Atrial Flutter...What Next?

As a (generally) healthy seventy year old, I am thankful for twenty five years of running. With distances from 5k to 50k I have usually done my own thing when it comes to training and racing. However, after twenty months with Atrial Flutter, and a heart procedure (catheter ablation) ten days ago, I am intrigued to know what is going to happen next.

My running during this AF period has been mainly at speeds two minutes/mile slower than before. Can I expect to get back to where I was before? (allowing for the age difference)

My personal 'shame barrier' for the marathon, until three years ago, was four hours, but the Thames meander at end of August, and the Warsaw marathon at the end of September, took me five hours nine, and five hours nineteen, respectively.

About two years ago I was working on my 5k, trying to get it back down to 24 mins, but with AF I have not been able to get under 30mins.

I have no way of telling if this is of any interest to anyone out there, but if anyone wants to ask questions, take shots, whatever, please let me know. Am quite happy to go away, or to share what happens next.

Enjoyed an easy two mile jog on grass today, to check that there were no issues with the groin area, and slight bruising from the procedure. All comfortable.



  • MrM2MrM2 ✭✭✭


    Managed a steady 5k on the track (29mins), three days ago, and a steady five miles on a very windy seafront, yesterday (49mins), including running up the slope to the cliff-top. Running up the slope is something that I haven't been able to do since the Atrial Flutter set in, twenty months ago.   All comfortable but heart rate is not as steady as I would like it to be. May need to experiment with different paces.

    Has anyone else got back to running after a heart procedure? Did you ever get back to previous levels? How long did that take?

    Would appreciate any comments.

  • MrM2MrM2 ✭✭✭

    On 16th Oct.(heart procedure + 16 days) did a steady 8 miles, Av. pace 9:20/mile. First 5km in 28:26 and 10km in 57:54. Av HR 140bpm after some silly highs in the first mile.

    These are best times since before the Atrial Flutter set in, 20 months ago. I'm still in the 'finding out what I can do' phase, without pushing too far too soon.

    Curious to know if I'll get back to anything like my sub 25 5km and sub 50 10km times. (The sub 50 was almost three years ago, so I don't expect to see that again.)

    Please comment if you have been through these experiences, or if you are waiting for a heart procedure.

  • MrM2MrM2 ✭✭✭

    Today (ablation + 18 days). Easy 2 mile warm-up run to the track, then two 'pyramids' of 200m, 400m, 800m, 400m, 200m, with walk-jog 200m recoveries in between.

    For the three distances I attempted three paces; sub 7 for the 200m, sub 8 for the 400m and sub 9 for the 800m. All successfully completed, then a 2 mile return home.

    Very happy with the results, and HR was steadiest yet; Av.133bpm, with some peaks up at 155.

    Plans for the next weeks are: to extend my long runs, building in some consolidating weeks, going up to 10 miles, then half marathon.

    I also want to return to Park run, soon, before going up to 10km, half marathon, and marathon events again.

  • MrM2MrM2 ✭✭✭

    Ablation + 20 days.

    The purpose of this morning's run of just over ten miles was: to set a reference time for ten miles and to consolidate or improve the 5k and 10k times from last week. I was also interested to find out what the heart would do, and check how the breathing coped.

    The conditions were ideal along the seafront today. I'm happy with the outcome.

    Results: 10 miles: 93:02 , 10k: 57:01 , 5k: 28:08. The breathing was fine at 3-3, and the HR Av. was136bpm, with a high of 149.

    Not sure if I will do the Parkrun this week or next week, but I will not set any other new targets next week. I'll do some easier runs, and watch the heart rate.

  • MrM2MrM2 ✭✭✭

    Ablation + 22 days.

    Feeling recovered from a variety of efforts this week, so went for the Parkrun.

    Mainly flat, with a short climb x 2. Happy to put my marker down at 27:44. Best for two years, due to AF. Hoping to gradually get back to somewhere near 25 minutes.

    Normally try to run on alternate days, and next week will consolidate on runs up to 10 miles, but slower than this week, to see if the HR will reflect the easier pace.

    Will possibly experiment with HR governed running, as I now have my first Garmin.

  • DarolaDarola ✭✭✭
    Thanks for posting this, I'm due to have the procedure 19/12 so am intrigued on how your return to running goes. I'm sure you'll be back to your pre AF times soon given your current process.

    I currently have a PR PB of 19:16 so hoping I don't lose too much for too long when the ops been done. I currently suffer from periodic SVT which when it hits stops me in my tracks, so will be glad when I can run without fear....

