Cycling with atrial fibrillation (AFib), arrhythmia and other heart issues

I’m not sure if this is the right section to post in but seems as suitable as any.

After experiencing significant breathlessness over the past 4 to 6 months - and initially dismissing it as long covid - things were getting worse rather than better. I visited my GP who was great, extremely thorough and absolutely on it with follow up calls. Outcome was a diagnosis of atrial fibrillation (irregular heart beat). Which wasn’t what I was expecting but does explain how I’d been feeling.

I’ve been referred for a cardio version which will hopefully be successful, and will of course take advice from the doctors involved, but would really appreciate any first hand experiences/tips on cycling/exercising with AF longer term.

I have no advice for you but are you familiar with rowing great Tom James?

"Tom James talks about his heart condition, atrial fibrillation"
https://www.youtube.com/watch?v=HZe220O3xQ0

"MyHeart Tom James - Part 1 Atrial Fibrillation symptoms"
https://www.youtube.com/watch?v=2-ybYhCPO7o

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.

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?

I’ve suffered with this for years , I think cases can be very individual and advice given re exercise can be really varied .I have a friend , another forum member and we both have had ablations , his seems to have worked perfectly mine didn’t (i believe it’s not unusual to have multiple tries).I’m waiting for my second.
We have had different surgeons and very different advice re exercise , so I wouldn’t like to offer any , it’s just too individual.
My triggers are not always exercise and can easily be stress related, it’s generally recognised booze , caffeine, chocolate, and recreational drugs can also trigger.
My cycling has had to change , exercise changed , lifestyle changed .AF hasn’t changed yet but I’m trying to minimise the episodes and therefore the risk of stroke.
It’s quite common amongst cyclists ( classed as endurance athletes by some Drs).
Your Chad score will almost certainly be a factor on your prescription of an anticoagulant, so age , BP etc .
You will do yourself no harm in reading up about the condition , but all doctors seem to agree it will only get worse without treatment, and treatment is not a forever cure.
I know when I’m in it , but if you have a newer Apple Watch the ECG function will confirm , and even alert you to an episode .
I wish you well , be sensible, listen to the professionals , listen to your heart.

Worth a listen

https://www.bbc.co.uk/sounds/play/b09h2z82?partner=uk.co.bbc&origin=share-mobile

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 60÷(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.

sport with Warfarin or OACs are pretty risky. I would suggest as above to get a good cardiologist and let you inform about cryoablation. Results are pretty good. you will have to stay on OACs after the ablation for a while but with good results you will be able to get it rid off. fingers crossed for you

Really appreciate the reply (including the podcast link)

Thanks, sounds like I misunderstood what I was told but can use this as the basis for further discussion with the cardiologist

Blood thinning medication has not been recommended for me and I think that consideration of ablation is some way off.

(Also "sport with Warfarin or OACs are pretty risky" sounds very broad - would swimming, for example, present as pretty risky?)

From memory warfarin has an antidote and therefore reversible ( of sorts) but requires monitoring and therefore it intrudes more in your life IMHO.
Other newer anti coagulation therapies are ( AFAIK) not so easily reversed so a trauma or bleed can be bad news but they don’t require much monitoring after you’ve been taking for a while ,swimming sounds pretty safe to me .. I swam a lot during my anticoagulant therapy , I also rode my bike ( not as fast or as long as I used to though )and walked but your GP or cardiologist may say different and that’s THE advice I’d take …. But be honest about ‘a bike ride’, to most,it’s around the park or down the shops not necessarily an 5 hr zone 3 fest or a Zwift race .Swimming , is it an hour in the local pool or 4km in the open water…?

These questions and they are all good ones I’d write them down and when you next see GP or make a telephone appointment and ask them … this is like a conversation you’d have in a pub, there are plenty with similar experiences but they are not you .No one is going to put their medical history on a forum , but your GP will have you specifically in mind .
There’s load of info in podcast form , or internet medical advice … read , listen inwardly digest then formulate those questions for your GP.
I’ll shut up now

Hey @Big_Ted, I hope everything is going well?

How would you feel about broadening the title to something like:

Cycling with atrial fibrillation (AFib), arrhythmia and other heart issues

I ask because I have some questions about a possible pending diagnosis of (what might be) exercise induced superventricular tachycardia (SVT) and this seems like the closest thread. Also adding heart to the title might make it more searchable since I couldn't find it again once I'd closed the tab.

Of course, I can post elsewhere if you prefer to keep this thread AFib focussed, but I'm not sure how many other heart threads this forum needs 😀.

Happy to amend the thread title if I only knew how!!!

Maybe @Velocio can help?

My suggestion of "Cycling with atrial fibrillation (AFib), arrhythmia and other heart issues" is only a suggestion and there may be other keywords relevant to the title.

changed to that

Happy to amend the thread title if I only knew how!!!

Top right hand corner, Edit Conversation.

While we are talking about cardiac testing, I would urge anyone with children to get along to CRY session when they are old enough.

I had never heard of them until a colleague's son sadly died while playing football aged 16. She fund raised for CRY and I had both of my boys tested as a result. They picked up an abnormality in my eldest son that was followed up for 18 months before they were happy that it was exercise related (he was racing as a junior at the time).

https://www.c-r-y.org.uk/

Not a heart issue but since you were talking about anticoagulants above, this might be useful
https://www.lfgss.com/conversations/258892/

I am normally on anticoags until I do a big event at which point I'll stop beforehand. Really, I'm more likely to be hit by a car near home though so it's probably a false sense of security but if anticoag meant I couldn't ride, I'd stop the anticoag. Come at me clots.

