AFIB and running

Posted by rice @rice, Aug 15 7:43am

I was recently diagnosed with paroxysmal atial fibrillation. They put me on Eliquis and Metoprolol Succinate. I am 74 and I run 3 X a week 5-7 miles at a 12:30 pace. I asked my doctor if I should be running and I did not get an answer. I will ask again when I get to see the EP team September 3. In the mean time I am still running only 5 miles and trying to keep my heart rate below 135. my questions is should I be running with AFIB?

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I can only tell you about myself, not answer for others:
a. lifelong competitive runner;
b. developed AF near the end of a 10 km maintenance run when just turned 65 years of age;
c. ER doc said it was paroxysmal AF because I reverted to NSR on my own while hooked up in the ER;
d. had every imaginable diagnostic to prove I had ischemia or plaque deposits, bad valves...and none were true;
e. placed on metoprolol to help reduce heart rate and contractile force in case I went into AF again;
f. placed on apixaban (Eliquis, 5 mg BID) to reduce the risk of embolic stroke from clots, a risk with AF; and
g. last diagnostic was an overnight polysomnography in a sleep lab. Bingo! Severe sleep apnea.
My cardiologist looked at the report, looked up at me, and quipped, 'Well, I guess we now know why you have AF. Your heart is irritable because it has to ramp itself up multiple times each hour to keep you alive when you, and it, are supposed to be at rest.' I have used a CPAP machine ever since, and with great results. No, my AF didn't subside. In fact, as a progressive disorder, it began to get worse over time, meaning more and more metoprolol. Eventually, I was referred to an electrophysiologist (EP) who agreed to perform a catheter ablation using RF energy. It took two attempts, seven months apart, but he finally got me permanently in NSR, and that was 29 months ago now.
Should you be running with AF? Maybe, but probably not as long or as fast. Every AF patient must go through the process, sometimes over many months or years, learning what his/her 'triggers' are. For some, it's food, even eating too much of it at any one meal (so, stomach distension). Visceral fat accumulating around internal organs (so lose it!). Too much sugar, too much calcium in the diet, not enough magnesium in the diet....and so on. For some, walking, pacing, even light jogging or cycling calms them, or distracts them, helps to reduce anxiety, and that will calm a run of AF....sometimes. I know of one person, very savvy, and engineer, very structured in his daily life due to a bout of AF many years ago, who found out that when he eats (calcium-laden) ice cream or cheese, his heart acts up. He intakes at least 1000 mg of magnesium, usually in a drink concoction he makes for himself, each day. If he doesn't, as a self-described mg dumper, he breaks into AF.
This is just a narrative to help you to get oriented to your newly diagnosed condition. You must be observant, maybe keep records of novel or occasional events, and try to figure out what sets your own heart off.

REPLY
Profile picture for gloaming @gloaming

I can only tell you about myself, not answer for others:
a. lifelong competitive runner;
b. developed AF near the end of a 10 km maintenance run when just turned 65 years of age;
c. ER doc said it was paroxysmal AF because I reverted to NSR on my own while hooked up in the ER;
d. had every imaginable diagnostic to prove I had ischemia or plaque deposits, bad valves...and none were true;
e. placed on metoprolol to help reduce heart rate and contractile force in case I went into AF again;
f. placed on apixaban (Eliquis, 5 mg BID) to reduce the risk of embolic stroke from clots, a risk with AF; and
g. last diagnostic was an overnight polysomnography in a sleep lab. Bingo! Severe sleep apnea.
My cardiologist looked at the report, looked up at me, and quipped, 'Well, I guess we now know why you have AF. Your heart is irritable because it has to ramp itself up multiple times each hour to keep you alive when you, and it, are supposed to be at rest.' I have used a CPAP machine ever since, and with great results. No, my AF didn't subside. In fact, as a progressive disorder, it began to get worse over time, meaning more and more metoprolol. Eventually, I was referred to an electrophysiologist (EP) who agreed to perform a catheter ablation using RF energy. It took two attempts, seven months apart, but he finally got me permanently in NSR, and that was 29 months ago now.
Should you be running with AF? Maybe, but probably not as long or as fast. Every AF patient must go through the process, sometimes over many months or years, learning what his/her 'triggers' are. For some, it's food, even eating too much of it at any one meal (so, stomach distension). Visceral fat accumulating around internal organs (so lose it!). Too much sugar, too much calcium in the diet, not enough magnesium in the diet....and so on. For some, walking, pacing, even light jogging or cycling calms them, or distracts them, helps to reduce anxiety, and that will calm a run of AF....sometimes. I know of one person, very savvy, and engineer, very structured in his daily life due to a bout of AF many years ago, who found out that when he eats (calcium-laden) ice cream or cheese, his heart acts up. He intakes at least 1000 mg of magnesium, usually in a drink concoction he makes for himself, each day. If he doesn't, as a self-described mg dumper, he breaks into AF.
This is just a narrative to help you to get oriented to your newly diagnosed condition. You must be observant, maybe keep records of novel or occasional events, and try to figure out what sets your own heart off.