    Good luck with your progress.
  • MrM2MrM2 ✭✭✭

    Thanks for your response Darola. Hope all goes well in Dec.

    I think everyones experience is different, even with similar conditions. I had three occurrences of AF over a period of three years; they all 'self-corrected' within 36 hours, and there wasn't much evidence for the medics to work on. This last one (March 2013) didn't self-correct. So plenty of data.

    Only put myself up for the procedure when I came back from working abroad, earlier this year. So far I am very pleased with the outcome, and my early progress. Just have to 'make haste slowly'.

    Today (Ablation + 24 days) I ran ten miles. Purpose was to monitor HR. Increased pace each mile, from  a walk start to  sub 9 minute miling by mile nine. HR trace shows a fairly steady gradient, with no silly spikes.

    Plan to do some more slow runs this week. If HR continues to look normal I would like to get my Max.HR reading, using a couple of hard hills, in two or three weeks.

    Does anyone have a 'favourite' method for establishing Max HR? When I did a little research today, I found several ways to calculate this figure. Using six different formulae I had figures from 156 to 163. Will be interesting to compare with the HR monitor in a couple of weeks.

  • MrM2MrM2 ✭✭✭

    Hi Nick. Thanks for your encouragement.

    What is your wisdom on Max HR, and would there be any mileage in a separate thread? Haven't found much recent thinking on this. I'd be interested to see how MHR, obtained from a physical work-out, compares with the various formulae.

    208-(0.7x age)

    206.9-(0.67x age)

    205.8-(0.685x age)

    217-(0.85x age)

    202-(0.55x age)

    206.3-(0.711x age)

    These are just six that I found, without including a couple of 'ladies only'.

    Would be glad to hear your thoughts.

  • MrM2MrM2 ✭✭✭

    Nick...'If I feel good I go faster if I feel bad I slow down...' Magic! I can totally relate to your method, having used it for twenty five years.

    Now my children come along with this inspired gift of a Garmin and HRM, for my 70th, and suddenly life has become more 'interesting'?

    Yesterday's run (Ablation + 27 days). Five miles total; 3x1 mile with 2minute walk between each, and a final mile of 8mins. After a walk start the first mile recorded my HR up at 180, but as soon as I walked it came down quickly to 100. After that the HR only went up to around 140, rising to 159 for my 8min mile.

    Just that first mile that didn't seem right. Can anyone shed any light on this? Certainly didn't feel that I was making any effort until that last mile.

  • MrM2MrM2 ✭✭✭

    Today's run (Ablation + 28 days)...(Yesterday's entry should show +26 days)

    Wanted to carry out some more HR checks, especially to see if that high of 180 would show up again.

    Two mile easy run to the track; first mile, HR up to 156, then 2nd mile 136, so still a question mark.

    On the track: 6 x Yasso 800s with walk recovery (first two recoveries of 400m in 4 mins, other six just 200m recovery in 2mins) Target for the 800s was 4:30, but they were very comfortable, and averaged 4:21. Recoveries were reduced to 200m as HR came down quickly to about 110. HR during the 800s was 146.

    Conclusions: all HRs seem a little on the high side, but reduce quickly. If the HRs are a true record, then I've obviously lost some 'heart-fitness' over the last twenty months of AF, even with running being maintained as far as possible. My question now is, will those HRs come down, and will it take special sessions to achieve that?

    Plans for next week: to do a steady H.Mar training run, to see how HR holds up over two hours. Will try a Fartlek session, and would like to check my mile time.

  • MrM2.. I don't think any of the calculations are acccurate for max HR. I think the more accurate ways are to actually do max hill intervals where you go out on each one.. ( almost sick inducing efforts). probably not the best idea when you are recovering..

    I'm only 47 and my HR are much higher then yours.. so high i stopped putting the monitor on..image


     good luck with your recovery. You seem to be doing a lot of hard sessions there but as you have been running for years i expect you know what your body can handle.

     Have fun  

  • MrM2MrM2 ✭✭✭

    Hi Seren

    Thanks for your response. Yes, I know what you mean about the efforts required to determine Max HR, and I'm nowhere near ready for that, which is why I asked the question about formula correlation. And this all to do with assessing the 'reliability' of my HR readings.

    Understand your concern over hard sessions. I differentiate between 'quality' and 'hard', and as I only run on alternate days, every session needs to have a focus. That can be pace control, breathing rhythms, cadence, hills, foot strike, acceleration, etc..

    Really having to hold myself back from doing too much, too soon. Wanted to do the Half Mar run this morning, but with a bit of self control(?) put it back in for next week. And I'm keen to do another Parkrun, but that will have to wait for mid December, and I've signed up to volunteer on some Saturdays.

