Atrial Fibrillation (AFib) Support Group
Atrial fibrillation (AF or afib) is an abnormal heart rhythm (cardiac arrhythmia) which involves the two small, upper heart chambers (the atria). Heart beats in a normal heart begin after electricity generated in the atria by the sinoatrial node spread through the heart and cause contraction of the heart muscle and pumping of blood.
I recently ran/walked 5 marathons in 5 days in 5 states. The first one was in Dalhart, Tx. Within a minute of starting, I went into afib. Walk, run, stop, gasp for breath, walk, run, stop gasp for breath etc. for a couple of hours. I took half a 25mg metoprolol and came out of afib about halfway through the marathon. I guessed that I had triggered the afib by starting too fast.
The next day, in Guyman, Ok, I started a lot slower and gradually picked up the pace. I never really pushed it and I never got afib.
The 3rd day, in Ulysses, Ks, I started slow and kept it slow until the last 2 or so miles and really picked it up, determined to "finish strong". With about a mile to go, wham! Afib. Mostly as low walk to the finish but ran the last 50 yards or so across the finish line. I got some very light headed, in part from the afib and in part from hypotension. I asked my carpool partner to drive the car as I was far too lightheaded to drive. Took a dose of metoprolol and about 2 hours later was in NSR.
The 4th day, in Lamar, Co, I took it very easy the whole way. No problems.
The 5th day I gradually picked up speed, both to limit my chance of triggering afib and because I needed to go faster to combat the cold. It was 15 degrees at the start with snow and ice on the ground. No afib even though I finished the last couple of miles running very hard.
This last Sunday I competed in a 10 mile race in Sacramento. I began warming up 40 minutes prior to the start and was running at race pace when the other competitors started, but I was about a quarter mile from the start. I was a bit late crossing the start line but still managed to race the 10 miles and ended up with a decent race time of a little under 78 minutes. That was a good time for a guy over 65.
What I've learned from this is that:
1. I can still race with a very slow start and gradual warm up.
2. Make a mistake and I get afib
3. Metoprolol takes about 2 hours to get me back into NSR.
4. I don't need to fool with additional medications yet
5. I can put off an ablation for now
6. All of my afib incidents have started when I've been running
7. A very slow warmup has, so far, avoided triggering afib
Before I left to do all this running, I consulted with my cardiologist. He offered me additional medication and an ablation if I wanted them. We discussed the options thoroughly and I passed on them with the idea that if it gets worse, they are still options.
I know triggers are different for different people. I'm hoping that someone else may find this helpful, particularly if they are new to afib.
Todd
The next day, in Guyman, Ok, I started a lot slower and gradually picked up the pace. I never really pushed it and I never got afib.
The 3rd day, in Ulysses, Ks, I started slow and kept it slow until the last 2 or so miles and really picked it up, determined to "finish strong". With about a mile to go, wham! Afib. Mostly as low walk to the finish but ran the last 50 yards or so across the finish line. I got some very light headed, in part from the afib and in part from hypotension. I asked my carpool partner to drive the car as I was far too lightheaded to drive. Took a dose of metoprolol and about 2 hours later was in NSR.
The 4th day, in Lamar, Co, I took it very easy the whole way. No problems.
The 5th day I gradually picked up speed, both to limit my chance of triggering afib and because I needed to go faster to combat the cold. It was 15 degrees at the start with snow and ice on the ground. No afib even though I finished the last couple of miles running very hard.
This last Sunday I competed in a 10 mile race in Sacramento. I began warming up 40 minutes prior to the start and was running at race pace when the other competitors started, but I was about a quarter mile from the start. I was a bit late crossing the start line but still managed to race the 10 miles and ended up with a decent race time of a little under 78 minutes. That was a good time for a guy over 65.
What I've learned from this is that:
1. I can still race with a very slow start and gradual warm up.
2. Make a mistake and I get afib
3. Metoprolol takes about 2 hours to get me back into NSR.
4. I don't need to fool with additional medications yet
5. I can put off an ablation for now
6. All of my afib incidents have started when I've been running
7. A very slow warmup has, so far, avoided triggering afib
Before I left to do all this running, I consulted with my cardiologist. He offered me additional medication and an ablation if I wanted them. We discussed the options thoroughly and I passed on them with the idea that if it gets worse, they are still options.
I know triggers are different for different people. I'm hoping that someone else may find this helpful, particularly if they are new to afib.
Todd
so running is your trigger.
Afib tends to be progressive. I understand that to mean that you want to have as few episodes as possible; or to put it another way, more episodes lead to still more episodes down the road.
I am/was until recently a high altitude backpacker and nordic skier. these are all high heart rate activities. they tend to precipitate episodes of afib. My question is whether these activities, which are triggers, have to be modulated to that they don't trigger episodes. Again, not having episodes of afib is more important to me than pursuing these activities full out. so I have to find what I can still do without causing episodes.
Giving up my 'normal' high aerobic activities continues to be a real issue for me. But I've had to face the hard reality of my condition and decide once and for all what's more important: short term continuation with activities that trigger afib until the condition enters a stage where I'm very incapacitated, or radically modulating my activities so that I no longer trigger episodes. I've chosen the latter.
Has it occurred to you that marathons may not be advisable for you? I understand that you're trying to find an acceptable level of exertion, but my word you're always reporting that running sends you into afib.
Again, more episodes lead to still more episodes down the road.
I may be entirely off base here, and my apologies if this is true. Just my two cents.
I recognize the progressive nature of AFib. I saw it progress in my dad who was not a runner. I read about it on this site and note that many people have not found a way to stop this progression. They try drugs and ablation with some success, but worry that it will come back, and sometimes does.
