Atrial fibrillation

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

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.

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.

https://www.bbc.co.uk/sport/rugby-union/67797424

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.

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 👍🏻

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. 

Both probably still post - viral, to a greater or lesser extent. It's the new normal.

😠

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/

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.

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.

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..!

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.

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

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!!

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.

Thanks for that link, Branes...interesting read.

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.

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.

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

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.

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

@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!!

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.

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 ?

my heart rate didn’t drop below 100bpm all night.

Not surprised after 3 bottles of brandy 😂

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 😉

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.

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.

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!"

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.

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.

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 🤷‍♂️.

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.

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.

“ 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.

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.

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.

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.

Quit drinking and it’s gone

Should be I quit drinking.

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

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)

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.

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.