High Heart Rate - 226 BPM ???

[Alexandra]

Ian, I've just done the reverse. 14 months of being clear and in the process of getting running fit again, It only took about 20 metres of running with the beagles and I knew I'd tripped into AF on Friday afternoon.

Alexandra, how did it go earlier this month? Did you manage to fight off the warfarin and beta blockers?

Chris, I'm really sorry to hear about your "incident". I'm so grateful that my sort of AF almost always happens in the middle of the night or early morning, so that I wake up in trepidation, check to feel if my pulse is irregular, and if not, get up VERY CAUTIOUSLY. If I can get as far as breakfast without problems, I'm probably in the clear all day. The sort that is triggered by effort must be heart breaking - on the edge of a precipice the whole time.

Well, I went off to France as planned on 1st September, against the advice of the specialist nurse, did lots of strenuous stuff at altitude and have had no further problems to date. I saw my specialist recently for a checkup, and was delighted to find that he was not particularly impressed by my fainting fit (maybe he'd have reacted differently if he had seen my black eye). He was more worried about the fact that I've had 7 incidents in 2011 - far more than ever before. He wants me to try Flecainide next attack, in hospital, and then go onto it daily. From the way he spoke, he would only recommend Warfarin if I had continuous AF. Flecainide works to stabilise the heart rate rather than lower it like Beta blockers. I'm still hoping to use it as a "pill in the pocket" rather than take it all the time, but it all depends how often I have attacks in the future. Of course I am racking my brains trying to work out exactly what triggers them so I can avoid it. There are links to changing position, especially from horizontal to vertical, going to the loo and slow heart rate. Also to sleep apnoea. I am getting a responding splint to stop the latter.

It's very odd, isn't it - one feels fine and yet any day it can strike again. When I'm not having an attack I can't believe I'll ever have another. However, I was reassured by the fact that recently, running a 10 mile race, I sustained an average HR of 150 for 2hrs 5 minutes without feeling distressed. So the incidents have neither damaged my heart, nor are they as shocking for my heart as they might be were I an inactive person.

Did they try Flecainide on you other times before resorting to zapping?

Finally, this has taught me that, helpful as Nurse Specialists are, they are not Consultants and don't know as much. If I had heeded the advice I got from the Nurse Specialist I would have sacrificed my wonderful holiday - for nothing.

Good luck!

[Chris K]

Can't find any links to my episodes, but they have all had a constant rate, usually higher than this one. Yes I tried Flecainide (I have it written down as Fleccanide?), I think in 2005, but didn't feel quite like myself running so (with consultation) stopped after a couple of months, and felt much better. I also had a spell with Warfarin, but so pleased to drop that as it was a nightmare trying to stop small scratches (I work mostly outdoors) from bleeding! Asprin is not so bad.
Staying active is what I do too, though must admit my walk today was very steady, I always feel as though I've a couple of marathons in my legs after zapping and felt no desire to run or cycle today!

[Alexandra]

I wasn't sure either of the spelling of Flecainide, but that's how Wikipedia spells it. I suspected taking it regularly would have side-effects, and shall resist this as long as possible - but if the attacks become too frequent I may have to give in. I'm hoping to take it just as a one-off zapper.

I think our maladies are very different. However, I too feel fairly rubbish after an incident, and even worse after taking just 5mg of Betablocker, which I am told is a very low dose. The day after taking it my HR is stuck at 77, which means I can't do any meaningful exercise, I get out of breath walking up the stairs. And the day after that is nearly as bad. So every attack takes 3 days out of my exercising life, except that I can do weight training, which cheers me up.

Interesting that you get a constant HR. I get a wildly fluctuating one. I take Omega 3 fish oil and eat oily fish to thin my blood a bit, as I am terrified of strokes. I monitor my intake and side effects and when eg I started getting nosebleeds I cut back a bit. I can't take aspirin as I have digestive problems (AS WELL!!!) It's very interesting to compare notes. You have been living with this for longer than me - I started in 2005 with one incident where out of the blue my HR went up to 200. You can imagine how alarmed I was, but the GP I saw told me to go home and stop fussing!

[IanDarkpeak]

That'll be a case of one up and one down..........so glad you've got back to full hard training/racing (you just can't hold a good tigger down!) Ian, I've just done the reverse. 14 months of being clear and in the process of getting running fit again, It only took about 20 metres of running with the beagles and I knew I'd tripped into AF on Friday afternoon. Tried everything I could to get back into gear, still went out for a pre-arranged dinner with friends, but eventually had to give in to the constant resting pulse of 130. Ambulance service (crewed by one of my cycling buddies), Carlisle A&E and the cardiology unit were brilliant. A couple of drug tests, mechanical bits checked then straight in to be 'zapped', pulse back to 44, back home Saturday afternoon...........knackered! Now its back to recovering energy and then daring to raise the pulse up to see if it comes down again. So I daresay I'll be back to the Freeman in Newcastle in the not too distant future. Could aim for last place at Dunnerdale, as a comeback run?
Alexandra, how did it go earlier this month? Did you manage to fight off the warfarin and beta blockers?