I'd rather not worry about the progressive nature of it. I will get treatment only when I absolutely need it to function.
I still have things on my bucket list so I am going to try to get them done. Virtually all of my bucket list items require me to be somewhat active. Amongst them is to run a marathon or longer in all 50 states. Right now, I've only got 13. I need to run 37 more to achieve that goal.
I've had to give up one goal recently. I can't see a way of doing it safely. I'd like to run from the south rim of the Grand Canyon to the north rim and back again in a day, a total of 46 miles or so and about 11,000 feet of climbing and descent. An AFib episode during that run could turn a "grand" challenge into an embarrassing rescue or worse. Safety and planning would require a crew so that if I had to spend the night somewhere along the trail, I'd be able to do so without a problem. So far, I've been unable to put together the logistics to do that.
You mentioned that the condition can enter a stage where you're very incapacitated. From what I've read, that's not the usual outcome. My dad and my uncle both had AFib. Both remained active and never became incapacitated by it, outside of the some of the episodes. Both eventually died of other causes, not AFib.
The hard reality for me is that I have to modulate what I do, not stop doing them...yet. At some point, I know I won't be able to continue. I doubt that it will be because of AFib.
I have put off taking additional drugs in part because I don't believe my condition is bad enough. I also rejected an ablation at this time as I see it as very invasive, potentially damaging, and as a last resort. I believe that they are in my future, but not yet.
Hegel, I do appreciate the concern and comments you expressed. I can't say you're wrong in what you're doing not that I'm right in what I'm doing. I can say that I'm doing what feels right and I'm sure you are too.
My best to wishes to you.
Todd
Most of us have had to adjust our lives in some ways because of this condition. that's just how it is. Continuing on with drinking coffee when it results in afib because we want to live our lives on our own terms is really just...stubborn. In the end, we're probably forced to adjust whether we want to or not.
No one should ski when they have a broken ankle. You'll simply make the condition worse and end up limping through life. I don't think that any of us actually live life on our own terms anyway, even in the best of circumstances, even if you're Bill Gates; certainly not if you're a middle class schlub like me. We all assess our circumstances and make the best choices that we can.
I believe by exercising, your heart is stronger, breathing becomes easier, and symptoms are lessened. Of course, no-one should expect that multiple marathons will improve your health. The right reason is the challenge.
Restricting yourself can lead to becoming sedentary. Here is where it could wind up: https://www.youtube.com/watch?v=lwEGSe_upuQ
Believe me, I'm all for exercise and continue to exercise as we speak. My question, really, is: should people exercise to the point where it triggers afib? todd is trying to find the sweet spot where he can run multiple marathons over successive days and not trigger his afib. I'm not so lucky; I can't do this--I can't run that much without triggering tachycardia at the least and possibly afib after that.
so I'm a bit confused about the guidelines. Maybe this is because my experience has been that when I enter afib/flutter, I've always had to be cardioverted. I want to avoid this. I'm not in afib at all, until I am and then it tends to be pretty bad and I don't convert on my own. Maybe this is different from others who go in and out of afib more regularly?
But do the guidelines say that you should exercise to the point of triggering afib, and then don't worry because it's all good? My understanding has been to avoid triggers. If exercising to the point of triggering afib occurs, find that limit and exercise just short of that trigger. But maybe I'm not understanding this right, and it's alright to put yourself into afib if exercise, rather than caffeine, for example, is the trigger.
Or do the guidelines state that drinking caffeine is fine, even if it triggers afib?
Finally, I thought that, with afib, less was more. Afib is progressive: more episodes lead to still more episodes later on. Hence, avoid having episodes if you can. Avoid triggers.
I may be misunderstanding because I'm not in and out of afib as an ongoing condition. My episodes have been spectacular, however, and not something that I could run or walk or exercise while I'm having them. My heart rate goes to 160 and down to 40 and back, etc; or stays at 160 period. I can't go running like this.
I'm not trying to be argumentative or sell a point here; I'm a bit confused and want to clarify my understanding. Again, I'm oriented towards avoiding triggers. I may be overemphasizing this.
Keeppumping, I like your attitude. I'm trying to emulate it. Prior to the start of this year I had two episodes of afib. The first was 17 hours and the second was about 27 hours. Since then I've had about 8 or 9 episodes, all lasting between 20 minutes and about 6 hours and all associated with suddenly running hard from a resting position. I've learned I can run hard if I gradually increase the pace. Step on the gas too quickly and the engine starts sputtering, no longer working on all cylinders.
Hegel, I understand what you're saying and agree that we all have to make our own choices. There is no way I could pretend to know what's right for anyone else, or possibly even for me. I appreciate your own situation and that it is unique, not like anyone else's. My best wishes to you.
Hawkman, I'm not really saying F-U to afib. I'm trying to stay alive. I'm just trying to stay positive in what I do. That means that I have to weigh the risks and benefits before I go off and do something. Where the risks, as I see them, outweigh any benefit, I will defer my plans. If I can see a high probability of a positive outcome, then I'll go through with my plans. My marathons had a safety valve. I found someone online that was also doing them who would keep on eye on me. We rode together and if I was incapable of driving, they'd take over. At the end of one of the marathons, I went into a worse than normal bout of afib (due to inexcusable exuberance in the last mile) and knew that I could not drive. Glad to have the safety valve. They proved to be a good driver and my new friend. Again, this was something I had to weigh. I had many friends and family who thought I was going to kill myself. My doctors didn't and neither did I.
Petey, as always, your knowledge and input are invaluable in any discussion.
Thanks,
Todd
Thanks for your kind words. They will help me keep on track and not get into too much denial.
Todd