Atriall Fibrillation

axel_knutt
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Re: Atriall Fibrillation

Post by axel_knutt »

PeteK wrote: 7 Mar 2023, 10:08am the lowest dose of beta blocker.....reduces physical output particularly on hills.
Diltiazem is the other alternative to betablockers which doesn't have so much effect on your ability to exercise. It's not without it's downside though: it causes oedema in some patients, which in the long term can cause damage to nerves and blood vessels. I didn't realise the damage oedema was doing to my skin until I started getting blisters last September which I didn't notice until they were full depth because nerve damage was numbing my feet.
I did ask about an ablation at the hospital, but they seemed to have a long waiting list and didn't encourage me to pursue it, suggesting I was a bit old at 70 (not sure I believed this). Thought they might just be managing the demand.
They give you whatever information suits their agenda. When they offered me a PVI they told me how simple it was, and that the risk was low and success rate high, when they decided they weren't going to do it, the same doctor told me the complete opposite.
“I'm not upset that you lied to me, I'm upset that from now on I can't believe you.”
― Friedrich Nietzsche
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MrsHJ
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Re: Atriall Fibrillation

Post by MrsHJ »

So depressed to be posting here but over the last 4 weeks I seem to have developed some sort of arrhythmia, most likely a fib. Whilst I wait for the doctors to get their act together and diagnose is there anything I can do. I’m having events every day, often several a day. No medication at the moment- it’s not constant enough for beta blockers plus I don’t score enough points due to being young etc and frankly I don’t fancy them anyhow.

I really cleaned my diet up about a month before that so I’m now trying to figure if I’ve cut something out that was helpful. Honestly though my recent diet has been the poster child for heart health.
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simonineaston
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Re: Atriall Fibrillation

Post by simonineaston »

Sorry to hear that. I'm accutely aware of how anxious these symptoms can make you feel. All I can say as an occasional sufferer is that I've been repeatedly told that they are very common and can occur even if you're fit & healthy. I've been given the same advice on more than one occasion, which has been all very basic, that is make sure you get good sleep, eat regularly, stay hydrated and most of all - and this is the hardest bit - try not to worry.
Good Luck with the doc and getting to the bottom of it all. That's probably the most important step - seeking medical advice.
S
(on the look out for Armageddon, on board a Brompton nano & ever-changing Moultons)
axel_knutt
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Re: Atriall Fibrillation

Post by axel_knutt »

MrsHJ wrote: 16 Mar 2023, 7:07pmNo medication at the moment- it’s not constant enough for beta blockers plus I don’t score enough points due to being young etc and frankly I don’t fancy them anyhow.

I really cleaned my diet up about a month before that so I’m now trying to figure if I’ve cut something out that was helpful. Honestly though my recent diet has been the poster child for heart health.
Do you mean the cha2ds2-vasc score? That's to assess your stroke risk with a view to taking anticoagulants, not betablockers.

What have you cut out of your diet, was it fat? There has been some research suggesting that low cholesterol may be associated with an increased incidence of AF, but I don't think it's any more than a suggestion thus far. My arrhythmia started about a couple of years after I made a big reduction in my fat intake (Cholesterol was 4.42 at that time), but if it had any effect at all I think it would have been only secondary.

Some take magnesium supplements and swear by them, although I never have, and I have seen someone complaining of symptoms that ticked all the boxes for magnesium overdose.

Alcohol is a no-no, and I was warned off caffeine at the time I was diagnosed, but there has been a big Chinese study since then which found that caffeine in moderation is slightly beneficial. I was drinking de-caff before diagnosis anyway, and I haven't changed.

Autonomic nervous system activity after big meals and after getting into bed are known and common triggers for AF, but not something you can easily avoid. A lot of patients find that laying on their left side in bed aggravates their arrhythmia; I didn't orginally, but I do now. Big time. The only position I can sleep in now is on my right (and I'm sick of it).

Swallowing hot or cold drinks can trigger an episode.

A DIY method for cardioversion is valsalva manoeuvre, but it's never worked for me. I have been told by the NHS to try carotid massage on occasion too, but there are also warnings not to do it yourself, so take your pick.

The ESC paper on risk reduction in AF patients lists many risk factors, most of which you can’t do anything about, but the ones you have some control over are:

Obesity
Blood pressure
Alcohol
Exercise
Sleep Apnoea
Smoking
“I'm not upset that you lied to me, I'm upset that from now on I can't believe you.”
― Friedrich Nietzsche
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MrsHJ
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Re: Atriall Fibrillation

Post by MrsHJ »

Thanks both.

Obesity (yes but I’ve lost a couple of stone and it’s definitely coming under control)
Blood pressure (normal-low for my age- light headed a lot recently so looking at that too)
Alcohol -nope
Exercise- I’d love to make out that I do so many miles a week but in reality I’m a go to the gym a couple of times a week sort of person and cycle on holiday- this diet programme has been combined with some a hit exercise and upper body work which is new to me but my heart rate is tough to get over 130 when exercising- I’m just a natural ambler even doing HIT stuff. The a fib doesn’t seem to happen when I exercise- it seems to reset it but I’ve taken a week off due to the light headed ness.
Sleep Apnoea- don’t think so but will get it checked. Quite lot of the problem is at night/when chilling and on the left side.
Smoking nope (nor drugs).

