Running with AFIB or After Ablation

I’m 54 and I had the ablation procedure May 14th. I was in atrial flutter continuously for 8 weeks prior to the procedure that prevented me from running. I was diagnosed with AFIB in Nov 2012 and was put on metoporol. Metoporol didn’t help so I was switched to propafenone in Feb 2013. I couldn’t train consistently since lst November so I was pretty out of shape by time I had the ablation. Luckily no AFIB since the procedure. I am still on propafenone since the ablation. To answer your questions:

-I haven’t run with AFIB after the procedure. I told myself if I went into AFIB I would stop running. I feel that AFIB begets AFIB and I don’t want to get back to where I was before the procedure.

-The propafenone limits my heart rate. It takes 5-10 minutes to get my HR over 120 bpm. I still have a tough time getting HR over 140 bpm but as I said I’m pretty out of shape (more legs than anything).

-I wear a HR monitor. Before the procedure I would watch for spikes (10-20 bpm increase within seconds) and back off. Now I use the HR monitor to gage fitness and tiredness. I’m down to 9 min miles with HR around 135 bpm. If I’m tired it’s 135 bpm at 10 min miles.

-Just 1 ablation. Meet with the EP in a couple weeks.

-As I said above, I won’t run when in AFIB after the ablation. Ease into it and the the heart heal and let the meds do there job.

Just a note, my EP told me my procedure was “boring”. No surprises.

Good luck. NSR is the way to go.

Thanks hamdog for the GREAT information! I guess the heart meds tamp down the heart rate and id a contributing factor to getting tired asd well. At first I was adverse to taking the heart meds after but as another Afibber pointed out to me, the heart is going to be pissed at me right now for burning it and "acting out" so it makes sense to keep that under control. I will definitely take your advice and ease into it.

BTW, I read this write up to stay positive:

www.afibbers.org/resources/journeys/Weisenthal.pdf‎

;

Not everyone is the same as this guy of course but keeping my fingers crossed since the guy has the same EP as I have!

Thanks snowshoedude. I was pretty impressed with the EP, Dr. Katsiyiannis at Mpls Heart Inst. so I've followed his instructions as best I could. I finally ran with my running pals over the weekend. They dusted me on a big hill 2.5 miles into the run but my heart rate was NSR. It's like Pete Magill wrote in Running Times "You get there sooner by going slower" (something to that affect).

I am 49 years old, had occasional A fib and flutter over a period of 2 years. Before this happened, I was running half marathons in about 1:40 without training very hard. Training with occasional bouts of AF, my race time slowed to 1:50 (again without training very hard because the rhythm control drugs decrease cardiac output and maximal heart rate. Did I mention that I study cardiac arrhythmias as part of my profession?).

One year ago I had an ablation procedure (pulmonary vein isolation in the left atrium). I started running after about 3 weeks (with my EP's permission) and jogged short, slow distances for the next 3 months while on rhythm control drug. I went off the drugs, started to feel better but had a few short episodes of AF. These mostly disappeared 6 months after surgery while I was running 20 miles per week without drugs. But, an ECG showed that there was a small remaining pathway that might occasionally cause recurrence of AF. (A second touch-up surgery is often done in cases like mine. I have so far chosen not to have it since I've had only 2 episodes of AF between months 6 and 12 after the initial ablation.)

What about my running? I feel like I have lost close to a minute/mile on my previous pace. And, my peak HR has decreased (from around 190 to 180).

Ablation procedures usually do some damage to the autonomic nerves that control heart rate. A successful ablation will raise your resting heart rate by as much as 25 bpm. Mine went from low 40's to mid 60's right after surgery. Nerve damage doesn't regenerate but there is tissue remodeling in the heart that occurs over a period of about a year or so. My resting HR is now down in the low 50's.

One year out, I am very pleased that I no longer have to worry about AF, but I will admit that the surgery has slowed me down a little bit. I would definitely do it again, but I wish I had known what to expect after the procedure and healing is completed.

