Monday, October 5, 2015

Atrial Bleeping Fibrillation, Part II--Gathering Info and Planning

Larry was most helpful.  No surprise there!!

Main points:
1) Afib likely to be recurrent.  (Again, I actually think I might have had it back in '99 after I ran my first marathon.  I seem to recall "funny heartbeats" for awhile after it, but they went away.)
2) Cardioversion and antiarrhythmic drugs are hit-or-miss.  They may or may not keep me in normal sinus rhythm (NSR).  In triathlon terms, NSR means that the atria squeeze in a coordinated manner before the ventricles, and I get to keep that 10-20% of top-end cardiac output, which is pretty important in a race).
3) As I suspected, anticoagulation (coumadin) is not necessary for me personally to decrease stroke risk.  With the exception of Afib, I just don't have any risk factors.  Asprin every day is enough.  Endurance athletes are just not likely to have the risk factors to justify coumadin (big gun blood thinner).  Plus, a hard bike crash on coumadin would not be good.
4) Catheter ablation is more reliable, but not 100% either.  This will likely be the solution if it recurs.
5) I will not just drop dead from afib (I was 99.94572% sure this was the case; it was my wife's question).
6) Having used an altitude tent for the last several weeks was a likely contributor of cardiac stress, but not a known cause of Afib.
7) Dudes and chicks over 40 have a 1 in 4 lifetime risk of afib.

What to make of it all? I'm almost undoubtedly still doing IMAZ.  I may not have the day I want, but that's just a little more out of my hands than it was a couple weeks ago.  We'll see what happens.  Still gonna be an endurance geek, still gonna give KQing a shot when it's feasible.  No more altitude tent.  No reason to try that experiment again.  I will be cardioverted this week, and we'll see if it sticks.  Modifiable risk factors for most people are alcohol intake (none here), caffeine intake (way too much, already tapering), and overall health--you know, like regular exercise...

I'd felt fairly knocked on my ass for the last few days, but I'm starting to get my emotional if not cardiac mojo back.  If the AFib thing still lingers, it's going to be ablation time, probably sooner rather than later.  I'm going to walk through the standard treatment algorithm of cardioversion--> antiarrhythmics--> ablation a whole lot quicker than most people would.  Color me impatient, but I don't see any benefit to putzing around with non-solutions.

Interestingly, Larry has also been putting in for the Norseman lottery...


1 comment:

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