Author Topic: Atrial Fibrillation and Heart Rate Monitoring Help?  (Read 3187 times)

Re: Atrial Fibrillation and Heart Rate Monitoring Help?
« Reply #25 on: August 29, 2019, 04:36:50 pm »

Does anyone know if AF is hereditary?

J

I was told by my cardiologist that AF is not hereditary but that it does run in families (my mother, one of her two sisters and one of her three brothers all had / have AF as do I, though neither of my two siblings have it). I think I know what he meant, but if one of the YACF medics cares to elaborate that would be great.
hereditary means that it is directly inherited in traditional terms or what is known as mendelian inheritance.  Runs in families means that we think that it may have some sort of genetic basis but it is patchy and unclear but probably occurs more commonly in families than chance alone.

The big thing at the moment is called Genome Wide Assessment studies (GWAS) which is picking up all sorts of interesting things. https://www.biorxiv.org/content/10.1101/242149v1

Re: Atrial Fibrillation and Heart Rate Monitoring Help?
« Reply #26 on: August 29, 2019, 05:03:38 pm »
 :thumbsup:
R10000 x 2   RRtY x 7    SR x 7    E = 129

Re: Atrial Fibrillation and Heart Rate Monitoring Help?
« Reply #27 on: August 29, 2019, 06:00:37 pm »
Thank you all, once again.  I am certainly being cautious!  I used the bike to go to the library today, without any problems - but then I never had a problem till I had a problem - and I've never had one since!  So, I'm being careful and trying to stay cheerful.

I am not reading anything into the home BP readings any more, except confusion.  They are now up around the 80 mark, which is closer to readings I got in hospital.  I guess it's very difficult to be sure when the heart is fluctuating as much as mine does!

@Pluck  I haven't got any Mk1 fingers because of arthrirtis, but the Mk3s indicate (as I have always known) a pretty variable rate, with missed beats.  I also don't appear to have the strongest pulse in the world - but it's got me round a few old rides!

Thank you all again - you are very helpful to someone who has been knocked sideways by all this!

Peter

Re: Atrial Fibrillation and Heart Rate Monitoring Help?
« Reply #28 on: August 29, 2019, 09:49:48 pm »
I know I need to discuss this properly with my own doctors, but I'm interested in general terms in the interaction between drugs used to treat these conditions, and cycling. For example, bisoprolols are used to reduce heart rate, but is that what you want when climbing a steep hill? (Or do you have to be more prepared to get off and walk?) I think my racing days are long past, so I won't be pushing it that much...

Re: Atrial Fibrillation and Heart Rate Monitoring Help?
« Reply #29 on: August 30, 2019, 07:30:31 am »
No. But if you have heart failure or angina then beta lockers act as a lock on the heart rate and prevent your brain from going high enough to cause problems.

In AF they will increase the cardiac filling by giving more time between each beat for the ventricle to fill and thus improve heart function.

T42

  • Old fool in a hurry
Re: Atrial Fibrillation and Heart Rate Monitoring Help?
« Reply #30 on: August 30, 2019, 08:10:30 am »
WRT climbing, I did quite a lot 2008-2011 when I was on bisoprolol. Every so often I had to stop pedalling for a second or two to let the burning pain in my quads die down. I still managed rides with 1500 metres of climbing, though.  I was on 25 mg/day.

In AF they will increase the cardiac filling by giving more time between each beat for the ventricle to fill and thus improve heart function.

A couple of days ago I began to think that something of the sort was what was happening with me, since my performance has actually deteriorated since I came of the BBs, and it now takes me a ridiculously long time to recover from rides I did easily three months ago.  I'm now awaiting the results of a pro-BNP test to see if indeed I'm going down the rabbit-hole.  Should find out this morning.

This feels more and more like wriggling on the hook.
I've dusted all those old bottles and set them up straight.

Re: Atrial Fibrillation and Heart Rate Monitoring Help?
« Reply #31 on: August 30, 2019, 09:33:12 am »
 :(

Thanks. In my case, as I mentioned above, I'm recovering from a bypass. I'm currently not allowed to cycle until the surgeons confirm that my rib-cage has mended, but otherwise feeling relatively fit and walking (which I am encouraged to do) as much as I can (did manage forty miles in a week at one point).

I'm hoping to return to Audax riding (although I've never gone beyond 200km) in the autumn, and hence the questions.

Re: Atrial Fibrillation and Heart Rate Monitoring Help?
« Reply #32 on: August 30, 2019, 10:28:33 am »
Good luck to all of you!

