Author Topic: Atrial Fibrillation and Heart Rate Monitoring Help?  (Read 4709 times)

Kim

  • Timelord
Re: Atrial Fibrillation and Heart Rate Monitoring Help?
« Reply #50 on: December 15, 2019, 08:39:43 pm »
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!

This isn't far from what the SCIENCE coming out of the Netherlands suggests.  E-bikes aren't dangerous because they go fast, they're dangerous because they're used by vulnerable and/or inexperienced cyclists, and the main risk is through falls at low speed and when mounting/dismounting.

(I'm also impressed that my lifting-impaired friend's 700c e-bike can push itself up a standard-height kerb in a controlled manner using the thumb control 'walk mode'.  Makes a big difference.)


Anyway, what Basil (and barakta) said.  I'm used to lungs being rubbish, but hearts are scary!
Careful, Kim. Your sarcasm's showing...

Re: Atrial Fibrillation and Heart Rate Monitoring Help?
« Reply #51 on: December 16, 2019, 08:12:03 am »
That is a right bugger of a thing to happen, Peter.

I wouldn't think too lowly of a nurse practitioner, actually. In my experience, they are absolute specialists, highly focused on the patient and interested in the subject area. More observant of patient behaviour, wellbeing and feelings than some specialists.
<i>Marmite slave</i>

Re: Atrial Fibrillation and Heart Rate Monitoring Help?
« Reply #52 on: December 16, 2019, 11:26:34 am »
Thanks, everyone, for the advice and encouragement.

Charley, I too have been impressed with the nurse practitioners I've seen (only a couple), so I do respect their expertise and concern.  However, I'm not sure that in this case an appointment with a NP six weeks down the line, is quite what my doctor and the echocardiologists had in mind when they were visibly shocked by my "figures".  Maybe it'll all be fine but I think I should push a little first.

@ Basil  Ha!

Peter

Re: Atrial Fibrillation and Heart Rate Monitoring Help?
« Reply #53 on: December 30, 2019, 11:04:33 pm »
Hi Peter,

Firstly I have to admit that I've not read every thread in this chain, so apologies if I'm repeating everything.

I was diagnosed with Ab Fib about 5 years ago when I was at my peak physical fitness, running 3 or 4 marathons a year, loads of Halves, and dozens of cycling events.

I had cardioversion which lasted about 2 weeks and shortly after this failed had the ablation op. Since then I still get the odd event which can last up to a few days. They typically come on when I have the perfect storm of too much caffeine, booze and stress. Each of which I try to manage but sometimes can be hard. My last event was after a week that involved a wedding (booze) , job interview (stress) and doing a 43 hour week in 3 days (stress and caffeine)  to accommodate the first two.

I was on blood thinners for about a year and rhythm drugs for a bit longer after the op. I'm now pretty much drug free except for one tablet to reduce my blood pressure.


There's a lot of risk factors for Ab Fib, I was told mine was a lone event, in that it didn't indicate any underlying heart problems, but that it was brought on by too much endurance sport ( hence the comments above) . Apparently it's very common in anybody over 70, men are more susceptible, possibly due to body mass. Bigger men (I don't really mean fat) are much more likely to have it than small women. Excessive fitness is a contributing factor as it can cause the heart to grow larger and fibrous which can create problems with the electrical wiring.

There's some evidence that taking Magnesium can help reduce the symptoms. It seems to work for me.

If you want to learn everything about it, there's a great book called The Haywire Heart' by Chris Case that's well worth reading, but settle in to read it, it's not an easy reader.

I'm back running and cycling, but not as much as I was. I've been told never to do another marathon but haven't been imposed any restrictions on cycling as the consultant seemed to think it was far more sedentary than running and who was I to correct him 😙.

Good luck. It's not the end of the world and a lot of people can get back to almost the same activity levels that they were at beforehand. There's a lot of stuff on the web about it and numerous groups on Facebook where you can chat with people with similar conditions.

Karla

  • car(e) free
    • Lost Byway - around the world by bike
Re: Atrial Fibrillation and Heart Rate Monitoring Help?
« Reply #54 on: December 30, 2019, 11:24:16 pm »
Peter, this had all passed me by until now but I'm sorry to hear it, you sound like you've got far too much on your plate.  I'll be thinking of you and hoping you find a treatment with the minimum of stress.  All the best.

Re: Atrial Fibrillation and Heart Rate Monitoring Help?
« Reply #55 on: December 30, 2019, 11:40:45 pm »
I meant to mention that you can get home use EKG monitors reasonably cheap. Here's a link.

