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

If you have had only three non-debillitating episodes, I'm not sure you'd be an ablation candidate yet. You and your cardio are correct that the procedure is still in the improvement stage, but the success rate curve is starting to flatten out. The big thing you want to consider is the complications rate, which on average I think is down to 2-3%. That seems good, until you learn that the two complications you can have are stroke and death. Clearly, he longer you can wait the better, as the safety factor is where most of the improvements are still coming.

You really need to look for somebody who 1) trained on the ablation during their residency vs. went to "ablation camp" and 2) has done a whole bunch of them. Practice makes perfect in this procedure, it requires technical skill. My cardio had done about 175 procedures and trained on it as a resident.

Can someone please explain the "no alcohol" recommendation. I have no trouble understanding the caffiene and/or stimulant drugs causing a problem, but why alcohol?

beats hell outta me. As poster above says, recent studies actually say caffeine ISN'T the a-fib trigger it has thought to have been. Sad to say, alcohol is, definitely. A-fib isn't actually a stimulation issue, it is an electrical issue, which is different. Somebody with more science than me will have to explain how.

Squid- thanks for the info. I think that I will happily wait. It is interesting that all three of my A-Fibs wre within one hour of ingesting caffeine, and not within 20 hours of taking alcohol. Needless to say, I am gun-shy on the caffeine.

Squid wrote:

beats hell outta me. As poster above says, recent studies actually say caffeine ISN'T the a-fib trigger it has thought to have been. Sad to say, alcohol is, definitely. A-fib isn't actually a stimulation issue, it is an electrical issue, which is different. Somebody with more science than me will have to explain how.

(I was posting as "controlled bleeding" today... :)

[quote]controlled bleeding wrote:

Squid- thanks for the info. I think that I will happily wait.

It is interesting that all three of my A-Fibs wre within one hour of ingesting caffeine, and not within 20 hours of taking alcohol. Needless to say, I am gun-shy on the caffeine.

[quote]Squid wrote:

/quote]

Curiously, when I first started having a-fib about a year ago, my a-fib would last for hours, and one time got all the way up to 24 hours. A few times it got to the point that my left arm was tingly and there was a real pain in my chest (this would last for a few days afterwards). There as also a pervasive feeling of anxiety, and although I suppose I could have the causality reversed, it seemed to me that it was a physical byproduct of the a-fib. All of this obviously prompted a trip to the emergency room, where I was finally able to get a proper diagnosis.

Since then, the frequency of episodes has increased substantially (again, I can pretty much guarantee to trigger it by running faster than a 7:30 minute mile, by bending over for more than about 10 seconds, etc), but the duration of each is way down to just 20 minutes max. I can also feel them coming on and a few deep breaths to correct will often do the trick.

My heart beats tend to be low and irregular during a-fib, though my father-in-law has the high & regular type (his a-fib was brought on by a heart attack several years ago).

Does anyone know what the implications of having a-fib are for getting life insurance? I'm glad I ramped up my coverage last year when I found out my wife was pregnant because I don't know if I would have qualified just a few months later when the a-fib began. If my doctor says its harmless, will that be good enough for them? In the event that we have another child I had hoped to double my coverage, but I am wary of even applying if it puts a black mark next to my name in some database (I don't think they can rescind the previous coverage, but it is unfortunately linked to my employer, and thus unless I am a lifer, this will become an eventual issue).

Here are the definitive studies on caffeine and A-Fib. There is tons of evidence that alcohol is a cause (in college I used to get weird heart shit every time I drank and it kept me awake) and there is evidence for other stimulants like pseudephedrine. Use PubMed to find this sort of study:

The effects of caffeine on the inducibility of atrial fibrillation.

J Electrocardiol. 2006 Oct;39(4):421-5. Epub 2006 Aug 21.

http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=16919674

Caffeine and risk of atrial fibrillation or flutter: the Danish Diet, Cancer, and Health Study.

Am J Clin Nutr. 2005 Mar;81(3):578-82.

http://www.ajcn.org/cgi/content/full/81/3/578

Caffeine and arrhythmia.

Am J Clin Nutr. 2005 Mar;81(3):539-40. No abstract available.

http://www.ajcn.org/cgi/content/full/81/3/539

Quoting from the first article:

"There is widespread belief that caffeine consumption is linked to atrial arrhythmias; however, there is a relative lack of systematic evidence to support the assertion. The purpose of this study was to investigate whether caffeine, in doses equivalent to daily use in the general population, alter the propensity for atrial fibrillation (AF) in an experimental model comparing normal and simulated predisposition to AF."

Eric, my experience with this is that it won't prohibit you from getting life insurance, but you'll definitely be in a higher risk category and therefore will pay more. If you pay enough, somebody will insure you. Well, almost.

Thanks Brian. Neat stuff and consistent with what my EP tells me.

