Heart arrhythmia during/following exercise (was: How much power does an average recreational rider generate when climbing?)

Michael Press wrote:
In article ,
"Carl Sundquist" wrote:

"Michael Press" wrote in message
...
In article ,
"Carl Sundquist" wrote:

"Michael Press" wrote in message
...

WPW?

It was not diagnosed as such, but not addressed (to me at least) as being
ruled out either. My main problem with it now is triggering it with a
sudden
dropoff in heartrate, such as coasting after going up a hill in a
criterium
or after doing a hard effort like an interval. I can avoid triggering it
by
gradually tapering off from the hard effort.

As early as 12 years prior to when I was officially diagnosed with atrial
fibrillation (AF) in 2003 I discovered that my heart rate would drop suddenly to
the point of my blacking out if I stopped suddenly after an extreme
aerobic--anearobic effort. To prevent this from occurring I did just as you did
by gradually tapering off hard efforts, cooling down.

I had an appointment for an ablation last March, but the
electrophysiologist
who was going to do the procedure said that there was about a one in a
hundred chance of "something bad" happening during the procedure. Also,
that
it wasn't a certainty that the procedure would solve the problem. I
decided
that I can wait a few years and see if those odds improve. Wikipedia
notes
that Bobby Julich had an ablation back in 1995 for an arrhythmia.

I have a definite diagnosis with a precise location,
and decided against treatment. I know how to manage
myself, and recognize increased susceptibility to PAT
by how I feel.

I know how to manage myself too, but when there are continuous attacks on
the upside of a hill and the immediate downside has several turns that you
have to coast through, it's not easy to manage.

No, it is not. Pretty much impossible.

My events have lasted anywhere from a couple of seconds to about 16 hours.
Although I have never had any related lightheadedness, my cardiologist was
concerned about the possibility that I might become lightheaded from an
event while riding and crash. I had to laugh and told him that I would be
worried about something like that if I were an open water swimmer, but I'm
not alarmed about possibly crashing while on my bike.

Sixteen hours of what? Susceptibility? Or tachycardia?
Sixteen hours is too long for the latter. You can shorten
the episodes to an hour or two; and less, mostly.

By the time I had AF events lasting 16 hours I was seriously considering an
ablation.

The procedure is one of the most difficult heart catheter procedures to perform
successfully, although the field is growing quickly as providers see a growing
populating of individuals who have acquired the condition, and the procedure is a
money-maker, at least for now.

If you opt for an ablation, increase your odds of success on the first procedure
by going to a center that specializes in AF ablation, even if that means
traveling, and if you are experiencing increasing frequency or length of episodes,
consider an ablation sooner rather than later.

In the mean time I found the following helped reduce the frequency and length of
my episodes:

1) Reduced exercise and aerobic de-training. This worked for me for a short
while, but eventually my AF came back with a vengeance.
2) Reduced stress. Hard to do if you're at the mercy of your job, family,
relationships, etc.
3) Eliminate supplemental calcium.
4) Increase supplemental magnesium. (I take 800 mg/day magnesium citrate.)
5) Increase supplemental taurine. (I take about 1g/day.)

Over the last year I did all of these, and they helped for a while, but my AF
returned, even in the absence of exercise. I underwent an AF ablation procedure
in March 2008, and aside from some lingering effects, it appears to have been
successful. I am off all heart medications (including aspirin), and so far no
recurrence of AF.

For much more information see the following web sites:

http://www.afibbers.org/
http://www.a-fib.com/
http://health.groups.yahoo.com/group/AFIBsupport/

Those of you who enjoy cycling and exercise in general may not be happy
with the conclusions drawn in the following article:

http://www.afibbers.org/conference/session64.pdf

--
Bill Bushnell
http://pobox.com/~bushnell/

"Bill Bushnell" wrote in message
...
Michael Press wrote:
In article ,
"Carl Sundquist" wrote:

"Michael Press" wrote in message
...
In article ,
"Carl Sundquist" wrote:

"Michael Press" wrote in message
...

WPW?

It was not diagnosed as such, but not addressed (to me at least) as
being
ruled out either. My main problem with it now is triggering it with
a
sudden
dropoff in heartrate, such as coasting after going up a hill in a
criterium
or after doing a hard effort like an interval. I can avoid
triggering it
by
gradually tapering off from the hard effort.

As early as 12 years prior to when I was officially diagnosed with atrial
fibrillation (AF) in 2003 I discovered that my heart rate would drop
suddenly to
the point of my blacking out if I stopped suddenly after an extreme
aerobic--anearobic effort. To prevent this from occurring I did just as
you did
by gradually tapering off hard efforts, cooling down.

