Author Topic: HELP wanted. Atrial Fibrillation  (Read 6245 times)

Dave_C

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HELP wanted. Atrial Fibrillation
« on: November 12, 2013, 04:38:06 pm »
I wonder if you lovely cyclists can help me here pls.

I had a episode at the weekend where I fell over and fainted not once but twice within 3 minutes. Ambulance parametics took me to A&E and they found I was suffering from Atrial Fibillation. I felt fine but they could see my heart misbehaving. I was sent to the Cardiac Care Unit for an overnight stay while they monitored my heart. 12 hours after my fall (a slip, not related to my AF) my AF stopped and my heart returned to normal rhythm. Later I was discharged and told loosely that the consultant would want me to come in as an out paitient and have an ultrasound and a mobile 24 hours recording of my heart. I was told they would write to me, and sent home with no form, letter, medication or other guidance. I have never had AF before, I don't take any drugs, drink, smoke, or have any underlying medical conditions.

Now my freinds and family are trying to bar me from cycling incase something awfull happens. They think the Dr will write to me within a week and I'll know what is planned very soon. Now I'm not happy at not being able to cycle (from family). I called the Dr's secretary and she has spoken to the consultant and reports that he doesn't know when he'll write to me if at all!! He may write if he thinks its important to follow up, but wouldn't say and when pushed, said I shouldn't expect a letter within the next few weeks and any treatment - not that the consultant had indicated such, would follow when he thought it should be done. I mentioned private health cover and was told he doesn't do private and I'd have to go through my GP for another consultant elsewhere.

So I'm in limbo, I don't know if he is going to write to me asking for more tests? I don't know when he os going to write if he does want tests. He recomends not cycling - but she did say this is standard practice, not to do anything to harm my heart - does that include going to work???? Also I won't be written to, instead he'll be writing to my GP and after that the sec couldn't say what would happen.

Has anyone any similar experiences please? I've found pages on the wrb about AF and excercise, which are promising, explaining that I'm probably not at risk, as other long distance cyclists have similar experiences and indeed its more common to have AF for Endurance Athletes.

PLEASE NOTE, I'M NOT INTERESTED IN WELL MEANING POSTERS WHO HAVE NEVER HAD ANY OF THESE SYMPTOMS, BUT WHO MEAN WELL AND WOULD ALWAYS URGE ANYONE TO STOP DOING ANYTHING EVER!! BECAUSE WE MIGHT HARM OURSELVES!! If you have gone through what I have and have anything to contribute, I'm interested in reading your posts.

Thanks, Dave C
@DaveCrampton < wot a twit.
http://veloviewer.com/athlete/421683/

Re: HELP wanted. Atrial Fibrillation
« Reply #1 on: November 12, 2013, 05:44:19 pm »
I'd suggest getting in touch with the Atrial Fibrillation Association. They have a very good helpline service and can signpost you to the right local services. Arrhytmia tends to be under-treated in the UK, so if you're to get the right treatment you'll probably need to be quite proactive and persistent.

AF is a very complex condition that tends to be comorbid with other cardiac disease, so it's difficult to speak in generalities. I think your doctor is right to advise you to avoid cycling, at least until you're on a stable course of treatment. Hard exertion can trigger an AF episode and cycling is particularly hazardous due to the risk of fainting at speed or in traffic. You want to find out what your limits are through a stress test in a cardiac lab, not in the middle of a busy roundabout. Most people with AF can engage in serious sport (I know of several competitive testers and triathletes with AF) but it does require careful management.

Basil

  • Um....err......oh bugger!
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Re: HELP wanted. Atrial Fibrillation
« Reply #2 on: November 12, 2013, 08:15:53 pm »
OK.  Firstly, don't panic. I've been there (actually, I'm still there) and I'm still cycling.  I'm 64, I've ridden 5000 km this year so far, I can still ride over 100 miles in one day (admittedly only once a year).  I'm asthmatic and I smoke and drink.  :facepalm:

Anyway, for what it's worth here is my experience.