It is good and sad to read these notes on running with afib. I think it takes time for ONE that has had an ablation to mentally be set with what has happen.

The ablation will make you stronger in my opinion, it does take a bit for the process to set in. To me its more a mental thing than medical.

I am 58 had 2 ablations and now have a pace maker. I am still running and only slowed when I was scared I might POP OR BLOW something and ruin what had been done to me.

I am now back to where I one was and it all started once I was not scared of the WHAT IF.

So my advice is to get back on the horse that bucked you and go for a ride.

Found an old thread on ablation and wanted to chime in to see if anyone still follows this.

I had my ablation in March of 2017. 6 months later, I am still not close to where I was before the ablation, I have heard it can take 8 months to a year.

After 4 months, I was slower and could not go on a run longer than 6 miles, but still feeling ok about everything as the last AFIB episode occurred about April. About a month ago, however, I started to have a few odd episodes that are not at all like the paroxysmal AFIB I was getting prior to the ablation. Much shorter lasting, sometimes just for a 5-minute span during the day. It almost feels like I miss beats or it just gets slightly off kilter, not close to the randomness prior to the ablation.

I have slowly increased the mileage from nothing for a month after the ablation up to about 22-24 miles a week with a gradual increase since I started back. Pace has been about the same, and has mentioned by a previous poster, I am easily a minute per mile slower. My max is a 5-6 mile run and a couple times I inadvertently did not slow down to 8 min pace (typical has been 7:45 pace after ablation) and that typically leads to an hour of lightheadedness or that funny off kilter heart beat.

Am I headed for a second ablation because the first one failed?

How are you doing 3 years later? I had a ablation 8 months ago and I am still not running well> before the ablation I ran a 19:53 5k now running under 9 minutes is hard.

Hey Michael -

I had an ablation for afib 9 months ago. I have been in sinus since, but my run times are slower. They are inching up but like others I feel like I'm a minute or more slower per mile. Months pre ablation I was at a 20 min 5k and a couple weeks ago I did a 24 min. My EP suggests it is lost cardio fitness from all the time leading up and that I can get it back. I've been trying to do VO2 max efforts and build cardio base to get back. Has it improved at all for you in the last four months since your post?

Just curious, do you have to take an anticoagulant and if you do, do you feel different than you did before you began taking it?

I’ve had paroxysmal a fib for about 25 years. I take Prophanone 325mg twice a day. Initially episodes were months apart initially and would almost always occur around the first 3/4 to 1 mile. Sometimes I would have an episode from getting caught in a cold wind after breaking a sweat a couple of miles into a run. 99% of the time, if I have an episode, I’m done running. It’s very uncomfortable and I can barely jog. I have had about five episodes where the intensity has been strong enough that I barely didn’t pass out from suddenly reduced blood flow.

I’m 62 now and when I was 58 I had a good stretch of about six months of consistent training with only a couple of episodes. I was able to run a mile in a meet in 5:37. It was the first race in about 6 years. I had four more races planned over the next two months with expectations of improvement. I had my six month checkup for afib the week following the race and my Electrophysiologist thought he heard something and referred me to another specialist. The next week after a echo and cat scan, they found I had a bicuspid aortic valve rather than the normal tricuspid valve. This caused my ascending aorta to distend. Normally this progresses to needing heart surgery to replace the valve and aorta segment. So, all racing was out of the question as well as any speed work because it could rupture my aorta. So I have been on and off running two to four easy miles a couple of days a week since then.

I just had my four year checkup last week and my valve and aorta have not changed. The Dr said I am extremely stable and this may just be the way my heart is. I am getting an ablation done on the Tuesday before Thanksgiving later this month. I am hoping to get back to running more miles without afib. I don’t plan on racing agar this point but if my heart continues to be stable it may be ok, just no marathons.