I have one but am not sure that want to post a specific link to it as I don't think that I'd totally recommend it. It's ability to read heart traces seems ok, but it's quite tweaky to use.

https://www.amazon.co.uk/s?k=Ekg&ref=nb_sb_noss

Re: Atrial Fibrillation and Heart Rate Monitoring Help?
« Reply #56 on: December 31, 2019, 04:43:22 pm »
Redjeep and Karla, thank you for the posts, info., and good wishes, they are very much appreciated.

I have actually had a consultation with a cardiologist now, and he was fairly sanguine.  When I asked him if I was likely to drop dead, he said, "We all have to die sometime!", which I think I take as "It's possible".  He thinks my heart is in a bad way and one that would probably have killed me, had it NOT been for my otherwise healthy lifestyle.  Really, the only two factors that are likely to be involved (apart from genetics) are stress (which is a big one, I'm afraid) and cholesterol, for which I have pretty good figures.  On this latter, the consultant wants me to have an angiogram to check the state of my arteries, so that will be the next "intervention".  He has also doubled my beta-blocker dose and introduced essence of foxglove.  He also said I don't look my age - which is actually a medical condition, apparently.
I check my heart-rate regularly and it does seem to be coming down gradually.  So, though I'm fed-up with the overall situation, I'm trying to remain optimistic (the consultant remembered at the last minute about being encouraging and said it was quite possible I'd be back on the bike before long because the drugs are much better than what was available 20 years ago).

I'm also taking encouragement from all the advice from fellow-sufferers and other friends on here.  Thank you again!

Re: Atrial Fibrillation and Heart Rate Monitoring Help?
« Reply #57 on: December 31, 2019, 06:59:58 pm »
Peter, no problem.  Good luck with all this.

There are a few good groups on Facebook such as 'Parkrun for people with heart conditions' which you may find helpful and supportive. Sometimes it's just good to know that you're not alone. There used  to be a very good thread on the Runner's World forum with numerous people who'd been through it and returned, mostly, to running. I can't find it now but if I do I'll post it here. 

If I can be of any help please feel free to PM me.

Phil W

Re: Atrial Fibrillation and Heart Rate Monitoring Help?
« Reply #58 on: December 31, 2019, 08:47:52 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

That’s what I have heard as well.

Wowbagger

  • Dez's butler
    • Musings of a Gentleman Cyclist
Re: Atrial Fibrillation and Heart Rate Monitoring Help?
« Reply #59 on: June 30, 2020, 11:24:43 pm »
I saw this thread when Peter first started it and have been doing some catching up now.

How is it going now, Peter? Wishing you well.
Eating's a serious business. Don't bollocks around wagging your tail.

MikeFromLFE

  • Previously known as Millimole
Re: Atrial Fibrillation and Heart Rate Monitoring Help?
« Reply #60 on: July 01, 2020, 11:07:25 am »
I thought I'd chip in here with Mrs M's AF experience.
(As we both have significant healthcare expereince, I don't tend to wade in on this type of thread, but thought her story might be interesting, and maybe useful)

She has known that she's got a PDA (hole in the heart) since she was a late teenager, it's something she was born with and has never knowingly caused any issues.
About 5 years she had a TIA (stroke) and underwent extensive investigations, which over the course of maybe three years, revealed she'd unknowingly had an MI (heart attack) at some point - possibly during childbirth some >30 years ago! and had frequent AF (Atrial Fibrilation) which explained a lot of her 'funny turns'.

She was shunted off to a multitude of Cardiology sub-specialities none of whom seem to talk to each other, including the congenital heart clinic (for her PDA). She was put on a full pharmacy shed load of drugs and she had a heart rate monitor implanted in her chest (aka 'loop recorder') with a receiver that 'phones home' every night to report any AF events back to the cardiology clinic - in theory.
The implanted monitor connects to the base unit (next to the bed) about 3am every night, and the deal was that she'd get contacted if there were any 'significant events' - yeah right, that happened!

She had a telephone consultation with one of the cardiology clinics last week, and mentioned about the implanted device which the doctor on the phone knew nothing of, and appeared disinterested - he said as she was having no symptoms, he was going to discharge her, and contact the recorder people to get it removed.
Cue the copy of the GP letter where - reading between the lines - he'd contacted the recorder people who'd said (something like) "but.... but... but" - the letter detailed multiple significant TIA events in the last three months, and he advised the GP to urgently change her anticoagulation therapy. No mention of removal of the device, or discharge.

She's trying to get hold of the consultant's secretary (as suggested by our very helpful GP) to find out WTF is going on.
Too many angry people - breathe & relax.