Jump to this post

gloaming, your comment parallels some of my Afib experiences. I'm not a competitive runner but I am fairly active...bicycling, cross-county skiing, paddling, hiking plus lots of yard work on my 10 acre property. Had my first Afib episode about 2 years ago. Cardiologist put me on 50mg of Metropolis and Xarelto. When I met with an EP, he asked about snoring and sleep apnea. I do not snore, so I figured apnea cannot be an issue. He cautioned me that sleep apnea is very under diagnosed and could very well be a contributing factor. On his advice, I did an at-home sleep study, which revealed moderate apnea, 27+ disturbances per hour. I now have a CPAP machine, which has been great because I'm sleeping much better, with fewer trips to the bathroom at night, no morning headaches, and better energy. However, like you, I still had an occasional Afib episode. In January I had PF ablation, and no Afib episodes since (touch wood), although an occasional palpitation. I just sent in my Zio patch monitor to check for any breakthrough Afib and waiting for results. Hopefully I might be able to cut back on the meds? My cardiologist said the CPAP machine will be good for controlling Afib, post-ablation. We shall see.

Questions I have...are you still on Metoprolol, and if no, did you experience any withdrawal symptoms when you stopped? What about anticoagulants? Thanks.

REPLY
Profile picture for nevets @nevets

gloaming, your comment parallels some of my Afib experiences. I'm not a competitive runner but I am fairly active...bicycling, cross-county skiing, paddling, hiking plus lots of yard work on my 10 acre property. Had my first Afib episode about 2 years ago. Cardiologist put me on 50mg of Metropolis and Xarelto. When I met with an EP, he asked about snoring and sleep apnea. I do not snore, so I figured apnea cannot be an issue. He cautioned me that sleep apnea is very under diagnosed and could very well be a contributing factor. On his advice, I did an at-home sleep study, which revealed moderate apnea, 27+ disturbances per hour. I now have a CPAP machine, which has been great because I'm sleeping much better, with fewer trips to the bathroom at night, no morning headaches, and better energy. However, like you, I still had an occasional Afib episode. In January I had PF ablation, and no Afib episodes since (touch wood), although an occasional palpitation. I just sent in my Zio patch monitor to check for any breakthrough Afib and waiting for results. Hopefully I might be able to cut back on the meds? My cardiologist said the CPAP machine will be good for controlling Afib, post-ablation. We shall see.

Questions I have...are you still on Metoprolol, and if no, did you experience any withdrawal symptoms when you stopped? What about anticoagulants? Thanks.

Jump to this post

Darn, there's so much to remember....and to forget. My dad has to rise at least twice, often three times, each night to void. He's a terrible sleeper/worrier at the best of times, so some nights his having to pee so often is a serious impediment to good/great sleep. Thanks for reminding me of yet another potential disruption to sleep that a health body might avoid by sleeping better....WITH A CPAP machine!
I am now 29 months free of AF since my last ablation, my second. I do have the very odd triplet of quick beats, and I'm pretty sure I have the odd PAC as well. This is normal...apparently, so for those reading who have had a recent ablation, and you still get the odd blip, don't panic. Every normal heart has variations in rhythm, minor ones, occasionally. It is when they gang together and run for hours that it has become a problem. Even then, a simple cardioversion in an ER often puts things right, including for those who had a recent ablation. I got this from the outreach nurse who had to hold my hand over the phone a few times when I was getting frequent blips after my first ablation...the one that failed. Then, second ablation, and after two weeks I was back in the ER with a long six hours of full AF. I was aghast. They declined to cardiovert me because previous attempts had never worked for me in past years. She pointed out that an ablated heart is a reset heart, and that they made an error in my ER. I should have been cardioverted. Happily, I reverted to NSR and was sent home, and that is the very last AF I have had.
Thanks, nevets, for your comment.

REPLY
Profile picture for nevets @nevets

gloaming, your comment parallels some of my Afib experiences. I'm not a competitive runner but I am fairly active...bicycling, cross-county skiing, paddling, hiking plus lots of yard work on my 10 acre property. Had my first Afib episode about 2 years ago. Cardiologist put me on 50mg of Metropolis and Xarelto. When I met with an EP, he asked about snoring and sleep apnea. I do not snore, so I figured apnea cannot be an issue. He cautioned me that sleep apnea is very under diagnosed and could very well be a contributing factor. On his advice, I did an at-home sleep study, which revealed moderate apnea, 27+ disturbances per hour. I now have a CPAP machine, which has been great because I'm sleeping much better, with fewer trips to the bathroom at night, no morning headaches, and better energy. However, like you, I still had an occasional Afib episode. In January I had PF ablation, and no Afib episodes since (touch wood), although an occasional palpitation. I just sent in my Zio patch monitor to check for any breakthrough Afib and waiting for results. Hopefully I might be able to cut back on the meds? My cardiologist said the CPAP machine will be good for controlling Afib, post-ablation. We shall see.

Questions I have...are you still on Metoprolol, and if no, did you experience any withdrawal symptoms when you stopped? What about anticoagulants? Thanks.

Jump to this post

About metoprolol, I had to quit it cold when they put me on amiodarone in the ER six days after my index ablation because my heart went completely chaotic. Sometimes a little metoprolol after an ablation helps to take the load off the heart by making it calmer....according to the outreach nurse. But I went off metoprolol on my own on her advice starting about a month after the second ablation. She just said to taper off it over about two weeks, but for sure before the Holter monitor so that what it measured was my 'real' heart performance.
I'm still on 5 mg of apixaban (Eliquis) daily and will be for life. My self-assessed CHA2DS2-VASc score is only 1.0, although I've gained some weight and it's probably close to 2.0, the line at which doctors want us on an anti-coagulant. I reason that, seated at a computer as I am at this moment, I could develop deep vein thrombosis, and that risk also rises over time. So, for me, it's a lifetime on apixaban. I tolerate it well, and also did the metoprolol.

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