Runners with Atrial Fibrillation................................Diltiazem???

I started having Afib several years ago after a virus. It would return when I was under high stress and not sleeping and too much caffiene. Never came back as frequenty as your situation. Like yours it would last about 24 hours.I have an irregular heartbeat anyway and visit my cardiologist every year. By the way, I was 100+ mile per week guy back in the 70's.

They first put me on Lanoxin and I was on that for a couple of years. Since I havent had an episode in while, Im off all together. I cut way back on Caffiene etc.

I never tried to run while in Afib. I think that is a huge risk since your heart isn't firing properly.

Good luck to you.

I agree...not good to run while in afib, and I only have done it when it starts during a run. thanks for your input.

i have seen others posting about afib here before, and would love to hear from anybody about their experience with the drugs or procedures...

DO NOT RUN WHILE YOU ARE IN AFIB.

I just had a major episode, in the hospital for three days.

Now two months later I haven't been Afib. I cut out caffine (drink decaf).

Not taking any drugs and listening to my body. Avoid stress and beer that is heavy lager.

I have had a few episodes, but none in the past 8 months. My worst episode happened at NAIA cross country nationals this past fall. I went into Afib right as I stepped off the line and somehow made it a little over 2 miles, in 2nd to last place, before dropping out. That episode lasted about 40 minutes which freaked me out since my heart was beating around 250 bpm. Since then, I have completely cut out caffeine, watched my hydration levels better, and gotten more rest and I haven't had a problem.

My episodes (5 altogether) have been spaced months(usually years) apart, with the last one being 6/17/07. My EP says he'll move towards a "pill in pocket" approach if/when I get out again. In the meantime,I take a good amount of fish oil and a baby aspirin to stay nice and thin just in case something does happen. With the frequency of your bouts, I would imagine you would be on some type of blood thinning protocol.

Diltiazem is the same as cardizem I believe, and I have had that in the ER. It does help to control rate (somewhat) during episodes, but since it's a beta blocker, it might not be the best option during the times when you are in NSR for those 2 weeks. You probably don't need your HR reduced any further since , as a runner ,it's probably already on the lower end. My primary guy was itching to do this, but my EP (who is a runner thank God) saw that appoach made no sense.

Talk with you doctor, or better yet seek out an EP. I would imagine that thinning your blood and taking a rhythm control drug (rhythmol,tambacor, or others) may be the best option for you. Of course, with the frequency you suffer with, an ablation procedure may be a good option. Your EP would essentially induce afib and then "map" your heart's electrical pathways. After targeting the "haywire" areas, they would zap them with a laser or freeze them to stop these electrical pathways from interupting the normal rhythm. The catheter is entered into the groin or neck, and you are heavily sedated but awake. Sucess rates are pretty good, but often people need one or two more procedures down the road. Still, with the frequency you suffer with, this may be a solid option. Good luck

diltiazem is a calcium channel blocker not a beta blocker. Caclium channel blockers will decrease your blood pressure and heart rate by basically decreasing the force with which your heart contracts. It is commonly used to control A-fib. Unlike beta blockers calcium channel blockers don't inhibit the sympathetic system, so it is possible to get a reflexive increase in heart rate while taking it (i would think that this would be especially possible in runners as they already have a slow heart rate). If I were the OP, I would try diltiazem (cardiazem) because your episodes of A-fib are fairly common. Just a note - one of the big problems with A-fib is that clots may build up in your atria, so you should be especially weary of leg/chest pain during or shortly after one of your episodes. That's my fairly uneducated opinion.

thanks. I thought it wasn't a beta blocker, but I just had to look that up. the doc had told me runners would hate beta blockers.

what do you mean by a "reflexive" increase in HR? Do you mean it's possible to get an even higher rate than when you're off the drug? I'm confused...

Yes, I'm aware of the clotting potential. If I'm ever in afib for more than 24 hours, i'm going to the hospital to get out...don't want that blood pooling for too long.

I had a few bouts with it 10 years ago, 13 years after my career ended (high mileage, middle distance runner (sub 4 mile). Can't speak to running while in Afib, but would caution strongly against it. What triggered my episodes (three in 2 years, none in last 8) was the ingestion of very cold substances (water ice, really cold water, soft ice cream) on a fairly empty stomach. The cold radiating from the esophagus triggered the afib (which is really an "electrical" impulse). Anyway, I avoid the cold stuff like the plague (but drink lager beer without effect) and have been free from episodes. There has got to be a connection to the high milage/high intensity training from years ago.

Been in a fib about five times now. Last bout lasted 80+ days. That really sucked. Ran several times; probably shouldn't have. 8 minute pace felt like sprinting uphill; just walking up stairs left me winded.

Since April all is good so far.

My plan

Give up alcohol

Give up caffeine

Try to reduce stress

Limit sugars/refined carbs

Magnesium

Fish Oils

Hawthorne

Taurine (2 g day)

I researched the hell out of this and this looked like the best plan. So far it looks like the OP self converts. When this stops, you're in trouble so I'd try to take care of it now. I can't say my plan works as going a few months without a fib isn't a big deal but I hope to say I got it right 10 years down the road.