My atrial fibrillation went undiagnosed for rather a long time due mainly to my own self mis-diagnosis and my lifestyle.

In 2005 I was beginning to get very breathless on the bike.  I put this down to my asthma getting worse and figured that exercise was the best method of treating it.  (It had worked before when asthma was the actual problem) I never went to the doc because, let's face it, what smoker is going to go to the doctor and ask "I seem to be getting breathless when I exercise.  What do you think I should do?"  ::-)
Anyway, the breathlessness got worse and worse until I was having to stop every day 3/4 of the way in on my 5 mile commute, sit on a wall or something and gasp until I felt strong enough to continue.

What I didn't realise was that the breathlessness was not a lung problem but was being caused by the malfunctioning heart failing to deliver oxygen properly and the lungs trying to compensate.

So eventually I went to see the doctor, telling him that I seemed to be having problems with my asthma.  He stuck a stethoscope on me, widened his eyes and called an ambulance.
10 days in the cardiac unit at Selly Oak Hospital.

The usual cure for atrial fibrillation is a cardioversion, but after my hospital treatment my AF became intermittent (sort of 2 days off, two days on), consequently on three separate occasions I attended a hospital appointment for this treatment and was chucked out for being in possession of a perfectly normal heart rhythm.  (Ever woken up in the morning and hoped that your heart wasn't working properly?  Sounds daft, but that that's how I felt before the third attempt)

Eventually, they put me on a seven day 24 hour mobile recorder (the guy said, "I can see when you cycle to and from work - left a bit early on Wednesday, didn't you?)  A week of no showers, just strip down at the sink. 
After seeing the results, they decided on an Ablation.

This is where they enter through the femoral artery via the groin and go up into your heart.  It's a sort of chimney sweep affair with a Swiss Army knife on the end that has a camera and a miniature cheap zippo lighter.  They check where the electrical current is leaking across your heart muscle and cauterise the shit out of it.
Worked for me!  :thumbsup:

OK, I'll be on flecinide tablets and either aspirin or warfarin daily for the rest of my life, but it's good.

The aspirin vs warfarin is my doing.  Doc would prefer that I take warfarin, I but object.  As a cyclist who fettles and someone who enjoys cooking, the occasional cuts are inevitable.  Cuts that absolutely refuse to stop bleeding are shite.

Sorry, that was very long winded, but I took you at your word and assumed that you would want to hear everything.

Don't worry.  You'll be fine.
The only difference should be that you need to get yourself treated before you become an emergency admission like me.  Don't ring the doc.  Make an appointment and see her/him face to face.  Ask them what they are doing to get you back on your bike.  Don't accept any compromises.  Tell them "Cycling is what I do." 
Quote from: Kim
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Pedaldog

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Re: HELP wanted. Atrial Fibrillation
« Reply #3 on: November 12, 2013, 11:09:52 pm »
Piggy backing on this thread, excuse me, I have had two TIAs, Mini Strokes, when cycling in the past 2 years. both involved hospitals and some tests a few weeks later.  I am now getting breathless a lot of the time, even small movements at home, should I be seeing somebody about this?

hellymedic

  • Just do it!
Re: HELP wanted. Atrial Fibrillation
« Reply #4 on: November 12, 2013, 11:19:09 pm »
Yes.

Re: HELP wanted. Atrial Fibrillation
« Reply #5 on: November 13, 2013, 09:12:14 am »
I have a couple of stents fitted and am now on the relevant drugs,  It was suggested that an HRM when cycling would be a very good idea and that getting my HR over 130  (level for me others may vary) would not be a good idea.

