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Atrial Flutter...What Next?
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So, at the end of October I celebrated 7 years of normal heart beats, since my Catheter Ablation.
This year has been a challenging year in many ways; Covid took two of our close relatives in Brazil (Mrs M is from Brazil). Mrs M was diagnosed two years ago with MSA (Multiple System Atrophy) and this year it has really started to make a big difference to what she can do. Earlier this year we moved house, to be nearer children. Then I had a fight with Sciatica, taking me out of running for 4 months. Only just starting to get back into a full range of running, but now bothered by periods of leg pain which could be nerve-related. Not sure where it is all going at the moment but always happy when I can get out for a run!
All the best to you. So pleased that you popped by again!
I know that you've been aware of a suspect heart for some time. Do you monitor your heart rate outside of running?
For several years I have taken my morning, resting heart rate. tbh I've not found it to be a very accurate indicator of over-training or illness-onset; there are usually much clearer indicators! However, it seems to reflect 'where I am' in a general sense (normally between 48 and 52). But you will certainly notice if it is really irregular. The trick, then, is to capture that evidence. Mine self-corrected a few times before the doctor got the clear picture that he needed, prior to taking any action.
Hope you get some answers soon.
I have an appointment in Feb for a 24 hour monitor, with a follow up phone consult in March. Hopefully that'll give a clearer picture.
Well, the Sciatica cleared up, and the severe leg 'cramps' fizzled out. But couldn't avoid Covid back in January this year. Thankfully it was a fairly light encounter...but do we really know what the longer term issues are?
This has been a very mixed year for me; quite a bit of ankle soreness, a lot of calf discomfort, and periods of feeling warn-out or washed-out. This has made it difficult to achieve a steady training routine.
Having said that, I've been averaging about 40 miles/week and have managed a 70% age-grading in distances from 5k to 17 miles. (Also celebrated the Queen's 70 years with a 70 mile week, and my own birthday was marked with a 78 mile week.)
Noticing some ectopic (?) beats when I take my daily rest-pulse, but nothing like AF. (I have read that they are not uncommon, and can possibly be due to stress)
My full-time care of Mrs M does result in a lot of complications; it's difficult to get out for much more than an hour unless somebody else is in the house. This is only going to get worse as her MSA has more and more impact on our lives.
Really glad that I went ahead with the heart-procedure on 31-Oct-2014. No regrets.
Would be good to hear from anyone else who is dealing with AF..
Doesn't seem to prevent you from being very active in a wide range of events, but it must be a concern.
Any further monitoring or investigations?
After a couple of months doing 5k training with a very modest target of sub 30 I noticed that my Hr would sometimes jump from 140s to high 150s low160s as measured by an arm strap with no obvious change in exertion.
Thinking this was either my superior heart (hah) or strap error I started taking my own pulse when it shows above 155 and was stunned to feel a lot of missing beats and irregularity. The high Hr indicated was the extrapolation between non missing beats I suppose. Looking back at my run data I also noted sometimes the jump occurred at the end of a run - when I should be recovering.
I have done a bit of reading and seem to be in the category of possibly exercise induced afib of some kind. If I keep my hr below 145 it doesn't seen to trigger. unfortunately, running at a pace of 5:30 per km (sub 28 5k) or up hills will not keep in the 140s. But if I do not push it, I maybe will not get more efficient.
so now I have booked a cardiac treadmill stress test however I believe they will only run that treadmill to 85% of my age maximum hr so perhaps this will not trigger an episode?
also… before running again i got a full workup done with heart ultrasound, ct scan for arteries and calcium score and everything was fine, but with a mild valve regurgitation that they said I could safely monitor every 3 years. So I thought well thats a green light to push it.