I get the occasional atrial heart racing thing but generally after fumes being to close to a solvent 60”printer . Lying on the floor feet up seems to be the only way to stop it . Riding home last week felt like i was on a 100 mile ride with no food. Fit and healthy normaly.

Thanks, how on earth did I not see that?!?!?

Ok, I'll update a little on what's happened in the last 10 months in case it helps anyone else.

Although I was referred for the cardio version at the end of last year, I saw the cardiologist for the first time 3 weeks ago and now have a date for the procedure. So that's good but may help manage expectations of how long these things take to arrange.

I've not wasted the intervening time though - I've shed 16kg (people ask how - eating like you are De Niro preparing for Raging Bull beforehand helps), mainly by getting back exercise confidence. When I was initially diagnosed, I was very cautious/scared to raise my heart rate, not helped by the GP saying not to exercise until I'd spoken to the cardiologist. But after a couple of months, I decided I'd start, gently - I'd been exercising consistently for well over 40 years so felt I was as well placed to judge as anyone else. This may not have been advisable but it worked for me and I gave myself permission and gradually became ok with riding up a hill slowly and being slight out of breathe or, when riding off-road, not being shy to walk up a steep bank. As well as helping with the weight loss, this all did wonders for my mental well being and I managed to play county tennis in the summer, singles too. When I did see the cardiologist one of the standard questions was "how far can you walk on the flat?" - he expressed disbelief when I said "15 miles" but I explained that I could ride for a few hours without issue so on the flat I'd be able to walk for a while, even if I felt weary at the end.

There's obviously been some fun too. I now have blood thinners - not rat poison - which can be quite amusing when brushing past brambles but was a concern on my first day at a new job. I managed to nick myself very slightly when shaving but it wouldn't stop bleeding no matter what I did so by the time I got to reception there was quite a bit of blood on my shirt; explaining that I was from Hereford didn't wash so my start, with a visit to A+E within half hour and the purchase of a new shirt, was 'memorable'.

But that's not the end of the blood thinning fun. In preparation for the upcoming procedure, I had to have a blood test. I don't fear blood tests but don't relish them - I prefer my blood on the inside - but the nurse was jolly and chatty so I was distracted. Until she said "oh, this is a juicy one" and I felt liquid drip off my fingers. I resolutely stared at the wall - "oh, so juicy" - and started to feel quite light headed, so much so that I didn't say to the nurse that repeating the word juicy - it was at least half a dozen times - wasn't really helping. Eventually she realised that I was looking a bit green as she asked if I'd like a drink of water and the fan on to which I answered, in a small, pathetic voice, "yes please". having recovered I realised that I needed to replenish the lost fluid - the nurse mopped the floor at one point - so, using all my common sense, I had a pint of HPA and felt much better. I had another blood test last week, same nurse and she didn't recognise me; took 3 goes for her to strike lucky though so there is that.

Ok, oversharing complete. I'd say that although it's only my anecdotal experience, regaining exercise confidence was really important to me both physically and mentally.

(PS I'll leave the recent diagnosis of a severe sleep disorder meaning sleeping in a mask like a non-scary version of Dennis Hopper in Blue Velvet for another time)

Just noticed this thread - I was one of the original guinea pigs for the ablation procedure back 30 years or so ago.

There's a medical journal article with my mad 6 hour > 250 bpm ecg trace, a description of the rather blunt (back then - im reliably informed its much more advance now) soldering job they did on my heart by sticking some wires through the main arteries, and something on the fact its worked (I would say "so far" but im not tempting fate).

Hope it all improves Big_Ted!

Hi @Big_Ted. We only met on my Panasonic pr6000 thread as far as I know. It seems though there's more similarities than that.

A couple of months ago -completely out of the blue- I had this close-to-blackout for the first time. When descending from Alpe d'Huez I suddenly got dizzy, had these thoracal cramps and the feeling I was going to have a heart attack. I was in panic (my kids -14 and 15 yo- were alone in a rented appartement on the flanks of the Alpe) and thought I was about to die on the Alpe d'Huez. I didn't.

Back home I went to my GP and had the same thing while waiting in the waiting room. Panic again. She did some quick examination of my heart and blood pressure (she is also my sports medic), nothing wrong. A couple of weeks later I had it again. This time after going really deep on the bike with some mates. I felt a hard "bang" in my breast and it took me half an hour before I had a normal feel again. I went to the GP again and insisted on her to send me to a cardiologist. I suppose our health system here in Belgium is better than yours because two days later I was doing these tests at the Ghent hospital. Conclusion so far: my heart is healthy but probably -after an absence of more than 20 years- I suffer from asthma again. Lung specialist will see me end of next month. My GP insinuated another possible reason: stress. Severe stress (I had some the last year) can upset your stomach, making it to produce more "gas". The gas inflates your stomach so it puts more stress on your diafragm, leading to the typical "I'm going to faint or have a heart attack" feeling. I'm not saying this is what you "suffer" from, only that it could be something else than arrythmia.