I have pushed it up to 140 for 20 mins, chasing a group, and this then led to several weeks of very high readings >300 ,short term 5 - 10 mins, when I got back on to the bike.  mention this to the Doc who asked how I felt when it was that high.  "OK but a little more breathless".  Basically slapped wrists and do not do it again,  but keep cycling is his prescription but below 130 HR.
Only those that dare to go too far, know how far they can go.   T S Elliot

Basil

  • Um....err......oh bugger!
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Re: HELP wanted. Atrial Fibrillation
« Reply #6 on: November 13, 2013, 10:37:39 am »
HRMs don't work for people with AF.  They give silly readings like 300 due to it not being able to correctly interpret the wild fluctuations in heart rhythm.
Or that was my experience.  (Although, it was a cheap Lidl/Aldi one)

I suppose it would be useful in showing that you are currently having an episode.
Quote from: Kim
And remember that friends who organise things on Facebook aren't proper friends anyway.

Re: HELP wanted. Atrial Fibrillation
« Reply #7 on: November 13, 2013, 10:54:23 am »
HRMs don't work for people with AF.  They give silly readings like 300 due to it not being able to correctly interpret the wild fluctuations in heart rhythm.
Or that was my experience.  (Although, it was a cheap Lidl/Aldi one)

I suppose it would be useful in showing that you are currently having an episode.

and to not exert myself too much.
Only those that dare to go too far, know how far they can go.   T S Elliot

Dave_C

  • Trying to get rid of my belly... and failing!
Re: HELP wanted. Atrial Fibrillation
« Reply #8 on: November 13, 2013, 01:07:12 pm »
Many thanks for all the input. I saw a GP lastnight - late cancelation, and as I have medical cover with work, I was refered to a specialist privately. I called the local Spire hospital this morning and am going to be seen tomorrow at 4:20pm. Depending on how it goes I'm hoping to get the OK to get back on the bike.

Cheers, Dave C
@DaveCrampton < wot a twit.
http://veloviewer.com/athlete/421683/

Re: HELP wanted. Atrial Fibrillation
« Reply #9 on: November 22, 2013, 06:52:59 pm »
I' m just recovering from a bout of AF about 2 months ago. I'd noticed my erratic heart rate and put it down to overtraining so left it a few days before speaking to my GP who sent me immediately to A&E.

They did an ECG, where the tech confirmed what it was and told me its really common 'I see between 5 and 10 a day'.

They then put me on drugs to get my rhythm back and blood thinners (Xalantro or something), and even laughed when I suggested that they just give me a bag of weed and some Bob Marley CDs instead.

I reverted back after a couple of days, but was told to keep on with the meds for a few months. I saw the consultant a couple of weeks ago and he put it down to a viral infection. He was happy enough for me to start training again but told me to take it easy for a while. He did however give me the ok to run a marathon in early December if I wanted to.

I probably stopped doing anything for about ten days and have been training again for about two weeks. I am a bit concerned about a relapse but am building confidence day by day.

Re: HELP wanted. Atrial Fibrillation
« Reply #10 on: November 22, 2013, 07:17:46 pm »
The only advice I can add is that, if you feel faint when cycling, either slow right down (keep pedalling) or stop and lie on the ground.  Don't stop and stand around, because the blood will pool in your legs and you are quite likely to hit your head very hard when you faint.  BTDTGTTS.

Also be ultra-cautious if you have, or have recently had, a cold or the 'flu, as these can muck about with your heart rate and rhythm even when you feel well enough to cycle.
Never tell me the odds.

robgul

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Re: HELP wanted. Atrial Fibrillation
« Reply #11 on: November 22, 2013, 07:21:01 pm »
I've had AF (or at least, I have know about it for about 10 or 12 years) ... no big deal ... I'm 66 and cycle probably 150 miles a week, pootling not racing pace.

Going back to the OP - don't bugger about - go to your GP and he'll undoubtedly do the 24 hr tests for both heart beats and blood pressure (not at the same time!) - and take it from there.

I take various medications to control BP and also Warfarin daily .. for life.  Yes, cuts are bit of a pain, but not that much of a problem. 

