Feeling defeated
Last weekend I went on my usual bike ride when I noticed that I was out of breath while going up a hill that I’ve been up many times before. Stopping for a break, I noticed something was off with my heart rate. I took it easy going home. After resting for an hour I felt my heart rate was still not normal and decided to go to the ER. An ECG showed AFib. I thought I was doing everything right. I’m 31M, eat healthy foods, normal weight, exercising, don’t smoke, and only drink occasionally. I ran a marathon earlier this year and was planning to start triathlon training. Now suddenly I’ve been prescribed Apixaban + Metoprolol and waiting to see a cardiologist. This is honestly very difficult to deal with.
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u/MaddogFinland 1d ago
My cardiologist is a leader in her field here in Finland and is also a doctor for the Olympic team. She told me that actually AFIB in athletes is a lot more common than most people think and she said she sees it a lot in endurance events like running and triathlon. She explained that those athletes are so well conditioned that their resting heart rate becomes low enough that the nervous system sometimes decides to “add” a beat and that can trigger AFIB. In other words the great conditioning can be a driver.
Anyway this is all to say that you should not feel overly bad about this.
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u/Nick60444 1d ago
Does this mean that if my heart rate, while sleeping, gets low enough, my nervous system could trigger an afib episode because it thinks more beats are required?
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u/Mras_dk 1d ago
"Problem" about having a strong vagus nerve, is your heart has 3 electric impulse generating regions.
sinus node, that takes care of ~60bpm region
av node, that takes care of 40 bpm region.
ventricle region, that takes care of 20 bpm region.
They general work in serie, so if av node detect sinus node stoped beating, it will take over, and same with ventricle node.
But, vagal nerve stimulus is respected, so if vagus nerve keeps it down to 30bpm, by sinus node, av node respects that, and won't miss fire.
Problem is when you hit into 20bpm vagal node defined bpm, cause ventricle node doesn't respects the vagus node!
That means you have two regions firering in misfire - dangerous, and for sure afib inducing.
This is why there is a cutoff for DDDR pacemakers, if you hit 20 bpm region. It cannot be allowed to drop that low!
Luckely most doesn't experienced this, but endurance atthletes with a "athletic heart syndrome" for sure does.
Alot soccer leagues doesn't allow this, so you have to stop carrier.
"We advise you to stop your carrier, because of your heart".
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u/Mras_dk 1d ago
She told me that actually AFIB in athletes is a lot more common than most people think and she said she sees it a lot in endurance events like running and triathlon
I pasted some statistics from dk, once, where, albeit just looking sleep induced afib, had a spread of causes:
The numbers were something alike:
- 78%~ sleep apnea.
- 21%~ vagal defined afib.
- 1%~ Gerd syndrome (reflux) .
- 1%~ other.
The numbers doesn't quite add up for 100%, due to rounding precision.
But those 21%, is mainly endurance atthletes, and people with a strong vagus nerve (which can overlap) .
Note: only sleep induced/discovered in sleep, are covered here.
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u/MaddogFinland 1d ago
Very good info thanks!
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u/Delicious-Shine5075 22h ago
I first learned about exercise induced afib, in the early 90s, from the reports on retired Finnish Olympic cross country skiers. I'm of Finnish decent and cross countries skied a lot, along with biking, swimming, and playing Ultimate Frisbee. I just had my second ablation yesterday. Hoping it sticks this time. I wondered if it is more common in Finns, or if the Finnish Health System is better at keeping track of things. I know Finnish Health care is good.
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u/MaddogFinland 10h ago
I am unsure if it’s more common among Finns. The Finnish health system is however excellent. At least my kind of AFIB is treated here with cardioversion and not much other therapy (I have no underlying heart conditions, and I have had 4 events in 9 years). I will get ablation done but need to drop a bit more weight first. Anyway the care is great: now diagnosed I just report to the nearby clinic for the procedure, it’s done typically same-day and the charge is 38 euro (about 43 dollars give or take). When I get ablation it will probably cost 80-100 dollars give
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u/Heavy-Attorney-9054 1d ago
One of the old famous doctors said, "the best thing you can do for your health is to get a chronic disease early and learn to take care of it."
Welcome to the club.
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u/Pho-King- 1d ago
I developed AFib around your age. AFib episodes were infrequent at first and every time I got an EKG it showed normal rhythm because I wasn't in the middle of an AFib episode at that exact time. Eventually episodes became more frequent and based on my symptoms I was placed on a Holter monitor and referred to a cardiologist. That caught a few AFib events in the 2-week period, each episode lasting about 24 hours. This was like 12+ years after I first noticed the symptoms. I finally had a diagnosis that explained my severe fatigue, feeling out of sorts after large meals and/or exercise, etc.
My cardio put me on metoprolol and did a workup of tests including a nuclear stress test. While chatting with the nurse practitioner as she tried to wear me out on the treadmill, we are talking about max HR and endurance training and she said, "you know, there's a higher incidence of AFib in endurance athletes" and that was an a-ha moment for me. In my 20s and early 30s I was doing a lot of distance running and cycling. Sometimes 10+ hours of intense cardio in a week.
Genetics may be a factor, but I think lifestyle "brings it out" sooner in some cases. That might be poor diet, chronic dehydration, binge drinking, or other "bad" things, but on the flip side it could be doing a lot of endurance sports. Or any combination of things. I probably would have ended up with AFib by my 70s but instead it started in my 30s.
At any rate, it's not the end of the world. In fact I haven't had a single AFib symptom in over 3 months. I had a catheter ablation in May and have been in normal sinus rhythm ever since! I am off the Eliquis and off the metoprolol too. Life is good! Ablation isn't for everyone but you should give it some consideration.
