NATURAL ANKLING wrote:Men are considerably more prone to arrhythmia than women — exactly why is unclear — and tall men are the most susceptible of all.
There are numerous risk factors documented by the European Society of Cardiology:
Biomarkers of haemodynamic stress
Biomarkers of inflammation
Biomarkers of cardiac damage
Bonefishblues wrote:There is no downside and much upside to taking a low dose aspirin daily, as I have been doing for years, long before I started to have AF's cousin, arrhythmia, in earnest.
The downside of aspirin is that the bleeding risk is as high as that for Warfarin, and there’s no upside, because it doesn’t reduce the stroke risk. Furthermore, before taking anticoagulants those with AF first need to tot up their CHA2DS2-VASc score in order to find out whether they will benefit from anticoagulation at all. It’s also not a bad idea to tot up your HASBLED score as well whilst you’re about it, in order to assess the risk of a haemorrhage.
mikeymo wrote:I had a 12 lead ECG a couple of years ago, and was pronounced top notch.
I had two Bruce tests, two 24 hour Holters, a 7 day Holter, and more ECGs than you can poke a stick at, but the only times the NHS have ever seen my AF were the occasions when I fetched up at A&E in an ambulance. AF is commonly paroxysmal, one minute it’s there, next minute it’s not. Even if you manage get to the hospital with arrhythmia, you have to get past the doctors who can’t recognise it when they see it. I was once sent home with atrial flutter by doctors who thought I was just having a panic attack, and that was after I had already been diagnosed, medicated, and put on the waiting list for an ablation.
Jdsk wrote:The possibility of AF being caused by intense exercise is fascinating.
Possibility? Since 2016 the European Society of Cardiology have acknowledged chronic endurance training as an arrhythmogen, and advise that “athletes should be counselled that long-lasting intense sports participation can promote AF”
. This is categorised as Class 1: “Evidence and/or general agreement that a given treatment or procedure is beneficial, useful, effective”
, and Level A: “Data derived from multiple randomized clinical trials or meta-analyses”
. The degree of risk remains an open question, there are numerous studies finding an increase in the incidence of AF ranging from 20% to 20 fold.
Bonefishblues wrote:has anyone had ablation as a fix for AF?
No, but I’ve had an ablation for atrial flutter. It was fine, but then, flutter ablations are quicker, simpler, and have a higher success rate than those for AF. Flutter is ablated on the cavo-tricuspid isthmus in the right atrium, which is where the catheter emerges when it’s threaded up from the groin, but fibrillation ablations isolate the pulmonary veins which are in the left atrium, so they have to pierce the atrial septum to gain access, which makes a much bigger job. My ablation took about 40 mins, whereas pulmonary vein isolation typically takes 4 to 6 hours.
AF ablation is around 70% effective, so it’s common to need more than just one. Complication rate is low (around 6%), but they are quite serious: heart attack, stroke, tamponade, phrenic palsy, oesophageal fistula etc. Mortality rate is 0.1%. Atrial septal defects are strongly linked to migraine, so that’s also a more common but less serious side effect. The best way to reduce your risk is to find a hospital that does a lot of them, because the ones with the lowest complication rate are the ones with the most experience.
John Mandrola is an interesting guy to read, he's not only an Electrophysiologist (a cardiologist who specialises in treating arrhythmia), but also an AF patient and a keen cyclist. We's written a book on exercise as an arrhythmogen, and also has a weblog.