The "risk" with AF is that a missed beat will cause a "pooling of blood" in the heart that could clot, push round your vascular system and cause a stroke, or worse.  Warfarin kills rats by thinning the blood - it helps humans by thinning the blood and reducing the risk of clotting.  [Aspirin has similar thinning qualities but is harder to control and has other side-effects that are not too good]

The alternative to Basil's "ablation" treatment (it's a bit like doing some soldering in your heart) is "cardioversion" where they shock you (under a general sedation ... can't spell the other word!) .. think of the paddles on Casualty - but front and back.  The idea is to shock your heart back into a consistent rhythm ... didn't work for me - I just got scorch marks on my back and chest (really!)

I've known Basil for ages and compared notes with him years ago ... as he says, don't panic - masses of people have AF and don't know!

My GP recommends cycling ... and the more the better ... but at a manageable pace.

Hope that helps

Rob

Re: HELP wanted. Atrial Fibrillation
« Reply #12 on: November 22, 2013, 07:35:25 pm »
also have AF- known for about 2 years now

They discovered it when waiting for a general anaesthetic to kick in :o

Same medication as above

GPs (never see same one twice) have all said do NOT give up the daily bike commute- keep on riding

I am a lot slower than before and get tired quickly and have little stamina for long rides (probably old age as well)
BUT I can still cycle and will keep on doing so until
heart, knees or arthritic hip tell me otherwise ;)

Dave_C

  • Trying to get rid of my belly... and failing!
Re: HELP wanted. Atrial Fibrillation
« Reply #13 on: November 24, 2013, 12:50:29 am »
I saw the Heart specialist who reconned my AF was as a result of my fall and blackout from the pain rather than the otherway round. I had an ecg, ultrasound and wore a heart recorder for ~35 hours and all was fine. The specialist said my heart looked healthy and strong. I've been commuting for the last week and not felt any AF return. Cheers for all the helpful messages.
@DaveCrampton < wot a twit.
http://veloviewer.com/athlete/421683/

Cycling Daddy

  • "We shall have an adventure by and by," said Don Q
Re: HELP wanted. Atrial Fibrillation Heeeeeeeelp!!
« Reply #14 on: March 15, 2015, 03:36:59 pm »
Read this i with a fascination.  SO after some 'hummin' and 'hawin' about whether I have Afib I went to the GP on Thursday because my heart was 'performing': deffo Afib.  Ended up having an ECG and then the GP getting an ambulance...this was because I had 'symptoms' and my resting heart rate was well over 145 (normally average of 48).  Day in A and E in resuss bit (as the nurse said... 'you have to be really naughty to be put here but actually they were out of space elsewhere'.  Given some IV gunk to bring the heart rate  down and sent on my way.  Went back to  GP, referred to Cardiac Consultant specialising in AFib.  appointment a week tomorrow.  Put on Warfarin and Beta blocker.  I can cycle but have to keep my HR below 130. 
Tried the London Oxford London this morning HRM warning went off within the first kilometre HR  to 145 to 150 and then took a long time to come back down.  Any movement sends rate up.  SO DNF'd after 10 minutes had a coffee and went back home.   :-[  Just as well I had my HRM because was not at all breathless at 150 normally down to the odd gasped word.

I am aiming to do PBP and have already got my 200 (x2) so there is a bit of room but wondering if my aim is realistic.  It seems very likely to be fixed in the end by one means or another but wondering how long this fixing takes? 
Too much sanity may be madness. And maddest of all, to see life as it is and not as it should be.”
― Miguel de Cervantes Saavedra, Don Quixote

Re: HELP wanted. Atrial Fibrillation
« Reply #15 on: March 15, 2015, 03:43:22 pm »
Good luck, CD.  I can't help thinking your target should be your heart and not PBP.  If you miss PBP, you can always aim at something else.

