atrial fibrillation

I have paroxysmal (i.e. intermittant) atrial fibrillation, triggered by any one of a number of factors. These factors are not consistent and not predictable, but include - some foods (too much chocalate, too much red meat), alcohol, coffee, or some combination of these

Also in the mix is exertion - particularly running at Lactic Acid threshold pace. This is the bummer.

So here's the dilemma - if I train to exertion, and cope with the consequences, will my LA threshold pace be raised gradually, so that in the future I can train at a faster pace without triggering an attack ? Or do I ease off to avoid the consequences, with the result that my LA threshold pace is reduced, thus making it more likely that I'll hit it in the future

I have just noticed PAF, though probably had mild episodes for some time.

Does it interfer with your training much ? Have you been given anything useful to control it ?

I had it for a long time before I had anything done about it - my GP was rubbish, saying it was nothing, but to take it easy if it happened again. Got progressively worse - happening more often, and episodes lasting longer. Got to the point where it was happening consistently 2 or 3 times a week, and lasting anything from 20 mins to 20 hours !

Eventually got referred and monitored a couple of times (unsuccessfully - both times the 'wrong' 24hrs), before presenting at A&E during a particularly bad episode. Had tests and diagnosed by specialist.

GP was rubbish again - prescribed beta-blockers: all they did was slow my resting HR, and slowed by 'fibrilating' HR. It was still irregular, but slower.

Finally went back to specialist, and prescribed Flecainide Acetate (initially 2x50mg, now 2x100mg). Although not completely under control, episodes are less frequent, don't last as long, and aren't as 'violent' when they do occur.

Hasn't had too much effect on training, but I'm aware that the training may trigger an episode, although usually a few hours later. After-effects of episode usually worse than the episode itself - if I've had an episode which has lasts a couple of hours, I feel fatigued afterwards - as though I'd done vigourous exercise for that time. That usually means I'm too tired to do a proper training session, so training is often delayed for a day, or reduced in intensity

Hope this helps. But I'd still suggest seeing your GP in case your's is something different

Thanks guys.

I saw an rhythm cardiologist today. He's modified to diagnosis to multifocal atrial ectopics and episodes of atrial tachycardia; he ruled out AF (diagnosed earlier) on seeing a large piles of ECGs and two 24h tapes! (It still feel unpleasant when it banging irratically for days on end, but a least theres no need for warfarin)

Also told me (today) that it has probably been aggrevated by a virus and to stop running for 1-2 months (!) to allow the irritable muscle to recover. Apparently too much excercise at this stage may

1) provoke further episodes of atrial tachycardia (bangs away at 120/min)

2) may lead to weakening of heart with risk of heart failure in later life.

Im being offered pill in a pocket (flecainide) if it gets worse. Apparently the therapy, which worked for Corinthian, is not on the cards yet.

Guess Id better take the advice, the alternative is pretty grim.

JB is right.  I had AF and sometimes SVT for 5 years that I know of (Sure I had it before but discounted it).  Some people only have the occasional attack, very sporadic and at irregular intervals - and it stays like that. 

Unfortunately, in my case it worsened until I was in AF for 36+ hours at a time; sometimes a couple of times a week.  It was getting so that AF became my normal rhythm!

With most who have AF  the Flec sorts them out... I couldn't have beta blockers as I've  a history of asthma.  I was on Flec and Diltiazem (sp) and now and again digoxin (sp?).  Was also on aspirin... but not warfarin.

The second catheter ablation sorted things out... been nearly 14 months without a problem.

Re training... was able to train for the first 3 years at the same level I normally trained... but the last 2 years I had to slow down... did virtually nothing for the final 12 months.

Please drop me an email if you want further info

C

HI

I was really pleased to read of your successful outcome and was heartened (no pun) by the support given by other members. I followed the thread with baited breath, a few nights ago.

I guess its still early for me. I had a bit a rhythm problem 5 yr ago (before I took up running, began to run 3 y ago) and was well for until very recently. At present the call is atrial tachy, not AF(though it feels like AF right now). Im hoping the viral trigger is correct and will have to take it quietly, because it does not take much to set it off this week.

Did excercise set yours off ? Did they talk to you about 'remodelling' as a result of SVT or AF ?

FF

No FF... exercise didn't set it off whilst running or immediately after and I was able to run very slowly whilst having an attack.  In all the time I had it I only ever went into full AF during one run; although, there were plenty of irregular beats occurring throughout most runs.

However, during the last 12 months I was so knackered all of the time through lack of sleep and spaced out with the drugs, that it was useless to even try.  Saying that, by the last 12 months I was more in AF than out.

What set me off in the early days was too much red wine and caffeine was also a trigger.  I'd usually have an attack about 2 - 4 in the morning and it would last 5 minutes or so... I noticed I was getting attacks in the early morning the day after a long hard run... so exercise might have been a trigger.  I used to drink alcohol most nights so there's a conflicting variable.

I cut the booze and caffeine out of my diet but was still getting attacks... even when I'd not exercised for weeks.

Not heard of 'remodeling'?

Hope things work out for you... I'm sure that they will.

C

Thanks

Remodelling appears to be a change in shape and circuitry of atria. Distorted atria get more AF. This seems to lead to more distortion and more AF... and on it goes.

 Chilling for a while. At least I dont feel breathless and the beats are less forceful

 FF.

How are you now FF?

Any change since the flec?

Hi C

Im afraid I shut off PC and phones for several days. Palpitations were provoked by phone ringing and changes in posture (moving from flat to upright to reverse changed venous return and upset the atria).

Low dose flecainide helped a bit but 100mg twice a day has pretty much shut them off. I get the odd bump on waking, but NO sustained disturbance of any kind.

SO - flec and a lot of bed rest settled it. Planning to stay on flec for a few weeks to see whether the viral trigger has resolved, if palps return I either use the 'pill in the pocket' as needed or resign myself to longterm flec.

Cardios say no running for a couple of months as the virus probably damaged th heart muscle as well as the electrics.

FF 

ah good

Corinth is on this thread

I have nothing to add, except to say good luck mate

Hello Hippo... not seen you around for a while... hope all's OK (Hippo helped me through my bad times... and much help she was... when she was sober)

FF... Wise decision to lay off the running for a while till heart gets well again.  Hopefully, time and flec will sort out the worst of the palpitations.  Though, If things stay as they are there may be other options available to you.

I know how horrible things must be for you... it can and will get better.

Please let me know how you get on.

.. and feel free to email me anytime

C