Sorry to hear this Chris, It's not good to hear.

I got zapped by an electric fence today, quite a shock I can tell you but luckily it didn't trigger any thing. Hope you can get it sorted

[Chris K]

Electric fence Ian..........I should have tried that one before going to Carlisle! Yes I'm gutted, but I'm looking forward already.
Alexandra, mine goes back to 1997, beta blockers have always been 'offered' as a treatment, but there is no way you can exercise properly with it in your system. Flec (whatever!) I think would be less intrusive and with your irregular AF could be a better alternative. But for all of us, it seems the level of fitness helps us recover more quickly?

[Chris K]

Well, with a couple of good long training rides in, and heart rate good and stable, I've entered a sportive bike ride this weekend. Hope everyone else is 'behaving' at the moment!

[Mike T]

I wasn't sure either of the spelling of Flecainide, but that's how Wikipedia spells it. I suspected taking it regularly would have side-effects, and shall resist this as long as possible - but if the attacks become too frequent I may have to give in. I'm hoping to take it just as a one-off zapper.

I think our maladies are very different. However, I too feel fairly rubbish after an incident, and even worse after taking just 5mg of Betablocker, which I am told is a very low dose. The day after taking it my HR is stuck at 77, which means I can't do any meaningful exercise, I get out of breath walking up the stairs. And the day after that is nearly as bad. So every attack takes 3 days out of my exercising life, except that I can do weight training, which cheers me up.

Interesting that you get a constant HR. I get a wildly fluctuating one. I take Omega 3 fish oil and eat oily fish to thin my blood a bit, as I am terrified of strokes. I monitor my intake and side effects and when eg I started getting nosebleeds I cut back a bit. I can't take aspirin as I have digestive problems (AS WELL!!!) It's very interesting to compare notes. You have been living with this for longer than me - I started in 2005 with one incident where out of the blue my HR went up to 200. You can imagine how alarmed I was, but the GP I saw told me to go home and stop fussing!

So 5mg of a beta blocker - presumably bisoprolol - takes several days to get out of your system - interesting.

[Alexandra]

Well, with a couple of good long training rides in, and heart rate good and stable, I've entered a sportive bike ride this weekend. Hope everyone else is 'behaving' at the moment!

WHAT good news, Chris! What procedure precisely did they do when they zapped you? Having had 7 episodes in 8 months in 2011, the last 2 worryingly close together, I have now managed September & October without any. Long may it last! This demonstrates how unpredictable the problem is, and how hard it would be to evaluate any treatment. If I had been put on regular prophylactic beta blockers or Flecainaide the medics might now be claiming that the treatment was a success.

I listen regularly to a running podcast from the US, "Lost Trailrunner" and in the latest episode Ron discusses his AF. His cardiologist has put him on regular beta blockers, he doesn't mention the dose, and he reckons he is now running 1 minute per mile slower as a result (down from c. 8 minute miles to c.9, if I remember correctly). Thinking about his plight has made me appreciate the NHS - my cardiologist can happily talk of getting me into hospital for a transfusion of Flecainide, Chris could get zapped, and Ian has had goodness knows how many hospitalisations and procedures, all without worrying about the cost. In the US at best we would be worrying about using up all our insurance cover.

[Chris K]

Yes, chuffed to bits to have 'tested' recovery after exercise. Ahh the zapping! Basically its the DC cardioversion, after anesthetic, and acknowledging the risks, one shock is enough to stop me and revert to normal sinus when the heart starts again. Did have a slight concern this time as I had nine medics in to observe the treatment.........just as I was about to go under, I gathered this was a 'first time' for the young doctor, being observed, about to deliver the shock!

[Alexandra]

My episodes of AF have all been at night or first thing in the morning, when still in bed or on getting up. The last was at the end of August 2011 and since then I have been given a mandibular responding splint to wear at night to prevent sleep apnoeia (which can trigger AF). After 4 months without an attack I was hoping not to have any more.

BUT today about 7-8 miles into my 12 mile run my Garmin began showing alarming readings with maximums up to 200bpm and an average for over a mile of 151. Before this, I was averaging mostly 120-130 with a max of 132, which is what i was aiming for. I wasn't feeling super-fit on this run, but I wasn't aware of palpitations or of feeling bad when my HR went up. I was able to go on running, though anxiety caused me to run more slowly. If I hadn't been wearing a HRM I wouldn't have been aware of a problem, except of feeling tired, which is not abnormal for me on a 12 mile run.

This evening I do feel rather tired, but again perhaps as much from anxiety as anything else. Since my HR is now completely normal, there is nothing to be done until/if it happens again. I am wondering if there is any chance this could be an expiring battery - but it seems rather a coincidence. I'd welcome comments.