T42

  • Old fool in a hurry
Re: Atrial Fibrillation and Heart Rate Monitoring Help?
« Reply #33 on: August 30, 2019, 10:44:59 am »
I'm hoping to return to Audax riding (although I've never gone beyond 200km) in the autumn, and hence the questions.

More power to you.

Good luck to all of you!

Thanks, Peter.

Good news: following my GP visit, my pro-BNP result shows no heart damage or enlargement, but doesn't have any bearing on A-fib/not-A-fib.  So GP says continue with no tea or coffee :o  :'( and just ride. So...
I've dusted all those old bottles and set them up straight.

Re: Atrial Fibrillation and Heart Rate Monitoring Help?
« Reply #34 on: August 30, 2019, 11:33:02 am »
Take it easy - but take it!  (Woody Guthrie?)  Speaking of which, is there a dose of Dorothy Sayers in you strapline?

T42

  • Old fool in a hurry
Re: Atrial Fibrillation and Heart Rate Monitoring Help?
« Reply #35 on: August 30, 2019, 04:54:08 pm »
Busman's Holiday.  My first bro-in-law used to call that the greatest line in English literature.

And yeah, I'll be out tomorrow, but only a shortie - it gets hot after 11 am.
I've dusted all those old bottles and set them up straight.

Re: Atrial Fibrillation and Heart Rate Monitoring Help?
« Reply #36 on: August 30, 2019, 05:09:45 pm »
Just as an observation, I happen to know a number of ex- real big hitter cyclists. A significant number of them Are diagnosed with AF, and others have other cardiac conditions.
As a layman, I wonder if having an ability to really suffer has caused damage, or maybe being mega-fit and perhaps not de-training correctly has had an impact?

Re: Atrial Fibrillation and Heart Rate Monitoring Help?
« Reply #37 on: August 30, 2019, 05:28:29 pm »
I think Steve redgrave had to consider this which suggests that cyclists are the same.  As I remember, his heart was so big and strong that he had to continue training after he stopped competing in order to allow his heart muscle to atrophy (shrink) safely.  The risk was that he would end up with less heart muscle but the same size and would therefore have floppy walls and risk clotting in his ventricles.

However this is half remembered and may be wrong

Re: Atrial Fibrillation and Heart Rate Monitoring Help?
« Reply #38 on: August 30, 2019, 07:25:30 pm »
My cardiologist told me that AF was more prevalent amongst endurance athletes precisely because of their enlarged hearts - that the greater volume and surface area of a larger heart provided more and/or larger pathways along / across which the errant signals could travel.
R10000 x 2   RRtY x 7    SR x 7    E = 129

Phil W

Re: Atrial Fibrillation and Heart Rate Monitoring Help?
« Reply #39 on: August 30, 2019, 07:30:42 pm »
I have a copy of this book, which is an interesting read if you want to see what the research is saying. Opinionated but interesting information nevertheless.

https://www.velopress.com/books/the-haywire-heart/

Re: Atrial Fibrillation and Heart Rate Monitoring Help?
« Reply #40 on: August 30, 2019, 08:32:28 pm »
How useful is it for those of us who are definitely not master athletes, and have never been in any danger of over-training (indeed, may never train at all), but do want to do more than the average member of the public? Serious question, since you've read it.

T42

  • Old fool in a hurry
Re: Atrial Fibrillation and Heart Rate Monitoring Help?
« Reply #41 on: August 31, 2019, 04:40:42 pm »
This looks interesting too:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4311486/

Have only skimmed it so far, since I've been out this morning & helping set the house to rights for visitors this afternoon (it's 32°) and I'm banjaxed.
I've dusted all those old bottles and set them up straight.

Re: Atrial Fibrillation and Heart Rate Monitoring Help?
« Reply #42 on: December 15, 2019, 12:26:24 pm »
Hello, again, everyone.

I've cobbled together a rambling update of what is happening to me.  I'm not really asking for help - you've already been very good with that - just wanting to reconnect at what is a rather upsetting time for me.  Sorry it's so long (it was written as therapy by a frustrated currently ex-cyclist).



I have stopped cycling.

