7:37 pm
jako reacted
 jako
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Thanks.  Much appreciated - and yeah, not being able to exercise and burn it off makes me grumpy.  I even enjoyed cutting the lawn today 😀 

And this “One of my friends is in permanent AF and she racks up about 10000 miles a year on her roadbike.” is encouraging.

 

 

 


 
Posted : 09/09/2025 8:53 pm
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'excellent plumber, but what you need is an excellent electrician'....almost the exact words mine used 9 years ago...wonder if it's the same bloke or if its a standard joke?

"From research, this seems to be the order of which things are done it - and that was also what the cardiologist said to me - seems in US they jump quicker to number 3.
Drugs
External DC Cardioversion
Ablation catheter"
I went straight to number 3


 
Posted : 10/09/2025 6:33 am
jako reacted
 jako
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If you don’t mind me asking, what was the main reason to go straight to ablation?  I assume it worked?


 
Posted : 10/09/2025 10:43 am
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Posted by: jako

If you don’t mind me asking, what was the main reason to go straight to ablation?  I assume it worked?

I seem to recall the docs thought drugs wouldn't work for me, not would cardioversion.  

Yes it worked... 9 years and counting

 


 
Posted : 10/09/2025 11:44 am
 jako
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That is great to hear. 👍


 
Posted : 10/09/2025 12:03 pm
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I've not had AF but I have suffered from other heart arrythmia. Anyone  suffering has my complete sympathy as it is indeed a mindf*** of the highest order, particularly when it affects the things you love (i.e. mtbing)

In my case it was really strong premature ventricular contractions. They'd come on randomly and I would feel like I was going to drop dead on the spot with the really strong ones.

Fixed with ablation. I'm 100% fine now

Hope you get it sorted OP

 


 
Posted : 10/09/2025 5:12 pm