It’s a bit too constant to chill about at the moment (daily/hourly) but I agree I wouldn’t be worried if it was an occasional thing. I also lean to the view that there may something about the super clean diet that isn’t quite right for me (obviously could be something else entirely- correlation isn’t causation). The diet isn’t low fat per se but it’s probably low in bad cholesterol- only cottage cheese occasionally and a reasonable amount of 5% fat Greek yoghurt. Lots of fish and legumes and veggies, nuts, fruit. It’s not even low calorie- around 1800 a day, eating 6 smallish meals plus a protein shake if you do a workout.

On the basis that having to suspend my eating of large quantities of milk chocolate, sugar and low quality carbs probably isn’t the problem I would guess possibly that I have lost something by giving up cheese (except for cottage cheese). I’m also getting a mild thyroid marker coming back that they said wasn’t anything to worry about.

Am adding cheese (whoop!) back into diet in sensible quantities and also upping my whole grain carbs slightly- will see if it helps whilst waiting for my appointment. I’ve also ordered some taurine which seems to help some. Annoyed that I’m self investigating but suspect it will be some time to get much out of the doc at the moment and as one of the main purposes was to get stronger in the bike for more hill climbing and I’m heading off on tour in a couple of months I’ll test my diet a bit as that’s something I do have control of.
brianleach
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Re: Atriall Fibrillation

Post by brianleach »

Sorry you seem to have joined the club Mrs HJ.

I was diagnosed in 2016 at the age of 67 so I got the full works straightaway. My only noticeable symptom was a more than usual shortage of breath on hills so I obviously have never suffered the symptoms you are experiencing.

No idea what caused it back then and I always found it sort of amusing that a number of professional cyclists developed it at the same time as my cycling has always been shall we say leisurely.

An ablation successfully took me out of AF for a bit but it is reckoned that it often returns. I am still on thinners and beta blockers which I am not very keen on.

However I was lucky enough to find a cardiologist who is a keen cyclist and in my case he never ever suggested I give up cycling but to continue in my leisurely fashion! I always ride with a heart rate monitor though so that I can see what my heart rate is and if it gets anywhere near 145 which is roughly the top rate for my age I understand I slow down or have a rest.

I also have a gadget which takes an ecg reading registering on my phone. Obviously it can only be an approximation of a full ecg but I find it useful as a guide.

I have to say and I do not wish to depress you too much but it does make me slightly nervous of solo unsupported tours in Europe.
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MrsHJ
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Re: Atriall Fibrillation

Post by MrsHJ »

axel_knutt wrote: 16 Mar 2023, 10:31pm
Do you mean the cha2ds2-vasc score? That's to assess your stroke risk with a view to taking anticoagulants, not betablockers.
I don’t know. The GP said I didn’t score enough points for medication, not sure what, mostly as I’m too young (54) and separately I had to go to A&E (lots of chest pain, light headed) to make sure nothing dire had happened and the doc there said not sustained enough for beta blockers.

Brian - do not depress me! If it’s under control I’ll still be going- I reckon medical care is likely to be better in France and I’m insured.
brianleach
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Re: Atriall Fibrillation

Post by brianleach »

I forgot to mention that I was initially prescribed amiodarone but after just a few days one late evening I woke up and found it almost impossible to breathe so my wife called an ambulance (remember those long gone days) and was taken straight to hospital.

I stopped taken it immediately and those symptoms never returned.

I'm sure you'll be fine MrsHJ for me it is a psychological thing I think. As you may have seen in other posts I had a major crash in Spain some years ago again on a solo tour but it never once occurred to me not to get another bike and continue touring. It was my fault as I failed to see the bollard so I knew it was unlikely to happen again. In my control you see, health issues are out of your control so that is my psychological issue. As I say I'm sure you'll be fine being so much younger.
Tim Holman
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Re: Atriall Fibrillation

Post by Tim Holman »

Hello, all.

Axel and Brian: much of what you say chimes with my experience with AF.

MrsHJ: I have been in Atrial Fibrillation for nearly thirty years. I'm sixtynine now but in my fifties I went on two unsupported trips to France/Spain via the European Bike Express. I had no problems. I also went to Australia and cycled unsupported around the island state of Tasmania with no problems. I have also been on several unsupported tours in Scotland with no problems. I am still cycling every day and have never been told by docs to desist. Mainly they are pleased to hear about my exercise and my sensible diet, I find. Do it... you can!
Tim
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bikes4two
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Re: Atriall Fibrillation

Post by bikes4two »