Peter


Re: HELP wanted. Atrial Fibrillation
« Reply #16 on: March 15, 2015, 04:30:56 pm »
For information that may be useful/calming to some on here:

Mrs S was diagnosed by GP as having AFib earlier this year by GP. We were referred to consultant - privately through work insurance rather than NHS, but same consultant... - he insisted on doing his own additional ECG and confirmed that she actually didn't have AFib, but benign PVC s(pre ventricle contractions). If these cause unpleasant fluttery symptoms he gave her a prescription for some beta blockers to take as and when - no regular medication - and he encouraged her to exercise and, even, to lose a bit of weight.

This is a website dedicated to AFib and PVCs, as well as general heart health, that we found useful:

http://www.drjohnm.org/


Stay calm and hope all is well and you are quickly on a good road again.

Mike

Cycling Daddy

  • "We shall have an adventure by and by," said Don Q
Re: HELP wanted. Atrial Fibrillation
« Reply #17 on: March 15, 2015, 05:01:18 pm »
For information that may be useful/calming to some on here:

Mrs S was diagnosed by GP as having AFib earlier this year by GP. We were referred to consultant - privately through work insurance rather than NHS, but same consultant... - he insisted on doing his own additional ECG and confirmed that she actually didn't have AFib, but benign PVC s(pre ventricle contractions). If these cause unpleasant fluttery symptoms he gave her a prescription for some beta blockers to take as and when - no regular medication - and he encouraged her to exercise and, even, to lose a bit of weight.

This is a website dedicated to AFib and PVCs, as well as general heart health, that we found useful:

http://www.drjohnm.org/


Thanks for the link.  I have had PVC's for quite a few years: this is different and I think the tachycardia supports the diagnosis.  ECG was looked at by four different doctors and
two paramedics.  It is not 'like' my PVC's: I can feel the difference between the two.


L
Stay calm and hope all is well and you are quickly on a good road again.

Mike
Too much sanity may be madness. And maddest of all, to see life as it is and not as it should be.”
― Miguel de Cervantes Saavedra, Don Quixote

Re: HELP wanted. Atrial Fibrillation
« Reply #18 on: March 16, 2015, 10:20:46 pm »
CyclingDaddy

I hope all comes out OK

Mike

Cycling Daddy

  • "We shall have an adventure by and by," said Don Q
Re: HELP wanted. Atrial Fibrillation
« Reply #19 on: March 16, 2015, 11:39:07 pm »
I will keep in touch.  See EP on Monday
Too much sanity may be madness. And maddest of all, to see life as it is and not as it should be.”
― Miguel de Cervantes Saavedra, Don Quixote

Re: HELP wanted. Atrial Fibrillation
« Reply #20 on: March 18, 2015, 02:12:57 am »
I'm another AF sufferer. It was paroxysmal (which means not all the time). Quite a few years ago, on my last 100 mile ride before a hip replacement op, I was riding with a HRM. A bit before halfway my heart rate went silly & stayed that way. I had to walk up several hills, but made it home at a reasonable pace.

Nearly 2 years ago I suddenly started to suffer random "not well" symptons. After a few miles of walking over easy level ground in nice sunny weather it semed like dehydration. A few weeks later near the end of an 80 mile ride I suffered serious hypoglycemia aka "the bonk" .

A few weeks later later I started to ride home after a day's haymaking in Alcester & discovered I couldn't ride up the slightest of hills. Fortunately I managed to struggle as far as Wooton Wawen, to catch a train to Shirley. It needed about half a dozen rests to make it home - only 6 km or so.

A second visit to GP confirmed that my lungs were doing fine but my heart wasn't/isn't. I was duly referred to the the cardiologists. Subsequently I've been through a fair number of measurements that have confirmed AF.

The best one was an ultrasound scan of my heart. There was a medical student watching what was going on & subsequently discovering how to use the kit to get some decent pictures - not an easy task. I had the benefit of seeing my heart in action (though not useful action if I'm only lying down on a hospital bed) and having a running commentary on how my heart was working & the state of my heart's valves. It's a wonderful experience that I cannot put into words, but will stick in my memory for a long time. In particular it was nice to discover how much of my heart is healthy, which I'd guess is typical for many cyclists.

