I've only had treadmill stress tests, but I believe there is a way they can do so kind of "chemical induced" stress test, where they give you some kind of IV med to get your heart rate up.

I'm sure you'll get an answer from someone who is more familiar with this kind of thing and lots more experience with Afib.

I've had 2 stress tests since diagnosis. I stayed in NSR both times.

This past one, I hydrated a lot. One of the nurses told me to take long strides when the treadmill speeds up....the tendency is to take small running steps, but the longer strides are easier and more effective.
Comfy supportive shoes and breath long slow deep breaths.

It will be OK!!!!!

Yes, I've done it twice, and both times the staff "talked me through it." I am more or less out of shape, and it never was too hard for me.They also monitored me very closely and there were 3 staff in the room. Only thing, for me, was my blood pressure spiked, so then gave me meds to bring it down. It wasn't too bad or strenuous. But of course just ask your .doctor.

Hi DB: The stress test is pretty important if you want to switch from Multag to Flecainide. They have to rule out any heart disease before the switch since people who have heart disease are not the best candidates for Flecainide. Good luck with your stress test! Yogacat had some great advice regarding the long walking strides. It is tempting to run when the treadmill speeds up. Afib is so unpredictable. At least you know if you go into afib on the stress test, there will be medical staff there that can address it immediately :)

Last stress test I did was something they called "modified" They did not want get my rate up too high but needed to get to a certain point for accurate results and in the event I did go into afib they were prepared to deal with it. I took yogas advice and the long strides do make a difference. Good luck!

DBinIL -

Flecainide works for a lot of people and is among the best-tolerated anti-arrhythmics. I am one of them, taking Flecainide, 50mg twice a day.

However, doctors will not give Flecainide to patients that have other cardiac issues, e.g., past MI, CHF, etc. For patients with other cardiac issues, Flecainide can actually be pro-arrhythmic - creating new dangerous arrhythmias such as VT, TdP, etc. Careful doctors will give their patients a "nuclear stress test" - which is really a myocardial perfusion test to check how well your cardiac muscles are supplied with blood - while resting and while exercising on the treadmill.

As for your question- concerns about the treadmill aspect - they do have a pharmacologic way to stress your heart that will substitute for the treadmill. I'm sure cardiologists know how deal with patients for whom treadmills may not be appropriate. Talk to your doctor before the test.

As for your other question - whether exercise would trigger an AF episode in you - I don't know if the exercise would trigger an AF episode in you. Although all of my own 3 past AF episodes initiated only at night while I was sleeping soundly, I know every person is different and has different experiences... I'd just talk with your doctor before the test.

You might also undergo an echocardiogram to check the full structure of your heart and valves. This test is completely painless and non-invasive. The tech will just place a ultrasound probe on your chest and move it around while watching a screen.

If you pass the above tests, you're deemed safe to take Flecainide without worry of it initiating new arrhythmias.

I've had both of the above and passed so Flecainide was a go for me. Flecainide has worked well for me for the past 6 months. I've not had any AF. It has given me very little side effects.

Thank you all for your comments and encouragement! It helped a lot.

I had my stress test today, and all went well. My knees did great, and I think my heart did ok. Heart rate got up to 145 which is a whole lot higher than it usually is! I walked uphill for 8 minutes before they stopped me. It wasn't easy (I'm out of shape!), but it wasn't as bad as I thought it would be. At least I didn't end up in a-fib, and that was what I was most worried about.

They did comment on seeing some "ST depression" on the EKG. Neither of my doctors have called with results yet, so naturally, I'm a bit concerned tonight. Anyone know if it's something I need to be worried about? I have to believe if they were worried today, they wouldn't have let me leave the hospital. I'll just feel better once the doctor calls with the results. Hope that's soon!

Thanks, again, for listening.

Hello. Back again....hope can get some advice and encouraging words.

Dr. wants another stress test. This time, it needs to be a nuclear stress test where they inject die, and then I have some imaging done.

In addition to worrying about the outcome, I'm stressed about the actual stress test. Does it have the potential for putting me back in afib?

I'd really like to know what you think about a nuclear stress test. Thanks!!!

I had one, no problem. But keep in mind, it will take most of the day (6 hours). They usually give you something to eat half way through.

The test is easy. They use a thing called the Bruce Protocol. It can be modified (made easier) for older or sedentary patients. They only take you as far as is needed to get your heart rate and blood pressure up to do the test. You will probably only go 7-10 minutes if you are in good shape. Athletes could go the whole 20 minutes. You are only walking. They increase the speed from a crawl to a brisk walk as they increase the grade.

You start out going 1.7 mph for 3 minutes (they take a measurement at that point). Then they move up the mph and grade as below. The rest is just drinking stuff and having them take images. 1.7 mph is a crawl. The elevation is what makes it challenging. After 14% grade it gets more difficult. Usually you won't get past that unless you are a real athlete.

Minutes Grade MPH
3 10 1.7
6 12 2.5
9 14 3.4
12 16 4.2
15 18 5.0
18 20 5.5
21 22 6.0

"The Modified Bruce protocol starts at a lower workload than the standard test and is typically used for elderly or sedentary patients. The first two stages of the Modified Bruce Test are performed at a 1.7 mph and 0% grade and 1.7 mph and 5% grade, and the third stage corresponds to the first stage of the Standard Bruce Test protocol as listed above."


petey

Gee Petey, you must of had something completely different than what I had. Mine was all day.

Really? Mine took a long time, but the walking on the treadmill was less than 20 minutes. The prep, the pre-test and the tests after took up most of the time.

I was there for 3.5 hrs.

Thanks for your comments.

As I understand it, I will not need to drink anything for the test. It is injected before exercise. I think I will exercise, wait an hour, and then have the pictures taken. They told me it would take 3-5 hours total.

I'll be glad when this one is over. Since the first stress test was positive, I am understandably more nervous about the findings of this one. I'm telling myself that it's best to know what's wrong so it can be fixed, but I'm still nervous!

I sure appreciate this site.....I know so many of you know exactly how I'm feeling. Thanks for being here!

Dear DBinIL,

The nuclear stress test or in medical parlance, "myocardial perfusion study" is no biggie.

They will put an IV in and inject you twice at different stages a small amount of radioisotope - either technetium or thallium. You'll be on an imaging scanner twice which will rotate around you. You'll be on the treadmill once. Mine took 3.5 hours.

Your note about the ST depression is interesting. Years ago, I had a regular stress test and the tech noted an ST depression. They put me through the nuclear stress test. The cardiologist who supervised my run on the treadmill was really friendly and he saw the ST depression on the EKG monitor as I was jogging at a rather high level ("level 5 they told me at the time). I pointed to that depression questioningly and he said, oh it's completely normal. Though I was younger back then.

NOTE - cardiologists want to be sure your heart structure is sound before they deem Flecainide will be safe for you. The nuclear stress test is part of that assessment. That's why they're having you go through it.