    Have a great week-end. 

  • MrM2MrM2 ✭✭✭

    A whole month has passed since my heart procedure. Too early to answer my question, about whether or not I'll get back to pre-Atrial Flutter running levels, but a good time to summarise the progress of the last four weeks.

    Wk.1...No running

    Wk.2...2' v.easy, on grass

               3' (5k) easy, on track (29:07) HR av.132, max 153

               5' easy, on promenade (49:46) HR av.143, max 177

               8' steady, on prom. (73:20) HR av.139, max 178 (5k:28:26, 10k:57:54)

    Wk.3...8' including 4' on track (pyramid session)  HR av.133, max 158

              10' steady, on prom. (93:02) HR av.136, max 149 (5k:28:08, 10k:57:01)

               3' (5k) steady+  Parkrun (grass and paths) 27:44. HR av.145, max 158

    Wk.4..10' var. paces, on prom., from walking to 9min.mile. HR av.129, max 150

               5' var.paces on prom.(walk recovs.), incl. 8min.mile.HR av.133, max 181

               8' incl. 4' on track (6xYasso 800s, av. 4:21)  HR av.132, max 156

    All runs completed with comfortable 3-3 breathing.

    Plans for Dec: alternate day running, mix of road, track and grass each week, extend long run to H.Mar, and consolidate, Parkrun on 20th and 10k (Round the Lakes) on 26th, another Yasso session, and check mile time with incr. effort.      Not ready for hill session or Max HR test.

    Darola. If you are following, I hope that you are as encouraged as I am, to see the way things are coming together. Hope you will be posting some of your own results, after your heart procedure, later this month. All the best.

  • MrM2MrM2 ✭✭✭

    Ablation +31days

    Feeling well rested after two recovery days and decided to do H.Mar. run. Hoped to complete in about 2:05, without pushing it. (approx. 9:30 min. miles).  Splits:

    Mile 1.....9:01   HR av. 110, max 129

    Mile 2.....9:33   HR av. 128, max 135

    Mile 3.....9:41   HR av. 131, max 135

    Mile 4.....9:42   HR av. 133, max 136

    Mile 5.....9:35   HR av. 135, max 139

    Mile 6.....9:25   HR av. 139, max 144

    Mile 7.....9:22   HR av. 141, max 145

    Mile 8.....9:36   HR av. 141, max 145

    Mile 9.....9:29   HR av. 142, max 145

    Mile 10...9:28   HR av. 143, max 145

    Mile 11...9:24   HR av. 145, max 148

    Mile 12...9:17   HR av. 146, max 150

    Mile 13...9:03   HR av. 151, max 153

    Feeling good in the last miles, so slightly increased effort, but maintaining 3-3 breathing throughout. Not breathless at any point, and no need for walk breaks.

    End result: Half Mar: 2:03:30.  HR av.138, max 155.


  • MrM2MrM2 ✭✭✭

    Ablation + 33 days.

    Today's plan was to simply run five miles, on grass, at about 10min/mile pace, so that I could see if the HR would be lower.

    Found that judging my pace today, was not as easy as it used to be. I blame it on the cold weather, extra clothing, wind and rough ground.

    So, my times were: 10:37, 10:50, 10:50, 9:57, 9:52.

    My HR in the first two miles played around up near 170! and then came down to around 140.

    Hard to draw any conclusions from that. Probably too many variables in one run.

    Would welcome any wisdom, to understand why the first minutes of a run can produce heart rates that are above the 'max'. This is the third time in recent days. (I'm working on a 160 max. until I can do a reliable test.)

  • I know you are keen to try your heart out but I'd concentrate on running by feel. I had different heart probs and went through an official cardiac rehab program supervised by nurses, they did a formula calculation (I think they used the Karvonen one which wasn't far out for me) and we worked to a safe percentage of that. They were pretty horrified when I told them I was off for my first race image

    The probs at the beginning may be poor contact/lack of moisture under the strap. It depends how good your strap is and how much you wet it and how much you sweat as you go along.

  • MrM2MrM2 ✭✭✭

    Joe Volcano.  Thanks for your input; just the sort of help I need, coming from someone who has been there already.

    Agree with the 'running by feel' method, certainly at the moment. And I only check the heart trace at the end of a run....and try to make sense of it.

    Once everything seems settled, and HRs are reasonable(?) I will try to keep within percentage bands for some of my training.

    Need to start getting wise. Might have left it too late!