I had a-fib symptomatically very similar to yours with onset when I was in my 30s. It went undiagnosed for over 15 years, some days felt normal and fresh as a daisy, the next if having an episode not able to run more than 2-3 minutes w/out stopping (I have PR's of 28:30/13:43, so no insignificant deal).

When finally diagnosed I was put immediately on coumadin and then a series of three drugs, rythmol, flecanaide, and sotalol. These were either ineffective or really limiting to my running as my heart rate would cap out at like 110. The drugs were just not at all compatible with what to me was a typical workout (at my age now 5 miles a day plus 8-10 mile runs on weekend). My first cardiologist said "well, can't you just walk?" I told him that was WAY down the list of my options and asked for a second opinion. He sent me to an electro-physiologist with experience in cardiac ablation.

Long story short, I had the ablation procedure a year ago and now am completely off arrythmia meds and coumadin. I take a baby aspirin, watch caffeine and limit booze. The ablation worked extremely well for me. I do have the occasional disturbance, but they are not nearly as long-lasting or as intense as before. I've been warned that this situation may not be permanent - apparently once the heart learns how to go into a-fib it has a habit of going back in. It is common for patients to have 2-3 ablations. The ablation itself is not that difficult a procedure, the worst part is the bladder catheter. I stayed in the hospital overnight, but it is technically out-patient.

My experience is that life on arrythmia drugs for a distance runner really sucks, though I did not take the specific med your doctor is prescribing. My EP insisted I try at least 3 drugs before doing the ablation to see if I could tolerate any of them. Fortunately the second guy was very sensitive to my desire to keep running. As I was relatively young (47) and in good shape, I was a good candidate for the ablation and it has worked out well for me.

You have blood pressure sensors (baroreceptors) in your carotid artery. These sensors use the sympathetic nervous system to increase BP when needed. Beta blockers block the sympathetic nervous system, but calcium channel blockers don't. When diltiazem lowers your blood pressure, they may sense that and tell your heart to start beating faster and your arteries to decrease radius. I keep going back and forth on whether this would be more or less likely to happen to a runner. This hour I believe that it is less likely because a runner's heart is stronger so you can produce a greater blood pressure with fewer beats than normal people. Either way, diltiazem should help with your A-fib problem. If you want a bunch of medical students to give you some free opinions go over to the allopathic (or osteopathic if you choose) forums at studentdoctor.net and ask their opinions. There are much better/smarter med students there. Here is the link (http://forums.studentdoctor.net/forumdisplay.php?f=11). Remember that my advice (and everyone's on here) is not endorsed by any physician, and it is formulated from a possibly under-educated perspective. It is in no way an expert opinion. You should ask your doctor if you have any questions/concern.

-Pack Runner

MSII

LY FLOCK FOR CIALIS wrote:

Avoid running marathons contained within Central Park on Saturdays in November.

actually, that's not funny. i was teammates with the guy you're referring to, and finally went to see the doctor two days after he passed. before posting, remember that these stories you hear happen to real people...it's not just a headline to everyone.

thanks everyone for all of the advice.

it's great to hear about others' experience with this. it's such a bummer to be a very fit 20-something-year-old and to all the sudden have a bad heart.

maybe i'll go try that medical forum one of you referred to. I also know someone starting their specialized training (fellowship or post-residency or whatever) in cardiology, and have a contact at Mayo, so i'll be talking to experts as well.

however, many of them won't understand the running stuff...

Remember it's not about the running so much, but about your life. Good luck.

Afibber wrote:

Remember it's not about the running so much, but about your life. Good luck.

definitely. i'll give up running in a second if any doc tells me it's a significant risk.

this shit left me bloated,hemmoroid riiden, lethargic,G.I. bleeding.etc. Went off it in 4 days. Cardiologist advised over the counter Cholest - Off. I return in six monthe to review my cholesterol and A-Fib.

I digress. I've had maybe two bouts of A-fib in the last 15 years . Started taking statins 10 months ago and within 8 months was having bouts of A-Fib 2 to 3 X a weeek.

Doc said I was crazy, But i'm off prescribed statins. And I'm going to work with my Cardio on alternative,homeopathic remedies.

Do not take my opine as gospel . But.....?

80+ days?!!?!?Why didn't you get a cardioversion?

sisyphus wrote:

Been in a fib about five times now. Last bout lasted 80+ days. That really sucked. Ran several times; probably shouldn't have. 8 minute pace felt like sprinting uphill; just walking up stairs left me winded.

.

i was going to ask the same thing. you're supposed to go in after 2 days at the most...

Oh God, bad memories. I'd self converted in two-three days before and knew that the reality is you have at least ten days - if you are lone afib with no other risk factors - before stroke risk goes above .5% so I thought I'd self convert again. When I came in on the third day, my doctor said give it a few more days and start coumadin. It was during the next three months that they played with my coumadin trying to get my INR above 2.0 consistently. It wouldn't happen. Finally, I kind of demanded they do the procedure that looks for the clot and when they figured out it wasn't there, they converted. Don't think it took on the first shock but they got it eventually. Bottom line, lousy three months. Being pretty monastic now trying to make sure it doesn't happen again.