T42

  • Old fool in a hurry
Re: Atrial Fibrillation and Heart Rate Monitoring Help?
« Reply #61 on: July 01, 2020, 03:51:31 pm »
Sounds like WTF aptly summarises it.
I've dusted all those old bottles and set them up straight.

Re: Atrial Fibrillation and Heart Rate Monitoring Help?
« Reply #62 on: July 18, 2020, 11:54:19 am »
I'm sorry, I hadn't noticed there were recent posts on this thread!

Wow, I was sorry to read that you have AF, too, now.  Mike, the confusions you and your wife have experienced in her treatment sound very worrying and I hope you get satisfaction quickly.

Everybody has been very generous with their time and suggestions (you lot, I mean) for which a repeated "Thank You"!  I've just re-read the thread and realised that there are a couple of links I haven't followed up, which I'll get on to immediately (Phil W, that publication you cited will be one).

As it is exactly a year since my TIA (mini-stroke) leading to a finding of an Ejection Fraction of 8 - 10%, I thought I'd sing "Hearty Birthday" and give a resume of to where I am up.

I'm still alive, having had a third of the allotted span for 75% of people with an EF/EV of <10%.  However, I'm not too anxious about that prediction because exercise is a better predictor of life-span than EV and I'm sure it's very likely that as I already live in the recommended fashion I am almost certain to be in the 25%.  Look on the bright side, Peter, it's better for the stress levels!

I never did get to see a NHS cardiologist.  In fact, I have been discharged by letter because of the need for the NHS to concentrate on Covid.  Yes, it actually says that in the letter.  I don't feel the need to dispute this at the moment, because I feel fine just as often as I did before the TIA.  But I've kept all the paperwork, just in case.  Apparently my affliction should continue to be managed "medically", which I think means keep taking the tablets.

Every now and then, I take the wheelbarrow down to the chemist's.  I am on statins, blood thinners, digoxin, beta blockers and an Ace Inhibitor, Ramipril.  This seems to be a full house and I am a little confused as to why I need so much.  Admittedly, the Beta Blocker level is quite low (5mg).  I have a regular appointment with the Nurse Practitioner (always cancelled into a phone appointment) at which she up-titrates the Ramipril, as my kidney function has thus far remained unaffected by the administration.  The next rise will get me to the intended 10mg.

What I want to insist on having is another echocardiogram, because I want to know if my EV has improved (it can) or deteriorated (it can).  This will help me decide about how to manage exercise and life in general.

I feel fine.  I very occasionally feel a little leaden-legged after a ride (I re-started in the New Year after more advice and ride most days, usually about 10 - 15 miles, occasionally more but so far not over 30, all at an easy pace) which I put down to the beta-blockers.  I do feel a bit weary from time to time and I occasionally get a light-headed episode, usually on standing up quickly, and very short-lived.  All these effects could be due to heart deterioration but are also known effects of the drugs.  It's a bit of a conundrum, as I didn't have any effects until I started on the medication -  but I also know I've got heart trouble!

(Apparently, Cardioversion and Ablation are not considered suitable in my case.)

I've had an angiogram, which confirmed my and my doctor's feelings that I haven't got any significant coronary artery disease.  That was a big boost but leaves me with the question of why I've got the condition (AF and low EV).  I think Chris suggested that AF can lead to EV, which seems very plausible.  And the exercise over the years has led to an enlarged heart and possibly stiffening of the Left Ventricle, which the Ace inhibitor is intended to ameliorate.

So, I'm really determined to get another echocardiogram to see how the LV is shaping.  I take my BP and pulse several times a week.  The BP is where it always was (acceptably low) but the heart-rate, while it usually averages between 65 and 80 (I take an average of five readings) can vary enormously in one series of readings from 65 to 90.  So I guess (know) I'm still fibrillating. 

 I'd like to know if I need to resign myself to my current bimbling lifestyle (I can do that and it's a lot more than many people are able to do) or whether I can eventually get back into the hills I love!

But I will be sensible (I hope).  There is a lot more at stake than whether or not I can ride my bike.

Thanks for your interest and comments.  Please keep in touch and let me know how you (and your loved ones) are doing.

Peter

Re: Atrial Fibrillation and Heart Rate Monitoring Help?
« Reply #63 on: July 19, 2020, 03:15:07 pm »
OOPS!  Just read this, browsing through the heart prOn:-

From NCBI, US National library of Medicine:-

EF of <15% is end stage/transplant candidates...….

At almost 75 I don't think I'd be considered for a transplant, so I've got to hope my treatment and life-style improve (as in at least double) the EF.

In the meantime, I may have 2 years to get my affairs in order.  And I may not......

"Smile, though your heart is aching....."   (Charlie Chaplin)