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Athletic heart with heart rate abnormalities post ablation for a fib
I’m writing about my daughter, 24 yo athlete who started having palpitations in July after a significant cold, presumably covid in 2024. At that time she hadn’t had a vaccine for 1.5 years. By 5 months later these palpitations worsened, by March she got a monitor that showed v tach vs aberrant a tach? With a rate of 311 while backcountry skiing. She got an ablation August 2025 and all that triggered was atrial fibrillation. One year post ablation she’s having fast rates at rest and slow rates with exercise. But no dizzy spells and is currently wearing a monitor again. She was a competitive swimmer for 15 years, very dedicated and had a resting HR 42 and I often wondered if she developed an athletic heart. She had little follow up and no rehab. I wonder if young people and athletes with this problem aren’t properly training their hearts after ablation. How is the medical community addressing this? There are heart centers in Boston and Chicago for heart training in athletes, but what about if you live in WYOMING. Anyone else have similar experiences? Thoughts on rehab?
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@skins64 The co-moderator of afibbers.org had five ablations from different EPs before someone pointed him to Natale. That was eight years ago. Not a lick of AF since.
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2 Reactions@labexperiment
I really appreciate all this information about different systems and who treats what type of arrhythmia. I m taking notes. Do you have any experience with training your heart back for athletes?
@skins64 It's something I'm currently doing. I am an avid cyclist and have done many 100 mile rides all in around 5 hours. Probably what gave me arrythmia. Now I'm riding 45 minutes at about 80%. fortunately my left atria is not enlarged. Marathoners and long distance cyclists as well as cross country skiers have high incidence of arrythmias as do basketball players. I understand Larry Byrd struggles with AF. My local EP is also a cyclist. We've both scaled it back. Too much exercise isn't the best for your heart over time. I'm coming up on 75.
When you do endurance activity for many hours the adaptation is atria and left ventricular hypertrophy. This gives more chance for ectopic foci to develope. What is unique with cardiac muscle is that each muscle cell can develope it's own electrical current. So imagine having multiple distributors in your car firing out of synch with the main distributor.
There's the arrythmia. As the heart hypertrophies there are more chances for ectopic foci.
My goal now is to maintain good fitness but my 100 mile ride days are over.
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1 ReactionI’m 74 yo and having ablation in about 2 weeks for flutter. The EP is optimistic and busy. I swim most day 40 minutes non stop in indoor pool. I’m hoping to return to this activity. It seems to me that my flutter is triggered by my swim followed by being in an overheated area for awhile. I wonder if after ablation I should switch to another lighter workout program?
@stan52 It wouldn't hurt....for a while. Maybe during the blanking period that follows the ablation, until you're given the all-clear? After that, try to claw back what you had. The thing is, was it your swimming that caused the flutter, or maybe the overheated space afterwards? Mebbe. Or, it might just have been age-related and genetics. You were due anyway.
Your EP would have something to say. You might run this past him/her and see if the guidance sounds reasonable. BTW, my church organist found out he had flutter during a doctor's visit. He was urgently ablated. Two days later, back on the water kayaking with the missus. On the open ocean. I believe he was about your age at the time, maybe a couple of years older.
@gloaming The reaso; I mentioned is this occured 3 times in the exact conditions I described. The HR accelarted to 125-138 and just stayed there dur8ng that time. Once it stopped on its own after roughly an hour. The other times they injected which brought it down quickly. Thanks.
@stan52 I was told by an internist that flutter tends to stay in flutter. It doesn't usually come and go on its own. However, there is always variance between patients and the 'empirical data' about a syndrome or a pathology....we're all different. Anyway, I hope you get what you need from the PFA. Please consider, if you ever think of it, to come back and let us all know how you made out. Also, if it turns out that it WAS flutter.
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1 Reaction@stan52 There are at least 2 types of flutter, typical and atypical, clockwise and counterclockwise. Typical is usually near the cavotricuspid isthmus in the right ventricle and carries a 90+% success rate with a really fast recovery. Atypical is in the left atrium. It is much more difficult to successfully ablate. Both flutters are regular and are the result of a rentry circut, hence it's referred to as regularly regular whereas fib is referred to as iregularly irregular and is chaotic.
Thanks for your knowledgeable feedback. Mine is the right and I believe moves clockwise. At least that’s what the EP illustrated when showing me. He was very optimistic but that may have just been to buoy my spirits. I’ve never had surgery. Do you know the incidence of reoccurrence. Typically can I return to my swim and hike workouts?Thanks.
@stan52 Typical is easy and has a 95-97% cure rate. Over time it can return and can turn into Fib. https://pmc.ncbi.nlm.nih.gov/articles/PMC5522718/. Just watch triggers especially alcohol