Fifty Plus (50+) - Riding with AFIB

Yesterday while out riding my normal 30 mile loop I do two to three times a week I got hit with AFIB after being free of it for a couple of years. I had to crawl home some six miles. Fortunately things settled out after three to four hours.

I was wondering if anyone rides having AFIB under control using drugs?

what?

All Freds in Bicycles?

what?

Assuming this isn't a troll, the OP is I think referring to atrial fibrillation (irregular heart rhythm) -- not pleasant, I should think, if caught out by this on a ride.

Read all about it:

http://www.bikeforums.net/showthread.php?t=68479

My experience with AFib and how I was cured.

Yes atrial fibrillation, AFIB. I have been though the drill of warfin, sotalol, cardio-version(s), and abalation(s).

Since this latest recurrence I fear it is going to be back to the beta-blockers and the other bad stuff. I just want to know if anyone is riding under these circumstances and the meds they are on and how they are tolerating it.

BTW warfin is a blood thinner that requires constant testing though blood work which means your veins get scared and tough to poke.

Do still have AFIB and taking warfin? If so what other drugs?

Thanks

Yes atrial fibrillation, AFIB. I have been though the drill of warfin, sotalol, cardio-version(s), and abalation(s).

Since this latest recurrence I fear it is going to be back to the beta-blockers and the other bad stuff. I just want to know if anyone is riding under these circumstances and the meds they are on and how they are tolerating it.

BTW warfin is a blood thinner that requires constant testing though blood work which means your veins get scared and tough to poke.

No drugs except one aspirin daily.

No AFib

There is a new machine that you can use in your home for finger pricks to measure INR. Medicare may pay for it, if you are eligible. My Cardio used it in his office to use it, and saved a needle in the arm. No lab - immediate results.

http://www.afibbers.org/toboards.htm

I have it and, currently take Flecainide (50mg twice per day) and Atenelol. Per my doc's approval, I cut the Atenelol and boosted the Flecainide to 100mg twice per day in the hopes of letting my heart run up some but, I get more episodes of Afib. So I have added back the Atenelol. I still have about 2 episodes per week and, they last anywhere from an hour to about 8 hours. Lately I have been also using the PIP approach (pill in the pocket) which consists of taking 150mg immediately upon going into Afib. My heart will often convert between 1 and 2 hours with this approach. If it doesn't, then it usually self corrects in 6 to 8 hours.

Afib is a real pain. Its the most uncomfortable thing I've ever had, and I've been living with it for 9 years now - though its been getting worse as the years pass. When it strikes on a bike ride, it will sometimes self correct within a few minutes and I continue, and sometimes it doesn't in which case I have to bail out or cut my pace way back. On mountain rides its particularly difficult to continue even on a reduced pace.

I don't know whether my next step will be ablation or a pacemaker with continued use of rhythm control drugs, or maybe something else. I have another appointment coming soon and its getting to the point where I will have to do something. The drugs are loosing their efficacy. You have probably seen all this since you've been through the ringer with it too.

I'm 63 and have had afib for 2 years. My "attacks" were becoming more frequent every month. My heart rate would go to 150+ and stay there for 20 -30 hrs. When it returned to normal (60 bpm) I would just be drained for the next day or two. Most of the drugs had adverse side effects. None of them stopped the afib. Doctors warned that it would become progressively worse. Last month I had a pulmonary ablation. You'll become familiar with this term. The jury is still out. I'm told to expect more attacks for the next few months. Then, if successful, I should be drug free and unlimited in my activities. I've always been a physical person and I'm not ready for the rocking chair.
Get a good doctor (I went through several), research, and educate yourself. Afib can be scarey and depressing, but it can be treated.
BTW I hope you have good insurance. My ablation ran close to $100,000.

I searched around the country and decided on Andrea Natale, MD as the best for me. I traveled a thousand miles to get to him. Ablation is more of an art than a science, and you want a doc who has an excellent record of success. In my case, Medicare footed most of the bill, and the cost was a lot less then $100,000 for medicare.

Prior, for one year, I was in AFib 24/7, nothing could get me out (meds, cardioversions - nothing). I have been totally free of any symptoms for almost 4.5 years now, and I am totally off of those horrible meds.

The docs told me to "learn to live with it - it is just a minor inconvenience." I can't write what I told them. That is no way to live, IMHO - especially if there is a solution.

My case is mild but yes. I started a ride yesterday and my HR was 220........fortunately it settled down after a few minutes. Mine flares up from poor dietary conditions....well mostly alcohol related-but no, I did NOT have tequila in my water bottle.

[QUOTE=DnvrFox;9985073]
Prior, for one year, I was in AFib 24/7, nothing could get me out (meds, cardioversions - nothing). I have been totally free of any symptoms for almost 4.5 years now, and I am totally off of those horrible meds.
QUOTE]
Good for you.
Did you have ANY episodes immediately following your ablation? I had 4 in the first 2 weeks... none in the last 2. Doctors said not to worry, give it 3-6 months. Damn I hope this works.

[QUOTE=DnvrFox;9985073]
Prior, for one year, I was in AFib 24/7, nothing could get me out (meds, cardioversions - nothing). I have been totally free of any symptoms for almost 4.5 years now, and I am totally off of those horrible meds.
QUOTE]
Good for you.
Did you have ANY episodes immediately following your ablation? I had 4 in the first 2 weeks... none in the last 2. Doctors said not to worry, give it 3-6 months. Damn I hope this works.

Nope.

But, having minor episodes is entirely normal - almost everyone has them as the heart heals.

Yes I have had two pulmonary ablations, the last about two and a half years ago. After riding/crawling home yesterday I popped a 50mg atenolol and converted in a couple of hours.

When I am on beta blockers they just drain me down and I cannot ride. That is the main reason I went for the ablations.

Thanks

I've had a pacemaker since 1994, heart was stopping on it's own. Started going into atrial fibrilation over a year ago when I was dehydrated. Stay hydrated and it doesn't happen, at least not yet. They've got me on Warfarin for that. The warfarin is fun, it weakens my veins and gives me "rhoids" that bleed. My pacemaker was recording heart rates around 200, so the cardiologist put me on Metoprolol Tartrate.

what?


Assuming this isn't a troll, the OP is I think referring to atrial fibrillation (irregular heart rhythm) -- not pleasant, I should think, if caught out by this on a ride.

Definitely not a troll. I was not familiar with the acronym. Sounds like a bad thing to have going on. Glad to see that many are able to continue to be active with the condition. Best wishes to the OP and others living with it.

Hydration my be an issue for me as I do not drink enough water, ever. It was in the upper 90's yesterday and I did not have my Camelback on as I probably should have.

Dchiefransom (http://www.bikeforums.net/member.php?u=4710) Thanks for mentioning that point.

I've been in solid AFIB for more than 20 years, since my mid-40s. Aside from the warfarin and bruising, it hasn't changed my life at all.
I was a runner when it started, and my split times increased suddenly from the 6:45/mile range to about eight minutes. At first the arrhythmia wasn't obvious, and i couldn't figure out why I'd slowed down, but an ECG pinned it down right away. I'd been thinking of getting more serious about cycling anyway, to save my knees, and since I was a little frustrated running so slowly, I made the switch for most of my aero exercise. I've done thousands of rides over the years with my heartrate under pretty good control with digoxin. Max pulse rate is limited to about 120 (or so...I don't bother to check it anymore), and I'm sure my performance is down from what it would be if I were in sinus rhythm, but whole weeks go by when I don't think about, and certainly don't worry about, the fib.
My cardiologist is my age within a couple of weeks, a former marathon runner, now an ultradistance cyclist. He's very supportive and puts no restrictions on my activity, though he does warn me to "listen to your body and stop when things don't feel right." The older I get, the easier it is to find things that don't feel right...

Hydration my be an issue for me as I do not drink enough water, ever. It was in the upper 90's yesterday and I did not have my Camelback on as I probably should have.

Dchiefransom (http://www.bikeforums.net/member.php?u=4710) Thanks for mentioning that point.

Not only that, but a healthy athlete that is dehydrated can also have a problem with mitral valve function while dehydrated (that's from the E.R. Doc).

Afib is a beast! I struggled with for about 6 years. There are basically 2 different types, one of which is triggered by exercise and one of which is triggered when you relax after a stressful time or at night.

Fortunately, mine wasn't a problem when I exercised. But to go along with it, and not associated with afib in any way, they discovered I had a deformed aortic value. I was born with it and it worked fine through years of basketball, running and biking. They only found the valve because of all the tests they did trying to figure out why a generally healthy guy had afib.

All of us who engage in endurance sports have a much higher incident of afib than the sedentary population. I sort of understand it from a technical standpoint, but suffice it to say it is a statistical certainty that long term endurance activities greatly increase your chances of getting afib.

They completely fixed mine with an open heart surgery procedure known as a Maze procedure. They literally create scar tissue on your heart wall to prevent errant electrical signals from causing afib. Of course, open heart surgery is a bit extreme to fix an occassional afib problem, but I got a kind of throw in when they opened me up to replace the valve and to fix an aneurism related to the valve. 2 1/2 years after surgery, I am afib free, hopefully forever.

[QUOTE=lukeee;9985320]

Nope.

But, having minor episodes is entirely normal - almost everyone has them as the heart heals.

I hope you're right. Yesterday, almost a month after the ablation, I hab an attack. Only lasted 8 hours , compared to usual 20+ hrs. I'm taking that as a good sign?

I've been in solid AFIB for more than 20 years, since my mid-40s. Aside from the warfarin and bruising, it hasn't changed my life at all.
I was a runner when it started, and my split times increased suddenly from the 6:45/mile range to about eight minutes. At first the arrhythmia wasn't obvious, and i couldn't figure out why I'd slowed down, but an ECG pinned it down right away. I'd been thinking of getting more serious about cycling anyway, to save my knees, and since I was a little frustrated running so slowly, I made the switch for most of my aero exercise. I've done thousands of rides over the years with my heartrate under pretty good control with digoxin. Max pulse rate is limited to about 120 (or so...I don't bother to check it anymore), and I'm sure my performance is down from what it would be if I were in sinus rhythm, but whole weeks go by when I don't think about, and certainly don't worry about, the fib.
My cardiologist is my age within a couple of weeks, a former marathon runner, now an ultradistance cyclist. He's very supportive and puts no restrictions on my activity, though he does warn me to "listen to your body and stop when things don't feel right." The older I get, the easier it is to find things that don't feel right...

I am in about the same boat as Velo Dog. Living and riding with afib for the last 20 years. Taking digoxin 225 mg along with an 81 mg asperin a day and no exercise limits from my cardiologist. I have been cardio-verted a couple of times but would not stay in sinus rythm and always went back to afib. So now I see my cardio every 2 years for a stress test and I live with it.

BTW, does anyone know of a heart rate monitor that will work OK for someone who is always in afib?

BTW warfin is a blood thinner that requires constant testing though blood work which means your veins get scared and tough to poke.

Just out of curiosity, is this really a problem for you? I've had blood tests regularly (supposed to be monthly, but I've been stable for a long time and tend to space them out) since 1987 or '88. The needles still slide right in. I've heard stories about the scarring, but I dismissed them as needlephobia. Maybe I've just been lucky.

Just out of curiosity, is this really a problem for you? I've had blood tests regularly (supposed to be monthly, but I've been stable for a long time and tend to space them out) since 1987 or '88. The needles still slide right in. I've heard stories about the scarring, but I dismissed them as needlephobia. Maybe I've just been lucky.

Earlier this year I went though the cardioversion with the TEE procedure and had to take coumadin/warfarin/rat poison for a couple of weeks prior and after, but the blood was taken by a small prick on my finger and put on a slide which was put into a device which gave an instant result.

I had my first A-fib experience about 15 years ago and for about 10 years I had one per year which lasted about 12 hours. They have become more frequent in the past couple of years, but typically last <24 hours. I can't take any of the "ol" or "il" drugs as they reduce heart rate and my normal resting is 41-45.
I thought the causes of the "attacks" were vodka-related, but I stopped drinking that and still get them. My cardiologist told me last week that there is a new drug to control A-fib, which does not require a hospital stay as tecosyn(sp?) does. I don't remember its name. I am choosing not to take it, nor to have ablation, but to make sure I am adequately hydrated. It's frustrating to have A-fib, but it should not be ignored because of the risk of clots forming.

I ynderstand that Medicare will pay for that machine. When I was taking Coumadin, the cardiologist would just use a drop of blood as you explained. Of course, all that is behind me now - I hope!!

... I had a deformed aortic value. I was born with it and it worked fine through years of basketball, running and biking. They only found the valve because of all the tests they did trying to figure out why a generally healthy guy had afib...They completely fixed mine with an open heart surgery procedure known as a Maze procedure. They literally create scar tissue on your heart wall to prevent errant electrical signals from causing afib.

Good to hear about the Maze. My cardiologist has mentioned it, but I really don't have much trouble from the fib and it's not worth the risk of cracking me open unless there's some other reason to be in there.
FWIW, I also had a valve problem, with the mitral. Never gave me single symptom; they found it while they were looking around for whatever caused the fib. It's not serious enough to fix, either, unless my symptoms get much worse, but they suspect there's some relarionship among that, genetics (mom spent 20 years in fib, and my brother went into it at 44) and 15 years of pretty serious running.