# Cycling after AF ablation



## DaveGM (7 Jan 2016)

I had a ablation for atrial fibrillation in 2014, and was signed off by my Electrophysiologist (Cardiologist who specialises in arrhythmias) in June 2015. I was encouraged to take some exercise and decided the gym, jogging and swimming were not for me.

I decided to buy a bike partly with the expectation that it may have one outing and then find a permanent home in the garage.

To my surprise I really enjoyed getting back on a bike after an absence of 40+ years since being a teenager!

I gradually and slowly built up distance to about 20 miles ( at a modest speed) until the wet and windy weather started in December.

I don't want to overdo it and bring on a return of AF, so I was wondering if there is anyone else out there who has taken to cycling in similar circumstances, and how are you getting on?


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## Colin_P (7 Jan 2016)

Yes, me and a chap called @Yorksman.

I suffer from ventricula tachycardia with small bouts of AF. I've had one attempted / failed ablation.

I have an ICD (Implanted Cardioverter Defibrillator) in my chest which is a last resort, my arrhythmias are managed with drugs. I managed to cycle over 2,000 miles last year. Cycling is completely normal for me, I just do it slowly, not that I the choice of going fast.

By the way AF is very successfully treated and is quite safe arrhythmia as far as arrhythmia go.

The most important thing though is to know that you are not alone.

You might want to have a read of this thread;
https://www.cyclechat.net/threads/any-survivors-on-here-cardiac-arrest-heart-attack-cancer.164623/


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## ozboz (7 Jan 2016)

To be honest I just had to google your condition to find out what it was , there is some history of heart probs in my family, I began cycling for fitness three years ago I am now 63 , my resting heart rate is lower than 60 now , and an excellent recovery rate after pushing up hills at a good speed for me , best thing I have done for years cycling , also as I am getting in to it more now it's becoming an excellent hobby , got myself a very old frame and plan to have it all restored up and running by April ,a single speed for local riding , Can't wait !!! 
Hope it works out for you !


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## Brandane (7 Jan 2016)

I have suffered with AF since my teens (unknowingly - I thought it was normal for my heart to beat strangely for short spells!) and it was only about 18 years ago (in my mid 30's) that I realised it was not in fact normal when I ended up in A&E.. 
Since then I have been on 2 x Flecainide Acetate pills per day and for the most part all has been well. I did once discuss ablation (I too had to google that!) with the cardiologist but was advised to stick with what appears to be working for me; i.e. medication.
As far as excercise is concerned, I have never given it much thought. Like many others I started to put on weight in my 40's and decided to try and halt the slide so started doing a bit of cycling. I found I quite enjoyed it when the weather is kind (detest it in the rain or wind, so just don't bother then) and for the last 6 years or so have been doing about 3500 miles per year including the odd 100 miler, with no ill effects. I quite regularly do 100 km rides, and hardly bother getting the bike out if it's less than about 15 miles. I do not consider myself to be very fit, and my rides are quite slow - that may or may not be down to the medication restricting heart rate (I never wear a monitor so not sure about that one).
Good luck with the recuperation @DaveGM , and happy cycling!


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## pawl (7 Jan 2016)

DaveGM said:


> I had a ablation for atrial fibrillation in 2014, and was signed off by my Electrophysiologist (Cardiologist who specialises in arrhythmias) in June 2015. I was encouraged to take some exercise and decided the gym, jogging and swimming were not for me.
> 
> I decided to buy a bike partly with the expectation that it may have one outing and then find a permanent home in the garage.
> 
> ...





DaveGM said:


> I had a ablation for atrial fibrillation in 2014, and was signed off by my Electrophysiologist (Cardiologist who specialises in arrhythmias) in June 2015. I was encouraged to take some exercise and decided the gym, jogging and swimming were not for me.
> 
> I decided to buy a bike partly with the expectation that it may have one outing and then find a permanent home in the garage.
> 
> ...


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## Colin_P (7 Jan 2016)

@Brandane 

How much Flec do you take? I'm on it as well and take 200mg a day, half in the morning, half in the evening. I'm also on a large dose of beta blockers.

