I’ve been on the Atrial fibrillation journey since 2018, and have learnt a lot so thought I’d best start writing some things down to try and help anyone else. It’s often quite a frightening thing to discover when first diagnosed.
Part 1 – Atrial Fibrillation and Endurance Athletes
Part 2 – the Good Years
Part 3 – Now the drugs don’t work, they just make you worse
Part 4 – Exercising with a beta blocker
Part 5 – Mini Maze procedure and recovery
I’ve always exercised throughout my entire life, I was doing day trips out cycling from the age of 17 onwards and have always played field hockey and ran. I got back into cycling in 2012 and gradually started doing more and more. I did the UK Coast to Coast in a day in 2014, and joined the Alba Rosa Cycling club the year before, doing chaingangs and longer days out with them. I started with a cycling coach at the end of 2014 and after seeing the Brownlee brothers at the Leeds Triathlon I started doing triathlons in 2016 with my debut at the Nidderdale Sprint, progressing to the Sundowner half distance in 2018.
In 2017 was getting really high HR when doing cycling efforts, over 200bpm, but no other symptoms at all.
I first thought it was glitches with my HR strap, tried various other straps and it was still there under high efforts like Vo2s or hill reps.
I went to a cardiac consultant who put me on a portable ecg for 24 hours and found atrial fibrillation but only occasionally, so we didn’t do anything.
Then at the end of 2018 I was getting higher HR overnight and more out of breath just walking the dog. I had another portable ecg for 3 days and was in a fib almost all of the time.
The consultant advised that beta blockers and anti-arrythmia drugs would make me feel ill as they tend to lower hr when resting usually. Sometimes they try a cardioversion where they shock you but we went straight for the ablation.
I had a 5 hour operation Feb 7th 2019 which was much longer than expected. They had to shock me 6 times during the operation, but they still couldn’t get my heart to go back into sinus rhythm.
Eventually put me onto flecainide which kept it in rhythm. I was in sinus for 2 days after the op then got a chest infection which knocked me back unto A Fib. I went in for another cardioversion 2 weeks later but it was all. OK so they sent me home! But it’s went back into a fib again over the weekend. So consultant said up the flecainide to 3 times a day which I did.
Since then I saw a slow but steady improvement, I stopped the flecainide May 2019 and was ok until July when AFib returned. I started exercising 5 weeks afterwards, keeping HR <120bpm and slowly started to push it higher and higher over the next 2 weeks.
I went back into Afib July and went back on flecainide which bought it back under control. I went for a second ablation in Sept 2019, much simpler operation and the consultant said there was only some minor patching to be done. My heart was in and out of A fib over the first 6 weeks after this second operation which is expected as things settle down and the scar tissue forms, and the heart gets over the trauma.
I started exercising 2 weeks after the second operation, just easy 30 min bike, keeping the heart rate low and steady.
I stopped the flecainide at the end of Oct and the blood thinners shortly afterwards.
The consultant was very keen to ensure that I continued to exercise, and some studies I’ve read suggest those who exercise suffer less with A Fib than those who don’t. After some detailed discussion about what my definition of exercise was we both agreed that things like TTing flat out at close to max HR wouldn’t be a good idea!
On a tech point of view I had some bad luck with Garmin watches which were all replaced under warranty, however the ECG and auto warning features of the Apple Watch had me switch over to that, which has been really good. I’ve swum, run and even walked the 3 peaks in 11 hours with it and it’s worked great. The ability to take an ECG at any time as well as the auto A Fib monitoring are reassuring.
Nobody seems 100% sure what causes it, the book “The Haywire Heart” has plenty of links to endurance athletes, inc runners, X country skiers and triathletes having issues.
This is more common than we realise and very individual as to the cause, treatment and long term prognosis. I don’t think there is a consensus yet as to why some people end up with AF and others don’t. Could be lifestyle, genetics, illness or a combo of all 3.
My message is DON’T PANIC BUT also if you see weird things like high HR (over 200) on rides/runs consistently then please do get yourself checked out after checking all your kit is ok/swopping HR with a mate is a simple thing to do.
Some common things which seem to resonate is to be healthy, reduce stress, get good sleep, eat well, reduce alcohol intake and listen to your body!