I've read where alcohol cases direct damage to heart tissue which may lead to afib. "Damaged" areas may cause erratic electrical activity. L - carnitine may be helpful in such cases.....I take it, along with several other supplements such as fish oil, magnesium, potassium,coq10,Taurine, and 5htp.

I thought I would dredge up this thread again because 6 years since my last afib, I had another attack Friday night and I am still in Afib Saturday night. I went to the ER this morning and since I came in withint the 48 hour window for anti-coagulation, he is giving me the rest of the day to convert back to sinus rhythmn on the drugs. If not, I go in for an electric conversion in the morning. I hope it goes better than last time. I took my pill 4 hours ago and it hasn't worked yet.

This time it happened while I was out at dinner. I had had 2 drinks (a Pale Ale and a ghetto vodka drink I mixed up) and had just started another beer, but it had been about 90 minutes since the previous drinks. I ran that morning with no problem at all and did a workout with a HRM on the day before with no sign of irregularity.

I had coffee that morning, but not much. It happened quite suddenly - fine one minute, my heart racing and irregular the next.

Anyone else from this thread have a repeat episode that required clinical cardioversion?

Hey Eric- yeah I had an episode in December, so right on the 3-4 year schedule :P I went in before 48 hours, but they were so busy that night that I was sent home and came in the next morning, 52-hour mark. Different doc who didn't want to electro-cardiovert! Anyway, she gave me the pill instead and it worked! I need to see the cardiologist about getting the pill to keep so I don't have to (hopefully) deal with the ER BS again. Sorry to hear it didn't work for you yet. Oh, I've been running 50-60 mpw since and feel great at 55 :)

Diagnosed with A-fib secondary to severe sleep apnea. Most docs don't think about sleep apnea with skinny runner dudes, but it does happen. I use an APAP nightly, which seems to have resolved the A-fib and the sleep apnea. That said, not the most comfortable thing to wear.

Is APAP like CPAP? I have apnea as well, I wonder about the link....

For what its worth... wrote:

Diagnosed with A-fib secondary to severe sleep apnea. Most docs don't think about sleep apnea with skinny runner dudes, but it does happen. I use an APAP nightly, which seems to have resolved the A-fib and the sleep apnea. That said, not the most comfortable thing to wear.

APAP regulates air pressure up or down according to need to keep the airway open, CPAP is constant air pressure. APAP pressure stops upon exhalation, much more comfortable.

The pill worked after 6 hours and I ran the next day with no problems. I have 30 pills on hand now.

Stop drinking more than a drink a night and more than a couple nights per week. Eliminate caffeine altogether and sugar as much as possible. As you get older, the afib will get more frequent and harder to convert until one day, it won't convert at all. Make the lifestyle changes and your quality of life in ten years will be so much better than if you let it get out of control. You really don't want to be in afib 24/7 for the rest of your life. Itt's worth it to make the changes now before it's too late.

I had 2 electro conversion and 2 conversions by drugs to address afib episodes just before Christmas. The pattern prior to my episodes were these: high stress, ate junk food as a way to deal with stress, and then if I swallowed the "wrong" way, I would go into afib. I'm 56 and have run year round for 40 years. Since then, I have been able to control the afib episodes or self convert if I do the following. Get more than 8 hours of sleep a night, reduce my stress level, no alcohol or coffee AND make sure that I get at least 5 grams Potassium a day. At the present , if go into afib, I can self convert within 2-3 minutes by drinking 24oz of low sodium V-8 ... this gives about 2.5 grams of Potassium.

Re the C-PAP/A-PAP/Bi-PAP thing--

My old machine was labeled Bi-PAP and is what my sleep&lung guy calls it (current model has no title) It is programable with setting for inhale and exhale. Hit the 15 year mark start of the month-one of the lucky ones that deal with the mask easily. No smashmouth either but I spent a lot of time finding THE PERFECT mask and headgear combo. Working with my sleepguy to find a tightness level coupled with pressure setting that would find that elusive sweetspot of efficacy and comfort. At the time I started with him he just opened his own sleepstudy facility a block from my house- the sleep part of his clinic built slowly so he often he had an empty bed and I came in and worked with the tech to fiddle the pressures.

Long story but a-fib and apnea were just the tail of an event that had the MDs figuring I'd never live the hour never mind the night- he was on the team and when I came out the other end we became friends- much more doctor& patient- so I was lucky to get a chance few get and really work on geting the maskcomfort efficacy ratio in line.

Have a-fib also but that has been fine for 11 years---- the first 4 years were hell and I actually was on Cordarone at a loading level (800mg a day) for 3+ years plus the digoxin/waterpills series. Went to other drugs to get off the amiodarone but needed to be chemically and or electro converted umpteeneleventyfive times... back to 800 mgCordarone--- finally 40 or so month after all this started diltiazem 240 worked.

In the last 11 years I've had a few short-term and self converted episodes while awake and sorting apnea from a-fib during the rare times I have had a wakeup episode while on Bi-PAP impossible.