  • MrM2MrM2 ✭✭✭

    Ablation + 35 days.

    Always have to work on my speed, otherwise I settle down to a limited range of paces. Like to go to the track for speed work; no guessing the distances or paces, or using the favourable wind direction......

    Today's session: 400m x 10 (at mile pace) with 200m walk/jog recovery. My mile time will hopefully come down to nearer 7mins than 8mins, but I'm not there yet.

    Results: 400m av. time: 1:53 (fairly steady apart from a 1:57 and a 1:47)               Av recoveries: 1:54. All 3-3 breathing. HR max on final effort went up to 163.

    Conclusions: easier than the previous run, on grass! and the pace was comfortable. By the end of the month will try to do a timed mile. Next time I do a similar session, I'll increase the pace for 400m or reduce recovery time.

    Now to catch up with the 24 hopefuls and their campaigning. 

  • MrM2MrM2 ✭✭✭

    Ablation + 37 days.

    Just a 5 mile run on the promenade today. Middle 3miles with increasing pace.

    Purpose(s): Starting to gauge how general pace is improving. Hoping to see improved times for mile and 5k, without racing. See if HR is stable.

    Results: mile 2: 9:07 HR 143, mile 3: 8:51 HR 151, mile 4: 7:55 HR 159 (max 162) Mile time is a few seconds faster, and 5k time of 26:45, is almost a minute faster than my Parkrun. Some of that is accounted for by different terrain.

    Conclusions:  HR seems almost stable, but a little high. Need to do some more long slow/steady runs (10' or 13'). Will also run on grass, and do another set of Yasso 800s on the track.

  • MrM2MrM2 ✭✭✭

    Ablation + 40 days.

    Plans for today were to consolidate my Half Mar distance, and to target a speed of 9:30 mile, out, and 9:00 mile pace return. Check HR only at end of run.

    Great day for running, but the Westerly wind was in my face going out, although  got some shelter towards half way. The following wind was a bonus on the return leg, and it was easy to sustain a good pace.


    Mile 1.....9:07     HR av.104,  max.113

    Mile 2.....9:44     HR av.132,  max.141

    Mile 3.....9:48     HR av.139,  max.142

    Mile 4.....9:35     HR av.141,  max.144

    Mile 5.....9:21     HR av.141,  max.143

    Mile 6.....9:18     HR av.143,  max.147

    Mile 7.....9:17     HR av.142,  max.146

    Mile 8.....8:51     HR av.142,  max.146

    Mile 9.....8:47     HR av.144,  max.146

    Mile 10...8:45     HR av.146,  max.149

    Mile 11...8:53     HR av.146,  max.148

    Mile 12...8:43     HR av.147,  max.150

    Mile 13...8:29     HR av.151,  max.154

    Half Mar time was 1:59:30 , and a new best time for 10k: 54:15

    The 10k time is wind-assisted, but the half mar. time was half favourable and half adverse wind.

    With the wind being a challenge on the outward leg, I probably worked a little harder than intended, and once I turned, and had the following wind, it was comfortable to sustain that same effort, and so the session didn't quite go to plan. (Worked a little harder on the last two miles, as I could smell a sub two hours!) 

    However, 3-3 breathing was maintained throughout, and no breathlessness was experienced. HR max. was 155, and average for the whole run was 140. Cadence was a secondary focus, and working on a 'mid' foot-strike. Cadence going out was 169, and 170 on the return.

    I was pleased with the run, the progress, and the sensible(?) heart rates.

  • MrM2MrM2 ✭✭✭

    Ablation + 6wks.

    Today's run: 6 miles on grass. Purpose: to run 10 min. miles and compare HR trace with similar run, 9 days ago. Then, run the final mile at nearer 9 minutes, to see HR change.

    Results: 9:38, 9:46, 9:56, 10:01, 9:57, 9:06. All with 3-3 breathing, although final mile was on the limit. Again the HR was a bit high for the first mile (partly due to slightly over-cooking the pace?); rising to 154, then settled down to about 144 until the final mile which went up to 155.

    The grass was waterlogged in many parts of the circuit, and I was conscious of the extra effort required to maintain the pace for five miles. (Much harder than the half marathon distance, on prom., two days ago.)

    I hope that my joints are thankful for the grass sessions. Everything else is voting against! Hopefully there will be some pay-off when the surfaces are firmer.


  • MrM2MrM2 ✭✭✭

    Ablation + 44 days.

    Today's plan was to run an out-and-back, along the promenade; total of 8 miles. Hoped to run out at 9-9:30 pace and back at sub 9 pace. Always good to start with a plan!