Because of another blood-test, à propos very slight (and now non-existent) puffiness in ankles – a sign of heart trouble but also a side-effect of statins! - I was referred as a matter of urgency for another echo-cardiogram because the blood test showed my level of some protein (which indicates heart distress) to be 10 times the acceptable level.  It is also an indication of inflammation in the body, so it occurs to me that it might be distorted by the level of my arthritis, which is very bad in my hands and significant in at least one of my several knees.
At this second echo-test, the technician expressed puzzlement that the results she was seeing did not seem to accord with the suave, light-footed, devil-may-care individual she had powerless on the couch before her.  Where was the breathlessness, the puce skin and hesitant movement?  I imagine that it is only the guidelines that prevented her from referring to me as an Adonis.  Similar guidelines presumably prevent her from directly passing on bad news and she wouldn't tell me anything that I didn't ask directly, such as have I got an enlarged heart?  (Yes.)  This is common amongst champion athletes, so look on the bright side (my thoughts, not her words).
Rachel (for it was she) side-stepped my request to know what the Ejection Volume (EV) fraction was (it had been 30 – 35% in the test in August).  She did mention that the previous reading had been sufficient for that technician to suggest referral to a cardiologist.  For whatever reason, that didn't happen.  Perhaps, as has been mentioned, I have been shunted onto an age-related siding? Rachel would only say that she'd have to calculate the EV fraction and that I would be hearing from my GP.  It looked as if I was in trouble.
Sure enough, my doctor called me in within a couple of days.  My EV fracion is 10%.  That's a drop of two-thirds in an already severe reading – in three months.  Both sides of my heart have “failed”
Even though I've been riding ten miles a day with absolutely no ill effects, I am now off the bike.  What I'm on instead is statins, blood-thinners, ACE inhibitor and a beta-blocker.  And I'm waiting for an urgent (within a fortnight?) referral to a cardiologist, which should have happened months ago.
My doctor is as baffled as I am to understand how this has happened, especially this sudden decline in EV – which has been mirrored by absolutely no change in performance or feeling of well-being.  Less than 3 years ago, an MRI scan showed that my heart had no abnormalities, although I did have occasional ectopic beats.  The GP confirms that my other tests indicate that I haven't got diseased arteries.  My life-style and habits (those that can be openly discussed) have always been healthy.  It's looking (to me) as if stress may be the significant factor: my wife and I are carers and neither of us can remember the last time we had eight hours – or even six of unbroken sleep.  But my wife is fine, while I practically write this posthumously, according to science.

Even though I have been keen on fitness and adventure, and am not a fanatical athlete, I think it also possible that my level of exercise, though modest by the level of obsession displayed by most of the current crop of contributors to the Arrivée magazine, may have set up a chain, which is recognised amongst heart “observers”:-

Strenuous Exercise  >  Arrhythmia  >  L heart failure  >  R heart failure  >  ????????

But what a jolt to go from 35 to 10 in 3 months!  More graphically, I have read of surveys which indicate that 75% of people with an EV of 10% or less die within 3 years.  Whoopee!
Still, that means 25% don't, and I intend to be in that 25%, so have been bloody-mindedly finished planting the tulips in case I'm around to see them.  I've also read research that suggests that a patient's level of exercise is actually a better indicator of mortality than the EV itself, so I might be lucky there.
What a strange business!
I'm still getting out, just on foot.  I see the same beautiful sights, wildlife, sunsets, Christmas lights, but at the moment I have a sort of misty filter and I realise that all these experiences are intensified for me by riding my bike.  It's almost as if I am my bike!  I am Flann O'Brian and you can keep your £5.
Today, I walked back from Rochdale, about three miles along roads and cycle-paths I would normally ride.  I may have done more than I should have, I don't know, since I still haven't had the fabled “urgent” consultation with a cardiologist.  But I did see and joyfully hear a flock of long-tailed tits as they flipped through the hawthorn hedge by one of the ponds near the sports goods exploitarium.
Without the advice from a specialist, I'm not sure how much exercise is enough and how much is too much.  It's peculiar to think that I may actually have arrived at a stage in which, when I have got up, made the bed and walked say to the Co-op and back, I'll have done my exercise for the day.  Actually, it's not just peculiar, it's horrid – one might say unhealthy!

Wish me luck!

ETA  11th December 2019

I have finally received the date for my urgent appointment with a cardiologist.  It turns out to be with a Nurse Practitioner and is in six weeks time.  I am being given the bum's rush here and have almost certainly been shunted onto the senile, waiting to die, don't waste resources on him siding.  It's all very clever, because if I accept it and keep calm I'll possibly drop dead before I'm seen, therefore becoming an easily managed statistic.  If I get agitated about it, I'll drop dead anyway.  I'd rather die trying, so I rang several places to try and find out whether the departments involved actually considered this to be appropriate procedure for someone who has been referred urgently, as a result of a rapid and alarming deterioration in heart function.  Nobody was answering any relevant phones, except to say they were away from their desk and by the way from Monday they'll be on holiday.  I've managed to get a telephone appointment with my GP who is one of the people who think I should be seen urgently.  Let's see what he thinks.  In the meantime...... and breathe....!

