Delayed Afib when hiking

@kudzu

Yes, I have created routes using the Garmin Basecamp Program. Once created I then export them to my Garmin handheld GPSMap 66sr to follow the route in the field. You can also print out a graph of the route which shows distance and elevation to that if something bad happens you will know the distance and total elevation gain at which it occurred. My test course has my car at the bottom and so if extreme fatigue strikes it's all downhill to the car. Both times this occurred were at the Point Reyes National Seashore north of San Francisco so basically at sea level.

@afm
Hmm, interesting. I didn’t know about that.
Well, I hope you can get it figured out. Please let us know how you do.

@afm

My EP doc ordered 30 day Holter four years ago, and it showed occasional AFib. My AFib occurs at a lower heart rate and I don't have symptoms. I was prescribed Flecainide to use for an AFib episode and Eliquis. My symptoms still continued with and without exercise. I self referred myself to Mayo Cardiology for a complete evaluation. My Echocardiogram showed normal ejection fraction, tricuspid valve regurgitation, mild pulmonary hypertension, VO2 max test was average for my age, but I went into AFib sitting in the lobby after the test. My Cardiologist said the only way to tell what was going on with my heart was to have an invasive right Heart Catheterization with exercise. I was fortunate that Dr Barry Borlaug, a world expert in heart failure, was available to perform the invasive test. The test measured my oxygen and CO2 levels, pressures in my heart during exercise on a supine bicycle where the work load was increased until I could no longer continue. My hemodynamics were normal at rest, but during exercise I dropped my oxygen level , and my wedge pressure increased. My diagnosis was a common type of heart failure called HFpEF. My Cardiologist explained I have type of diastolic heart failure, where the left ventricle is stiff and does not relax well enough to accept the normal flow of blood coming from the left atrium. There is no cure.

Heart failure is associated with AFib. This is why I have moderated my exercise intensity and all my heart values have stabilized. I still jog 5 miles indoors flat, and I keep my heart rate under 120 because I experience arrhythmias and dyspnea when my heart rate goes over 120.

Try purchasing an oximeter and check your oxygen and heart rate when hiking. A smart watch would be very helpful. I have an Apple Watch, Lookee Tech 2 lead ECG. and Oximeter. Both upload data to my Apple Watch. There are other reviews on Smart Watches and Oximeters on Mayo Connect.

The heart has a high demand for oxygen and oxygen levels generally need to be 88-90% or higher at all times. Mine will drop to lows of 82% at high altitudes or on a plane just sitting. I have a portable oxygen concentrator I carry with me when I travel. All my pulmonary function tests are normal.

Everyone is different. My brother is 78 and he has a different type of heart failure, no AFib, and his blood pressure and heart failure are controlled with meds. He does not have exercise restrictions and he continues to hike in the mountains as usual up to 10,000 feet.

I hope you get answers soon.

This sounds quite familiar to me. Three years ago I was diagnosed with paroxysmal Afib and put on meds. My triggers were vigorous physical activity, dehydration and poor sleep (among others). At 71 I returned to Nepal for a challenging remote trek at altitude. I trained hard on local ski hills and was in excellent shape but was unsure how I’d do at higher altitudes (4,800M). Our first day started fine - hiked 4 hrs in the morning and I felt great. But an hour after stopping for lunch I hit the wall energy-wise, which fit my previous pattern where afib would usually kick in an hour after exercise. Our route that day had a glitch and turned into a 9 hour slog in very hot humid temperatures, at very low altitude. My heart rate averaged 121 over 7 hours and hit 186 - very tough day! I recovered the next day and as we trekked higher over the next few days (more normal days) I was fine until we reached 3,400M and I could not go on as my afib started right away when I tried to move on. I had to abandon the trek unfortunately but was fine thereafter. It was extremely disappointing, especially as I had trekked Nepal 3 previous times and handled over 5,000M without a problem. Five months ago I had an ablation and have not had an Afib episode since. My energy levels are great and I can exercise vigorously without triggering an episode. I even started playing hockey. Huge relief. I am reluctant to try another trek at altitude but have not ruled it out completely. BTW - I used a kardamobile device several times a day so I could record readings and present data to my cardiologist rather than trying to convey my experiences in my usual 5 minute verbal conversation with him. Seeing the data finally convinced him to refer me for an ablation which has been a life-changing event thus far. I’ve had a knee and hip replacement and the ablation is on a par with those as far as returning to normal life is like. I know what it is like to fear having to stop doing what you love due to afib - it can be devastating. So my advice is to discuss the possibility of an ablation with your doctor - I wish you all the best.

@janet23

Thanks, I bought a health monitor wrist device which records heart rate, blood pressure and blood oxygen. The data is recorded every 15 minutes. I was able to duplicate the dizziness/light headedness/extreme fatigue this weekend on a couple of hikes. Roughly 1000ft of climbing in 3 - 4 miles of hiking will set it off. Yesterday I had to turn around near the top of a climb after 3 miles and 1000 ft. Made it home safely. The data on the monitor for yesterday shows a lot of variation in heart rate and blood pressure (the blood pressure accuracy is questionable but the variation real?). Blood oxygen was 96 - 98%. Elevation is sea level. This morning walked 6 miles on the flat with no problem.

I get the one month Holter tomorrow so will be doing hikes to activate the extreme fatigue response as much as possible.

@otiswinston

Thanks for the good wishes and the same back to you. And thanks for taking the time to share your experience. Two years ago we did Kiliminjaro and the Inca Trail plus a couple of California 14'ers - White Mtn and Langley. I have discussed ablation with my cardiologist but decided to try the beta blocker Metoprolol first. Apparently this can adversely affect performance when for example going uphill by suppressing heart rate and also hearth pumping power by suppressing adrenaline. I start the one month Holter tomorrow which will hopefully tell what is going on.

I thought all AFib occurred like this; push your body a bit and then later, AFib happens. Mine kept getting worse and worse until I finally had a PF ablation in February. Best decision I ever made. No pain, zero bad outcomes. Now, I’m back to pushing my body with no AFib results. 73M. Find a good shop and then go on with your life. Mine was done at Mayo Rochester, a 3.5 hr drive for me.