    Had probably under-estimated the recovery time needed after running the six miles on waterlogged-grass, two days ago. (Other excuses: 7am, still dark, fresh SW'ly, sand on the prom, extra layer of clothing, rain...). But it's not really about the time.

    Results: Outward pace: 9:59 miles, Return pace: 8:57 miles. Cadence: 169/170. However, the good news was the HR trace; showing av.137 and max.147. Unfortunately, unable to compare with pre AF levels (No HR monitor), but they are in line with the levels that I would get when taking my pulse, manually.

    Thoughts: With an impatience to get back to where I was, two years ago, it is easy to lose focus about the main purpose of each run, since the heart procedure. I have to remind myself that every run, over the last five weeks, has been to check how the heart is performing. Everything else is secondary, at this stage.

    So, today's HR is significant; with it's relatively low average and the narrow band between Av.and Max.. It also marks a whole week of the HR not exceeding the (guestimated) MaxHR of approx.160.

  • MrM2MrM2 ✭✭✭

    Ablation + 45 days.

    O.K. it should have been a rest day, but when I saw the conditions........ Ideal for an easy 5 miles, at approx. 10 min.miling, to see how low the heart would go.

    Results: First four miles, max.HR 134. Mile five (including hill) HR briefly at 145.           The average for the whole run was 129, and average pace 10:16.

    This was just what I was hoping to see. Probably still too soon to presume that there will be no more 'out of range' figures, but feeling good about testing my pace at the 10k, on 26th. Cannot do Parkrun on 20th; visiting daughter (who runs!). 

  • MrM2MrM2 ✭✭✭

    Ablation + 47 days.

    Track session today; Yasso 800s x 8. (Compare with similar session on 28th Nov.)

    Purpose: Increase to 8 reps. Run 800s @ 

  • MrM2MrM2 ✭✭✭

    Don't know how the report was lost. Will try again.

    Purpose: Increase to 8 reps. Run the 800s sub 4:15, and do the walk/jog 400s in approx. 3 mins. Compare times and HRs with previous Yasso session.

    Results: Following a 1600m warm-up, bringing the HR up to 110, the 800s were run in an average time of 4:10 (4:08, 4:17, 4:10, 4:12, 4:10, 4:11, 4:11, 4:03). The HR went up to 145 for the first 800, then 147, 150, 149, 151, 151, 152, 154. (The max. of 154 was on the final 800 as I got closer to a time of 4:00)  HR dropped to 115/125 on the 400m recoveries. Breathing was 3-3 throughout, and comfortable.

    As a marathon predictor, this session encourages me to think that I can get back to somewhere near 4 hours again. But still the main focus is on the HR outcomes from each session. Today's HRs look a little on the high side, but followed the activity in an appropriate way, and there were no high spikes. Happy!

  • MrM2MrM2 ✭✭✭


    If you are still looking in, I hope that yesterday's procedure went ahead. How will you know if has sorted out your problem? It was easy with mine, as I was in constant AF.

    When will you be able to get back to running?

    Enjoy the rest over Christmas, if poss..

  • MrM2MrM2 ✭✭✭

    Ablation + 50 days.

    A hilly run of 7.3 country miles!

    A challenging run with my daughter in Chipping Norton area this morning. Had no idea where we were going, until the last mile, as we headed for home. That final push got my HR up to 159, but average for the run was 136. Two earlier hills gave me HR up to 151. So, probably higher than it should be, but staying under 160, which I am currently using as a theoretical Max. until I do some proper checks in the New Year. Average pace for the run was exactly 10 min. miling.

    After the run the HR fell steadily, and was reading 95 after two minutes.

    Nothing adventurous planned for the next few days, but will put in an effort on the 26th for 'Round the Lakes' 10k in Poole. Would be pleased with anything near 55 mins. at this stage. Then would work to decrease that in 2015.

  • DarolaDarola ✭✭✭
    Hi, I had the EPS but they were unable to induce, so couldn't pin point where to do the ablation. Incredibly frustrating as Ive had close to 40 episodes of SVT this year, all whilst running, but they couldn't reproduce in the lab.

    I've not yet had the full report, or the opportunity to speak to the consultant, but in a brief email he said:

    "Very extensive EP study

    Nil provoked except few consecutive beats from atria after large doses of isoprenaline administration and multiple extra-stimuli

    No complications of any sort

    Train to 160bpm if possible to avoid tachycardias precipitated by training / racing at higher level"

    Just hoping that's not his final prognosis and there are still more options.

    Glad to see you are still making progress.
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