Returning to training after Atrial Fibrillation and Cather Ablation?

Training
1

I’m currently at home recovering from a catheter ablation. Sadly I developed an infection/fever which kicked the heart back into A Fib. So step 1 is to get it back into sinus before thinking about training, but hey I can start to plan!!

I’m 51 and would class myself as pretty fit, I’ve done various sports all my life, field hockey, and various other sports inc gym classes etc.

About 5 years ago I started doing more serious cycling and longer and longer distances even doing the UK Coast to Coast in a day 250km ride in 2014. All was good, if I look back at that ride my max HR was 186bpm at the top of a renowned climb called Hardknotts Pass.

However during 2018 I noticed my monitor sometimes reading HR over 200. Despite no other symptoms something wasn’t right so I got checked out, inc a day with an ECG. That diagnosed Atrial Fibrillation but only under extremes of exercise, and with no other symptoms and no discomfort the agreement was to do nothing, but keep an eye on it.

Over time it got worse and I noticed myself out of breath when simply walking my dogs, an elevated HR of 165 bpm at the easiest of jogs, and went back for further tests. I wore the ECG for 3 days and concluded I was now in permanent A Fib. I’d continued to train, but trained wisely with a coach, so easy days were easy and I’d perhaps do 3 hours of very hard work spread over a week.

I also started doing triathlon at the age of 50, so I was no longer doing the long 6 hour bike rides, more shorter stuff, and adding in running and swimming.

Due to my age and my low resting HR, we decided an ablation was best. I had the op on Thurs 7th Feb, it took longer than expected, the consultant had to cardiovert me 6 times and after he’d fixed the A Fib on the left he found flutter in the right so also fixed that.

All was good, stayed in sinus all night in the hospital and I tested at home the day I was discharged and was still in sinus. Then I started shivering uncontrollably around 9pm, rang the hospital who told me to ring 999 and get to A&E! I was tested by the ambulance who said I was back in A Fib and had a fever with a temp of 38.3

I stayed 2 nights back in hospital and was discharged again on Sunday, a phone call yesterday said they’d found signs of an infection on the chest X Ray so I am now on antibiotics. My temp appears normal.

Now I’ve read the Haywire Heart book and done plenty of googling, it’s clear that there is mounting evidence that endurance sports do seem to enlarge the heart which could potentially cause these electrical issues that lead to A Fib. I wouldn’t say I’m 100% convinced that it is purely down to that, and would like to see and read more research.

I’m back to see the consultant next week to agree my next steps.

However I do enjoy exercise, I intend to carry on playing competitive hockey, that doesn’t seem to make my HR peak even with A Fib.

The reading and research I’ve done says I can continue to exercise once the heart is sorted, but I should cut back, which I am fine with doing. Exercise for me is important, but a gentle ride or jog in the countryside is going to be fine.

What I’m not clear on is it “long” endurance work that stresses the heart and causes the long term issues or would short high intensity workouts cause similiar issues?

The consultants I speak to say they see this a lot in marathon runners as an example.

Sorry for the long winded post, but I’m keen to hear from others who have had similiar and returned to regular exercise.

What did you do before, and what did you do after?

Did you change anything?

Is anyone out there still competing, ie 10km runs, Triathlon etc?

I’m wondering whether a TR low volume plan might be something to aim for if I decide a full on coach is over the top?

Finally some things I’ve found useful.

I bought the Kardia ECG monitor and that has been very useful in keeping an eye on if I am in or out of A Fib, and my consultant and another one has said they agree with it’s accuracy.

This is the book I referred to: The Haywire Heart: How too much exercise can kill you, and what you can do to protect your heart

by Amazon.co.uk

Learn more: amazon.co.uk/dp/1937715884/…

and some more research I read (which I think is also referred to in the book)

ncbi.nlm.nih.gov/pmc/articl…

6 Likes
2

Good to hear you’re doing well. I suffer from lots of pvcs and pacs but just ignore them as they’re benign. The only problem I have is that occasionally they kick off an episode is PSVT which in my case are also benign. I’m always able to kick it back into normal rhythm by using the vagal manuever.

1 Like
3

Thanks George and hope your symptoms stay manageable. I’m off to see the consultant Tuesday for next steps.

2 Likes
4

@kitenski
Keep us updated on your improvements

1 Like
5

I have not read the book but I have live through Afib. Had my first episode on the bike 10 years ago in my 40s. Thought it was nutrition or hydration issue. I could feel a flutter but after a 15 or 30 minute spell it would go back to normal rhythm. Lucky I have a wife which nudged me to get it checked out by a doctor. Long and short is that I had lone afib and had a pulmonary ablation surgery. I was lucky and the procedure worked. As you know afib is not a one size fits all type of solution. Per my doctor, he was ok with the exercise within moderation. Didn’t do hard intervals or anything to spike the heart rate. All just nice endurance rides with the longest around 2 hours after several months of riding. You really have to listen to your body. After about 2 years went back to racing with no issues. Since that time I’ve completed Dirty Kanza, Ironman Triathlons, and crit races. Im currently 53 years old. I agree with you on using the heart rate monitor during your rides. In fact, I used my hrt rate data to show my doctor what my workouts were like.
Good Luck with your recovery and listen to your body.