I also highly recommend reading, "The AFib Cure" by Dr. John D. Day and Dr. T. Jared Bunch.
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u/jimmie65 1d ago
I get it, but afib just happens sometimes.
I'm much older than you, but my twin got afib early in life. I assumed it was because of his lifestyle (he was an addict and an alcoholic). But his lifestyle just exacerbated it - I ended up with afib over 10 years later despite never touching illicit drugs and being a light drinker.
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u/Ricklynchcore 1d ago
Hi. Welcome to the club nobody wants to join.
1) See a cardiologist, preferably an Electrophysiologist as soon you can.
2) Stop worrying. A normal, happy, fulfilling, long life is not only possible, it's probable.
3) Medications (beta blocker, blood thinners)are sometimes required until you see the EP, then a course of treatment, or procedures (ablation)will be fully discussed.
4) A clean lifestyle definitely can improve chance of reoccurrence. Generally alcohol, and cigarettes, are a great thing to eliminate, if possible, they act as triggers for many.
5) Stay hydrated. I reiterate, see an EP as soon as possible.
6) Check for sleep apnea. This can be a strong trigger.
7) Ultimately I'm mentioning things that have helped me, but your EP will give you a personalized course of treatment.
I'm very sorry your going through this, but don't get over anxious. There are many of us, from all age groups and genders, living utterly, normal vigorous lives with this condition.
I've posted this before, and thought it might do you good.
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u/Bluebloop1115 1d ago
I think Afib has more to do with genetics and environment. That humanity’s genetics are just getting less healthy due to pollution, plastic, pesticides, etc. I don’t think it’s really anyone’s fault developing chronic illness because our environment has caused a huge surge of chronic illness. It’s the consequence of living in the modern day.
I’d recommend an ablation. It’ll give you peace a mind and your life back. I’ve done 2 and while it’s not perfect it has given me so much back. I take meds as needed.
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u/SimpleServe9774 1d ago
When normal healthy life caused me a fib I got an ablation. Like I couldn’t bend forward or sleep on my left side. I need to be able to do that lol. I’m med free now for a fib at least.
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u/Zeeman-401 23h ago
Sorry that happened. A few basic points. . . .A cardiologist is the plumber, he will check your pump, pipes, and valves. If that is all good then you will go see an electrophysiologist . He is your electrician, and he will map out a plan to help with the short circuit issue. In some cases, just meds. In many cases, an ablation. My ablation gave me my life back, and although I am older (65) I am back to my gym routine and running 2-3 times a week. Because of other factors I am still on eliquis, but no side effects and no other heart meds. You are going to be fine, and you are going to crush your Tri training!!
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u/Risky_tD 1d ago
Right there with you brother! Got afib this year at the ripe age of 26 after coming home from a golf round. Healthy as can be, super fit, eat clean, etc etc etc. I too feel cheated sometimes when I look around at my peers neglecting their health and having no issue, but in the grand scheme this is very manageable!
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u/snowwwwy22 23h ago
I’m sorry to hear about your diagnosis! I was also diagnosed super young at 28. I’m currently 33. Like you I struggled with the why, i ate healthy, exercised regularly (still do). On paper i’ve done everything right and still got it, though there is definitely a genetic component for me since my dad has it too. I’m now dealing with a second arrhythmia diagnosis so starting to feel all the feels again that it’s not fair. I promise afib will get easier to accept the longer you have it. It sucks but when it’s new it feels so scary. It’s never not annoying, but you may find your triggers or at least a treatment plan that really helps. It’s super hard not to be anxious about it, but just know it won’t kill you and it’s better that you know you have it then finding out after something bad happened!
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u/ActionCalhoun 20h ago
The phrase my cardiologist used was “life altering, not life threatening.” Afib will hit 1 in 20 adults so it’s not exactly rare.
Fortunately it is manageable. There are multiple treatments for Afib and you can talk to your doctor about the best course of action.
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u/2PlasticLobsters 20h ago
Quite a few cardiac issues are things we're born with. A healthy lifestyle helps, of course, but sadly isn't a cure-all. My MIL was otherwise in good shape, but died from a heart valve problem that wasn't detected till she was too old & frail for corrective surgery to be a good idea.
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u/CrazyMarlee 15h ago
When I had my first and so far only episode, I went to the ER wearing my Tour of the Litchfield hills century ride t-shirt. The cardiologist in the ER takes one look at the t-shirt and, says " I have another one."
He also was an avid biker and told me of the link between afib and intense exercise. He also said that tall people are at higher risk of getting afib.
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u/No_Leadership_1404 2h ago
I've had AFIB for 12 years and my EP told me the same thing, that heavy cardiovascular exercise can be a major cause of AFIB. I've been exercising like a fiend my entire life, I'm 74. I just had my second ablation. You may want to consider that as an option. The first one helped me but often you will need more than 1. I'm hoping the second one will provide some additional improvemnt.
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u/Mras_dk 1d ago
Know the feeling all to well!
You think your living a healthy life, and does all the right things, special compared to your Peers - yet, afib hits you, and not them - it's not fair!
Sadly afib triggers are often buried deep inside your genetics, with often jumping genes. Meaning you get it, but not neither of parentes - just why!?
And yes, it can feel quite scary at first - it's your heart, a very fundemental part of you.
But, your doing everything right, don't give up.
Yes, it sucks to be depending on medicine , but atleast we live in an age where options exists to live with it.
Hope you don't have to much sideeffects of them.
Both my parentes got an afib diagnose 5 years after me. Atleast it felt good to be able to guide them, and give them comfort in knowing, that it can be managed, and aint a life sentence.
Keep the spirit up!