I have a feeling caffeine may provoke this irregularity more easily and I have also ceased creatine supplement ( just in case.).
anyway without all these fancy running watches and pulse monitors I would have run thru the flutter and never really realized. When its irregular I dont really feel symptomatic like dizzy or breathless. Maybe I would have dropped dead. who knows. I fear the cardiac doc is going to say: well, we don't know why and cant fix it, so just don't train faster than 130 on your hr monitor!
what do you think I should do. Push for a monitor to wear and then deliberately trigger high hr on a run or leave sleeping dogs where they are..
Not sure that I can be of much help. Everybody's situation is a little bit different, and it isn't easy to advise. None-the-less, the basic requirements must include a full assessment, and that ought to include a 24hr or 7day monitoring, to capture the full story through your full range of activities, in my opinion.
I'm now 79, and enjoying 30/40 miles of varied running every week. I am aware of some 'missed beats' when I take my resting h.r. (So much so that, often, I can't get an accurate number over a minute of sticking my fingers in my neck.) So, I take my Garmin wrist watch readings with a pinch of salt...
As you might have gathered from my thread...mine seems to have been a straight forward case of AF. The specialist told me that I had three choices; Cardio-version (?) i.e. 'shock treatment' to re-set the rhythm, or Catheter ablation, or Do Nothing...because it wasn't going to kill me. (That was re-assuring!) The shock treatment was very unlikely to have had much success, for various reasons, and I opted for the Catheter ablation. The spurious matter in one of the chambers that was causing the 'flutter-circuit' was burnt away, and I've been clear for almost 9 years.
My experience, when running with AF, was that if I kept to a pace about 2mins/mile slower than pre-AF, I could keep going. But if I attempted to increase the pace I would soon feel the need to walk; the oxygen supply was compromised. So, running a parkrun 5k my time was over 30mins instead of 24mins. And my marathon time was 5 hours rather than 4 hours. (I ran two full marathons in the period when I was in constant Flutter.)
I have no regrets about my 'procedure' and I hope you can come to a good decision.
I'd be interested to know how you get on, so do come back and keep us up-dated.
I'm not normally too far away as I contribute to the '1000 miles in 2023' thread. (I notched up a thousand miles a week ago.)
All the best, and see you soon.
Will report back if the treadmill and cardiac consultant sheds any light on it as google seems to put this topic fairly high up for searches of running afib and related issues and it might help others who wonder why their max hr seems unrealistically high and discover a possible arrhythmia .
They told me it is safe to exercise with this condition however if it becomes annoying (dizziness tiredness) I can get the ablation. It is annoying to live with for two reasons: one is it throws off all the hr based zone training. the other annoyance is probably my heart is pumping with reduced efficiency. Not that my jogging pace is exploring that.
nevertheless am a bit reluctant to get an ablation for something that only shows up while running for longer than 10 minutes. There is also more some evidence that fixing flutter might increase the chance of developing fibrilation if you then go out and hammer away with your now fixed heart.
anyway I am relieved that I was not imagining problems and it shows you that getting cardiac checked without a stress test is not necessarily a complete check up!
I can only repeat that I am 100% glad that I went ahead with my procedure.
(9th anniversary coming up in about 7 weeks)
All the best for the future, whatever you decide to do.
Still able to run about 4 times per week, notching up over 30 miles p/wk over the year.
A few weeks with Plantar Fasciitis earlier in the year, and an unreliable pace/distance caused me to pull out of the MK marathon in May. I've also needed to take a couple of days off from time to time due to ankle or knee soreness, but nothing major.
A couple of Physio sessions over the year, to help with calf tightness, otherwise try to self-maintain with plenty of stretching.
Age-Grade is still a helpful indicator, and I regard 70% as my 'respectable' achievement.
I've managed that, from time to time, in distances up to 16 miles. (Not so easy to come by on the shorter distances as my pace has dropped quite markedly, and rarely manage to get below 10 min/mile.)
Again, I have to say how pleased I am to have made the decision to opt for the heart-procedure. Now I need to put some work into improving pace, over shorter distances.
Look forward to hearing from anyone who has AF, and is considering a procedure.
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