1 Like
6

That gives me hope, thank you!

I saw the consultant last night, going back a week Thursday for a cardioversion. Which is basically electric shock! Start on some drugs over the weekend. Hopefully the 2 things get the heart back into rhythm

1 Like
7

Glad you’re recovering. Hope you continue that beautiful sinus rhythm.
My story is quite the opposite of yours. I was in my early 20’s and had never done any type of endurance sports. I played a little basketball on the weekends, but that was about it. I began to experience shortness of breath and fatigue just during my day at work (physical labor job). After setting a Dr. appointment for the next day the breathing difficulty got much worse. I ended up going straight to the doc. Admitted to the hospital w/ severe a-fib and was able to be drugged back into rhythm. By the time I was 32 I had been admitted three times and had two cardioversions. They could not find any reason to do an ablation and I had basically quit any type of exercise or exertion out of fear.
I finally got fed up with getting old and fat and bought a bicycle. After just riding for fun for a year or so I started racing. Talked to my cardiologist about my activity and heart rate data. Right now I’m 41, I train 6-10 hours per week depending on the time of year. I race cat1 in our state mtb series, cat3 cx, and do 50-100 mile races throughout the year.
My condition is drug regulated. Only one medication and adult aspirin daily. No bp issues and no recurrences for almost 10 years now.
All that to say I didn’t start endurance sports until after I was already diagnosed with a-fib. I’ve not had an ablation, so I’m relying only on meds to keep me in rhythm and I push HARD and so far I’m still kickin’.
Best of luck! Finding the right cardiologist is helpful. Most of them think you’re crazy when you tell them you want to race bicycles

3 Likes
8

I’m curious how you’re getting along. I’ve been reading back through some of these threads on afib, ablations, and other heart issues due to my own catheter ablation two weeks ago. Are you back to training? Have you noticed a difference in heart rate?

9

bit of a long story, but all was good, training as normal, then it came back in July. So had a 2nd ablation in oct.

Back training again, doing a TR low volume plan which I started in November. Hit a max HR of 194 playing field hockey last Saturday! My resting HR is higher than it was at “peak” fitness, but I’m also not seeing the crazy 220bpm readings I was getting when I was getting A Fib episodes.

After my first operation (which took 6 hours) I don’t think I got back into training for 3 months, the second op was much quicker so the consultant said I could get back into training sooner.

From memory all I did 2 weeks after my first ablation was some gentle walks, keeping an eye on my HR and keeping it under 124 even when walking. I also had all sorts of A Fib episodes over the 3 month period which they call a “blanking period” and warn that all sorts can happen!

good luck, happy to share more experiences etc if you wish.

10

@heypoolboy78 how long did you wait to get back on the bike. Just curious how long you waited and how it felt on the groin.

11

I started with Baxter and Collins first at day 15. IIRC the groin didn’t feel bad, out my heart felt a little funky for a few rides.

12

Thanks for that, had ablation three days ago, itching for a gentle indoor ride already but very worried about starting bleeding. Too two days to stop. Will restrain for a few more days. heart defo feels funky, good description.

13

I was told it can take up to three months for the heart to fully recover from an ablation, so take it steady and keep a eye on it!

14

I had an ablation just over a year ago. I was able to start some easy rides after 3 days. My groin was tender but after 10-14 days it felt better very quickly. I had occasional afib episodes for a few months but they were never as bad as before and resolved very quickly. The last one I remember was in May, so don’t be too concerned if you have episodes past 3-6 months.

1 Like
15

Thanks all. Day 12. Tried to walk at least half an hour a day since day 4, and low intensity cycling. Gradually increasing the cycling but finding I am very quickly fatigued and exhausted after a moderate hour on the bike. WIll persevere at gentle pace and see how this progresses.

1 Like
16

I’ve had my ablation a week ago. Apparently it was an easy procedure and I feel fine at the moment.
I haven’t started training as I don’t want to rush too quickly. I might start doing a few gentle run or bike soon but I’ll play it by ears.
According to this post Ten things to expect after AF ablation – Dr John M resting heart rate can be higher than normal. I very much see that myself… I’d say 20/25 beats more than normal. I’m curious to see if that was the case for anybody else and if yes how long it took before coming back to normal?

1 Like
17

I don’t even remember what “normal” was. Medication had kept my hr under control and even abnormally low for so many years. After my procedure I know it was 8 weeks or more before my hr seemed to be in a range that I would describe as normal.

18

I seem to remember being told it could take up to 3 months for the heart to fully heal from the ablation!

19

I’ve never taken medication but I share the same feeling that I’m not sure what normal is or should be anymore…

20

My specialist keeps reminding me that even though recovery on the surface is quite quick… Having an ablation is still a MAJOR procedure and it needs proper healing.
With that bein said he also told me that in 4 to 6 weeks I could be back to the same training regimen as before :slight_smile: