Cycling UK Forum

Hi,
Came across this today, might of been in connection that someone else posted / led me that way.

https://www.cyclingweekly.com/fitness/c ... ard-335700

"The most common form of heart rhythm problem is atrial fibrillation (AF), where the top chambers of the heart (atria) intermittently contract too fast — thankfully the heart’s atrioventricular node acts like an electronic resistor and prevents the lower chambers (ventricles) from joining in the chaos.

A 2009 meta-analysis of six case-controlled studies on athletes concluded that being an endurance athlete makes you five times more likely to develop AF — one in four of us ends up with the condition.

Men are considerably more prone to arrhythmia than women — exactly why is unclear — and tall men are the most susceptible of all.

The biggest concern about AF is that it increases stroke risk, as fibrillating atria do not contract or empty fully, which can allow blood clots to form."

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.

I am not a doctor.

I can't see a link from the Cycling Weekly article to the study mentioned.

I assume it's this:

https://academic.oup.com/europace/article/11/9/1156/465401

The Alivecor six lead device looks useful for self checking. I may get one sometime:

https://www.alivecor.com/kardiamobile6l

and was what the nurse at my doctors used to check me a while ago. Though I had a 12 lead ECG a couple of years ago, and was pronounced top notch.

I think I read somewhere that a problem with AF is that it can be intermittent, so a check in clinic once every blue moon may not detect anything.

mikeymo wrote:I am not a doctor.

I can't see a link from the Cycling Weekly article to the study mentioned.

I assume it's this:

https://academic.oup.com/europace/article/11/9/1156/465401

The Alivecor six lead device looks useful for self checking. I may get one sometime:

https://www.alivecor.com/kardiamobile6l

and was what the nurse at my doctors used to check me a while ago. Though I had a 12 lead ECG a couple of years ago, and was pronounced top notch.

I think I read somewhere that a problem with AF is that it can be intermittent, so a check in clinic once every blue moon may not detect anything.

It's important to capture episodes, you're right. I use a little Kardia device that was recommended by a Cardiologist.

My wife has multiple cardiac issues and has an implanted monitor that phones home every night alerting the hospital of any AF she's had in the preceding 24 hours and they contact her if she needs to adjust her various pills and potions.

She's also recently bought a Withings ECG smart watch - this also alerts her of AF and she can do a manual ECG any time she wants. The ECG comes up on her phone. The ECGs from the watch certainly show her inverted ECG pattern, but the AF monitoring is 'patchy' - sometimes the reading is ambiguous and other times she knows there's been an episode of AF but she's not been alerted by the watch.

The watch is nice to have, but no replacement for professional monitoring.

It's a very poor article, with some important nuggets that deserve better.

1 Screening for risk of sudden death in athletes is very important, and good advice is available.

2 It isn't clear why the author is writing about his own arrhythmia before it's been monitored. And I have no idea why anyone said “I would have thought AF or SVT [supraventricular tachycardia], both of which are benign.” AF often isn't "benign".

3 Detecting AF in the general population is an important public health issue: Here's a recent commentary:
"Screening for atrial fibrillation: a call for evidence"
https://academic.oup.com/eurheartj/article/41/10/1075/5663566

4 The possibility of AF being caused by intense exercise is fascinating.

mikeymo wrote:I can't see a link from the Cycling Weekly article to the study mentioned.

I assume it's this:

https://academic.oup.com/europace/article/11/9/1156/465401

Me too.

But note the caution about what is actually being detected... is it the same disease that is classically described as AF? (This is also about to come an issue with self-reporting using Apple Watches and similar, see 3 above.) And in line with good practice in evidence-based medicine note the comments about the limits of knowledge and what should happen next. (This point may well recur in this forum on another health topic... )

Should we worry?

Absolutely not. If you've got a concern talk to your GP. And, as comes up time and time again, if you're worried about your heart rate and want to discuss it in a public forum please include the answers to two questions: does the rate come down quickly after exercise, and is the beat ever irregular?