I'm now in a queue for a catheter ablation that may fix the problem. The second consultant advised that success rate of the operation is around 50%. AUI failures are ususally "problem not resolved" & only very infrequently generate complications worse than the original condition. It was & is my choice to take the risk. I don't yet know what may happen if "problem isn't resolved".

The concept of queue appears to be more complex than my simple mind would have expected. At present I shall say no more than that I've always viewed progress through the hospital system as a game of snakes & ladders without any ladders.

Meanwhile, perhaps due to the medication (Digoxin & the especially nasty Amiodarone), I struggle to ride the usual 40 or so miles to work & back, and often need more than one rest day to recover before I can manage another day's work.

Hope my experience is helpful to you.

Cycling Daddy

  • "We shall have an adventure by and by," said Don Q
Re: HELP wanted. Atrial Fibrillation
« Reply #21 on: March 20, 2015, 06:55:14 pm »
Now due to see a different EP on Tuesday.  I am on Beta blockers which is helping keep my HR stable... ever increasing doses of Warfarin...may try to go out for a ride over the weekend
L
Too much sanity may be madness. And maddest of all, to see life as it is and not as it should be.”
― Miguel de Cervantes Saavedra, Don Quixote

Re: HELP wanted. Atrial Fibrillation
« Reply #22 on: March 20, 2015, 08:55:44 pm »
Respose to warfarin is very individual. My first experience (after DVT & PE 15 years ago) was about 13mg daily. Last summer that had dropped to around 10mg.

My GP's surgery has regular warfarin clinics, with HCAs (basically experienced nurses with specialist training) using a bit of software called INRSTAR. That started me on 1 mg daily &, when my INR failed to change, tried to continue that dosage for a couple of weeks. Fortunately my GP knows (with the help of good record-keeping) my history and rased my dosage to something that had a measurable effect on INR.

When I went on to Amiodarone (not recommended, but we're not in a position to argue) my INR went sky high & only became reasonable at around 6 mg warfarin daily.

Meanwhile, keep riding. It's essential to maintain fitness for post-op, but listen to what your body is telling you.


Re: HELP wanted. Atrial Fibrillation
« Reply #23 on: March 21, 2015, 09:06:18 am »
I was diagnosed with atrial fibrillation in September last year after struggling while cycletouring being breathless, tired and dehydrated. I was given amioderan, bisopralol and xarelto. The symptoms became worse for me (I never noticed palpitations or an irregular heart rhythm), since I became even more zombie like. The generaliste (I live in France) said ah yes, that will be the bisoprolol, take half the quantity. It did improve. In December they gave me a cardioversion (electric shock) which shocks the heart into working properly which it did. After another month the cardiologue changed the pills for diazeltem, flecainade and to continue with xarelto. I did a stress test two weeks ago and it still seems to be in order. She did say to continue to take the pîlls until further notice. I don't like taking pills and there were a few side effects in that when I bend down and then stand up I feel dizzy. Here they seem to prescribe xarelto (I think the generic name is rivaroxbaran) rather than warfarin as an anticoagulant. It doesn't have to be monitored in the same way as warfarin and is supposed to be slightly more effective. I haven't noticed any side effects and don't seem to have any problems with bleeding when I nick myself.

Re: HELP wanted. Atrial Fibrillation
« Reply #24 on: March 21, 2015, 11:05:28 am »
There's a lot of it about then.
Mine probably started a with infrequent and mild symptoms about a year ago. I worked out what was happening just before christmas when the symptoms came more often and high BP was detected through routine screening. After 2 months during which I felt GPs weren't taking it seriously I had a bad episode and ended up in A&E where AF was diagnosed. Now I'm on precautionary beta blockers and warfarin, just waiting for a referral, which apparently could take some time. Even gentle exercise can trigger attacks so I'm really not able to do anything until hopefully, I can find out what's causing it and get some treatment.