The Framington data is a new one to me. Worth checking out. I have been told by my doc that I am 5x more likely to have a stroke due to A-fib.
I am 51 and have been on meds about 1 1/2 years. They help to a certain extent. I still have an occasional episode but they dont seem to last as long.
I also like to get some strenuous excercise. I have noticed that when my HR gets up about 120 ( low due to meds) it will often trigger an episode. As a result of that I tend to not push myself like I used to.
My doc has also told me it is no problem exercising while having an episode which just does not seem right to me. So, I am listening to my body rather than my doc.
Anyone have any more input on this ?

KrazyP, I think your HR is quite high for an exercise routine at your age. Before my ablation, we were bicycling in Sun Valley (lots of hills). I was in afib and my heart rate was over 210. I was determined not to let the afib stop me, but I was gasping for air at that rate and had to stop because I thought I was going to pass out. There is danger in having your heart rate too high for too long. I think I was about 62 at the time.

I have had afib for many years. I was told by my Cardio. to try to keep my heart rate under 100 while in afib to prevent damage to the upper chamber (i.e. heart enlargement) I have afib all the time. I walk 35-40 minutes a day on a treadmill and I sometimes go over that rate. I control the rate with Metropol, I have not had any ablations. Too low of success rate for me. My odds of it working are about 60% according to the EP. I have never heard of the Framington data?

I am 55 and in afib most of the time and have been for about a year. Rate fluctuates between 40 and 240. I am not on any meds just asprin and supplements. My blood pressure is 115/75 which is ok.
I try to get an hour of cardio four or five times a week. Strokes are due to blood clogs and I believe the asprin and the cardio will take care of the blood clogs. I especially exercise during an episode. Although it is tougher at first to get started, I feel better afterward. I consider it like taking medicine and believe it helps keep the heart muscle strong.

WOW... reading your replies are interesting to me...

My EP and Cardio told me there were no exercise restrictions, so what happens? My wife goes out and buys a treadmill (with the HR monitor).

Well, i'm on it, and know the readings are suspect, as I tried to calibrate the monitor with my usual cup-pressure-HR monitor.

Turns out I can't get my HR up to 100. On the treadmill, I'd pass out before I get there. So, I _can_ exercise, but not like I used to.

Also, we have a golden retriever who is ~75#. When she wants on the bed, she jumps up 'half-way' (front paws on bed, hind paws on floor), and waits for someone to help her up. Well, I tried that the other evening, and almost passed out! I couldn't believe it.

Not that I was an exercise guy to begin with (I'd always walk the dogs, rake leaves, cut grass, saw limbs, etc.), but it seems to me that I can only have, at best, half the strength I used to have.

I see my Cardio next Monday.. I'm interested in what she has to say.

BTW, I'm on Tikosyn, Metoprolol, and Warfin.. I believe the Metroporol wipes me out...

Thanks for listening...

Robert

If it makes you feel any better my friend has had aFib AND cancer for 20 years. He flies to Sloan Kettering once a month to see his oncologist there and the aFib is kept under control by lowering his heart rate with meds. With stress like that he's still never had a stroke and they travel all over the world on 2 week trips so he can see the world before he dies. I have had aFib continuously for 2 years and my cardiologist told me that with Metorolol I can keep my rate down to 60 and to exercise mildly every day. I go to the gym, walk the track and then do the cardio-vascular machines (one a day). He said that my blood pressure is much more serious because its causing an enlarged heart. None of my doctors seem to worry about the aFib but the high BP is a big concern. I was shocked 5 times which did nothing so now I just live my life one day at a time and forget I even have it. I'm lucky that I don't feel it but the doctors all tell me that its ALWAYS flip flopping around. I think worry is worse than the aFib.

Hi Hidds,
I understand you are in constant afib but do you not feel that flip-flopping in your chest? Can you feel it if you check your pulse? The two times I've had afib, the feeling I had was awful, very scary! If you don't feel it, isn't it more dangerous? I never heard of afib prior to my episode, and I'm still learning. It's definitely a learn as you go disease. Also, if you're in constant afib, wouldn't that increase your risk of a stroke? I've read that having afib does increase your chance of getting a stroke by five times, but there has to be certain variables, like intensity of afib, duration, etc. I'm sorry for the questions, but I've read of people being in permanent afib and don't quite understand it.
Thank you,
Cat

Undetected afib is very dangerous, a major cause of strokes and heart attacks. Your risk is lowered if you know you have it and are being treated. Lots of people cannot tell when they are in afib and go untreated. Many of us can emphatically feel the afib. I could even see my chest jumping around sometimes. In the end, before the ablation, I was in afib about 90% of the time, and I could feel every beat of my heart. I am now medication and afib free. All I take is 81 mg of aspirin a day.

Being in afib all the time certainly increases the stroke/sudden death risk - that's why they want to move quickly to stop the afib. The Framington data is as follows (my layman's interpretation):

A regular person (no heart issues) has a 3% chance of stoke (at my age). With persistent afib it goes up to between 8-23% depending on other things (smoking, diabetes, heart murmur, blood pressure, and something called a Pr wave length - don't know what that is). Anyway, my blood pressure is really good, so I think I am in the 8% range.