I'm not sure which of the two slows me down the most but having read your post, it seems that the beta is probably the culprit.


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## Brandane (7 Jan 2016)

Colin_P said:


> @Brandane
> 
> How much Flec do you take? I'm on it as well and take 200mg a day, half in the morning, half in the evening. I'm also on a large dose of beta blockers.
> 
> I'm not sure which of the two slows me down the most but having read your post, it seems that the beta is probably the culprit.


Same as yourself - 100mg in the morning, 100mg in the evening. About a year ago they also decided to put me on a small dose of beta-blocker, so I take 1.25mg of Cardicor daily too.


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## Colin_P (7 Jan 2016)

Brandane said:


> Same as yourself - 100mg in the morning, 100mg in the evening. About a year ago they also decided to put me on a small dose of beta-blocker, so I take 1.25mg of Cardicor daily too.



I'm on 20mg of Nebivolol which is also started at 1.25mg. It knocked me for six when I started it and at every dose increase.


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## Brandane (7 Jan 2016)

Colin_P said:


> I'm on 20mg of Nebivolol which is also started at 1.25mg. It knocked me for six when I started it and at every dose increase.


That sounds like a large dose of beta-blockers right enough! Is your high dosage to do with your VT, rather than AF?


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## Colin_P (7 Jan 2016)

Brandane said:


> That sounds like a large dose of beta-blockers right enough! Is your high dosage to do with your VT, rather than AF?



The drugs are mainly for VT which with me can and has gone to VF (ventricular fibrillation) which isn't nice.


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## DaveGM (7 Jan 2016)

Thank you all for your comments

I am not sure how far I should or could push it , so I think the mantra is stay within what is comfortable.

I know that endurance athletes ( serious bike riders) are prone to developing AF - I certainly do not come into that category!! 

As a side note - I never got on with any of the medications for AF hence going for the ablation which I am delighted to say appears to have worked. Fingers crossed!


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## Brandane (7 Jan 2016)

Colin_P said:


> The drugs are mainly for VT which with me can and has gone to VF (ventricular fibrillation) which isn't nice.


Sorry to hear that; hope the meds do their job!


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## DaveGM (7 Jan 2016)

Colin_P said:


> Yes, me and a chap called @Yorksman.
> 
> I suffer from ventricula tachycardia with small bouts of AF. I've had one attempted / failed ablation.
> 
> ...



thanks Colin I will read the thread - all 20 pages of it!!

Yes, I understand AF is a less serious condition than VF. 

hope you keep well, and keep cycling


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## DaveGM (7 Jan 2016)

Brandane said:


> I have suffered with AF since my teens (unknowingly - I thought it was normal for my heart to beat strangely for short spells!) and it was only about 18 years ago (in my mid 30's) that I realised it was not in fact normal when I ended up in A&E..
> Since then I have been on 2 x Flecainide Acetate pills per day and for the most part all has been well. I did once discuss ablation (I too had to google that!) with the cardiologist but was advised to stick with what appears to be working for me; i.e. medication.
> As far as excercise is concerned, I have never given it much thought. Like many others I started to put on weight in my 40's and decided to try and halt the slide so started doing a bit of cycling. I found I quite enjoyed it when the weather is kind (detest it in the rain or wind, so just don't bother then) and for the last 6 years or so have been doing about 3500 miles per year including the odd 100 miler, with no ill effects. I quite regularly do 100 km rides, and hardly bother getting the bike out if it's less than about 15 miles. I do not consider myself to be very fit, and my rides are quite slow - that may or may not be down to the medication restricting heart rate (I never wear a monitor so not sure about that one).
> Good luck with the recuperation @DaveGM , and happy cycling!




Brandane

100 miles!!! Blimey

Agree about riding in the wind and rain - we've rather a lot of that around here.

Incidently - first got AF at the age of 43 had a first ablation at 48 and 15 years AF free thereafter.

Unfortunately a return of AF in 2014 so opted for another ablation as drugs in the past were for me pretty useless.