Blood Pressure pills are way off

I'm 60 years old. Been running since I was a teenager, with a couple of decades off somewhere in the middle. Was doing 50-60km a week and planning to train for the (subsequently canceled) Berlin Marathon before Afib symptoms came on in April.

I had my second (RF) ablation procedure about 10 weeks ago. The first was a cryo-ablation 4 months before that but didn't work: still had the paroxysmal Afib symptoms even after coming out of the 3-month "blanking period." I took a 2-week break from running after each of the ablations, which is what the EP recommended. After the first ablation, I found running hard. Now, after the second, I find running very, very hard. It's strange: like I'm breathing far too hard for what my heart rate is. I'd normally have a lactate threshold pulse of about 160-165 and I'm pretty experienced and would recognize it even without knowing my pulse. Now I can be at 130-145bpm and I'm huffing and puffing as if I were sprinting. It's like there's a complete disconnect between my heart rate and my breathing. This is at a pace about 40 sec/km slower than my pre-ablation slow (zone 2) pace. And I can only do short distances, even after working at it for weeks. Where my base runs used to be 12-13k (doing maybe 60km a week), now I'm doing 3-5km at slower paces and breathing really hard.

I've been on an anticoagulant (edoxaban) since the first procedure, even though I've got a low CHADS-VASC score (1).

And it seems nothing is improving. It's like: I go out running and it never gets any easier and I'm breathing hard every time. It's really discouraging. I know I have to be patient, but I'm fearful my running days may be over.

Anyone been in a similar situation and have any encouraging words?

I'm 72, one week out from ablasion. I read your comments from 3/20/20 and prior to my procedure I was having symptoms like yours. I have a pace maker (2018) which appeared to be the fix to my running related difficulties but similar symptoms returned in 2021 which led to the ablasion. I have not done any running yet, only long slow walking. I hoped to regain some runs in about mid May. Please reply with any updates to your condition. Thank you!

I too am 60, ran in high school track (4:35 mile/9:52 2-mile) & XC. Also ran and trained post high school in my early 20s with PRs in the 10K (32:56) and 15K (50:57) and Half marathon (1:17). I also took a few decades off of serious training, put on some weight, and began to train actively again around the time I turned 40 (2000), but in triathlons. Did many half-ironmans, and later 5 full Ironman races during my 40s with a PR of 11:30. In 2010 I switched to just running and in 2013 developed Atrial Flutter (Right ventricle issue). Still, it was very rare/intermittent and I trained about 75 miles/week for about 6 months. I then ran my marathon PR at the CIM marathon in 2013 of 3:05 at age 53. The flutter became more frequent and in 2013 I had ablation surgery in the spring when it was getting bad - but not persistent. I was told it may come back as AFIB, not A-Flutter (spoiler - it did) with a 50/50 chance. Nevertheless, I continued training with the sub-3 marathon as the elusive goal. I ran masters XC and did significant tempo/speed work but was not running the same speed/volume. I did a 41:10 10K in 2016 in the spring and pushed a bit harder through the summer. In October ran a 1:28 half marathon at the RnR half in San Jose for a AG#2 in 55-59 group and in November NYC Marathon in 3:23 - a disappointment.

I had moved and had a new job by 2017 and was training much less, but still running - but now slower again, and lower volume. I was traveling a lot and still running, but not competing again yet. However, I had developed full blown AFIB and it was not a 4-5x/month rate of bad conditions for which I took flecainide and metoprolol and could not run for a couple days afterward. The frequency increased and by 2020 it was 2x/week. By mid 2021 the incidents were now frequently daily and more like 50% of days in the month rendering consistent training impossible. Now, at age 60 my running was more like 20-30 miles/week on all days w/o AFIB. I typically ran 5 miles around 8:00 - 8:30/mile, with some runs about 7:45/mile.