Will it never stop raining?  I need sun – and sunsets!

T42

  • Old fool in a hurry
Re: Atrial Fibrillation and Heart Rate Monitoring Help?
« Reply #43 on: December 15, 2019, 01:24:38 pm »
Let's hear it for bloody-minded, I'm right with you. Thump the table for a real cardiologist - cycling's important for more than physical wellbeing.
I've dusted all those old bottles and set them up straight.

Re: Atrial Fibrillation and Heart Rate Monitoring Help?
« Reply #44 on: December 15, 2019, 01:37:00 pm »
That's the plan!

hellymedic

  • Just do it!
Re: Atrial Fibrillation and Heart Rate Monitoring Help?
« Reply #45 on: December 15, 2019, 01:59:10 pm »
[Non-medical suggestion]
If you can afford it, get a e-bike, get out and enjoy being out.
If the Grim Reaper decides to push you off, so be it!

barakta

  • Bastard lovechild of Yomiko Readman and Johnny 5
Re: Atrial Fibrillation and Heart Rate Monitoring Help?
« Reply #46 on: December 15, 2019, 03:20:04 pm »
[Expert NHS wrangler opinion - not a clinician]

GP appt is right idea, they're taking the piss and you need to not accept "no" for an answer. A failed referral and now a delayed referral is unacceptable. Hopefully your GP can read the riot act at them!

I got myself shifted up the "we have no appts yet available" waiting list after Dept B screwed up and meant I had to defer procedure from Dept A (couldn't have both within 6 weeks, Dept A's was more time critical) by basically saying "I should be seen sooner because the only reason I didn't have procedure in September was cos of Dept-B screwup and hospital maladministration. I told the person I have copied Complaints@ into this email in case you need to seek their permission to do this (cos the admin person wouldn't herself have authority). BANG, appt in 10 days after talking to the medical consultant himself.

Honestly 50% of NHS wrangling is going back and saying "No, the followup was in X weeks, Y is a LOT longer than X, please to be fixing" which usually gets me something like X+2 weeks...

And none of my stuff is as scary as hearts, although some is now age-critical. When I found out delays and age criticality were a thing I basically emailed complaints (who I have an ongoing dialogue with about hospital maladministration issues - cos they think ignoring the issue means I'll go away - fools) to say "My condition from Dept A is now age-critical, I'm taking even less crap than before, I will kick off if there are further delays and insist you resolve them".

Let your GP do the stress of chasing, but don't let them take the piss.

Re: Atrial Fibrillation and Heart Rate Monitoring Help?
« Reply #47 on: December 15, 2019, 03:35:59 pm »
Barakta, thanks for that.  I thought I'd talk to my doc, who is good and concerned, before going down the complaints route but I'll certainly follow your advice if it seems I need to!

@ Helly

I can ride fine and with no symptoms, it's just that I've been advised not to.  I don't get breathless and can ride up hills ok.  An e-bike wouldn't solve my current dilemma because effort isn't the problem.  Anyway, I think we'll see, in the future, health warnings issued with e-bikes because the very people they are designed to benefit will be having heart attacks just trying to lift them over kerbs or up garden steps!

As for the grim reaper - if I was on my own there would be no problem, really, but I am a carer and need to live for ever.

Re: Atrial Fibrillation and Heart Rate Monitoring Help?
« Reply #48 on: December 15, 2019, 07:13:54 pm »
My cardiologist told me that AF was more prevalent amongst endurance athletes precisely because of their enlarged hearts - that the greater volume and surface area of a larger heart provided more and/or larger pathways along / across which the errant signals could travel.

There are certainly a higher than one might expect number of ex big hitter riders with AF, starting with a certain Mr E Merckx. Quite a few ex pros I personally know have AF as well. The more encouraging news is that they all still ride, albeit at a more monitored pace.

Basil

  • Um....err......oh bugger!
  • Help me!
Re: Atrial Fibrillation and Heart Rate Monitoring Help?
« Reply #49 on: December 15, 2019, 08:15:37 pm »
Best wishes, Peter.  No expert advice to offer, but DON'T PANIC.
My af was diagnosed nearly 20years ago, and although it did knock me back at first, teh drugs n stuff got me back on the bike.
I'm not riding as much as I used to, but that's because not enough of Wales is downhill.

Keep on keeping on,  mate.
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