Jonathan

NHS advice:
https://www.nhs.uk/conditions/atrial-fibrillation/

Wikipedia:
https://en.wikipedia.org/wiki/Atrial_fibrillation

Bonefishblues wrote:... long before I started to have AF's cousin, arrhythmia, in earnest.

On the language... atrial fibrillation one of the many types of arrhythmia.

Jonathan

mikeymo wrote:I think I read somewhere that a problem with AF is that it can be intermittent, so a check in clinic once every blue moon may not detect anything.

Bonefishblues wrote:It's important to capture episodes, you're right

millimole wrote:My wife has multiple cardiac issues and has an implanted monitor that phones home every night alerting the hospital of any AF she's had in the preceding 24 hours and they contact her if she needs to adjust her various pills and potions.

Yes, there's lots of brilliant technology to help both in diagnosis and subsequent monitoring.

https://www.nhs.uk/conditions/atrial-fibrillation/diagnosis/

Jonathan

Funny old thing, the heart. In that it absolutley has to carry on doing its thing, day in, day out, minute by minute, all the time. One "day off" and you're nobbled!

My father in law developed AF in his late fifties. He died last year aged 96 and still active. He certainly didn't worry about it.

simonineaston wrote:Funny old thing, the heart. In that it absolutley has to carry on doing its thing, day in, day out, minute by minute, all the time. One "day off" and you're nobbled!

Yes. I try not to think about it!

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.

Yes there is: chronic gastritis. DAHIKT. Bayer 50 mg slow-release aspirin accompanied by omeprazole at that - sandpaper for the gut.

Re Afib, I have a watch that monitors my pulse for irregularity, and has a built-in 2-electrode ECG that displays on my phone. No instances so far. And a bunch called Alivecor do a 200€ pocket gadget that will output the equivalent of a 6-lead ECG with which you can diagnose a narrowed or blocked artery if you're still alive and know how to read it. And there's a Ladybird book for that.**

* lie, but a bunch called Medcram (no connection) do a 12-video course that appears to be free of charge. Sample:

https://www.youtube.com/watch?v=D2Zpsgf ... aI&index=4

mikeymo wrote:

simonineaston wrote:Funny old thing, the heart. In that it absolutley has to carry on doing its thing, day in, day out, minute by minute, all the time. One "day off" and you're nobbled!

Yes. I try not to think about it!

The interesting thing about that is that the heart is made of so-called smooth muscle, which does not tire. Skeletal muscles are striated muscle, which does. It'd be great if we could convert quads to smooth muscle. I have an idea there might be drawbacks on the energy-supply side...

Interestingly, back in the days when cardiac stimulators were implanted in the abdomen and the leads taken up into the thorax I read of a case where one of a woman's pacemaker leads ended up planted not in her heart but in her thoracic wall. The striated muscles it stimulated changed into smooth.

Fascinating, but they had to unzip the poor soul all over again to fix it.

Audax67 wrote:The interesting thing about that is that the heart is made of so-called smooth muscle, which does not tire. Skeletal muscles are striated muscle, which does.

Muscle is traditionally divided into three types: smooth, skeletal and cardiac. Cardiac muscle is striated.

https://en.wikipedia.org/wiki/Smooth_muscle
https://en.wikipedia.org/wiki/Skeletal_muscle
https://en.wikipedia.org/wiki/Cardiac_muscle

Jonathan

Audax67 wrote:

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.

Yes there is: chronic gastritis. DAHIKT. Bayer 50 mg slow-release aspirin accompanied by omeprazole at that - sandpaper for the gut.

Re Afib, I have a watch that monitors my pulse for irregularity, and has a built-in 2-electrode ECG that displays on my phone. No instances so far. And a bunch called Alivecor do a 200€ pocket gadget that will output the equivalent of a 6-lead ECG with which you can diagnose a narrowed or blocked artery if you're still alive and know how to read it. And there's a Ladybird book for that.**

* lie, but a bunch called Medcram (no connection) do a 12-video course that appears to be free of charge. Sample:

https://www.youtube.com/watch?v=D2Zpsgf ... aI&index=4

OK, in the overwhelming majority of cases