I finally had a second Ablation operation this past week. The cardiologist and a couple members of his staff were runners. When they discharged me yesterday they told me “don’t run anymore, but if you must, keep it at a conversational pace.” I’m on blood thinners and an AFIB medication - Tikosyn.

This is a replacement for Flecainide (which I disliked taking about as much as the AFIB itself). So i’ll keep posting. Conclusion: you can still run competitively after ablation surgery - but - you’ll continue to contribute to the Atrial Fibrosis caused by tempo/speed work and may trigger more AFIB.

A couple weeks ago, I didn't even know what Atrial Fibrillation was. Now I am the latest addition to the afib club.

This thread has been really helpful in understanding the condition from a runner's perspective.

In my mid 40s, I was running 5k in the mid-16s.

I am late 50s now and haven't raced in 10 years. Been really struggling with runs lately and figured it was just lack of fitness or conditions.

Just got an Apple watch with an ECG function. It shows I am in constant afib with high heart rates. This was confirmed with a lab ECG and Holter monitor.

Now getting various tests done and will update the thread when I know more - might help the next one up.

Follow up - after 5 months of intermittent running i've concluded that either the dofetilide or the ablation surgery has really slowed me down and made running faster than 8:30/mile challenging. still trying to "ramp up" but it's not been easy and i'm stuck around 20 miles/week with some biking and lots of walking. Very depressing....could also be older age (now 61). I'm hoping I'm taken off dofetilide next spring, but until then still jogging.

good news: not a single incidence of AFIB since the ablation and while taking the dofetilide.

Hi bupkis - I think we're in the same boat. I think the 1:28 half marathon I ran a few years ago at age 56 may be the last "fast" race i'll ever run. There are simply no "good" days any longer. I've been running a few 10 milers once a week - the last one a couple weeks ago. The same pattern every time - takes me like 3 miles just to warm up at 9:30/mile, but, by mile 10 I was running 8:10/mile and the same (low - 120) HR.

just keeping hope alive! Best luck to you. Hope your running has improved or become more tolerable.

Thanks for linking here from my thread. I fall within the category of a fairly intense masters runner; running since 1971. Not high mileage but fast training. Some of my PRs are comparable to yours, plus a 2:48 NYCM at age 50.

Some are mentioning knowing when they are going into AFib. I don't recall anything like that. Just the inability to run more, as I say, than 2.5 miles and being unable to understand What Was Wrong. Now it seems I know.

Thanks. I'll keep following this.

Add me to the list of afibers. I'm 56 years old and have been running races since the 70's. My afib has been a major problem for the last ten years, but it may go back even further because in retrospect I had some terrible races which had all the signs of afib. Doctors said it was exercise induced asthma. Wrong diagnosis. I just didn't know what it back then and thought I was dealing with asthma as the doctors told me. It's been in these last ten years that I know all about the condition inside out due to so much research. 2004 was my last marathon because I went into afib during the race. I didn't completely know was happening, but I knew it was something to do with my heart. I could feel my heart pounding. This would only happen during races at that time. As years passed, I would get afib attacks while just sitting around. I've been able to control it somewhat with lifestyle changes and medication but ultimately it seems like a futile attempt. Ablation seems like my last option to control the attacks and get back to life and running competitively without this burden. My main reservation about the surgery is will it work or make things worse. From reading posting of others who have had the ablation surgery, it seems like a roll of the dice on whether it will work or not. I've heard some who say it was the best decision they made, while others are still struggling with afib attacks. I'm eager to hear any further thoughts about the subject of afib and/or ablation as a treatment. From some of my research, there is a newer ablation procedure called radiofrequency ablation which is more precise to target bad pathways without damaging surrounding tissue. Not sure when it will become more readily available nationwide. There was also a research study using a Tens unit to stimulate the vagus nerve attached to the ear. It was said there was an 85 percent reduction if afib attacks at around 6 months. Advancements to treat afib keep happening so hopefully there is a better cure around the corner.