  • The resistance to Amiodarone varies between folks
  • As posted before I've had 6 episodes of persistant AF over 5 years
- 2 episodes self cleared,
- 2 episodes cleared by DC cardioversion and
- 2 episodes cleared by taking Amidarone and within around 4-5 days of taking it too. It was like a miracle cure for me
  • Amidarone is quite an agressive drug and whilst some people can take it for a year or so without major concern, it is not a permanent fix, hence I had my first ablation 5 weeks ago. The current round of Amiodarone finishes in 3 weeks by which time I will have been taking it for around 6 months with the only noticeable side effect being slightly itchy skin, countered mostly by Piriton (and a decrease in libido.... but that could be my age - lol)
  • At my next cardiology review, I'm going to see if having some spare Amiodarone around, could I use it as a quick reset if/when persistent AF re-occurs?
As they say "different strokes for different folks." (but hopefully no strokes so keep taking the blood thinners!)
Without my stoker, every trip would only be half a journey
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MrsHJ
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Re: Atriall Fibrillation

Post by MrsHJ »

I’ve been eating an awful lot of salmon and trout on my diet (the veggie food was more time consuming and not always convenient). There are suggestions that fish oil supplements and salmon could be an issue so I’m going to try dropping fish for a while (not permanently but I’ll go to more of a mix and in moderation model eventually instead of salmon/trout twice a day which I’ve had for the last couple of months) and see if that helps.

Sitting here spending too much time on google after eating a salmon sandwich!!

https://www.cedars-sinai.org/newsroom/o ... rillation/

Edit: it seems to be getting better. Obviously it could be coincidence but fingers crossed no more incidents. I’ll still be getting checked out by the cardio team.
saudidave
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Re: Atrial Fibrillation

Post by saudidave »

I was woken in the night almost 2 yrs ago with AF - Heart rate between 140 & 180, bouncing about all over the show. The worst of it subsided after 15 mins and according to my Apple watch it had ceased after 2 hours. It ocurred about 7 weeks after I had my prostate removed due to cancer, followed by internal bleeding 24 hrs later, (3.5 litres of blood lost!), an emegency laparotomy, 2 days in a medical coma on life support then another 5 days in intensive care, so a lot of stress events. I'd also drunk alcohol for the first time in 2 months the day it happened and gone a bit OTT with it! Booze is a big catalyst for AF

On the advice of my daughter, a doctor, I went to Wythenshawe hospital the day after the AF event and they kept me in for 4 days during which I had an angiogram and watched my heart beating on TV. The doctor who performed that procedure said my heart was in fantastic condition, cardiomyopathy aside, with clear chambers etc. She said it was all functioning well and said those bicycles do work don't they?. I was prescribed beta blockers at that point (Bisoporolol) which gave me horrendous side effects despite the tiniest dose. I took that for a year then got a wheezing cough (common side effect) so I stopped taking it for 3 months, the wheeze cleared, then I went on another betablocker (Nebivotol), which precipitated the wheeze again and I've now been prescribed yet another, Carvedilol, which I'm tolerating well. I also take Apixaban (blood thinner) & Candesartan (B.P. tablet).

I've had cardiomyopathy for about 20 years now, it's genetic,my brother had it, my dad, a heavy smoker died from it - Massive M.I. & acute left ventricular failure, his sister had it, as does her son. That is the root cause of the AF in all probability. Apart from that one event of AF I had it hasn't recurred in the 2 years since. I also get regular check ups and in the last 3 months I've had an echocardiogram (Good strong output), 24 hour heart monitor (totally regular beat) plus a treadmill test - I smashed it and after 10 minutes they had me holding 150 B.P.M. for a minute and I was chatting easily to the technician alongside me during that. I've also had a lung function test that produced excellent results.

So, a long laborious post but hopefully one that will give hope to anyone diagnosed with A.F. It isn't necessarily some sort of death sentence, nor inevitably progress and it's certainly not impacting my life in any way at all. I continue to cycle regularly, I keep an eye on my weight and hopefully I've got another 2 decades to look forward too in addition to the 7 I've clocked up so far!
pete75
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Re: Atrial Fibrillation

Post by pete75 »

saudidave wrote: 21 Mar 2023, 9:09pm

So, a long laborious post but hopefully one that will give hope to anyone diagnosed with A.F. It isn't necessarily some sort of death sentence, nor inevitably progress and it's certainly not impacting my life in any way at all. I continue to cycle regularly, I keep an eye on my weight and hopefully I've got another 2 decades to look forward too in addition to the 7 I've clocked up so far!
As I said upthread. Father in law was diagnosed with AF at 56 and managed to live an active life until he died 40 years later. He was still active in his nineties.
'Give me my bike, a bit of sunshine - and a stop-off for a lunchtime pint - and I'm a happy man.' - Reg Baker
Pendodave
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Re: Atriall Fibrillation

Post by Pendodave »

The most recent GCN youtube video has a discussion about heart issues and cycling :
https://youtu.be/cX4AUZEwyPI
Jdsk
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Re: Atriall Fibrillation

Post by Jdsk »

Thanks for that.

Excellent and responsible contribution to public understanding.

(Just one bit of unnecessary music over voice in the summing up, and one inappropriate cutaway to what alcoholic drinks look like!)

Jonathan
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