Running with afib

According to the Training Heart Rate Zones available online, the max heart rate for your age would be 135. Are you in A-fib with a rate of 173 as an average? I am surprised that your doctor didn't give you an answer. When I was in A-fib, my max heart rate on the elliptical was around 125 and I am 79. In my humble opinion, that heart rate is way too high to be safe. I'd be looking up more information from other sources if the doc is blowing you off.

I am going to talk to my GP on my yearly physical this week. When I was wearing the halter test the one time I was in afib my average was 129. According to my fit bit my vo2max is 41 which is excellent for my age. I have read those as you get those formulas are not accurate because they don’t account for individual cardio fitness

@rice It's one thing to have an exercise heart rate, but it's quite another to have an exercise heart rate while fibrillating. I agree with rice...the rule-of-thumb is max sustained heart rate plus one's age should not exceed 220. You're way over that.
I, too, am a life-long cyclist, runner (many, many races), and snowshoer. I went into AF at the tail end of a 10 km maintenance run the summer I turned 65. They did every conceivable test, all showing no ischemia or blockages. Finally my cardiologist ordered a polysomnography which revealed that I have 'severe obstructive sleep apnea'. What this meant is that 'for God know how long' I had been subjecting my heart to nocturnal marathon-like stress because it was trying desperately to oxygenate my organs against the 30+ obstructive events I was having...EACH HOUR....night after night!
This may or may not turn out to be your problem, and so far your other numbers indicate you're not in a lot of distress. That's good. And if you're asymptomatic, you're getting off very lightly indeed. For the rest of We Lesser Mortals, we are not only highly symptomatic, which is awful (believe me), but we deteriorate in a linear progression with the advancement of the electrical disordering of the heart's substrate. And advance it does...and will...in all cases. Some very slowly, some precipitously...fast! I went slowly at first, well controlled for three years with only a weak dose of metoprolol and apixaban, but then the wheels began to fall off. You are not there, clearly, and again, it's great news. I recommend staying on top of the typical changes that happen for AF patients whose hearts beat chaotically unbeknownst to their owners: mitral valve prolapse as a possibility and eventual heart failure...again...only a possibility, neither one a certainty. But they do happen to many AF sufferers, so please get regular checkups to make sure you're not getting atrial enlargement. Also, might be a great idea to get in the back pocket of a good electrophysiologist soon so that you can be evaluated for a catheter ablation or maybe only a Watchman device (you can google it and read up on what it is and why it can obviate having to take an anti-coagulant with its associated risks and expense).

Unless I mostly walk I can not get to down to 135 so should I just give up running ?

@rice Well....I don't have any data on your ECG under stress, which running is. I also am not a qualified medical expert in anything....no training in medicine. However, I do know that if your heart insists upon such a high rate as 173, and you push it up to that level, either you're running too hard or your heart is fibrillating instead of beating in normal sinus rhythm. Either way, it's a problem. Your claimed heart rate is too high for your age....according to that rule I mentioned. You should at most reach for about 145. But you should really consult a qualified cardiologist and let them know what's going on when you exercise.

Also, you should have been put on a DOAC unless your risk of a stroke is deemed to be very low. A DOAC is a direct-acting oral anti-coagulant (Xarelto or Eliquis). Patients with AF have about a 4-6 times higher risk of stroke than they would with their heart beating in NSR. Also, in order to keep your heart rate under control, cardiologists normally prescribe a rate control medicine like a beta or calcium channel blocker, something like diltiazem or metoprolol. With your high rate, I would have expected you to say you are on one of those two, maybe bisoprolol....something to control the rate.

Ok the cardiologist did a ecg, echocardiogram, and a holster test. When the tests came back he never discussed them when th me. His nursed called and they put me on metoprolol,eliquis, referred me to EP team and wanted to do a Lexi scan and did a 6 months follow up. I emailed back and asked if I could do a treadmill instead of the Lexi scan because I did not want radiation. And I asked about running. The nurse called me said we did not need to do a Lexi scan or treadmill. When I went to the EP appointment they told me my ecg and my endocardiogram were good. Because I was having side effects she took me off the metoprolol and because my BP is 117/70 and my resting hart rate is 49 she did not give me anything to replace it. I asked about a Lexi scan and was told that would not have anything to do with Afib and she said it was ok to run. Yesterday I emailed the ep team and asked about the high hart rate while running. Friday when I see my GP I plan on asking if she will order a treadmill test and refer me to a different cardiologist. That is where I am at

@rice Okay, that all sounds reasonable. Yes, I would get a second opinion AND assessment if possible (different machines, different techs/operators, different interpreters of the data, etc).

What the cardiologists first think of is ischemia...low blood supply with oxygen which makes some organs suffer....chiefly the heart. The ischemia might be from blockages or it could be from low BP due to cardiac insufficiency, or even from a prolapsed or stenosed mitral, tricuspid, or aortal valve. These can all happen, and they all affect the heart's needed output. So, the treadmill stress test can show if there is ischemia, but not pinpoint its cause or location. For that you need the contrast with dye or you need an angiogram. BTW, I had to endure two MIBI stress tests, both with dye and CT scans, plus my EP ordered an MRI and an angiogram. With no indications from either test that I have ischemia, the EP felt better about me as a candidate for cathter ablation.

@gloaming

Gloaming, re: sleep apnea, were you or someone else aware of the obstructive events? They are often accompanied by loud snoring, gagging etc. My sleep study indicated obstructive events but I never wake up (light sleeper) and my wife never hears anything that would indicate sleep apnea.

According to my fitness tracker I get good sleep but not a lot of it if I am licking I get 6 hours

@gloaming — can running and/or tennis trigger AFIB?

I’ve had AFIB in the past but have been in normal since my cardioversion in September.