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## Yorksman (8 Jan 2016)

I started off with Atrial Fibrillation and was put on Amiodorone with a view to cardioversion. However, I went into Ventricular Tachycardia whilst on an exercise bike and had to be cardioverted out of that dangerous rhythm. I was OK for about 3 days but then went into Atrial Flutter, which is different from Atrial Fibrillation. I had an ICD fitted in case I ever went back into VT and was switched from Amiodorone to Digoxin. Underlying all this is a Dilated Cardiomyopathy.

I was referred for Flutter Ablation but the ECG showed that I was no longer in flutter but back in fibrillation. Ablation is much more successful for flutter than it is for fibrillation. In addition, my ICD is pacing me to get me back upto 70 BPM indicating that the Digoxin is slowing my heart down too much. I'm now off the digoxin and will be back on the amiodorone in a few days and will also have my ICD reprogrammed. They then want to cardiovert me again and possibly add a third lead to my ICD. 

I asked about cycling as I was cycling when I went into VT. I am told it is OK but to keep within a comfortable zone, ie, don't push it. If I can talk whilst cycling or sing to myself, it's OK.

When I went into VT I was on the bike in the shed wearing a chest band transmitting to a PC. I knew something had changed when my heart rate shot up to 163 from it's more usual 130 but wouldn't come down even when I backed off. Even 30 mins laid on the bed with a finger pulse monitor showed a steady 163. So, I went to A&E. Odd thing is, I felt OK and if I hadn't had a HRM, I wouldn't have known a thing about it, until I started to feel ill three hours later. By that time though, I was already in A&E.

Having learned that monitoring heart rate during exercise when you have a heart condition can save your life, I have stuck to cycling in the shed where I can monitor it. I set the upper alarm at 115. I have a wrist watch type monitor and chestband to warn me if I go out. I use it when walking and will use it when cycling in warmer weather.

The important thing is to detect when your heart is beating above a nice safe limit, so you can slow down immediately, and not have to wait until you feel ill before you slow down.

A light hearted look at some arhythmias:


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## david k (26 Mar 2016)

Colin_P said:


> @Brandane
> 
> How much Flec do you take? I'm on it as well and take 200mg a day, half in the morning, half in the evening. I'm also on a large dose of beta blockers.
> 
> I'm not sure which of the two slows me down the most but having read your post, it seems that the beta is probably the culprit.


Hi, I take beta blockers for AF and hate them, they tried me on flecinacide and it didn't work but I was not on 50, they returned me to beta blockers which I hate as they slow me down. They talked of putting me back on flec but a doe of 200 as I'm big bipartisan also advised ablation. I'm waiting for my date now, I took th decision to do the ablation and get off drugs as they are slowing me down so much I cannot stand it


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## gavgav (27 Mar 2016)

DaveGM said:


> I had a ablation for atrial fibrillation in 2014, and was signed off by my Electrophysiologist (Cardiologist who specialises in arrhythmias) in June 2015. I was encouraged to take some exercise and decided the gym, jogging and swimming were not for me.
> 
> I decided to buy a bike partly with the expectation that it may have one outing and then find a permanent home in the garage.
> 
> ...


I've only just caught up with this thread, but I had ablation performed in 2011 to correct Mahaim Fiber Tachycardia, a rare type of VT which caused my heart to trip into an uncontrollable 250 beats per minute. I've cycled 4000 miles since then with absolutely no problems. I still get occasional ectopic beats, which can be a little alarming sometimes, but I tend to find it easier to ignore them now. Hope you continue to cycle and are problem free


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## Yorksman (27 Mar 2016)

They've given up on the idea of ablation now and are going for cardioversion. This either means that I am going to be converted to Catholicism or they are going to put a lot of volts down the jump leads which are already connected to my heart. I thought technology had improved since the days of giving things a good kick to sort them out.


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## david k (12 Jun 2016)

Well I had my ablation on Tuesday and they said I have a good chance of it being successful.

They also said I not only had AF which was being treated but also atrial flutter so they treated that at the same time. That was a bit of a shock pardon the pun  

I was told not to do much for a week, walking to a cafe from the car is about the max, I went the shops yesterday walking about 100m in total and felt light headed and dizzy, I quickly returned home. Just walked around the corner and same happened, pretty boring sat still but cannot do anything else.
My back and sternum are also sore.

I have to remain on the beta blockers so really tired, but fingers crossed it works, I can stop the beta blockers in 3 months


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## DaveGM (12 Jun 2016)

It does take time for the scar tissue to form. The scar tissue creates the "barrier" to block the errant heart impulses that are the cause of atrial fibrillation. 

Take it really easy for at least the first two weeks.

If you have any concerns the Heart Rythm Nurse specialists at Lverpool Heart and Chest Hospital I found to be very good.


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## JtB (12 Jun 2016)

I have the opposite problem in that my heart rate drops too low and even has a habit of stopping when I get too relaxed. My Bradycardia (due to sick sinus syndrome) resulted in a dual chamber pacemaker set to pace at 60bpm. On average I seem to be getting paced at about 70%. I do occasionally monitor my heart rate when cycling and display it "real time" on my Garmin SatNav,, but I feel uncomfortable having the monitor so close to the pacemaker and so in the end I usually base how much I push myself on how I feel.


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## Yorksman (14 Jun 2016)

Although I had an ICD implant because of tachycardia, my AF, orinally diagnosed as fibrillation, then flutter and then fibrillation again as also causing very slow heart beats. The primary function of the ICD is the defibrillator part, which you hope is never required, but it also paces the heart and mine was pacing me up whenever it dropped to 50 bpm. I felt better immediately but, it was pacing me about 35% of the time. I am now back in sinus rhythm after cardioversion and can mow the lawn, trim the hedge and cycle easy routes all day. This is despite having heart failure which limits the amount of blood being pumped.

I monitor my heart rate and on a turbo trainer, it rarely goes much above 80. In the real world I cycle between 90 and 120 which is well within my safety zone. The main thing is though that the heart rate is predicatable and directly related to effort whereas before, it used to jump all over the place and likely to get me into trouble.

Fingers crossed that I stay in sinus rhythm. I have stuff to look forward to:


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## Yorksman (14 Jun 2016)

david k said:


> Well I had my ablation on Tuesday and they said I have a good chance of it being successful.
> 
> They also said I not only had AF which was being treated but also atrial flutter so they treated that at the same time.



I went for a pre assessment for flutter ablation but the ECG they did showed I was not in flutter but fibrillation. That's why they thought they'd have a go at cardioverting me out of it. Depending on how the rhythm behaves over the next few months, they may or may not do ablation as well - as a sort of belt and braces job.


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## david k (14 Jun 2016)

Yorksman said:


> I went for a pre assessment for flutter ablation but the ECG they did showed I was not in flutter but fibrillation. That's why they thought they'd have a go at cardioverting me out of it. Depending on how the rhythm behaves over the next few months, they may or may not do ablation as well - as a sort of belt and braces job.


Good luck mate, I had AF but they also found flutter?? So they treated both at same time, let's hope it worked


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## Yorksman (15 Jun 2016)

david k said:


> Good luck mate, I had AF but they also found flutter?? So they treated both at same time, let's hope it worked



You might be interested in this article: Atrial Fibrillation and Atrial Flutter. It explains the differences and shows the typical ecg curves for each but states that you can have both. I suspect that when you have both, the resultant wave created on an ECG might be hard to decipher.


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## david k (16 Jun 2016)

Yorksman said:


> You might be interested in this article: Atrial Fibrillation and Atrial Flutter. It explains the differences and shows the typical ecg curves for each but states that you can have both. I suspect that when you have both, the resultant wave created on an ECG might be hard to decipher.



Yes that's very good

Odd they never picked up the flutter, but then again it took them years to pick up AF 
I had numerous ecgs which picked up nothing, I kept telling them it goes now and then, usually after a long cycle of some alcohol but it was hard to convince them. I finally went to a and e after a cycle and they found it, I went again the week after when it was racing and same again. On each occasion they gave me a beta blocker and it calmed down then went regular. Since flecinacide didn't work they kept me on beta blockers, maybe because flecinacide doesn't work for flutter so I seem to recall reading ? Ablation was the best option


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