I had an appointment for an ablation last March, but the
electrophysiologist
who was going to do the procedure said that there was about a one in
a
hundred chance of "something bad" happening during the procedure.
Also,
that
it wasn't a certainty that the procedure would solve the problem. I
decided
that I can wait a few years and see if those odds improve. Wikipedia
notes
that Bobby Julich had an ablation back in 1995 for an arrhythmia.

I have a definite diagnosis with a precise location,
and decided against treatment. I know how to manage
myself, and recognize increased susceptibility to PAT
by how I feel.

I know how to manage myself too, but when there are continuous attacks
on
the upside of a hill and the immediate downside has several turns that
you
have to coast through, it's not easy to manage.

No, it is not. Pretty much impossible.

My events have lasted anywhere from a couple of seconds to about 16
hours.
Although I have never had any related lightheadedness, my cardiologist
was
concerned about the possibility that I might become lightheaded from an
event while riding and crash. I had to laugh and told him that I would
be
worried about something like that if I were an open water swimmer, but
I'm
not alarmed about possibly crashing while on my bike.

Sixteen hours of what? Susceptibility? Or tachycardia?
Sixteen hours is too long for the latter. You can shorten
the episodes to an hour or two; and less, mostly.

By the time I had AF events lasting 16 hours I was seriously considering
an
ablation.

The procedure is one of the most difficult heart catheter procedures to
perform
successfully, although the field is growing quickly as providers see a
growing
populating of individuals who have acquired the condition, and the
procedure is a
money-maker, at least for now.

If you opt for an ablation, increase your odds of success on the first
procedure
by going to a center that specializes in AF ablation, even if that means
traveling, and if you are experiencing increasing frequency or length of
episodes,
consider an ablation sooner rather than later.

In the mean time I found the following helped reduce the frequency and
length of
my episodes:

1) Reduced exercise and aerobic de-training. This worked for me for a
short
while, but eventually my AF came back with a vengeance.
2) Reduced stress. Hard to do if you're at the mercy of your job, family,
relationships, etc.
3) Eliminate supplemental calcium.
4) Increase supplemental magnesium. (I take 800 mg/day magnesium
citrate.)
5) Increase supplemental taurine. (I take about 1g/day.)

Over the last year I did all of these, and they helped for a while, but my
AF
returned, even in the absence of exercise. I underwent an AF ablation
procedure
in March 2008, and aside from some lingering effects, it appears to have
been
successful. I am off all heart medications (including aspirin), and so
far no
recurrence of AF.

For much more information see the following web sites:

http://www.afibbers.org/
http://www.a-fib.com/
http://health.groups.yahoo.com/group/AFIBsupport/

Those of you who enjoy cycling and exercise in general may not be happy
with the conclusions drawn in the following article:

http://www.afibbers.org/conference/session64.pdf


Thanks for the links.

I suffered from Wolff Parkinson White syndrome. WPW is a syndrome of
pre-excitation of the ventricles of the heart due to an accessory
pathway known as the bundle of Kent. It's much more dangerous than
simple AF, and you can literally drop dead with it. It's often
undiagnosed if you've never had an ECG.

I found I had it in my late 40s and thank God I wasn't a manic
exerciser. I had two ablations - the first didn't work since the
pathway was right next to the bundle of Hiss, so hairy stuff. Anyway,
the WPW went but some degree of AF remained. So I stay on Amiodarone
and aspirin. The main things to avoid are caffeine and alcohol. So I'm
strictly de-caff and only drink lightly. Being de-caff exposes the
lack of provisions for this in a lot of UK food places. Europe is
generally much better, particularly Spain and France. No idea about
USA.

I don't exercise much but my surgeon told me this shouldn't be a
problem. Nevertheless, I have no intention of overdoing it.

How did you find out about all these mineral supplements?

Andy

Andy Evans wrote:
I suffered from Wolff Parkinson White syndrome. WPW is a syndrome of
pre-excitation of the ventricles of the heart due to an accessory
pathway known as the bundle of Kent. It's much more dangerous than
simple AF, and you can literally drop dead with it. It's often
undiagnosed if you've never had an ECG.

I found I had it in my late 40s and thank God I wasn't a manic
exerciser. I had two ablations - the first didn't work since the
pathway was right next to the bundle of Hiss, so hairy stuff. Anyway,
the WPW went but some degree of AF remained. So I stay on Amiodarone
and aspirin. The main things to avoid are caffeine and alcohol. So I'm
strictly de-caff and only drink lightly. Being de-caff exposes the
lack of provisions for this in a lot of UK food places. Europe is
generally much better, particularly Spain and France. No idea about
USA.

I don't exercise much but my surgeon told me this shouldn't be a
problem. Nevertheless, I have no intention of overdoing it.

How did you find out about all these mineral supplements?

Andy:

I spent time browsing the bulletin boards at www.afibbers.org. Lots of good
information as the founder of the site and many of the posters (most of whom
suffer AF) are sharp research hounds.

