lone a fib

[jane]

Anybody here have any experience with this? AFter many tests (all very positive), the cardiologist put me on Toprol XL to try to regulate my heart. My heart rate and bp is already really low. I'm a 44 year old female who rows about an hour each day (for years). Problem is that I get into a fib and it goes on for hours (until I get a little winded and lightheaded not to mention PANIC) then--it stops. It always happens at night or while resting. I wonder how long it takes the medicine to work. I'm still hooked up to the event monitor (2 weeks now). Echo and bloodwork came up GREAT!

I find it interesting that I repeatedly come across athletes/weekend warrior types that have this to some degree. I'm wondering how other people deal with this situation? I'm bummed b/c I have to give up coffee and booze--other than working out--what is there to live for!

Thanks, Jane

[dlsisk]

Hi Jane -

Yes, I do. I first noticed it in 2003 while cross country skiing. I had absolutely no idea what it was, especially as I'd always enjoyed aerobic exercises.

Tried drug therapy as you are doing now, but I didn't like the exercise limiting effects (or just general ineffectiveness) of most of them. Fortunately I had the opportunity to get ablation done in 2005 which was very successful!

My cardiologist said fit and active people are the worst A-Fib patients to have. Always griping and whining about their diminished athletic performance! Interestingly, no cardiologist or E.P. ever suggested inactivity - just common sense like learning what it feels like when you're overdoing it.

Anyway, ablation was very successful for me and I was very pleased with my medical treatment courtesy of Canadian Medicare!

Best of luck, have patience!

Duncan

[DavidA]

I don't lie, so I don't think I have one I can loan you.
What were you planning on doing with it?

David

[jane]

Duncan,

thanks for sharing your experience with me. Glad that the ablation worked for you!!! Although I know that this isn't a life threatening situation, it sure is a life disturbing one...

Going to have to give these meds some more time, but I am interested in the ablation. The meds sure don't seem to be doing too much yet.

Funny thing, when I exercise, the a fib stops (after about 5 minutes). My cardiologist never told me not to exercise. I'm such a whiny baby if I don't get my cardio!!!

Jane

[chris.speed]

Hello Jane,

I have had a number of episodes of AF. Initially I didn't know what was happening, thought it was transient and just waited until the episode passed. This usually took between 6 and 24 hours. I would then resume training albeit at a lower intensity for a couple of days.

In December I had an episode that lasted for several days. I was able to have ECG done privately and this confirmed that it was AF. My GP referred me to a cardiologist but by the time I got an appointment I'd come out of AF. I had to have a 24 hour Holter monitor and an echocardiogram. Fortuitously the day of my echo I went back into AF so the consultant and the echocardiographer saw my heart at its worst.

The upshot was that I was given flecainide acetate an antiarrhythmic drug and metoprolol a beta blocker. The consultant felt that if the rhythm could be controlled then the rate would return to normal. I took one dose on the first evening and was out of AF the next day.

To date I've had 1 more episode and again a single dose brought me out of AF. I wasn't keen to go down the ablation route when the 'pill in the pocket' approach worked. However, if the effectiveness wears off I wouldn't want to be taking the medication long term so would opt for the operation.

I discussed training whilst in AF with my consultant and his view was that it should be at a rate that didn't cause discomfort. I monitor my HR and I was told not to exceed 170 bpm. I usually hold a 1:55 split with an HR of 150, however when in AF I managed 2:12 splits with an HR of 170!

Best wishes

Chris

[dlsisk]

I concur with Chris that training with lone A-Fib inside of a "comfort range" is quite safe, "lone" being the operative word: A-Fib without any other underlying conditions or causes.

It's interesting to compare results. Chris' HR with flecainide and metoprolol is much more responsive than mine was. Antiarrhythmic drugs were very successful in my case - too much so, in that I couldn't achieve an exercise HR much over 140!

If I pushed the exercise intensity I began have tightness in the chest and a quite alarming heart pain - similar to a heart attack I suppose...

If I kept the intensity moderate and lengthened the exercise sessions I experienced long recovery times between sessions, a greater than usual fatigue and more of a tendency towards injuries.

None the less, we who are compulsive exercisers find a way!!!

All the best, Chris and Jane.

Duncan

[jane]

Chris and Duncan,

I'm so grateful that you have shared your experiences with me. I'm so glad to not be alone...

Update... since I'm still wearing the monitor the cardiologist (who is great) has been monitoring my strips every day. She isn't happy about the results of the Toprol (beta blocker) so I am scheduled for a stress myoview (stress test) in early June. In the meantime, she has increased the Toprol by 50%--I should have a little more improvement. If I pass the stress test, I will be able to get off of the beta blocker and I will be put on a different class of drugs.

Thanks again for sharing & for your support!!!

Jane

[canoeguy]

Just had a 2nd A-fib ten days short of 14 years. My 2 fibs occurred at rest and no heavy physical activity preceded the events. Now on Cozaar with no issues.

Tons of info about AF types and it all seems pretty much of a black art
as every doc has their own opinion.
Vagal vs adrenergic are two categories. Even when you seem to fall into one category according to available info, a clear relationship still goes undeclared.

Unless there is an obvious physiological defect, the classification and cause are a crap shoot. My cardio claims many AFs are related to high blood pressure. Seems anything can cause an AF but try to get someone to declare an exact cause and you will be left with a bag of smoke.

Any test results, such as an echo, are open to subjective interpretation so always get a 2nd opinion.

Had beta blockers given and I don't do well on them. Toprolol was given at the hospital by the in-hosue cardio guy. When I saw my cardio later I asked to have the med changed. He felt toprolol was not as effective as Cozaar for preventing AFs.

This fib did not feel like the last and I thought I was having a heart attack. It happened after I got up around midnight and decided to cut up a controlled relase ambiem..... THIS IS BAD THING TO DO!!!!!!!!!

Within a few minutes the fib began. So was it due to a sublingual dose of powdered Ambien CR? Who knows. Ambiem AEs, when taken as directed, do not include AF but does include other electrical conductive issues.

The hospital guys strongly suggested a cardioversion after 5 hours citing the findings in a Canadian study. I thought it was more economics than science.