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I guess I maybe overdid it a little...
I celebrated my five-month anniversary of my one and only ablation (so far) by walking more than 15,000 steps in the 85-degree heat on Sunday afternoon here in Boston. That's nearly 6 miles and 3 hours of walking in the heat. At the time, I felt up to the challenge.
Boy did I regret it late Sunday night. I woke up with chest pain and palpitations. Neither were serious enough to make me worry I was having a heart attack or needed to go to the ER. Plus, I have passed every cardiac test in the world over the past few months and have received great reports from cardiologist and EP.
But my heart kept jumping between its normal 55-60 bpm and 95-100 bpm for the rest of the night. Not uneven beats like my afib. Just faster all of a sudden and then back to slower a few minutes later. I couldn't sleep and proceeded to drown my sorrows by eating a whole box of coconut popsicles while lying awake from 2 to 6 a.m., when I finally got up.
I went to work, but took the day off from walking my usual 10,000-plus steps (a normal day for me with my regular commute is about 5,000 steps) and came home after work, ate a sensible and early dinner, took all my nightttime meds (sotalol, etc.), and got a good night's sleep. I also cut out the licorice extract supplement I had been taking for reflux because I read (while I was awake overnight) that it can cause afib and high blood pressure.
Today, after a night of rest and no licorice supplement, I feel much better and even went out for my usual noontime walk around Boston Common and the Public Garden. But I went much slower in the heat.
Important lesson learned: Even though I often feel recovered from the ablation five months ago, I still have a ways to go for full recovery and need to continue taking care of myself and not overdoing it. I'm 57, not 27 or even 37. This is going to take a while, I guess.
garritjn, July 31, 2018 1:02pm EST
You were possibly dehydrated from the heat...A huge trigger for afib..
Spencer, July 31, 2018 1:27pm EST
Heat, extra exertion, lack of water... big triggers for AFib. Take it easy! Be like me... oh, that's right you shouldn't.
bshersey, July 31, 2018 1:27pm EST
Thanks garritjn. I'm sure dehydration had something to do with it. I will make sure to bring a water bottle next time.
Also, I am going to make sure I check with the doctors next time before I start taking a new supplement. Between the afib and the sotalol, I seem to react poorly to just about everything I try in that area.
bshersey, July 31, 2018 1:28pm EST
Thanks Spencer. I was hoping you would drop in. Good advice :)
lmetzger, July 31, 2018 1:57pm EST
My Cardiologist and I have been discussing that we see this as 2 issues that interact. The two issues are Triggers and Afib, do those triggers cause Afib. Sometimes the continual Triggers that cause a rapid heart rate happen but don't cause Afib, but these Triggers can bother us are as bad as the Afib.
I see pretty close to what you see, sometimes when I exercise I get rapid heart rate but don't get Afib from it, so one problem solved :-) But, I still get many of the Afib symptoms when I have these continual triggers.
I would like to see a study on Triggers and how often they turn into Afib, especially after being treated for Afib. I wonder... is it true that what we attribute to Afib is actually the "Continual Triggers" and not Afib.
bshersey, July 31, 2018 2:07pm EST
Thanks lmetzger. I agree completely.
I see these symptoms as different than afib, but related. They are still arrythmias. I have not had any classic afib since my ablation 5 months ago. But I have had plenty of these rapid heart rate episodes. They happened a lot in the first month after, then went away, and then came back in the hot weather.
Since my heart rate, even with the fast beat episodes, rarely breaks 100, my EP and cardiologist don't seem too bothered when I report these episodes. The episodes were freaking me out completely at first. But now I am more used to them and understand they will go away in anywhere from 10 seconds to 10 minutes or so. Sunday night was the first time I had continual episodes like that for hours.
My triggers for these fast heartbeat episodes are definitely exercise, heat, dehydration, alcohol, and now, it seems, licorice extract supplement. I can avoid some of them - the alcohol and the supplements. Others are more difficult, especially the heat here in the middle of the summer.
Edhammer, July 31, 2018 2:52pm EST
....and here I thought you were one of the moderate ones like Spencer!! Seems like a lesson learned. I’m a couple of months post ablation and am feeling really good and am tempted to overdo. Came close last week, trekking around waterfalls in upper Michigan, but I forced myself to moderate behavior, basically watching my pulse.
So, be careful!
bshersey, July 31, 2018 2:54pm EST
Thanks edhammer. Definitely a few lessons learned. I aspire to be like Spencer. But I am not nearly as good a writer as he is :)
Oceanside, July 31, 2018 3:21pm EST
I have not had afib for over a year now due to lifestyle changes, but I do have SVT episodes on rare occasions. Usually, the trigger is a higher level of exercise paired with fatigue and dehydration. Dehydration can be the biggest culprit so try to always be super hydrated especially when exercising. Best to you in your recovery.
lmetzger, July 31, 2018 4:56pm EST
I had my ablation for WPW in 1992 (I was one of the first people to have ablation in the world) and have been dealing with Triggered High Heart Rate + Afib (without WPW) for 45+ years. The Ablation fixed the WPW and removed all bylateral pathways but the ones that were so close to the AV Node that they chose not to clear them... thus the Afib. I will probably have Paroxysmal Afib forever, but I find the Afib to be minimal compared to the Triggers.
My triggers that cause the "Continual Triggers" have changed over the years, but the results are pretty much the same. Having rapid heart rate that is not high enough to be a danger is pretty common in my experience. I can be in great shape and it happens. I also found that it has been cyclical, like about every 14 months I will have 1-3 months of this and then it goes away. While going through these periods, I try to stay in shape, but have to take it much easier. When they clear I can get back into shape. My biggest achievement is to recognize that its happening and staying with it until it goes away... its hard after a month or so, but it has always cleared up.