You might think that free advice is worth just that. But then supplements are
relatively cheap and safe compared to pharmaceuticals and surgery and are worth a
try. Some people who suffer short and infrequent episodes of AF find they can
keep it at bay with diet and/or adjustment of supplementation.

I would not wish to be long-term on amiodarone with its toxic side-effects.
There is a recent discussion on a replacement for amiodarone (dronedarone) that is
being fast-tracked by the FDA, that you may wish to read.

http://tinyurl.com/5eawur

(Give the username/password afibbers/2sesame, if you're asked.)

--
Bill Bushnell
http://pobox.com/~bushnell/

I would not wish to be long-term on amiodarone with its toxic side-effects. �
There is a recent discussion on a replacement for amiodarone (dronedarone) that is
being fast-tracked by the FDA, that you may wish to read.

http://tinyurl.com/5eawur

(Give the username/password afibbers/2sesame, if you're asked.)

--
Bill Bushnellhttp://pobox.com/~bushnell/- Hide quoted text -


thanks for that. I just took Amiodarone for granted but should look at
it. Maybe I could halve the dose for instance. Andy

"Andy Evans" wrote in message ...

I would not wish to be long-term on amiodarone with its toxic side-effects. �
There is a recent discussion on a replacement for amiodarone (dronedarone) that is
being fast-tracked by the FDA, that you may wish to read.

http://tinyurl.com/5eawur

(Give the username/password afibbers/2sesame, if you're asked.)

--
Bill Bushnellhttp://pobox.com/~bushnell/- Hide quoted text -


thanks for that. I just took Amiodarone for granted but should look at
it. Maybe I could halve the dose for instance. Andy

Consult your Doctor first. I knew someone in the trade (bike biz) with an irregular heart beat that was under medication that made him pretty groggy. Not fun stuff. According to someone who worked with him, he started adjusting his medication downward on his own, wanting to feel more like normal. He's no longer with us. Dropped dead on a bike (and wasn't doing anything too strenuous; this wasn't Clay Mankin of City Cycle).

--Mike-- Chain Reaction Bicycles
www.ChainReactionBicycles.com

Mike Jacoubowsky wrote:
"Andy Evans" wrote in message ...

I would not wish to be long-term on amiodarone with its toxic side-effects. ?
There is a recent discussion on a replacement for amiodarone (dronedarone) that is
being fast-tracked by the FDA, that you may wish to read.

http://tinyurl.com/5eawur

(Give the username/password afibbers/2sesame, if you're asked.)

--
Bill Bushnellhttp://pobox.com/~bushnell/- Hide quoted text -


thanks for that. I just took Amiodarone for granted but should look at
it. Maybe I could halve the dose for instance. Andy

Consult your Doctor first. I knew someone in the trade (bike biz) with an
irregular heart beat that was under medication that made him pretty groggy. Not
fun stuff. According to someone who worked with him, he started adjusting his
medication downward on his own, wanting to feel more like normal. He's no longer
with us. Dropped dead on a bike (and wasn't doing anything too strenuous; this
wasn't Clay Mankin of City Cycle).

I agree with Mike on his advice to consult your doctor (or a doctor) first. But,
if your doctor put you straight on a long-term course of Amiodarone without trying
less-risky medications first, then I have doubts about your doctor's competence to
treat you properly and suggest you consider consulting another specialist.

I disagree with Mike's suggestion that his friend's self-medicating necessarily
caused his sudden death. It may or may not have contributed. Unless Mike knows
more than he wrote, we don't have enough information. The biggest risk from
Atrial Fibrillation (AF) is that of a stroke, unless the drugs one takes to manage
it kill you first.

Beta-blockers (BB's, drugs whose names in end -lol) are commonly prescribed to
heart patients with tachycardia. They suppress the adrenergic response and affect
ventricular rate, but don't stop AF. They also cause drowsiness and lack of
energy in most people.

I was on low-dose of nadolol (20mg/day) for a few years until one 24-hour holter
monitor revealed that my HR was dropping to 15 bpm in my sleep. When this
occurred I would throughout the night repeatedly and without awareness wake up
then fall back to sleep, over and over again, like a patient with sleep apnea.
My doctor immediately had me stop taking BB's after that discovery and my energy
level and sleep quality improved markedly, although my AF became more symptomatic.

A interesting side-effect of the adrenal suppression of the beta-blocker was that
it made me a fearless descender and kept me cool under pressure, explaining,
perhaps, why the stuff is banned in competition. Even after almost crashing
several times at high speeds, I seemed to be able to recover without overreacting,
and I never got spooked after a close call while on the stuff. I kind of miss
that effect, but on the whole I prefer being drug-free.

--
Bill Bushnell
http://pobox.com/~bushnell/