-
Thanks for the response, much appreciated.
The doctor did mention ablation as well as pace maker but more as things to potentially look at in the future depending how things go. Blood thinning medication was also referred to (but from blood test not indicated) as well as beta blockers but they weren't prescribed due to general resting heart rate of 50 (I took some likely unjustified pride in the heart rate).
My heart rate at the moment does seem pretty irregular - yesterday I went for a flat walk of a couple of hours, not a total stroll but neither banging along at pace. Heart rate ranged 46 to 148 (measured on a Garmin watch, not sure how accurate but when GP took my pulse and blood pressure the readings from the watch at the time were consistent).
Doing some reading, exercise is seen as a good thing but the recommendations seems to be for very gentle (almost as if minimal exercise prior) so I'm wondering what it means in practice - slow, steady rides on the flat at most? An e-bike? Or am I being overly cautious/pessimistic?
Big_Ted-
Heart rate readings from a machine (either watch or obs machine in a Doc's office) are useless for calculating heart rate in AF. They expect a regular pulse, and work by extrapolating the BPM with 60รท(time between beats). If that's irregular then it will jump all over the place.
To measure your true BPM, measure you heart rate for 30s at the wrist, then multiply by 2.Blood thinning medication was also referred to (but from blood test not indicated)
The decision to give anticoagulants isn't based on blood tests (other than to exclude underlying haemophilia etc). It's based on assessing your risk of clotting (CHA2DS2-VASc score) vs risk of bleeding (HAS-BLED score), and taking into account personal circumstances like falls risk (obviously not relevant to you).
Medical therapy is either rate-control (like beta blockers), as you said it sounds like they're not suitable in your case with a resting heart rate of 50; or rhythm-control, but there are a number of contraindications to these which would have to be excluded first.
Ablation, as a rule, tends to be reserved for people who haven't responded to medical treatments and remain symptomatic.
IrPOWERranger
I had it. I'd had a slightly irregular heartbeat for as long as I could remember (childhood) and didn't realise it wasn't normal. It suddenly got worse. Took lots of persistence with GP because it wasn't always there. Eventually with 48h/72h monitoring they believed me. I also felt a bit shit at the time but discovered I was quite anaemic, so sorting that out also helped. The AF didn't affect me that much - a bit of breathlessness/fatigue.
For a few years I took Warfarin to prevent clots (with AF heart doesn't pump fully properly so blood can stay in chambers longer and clot risk). This worried me slightly in terms of cycling - what if I have an accident out in the sticks and bleed to death etc. I had occasional monitoring of heart, and frequent monitoring of clotting stuff.
Then I had surgery (ablation) to burn off the pesky misbehaving nerves. Local anaesthetic while the surgeon feeds a wire up to your heart from accessing a blood vessel in your groin. You can watch it on the same screen as the surgeon. Very wierd sensation. It worked, no more blood thinners, no more checkups. That was about 10 years ago and apparently the effects of the ablation can wear off after 5-10 years. I have had a tiny bit of irregularity in the last couple years but nothing to write home about.
My dad had AF too and same monitoring regime, until it deterioriated, too late to do the surgery, and he got a pacemaker instead. I think the reason I got the surgery then is that they didn't want the same thing to happen to me. I'm not sure how readily available the ablation procedure is otherwise.