People who have other conditions can increase their risk up to 23% or higher. This is five year stroke and sudden death risk.

You can do a search on the Framington heart study - they have a little calculator and spreadsheet to assess risk factors. The Framington study is quite famous - used for lots of research. Huge sample size going over a long period of time.

Hope this helps. I am a bit of a nerd and pretty good at research so I have read a ton on this already.

Jerry West and Bill Bradley have afib (basketball players). Lamar Aldridge (all-star for the Blazers) had Wolff-White-Parkinson which is a genetic version of afib - he had ablation and is playing better than ever.

FIbbers,

Wouldn't you all agree that risk of stroke is low once treatment for AFIB begins? For example, since I'm on the warfin, isn't my risk of stroke non-existent?

I'm just wondering... I haven't looked at that aspect of AFIB yet. Anyway, i was just "thought" that my stroke risk was virtually zero.

Wrong?

Robert

my husband was diagnosed with afib in 2004, He went back to normal for a few years. Then it started again. he's been on sotilol and shocked, it stayed normal for 2 days that was it. Oblation isn't an option yet, since the dr said with his ankylosing spondilitis it would be more of an aggrivation. And it may have to be done more than once and just putting him under anesthetic is aggrivating enough. His dr said its more of an annoyance than a threat. As long as bp is controlled, heart rate is controlled, and is on warfarin, he is fine. The dr many ppl have it (its the most common arythmia), and live long normal lives. He is supposed to exercise moderately and can do everything he'sdone before it. If he feels it, usually when hr goes up, he'll feel pounding in his throat, and he is to sit and relax for a bit. Even controlled, he was told there will still be episodes for anyone. he can be in normal rhythm for awhile, then back to afib again.Doctor said as long as he is on warfarin and his INR is regulated, its fine. the one part of the heart that is the afib, quivers instead of pumps so the blood pools in the heart and that can cause a clot and thats where the risk of stroke comes from. As long as on blood thinner, then its fine. doctors say like any condtition, take meds, and go on about life. Its hard when it feels like it does, but he and i deal with it. Its not something that is deadly, only if ur not warfarin. We deal with it together. That makes a big difference. :)

Your risk of stroke and heart attack by your heart throwing off clots from afib is "significantly" reduced by taking warfarin or coumadin. And, if you should have an event, your survival rate is way better. I don't know that you can say it is zero, but your doctor can give you the stats.

Since I am pretty good with numbers and statistics, perhaps I can provide some perspective.

As near as I can tell, the various treatments for afib do reduce the risk of stroke - the degree of reduction depends on the risk category that you are in.

Think of a curve that is not straight. At one end of the curve let's say those whose profile puts them at high risk (over 70, diabetes, prior stoke), these people will benefit the most from drug treatments to improve their chances of not getting one. This risk might go down for 23% to something like 12%

For someone like me (relatively young, low blood pressure, good lipid numbers, etc.) the drugs will help - but not by much (maybe from 9% to 8%). Without afib the risk for a normal population is 3-4%.

For me I would balance the benefits against the risks of the drugs themselves. For example, I am tall, hit my head often (bleeding risk and subdermal hematoma risk). I also go hiking a lot (often alone). Do I want to give that up for a 1% risk improvement?

Then, there are the medical protocol issues. There is a routine for afib treatment I am learning - and it varies with the type, For persistent, it appears to be drugs, shock then ablation. This is driven by cost.

Interestingly, costs in the U.S. are hard to find - my best info for the shock is around $2,000, Ablation is roughly $50,000.

In France, ablation costs around $7,000 - in India $2,500.

Still doing research, and this is what I have noodled out so far. Might not be accurate - there are differences of opinion in some areas - this seems to be the conventional wisdom as near as I can tell.

Hey Krazy! Your explanation of stroke risk is very good.

Everyone:
If you want to know what your stroke risk is, ask your Dr about your CHADS score and to explain your risk. You can also Google it if you are interested.
C=recent cardiac failure
H=hypertension
A=Age 75 or older
D=Diabetes
S=prior stroke or TIA.

For example:
You get 1 point each. If you have hypertension and diabetes and are over 75 your score would be 3. For someone with a score of 3 without any treatment (aspirin, warfarin, or pradaxa) your risk of stroke is 5.9%. With warfarin it is 3%, or almost half.

You also have to take into account the risk of treatment. Your risk of having a major bleed with aspirin is 0.25 and with warfarin it is greater than 1.5.

For someone with a CHADS score of 1 or 0 you have almost equal risk of stroke whether you take aspirin or warfarin, but you still have the increased risk of a bleed with warfarin or pradaxa. So as Krazy said he would be safer overall not to take warfarin since he enjoys risky activities,and apparently forgets to duck :)
It's a very individual decision for all of us.

I am so confused! I spoke with my doctor, and according to him, because I have been afib free for 17 months, my chance of getting a stroke is the same as an average person without heart problems. I do take aspirin and rythmol. After reading so many comments, I'm totally confused. Is he wrong in saying my chance of a stroke is minimal? I am not overweight, under 60, normal (115/70) BP and 2 episodes of afib within the past 2 years, each lasting less than 2 hours, converting on my own. I guess I'm looking for input because I worry about strokes and risks associated with afib, even though I'm not in afib!
Thanks :)