Rejoice – Not All Runners in Atrial Fibrillation Are Slow

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Moore Mountain 1/2 Marathon

The thing I enjoy most about the afibrunner blog is comments from other athletes who are dealing with atrial fibrillation. A recent comment from a runner (we’ll call him “Lon”) really caught my attention – here is a runner who, while in atrial fibrillation, was able to race at six minute mile pace (or better).

Here are some excerpts from his comments:


Way to Go!!!
Since 1983 I’ve run/jogged 59 full marathons and have suffered with A-fib on and off for the last 12 years. I’ve finished the Boston (2001 in 3:23) and NY City (2005 in 4:15) marathons while in constant A-fib while carefully monitoring my heart rate. My cardiologists encouraged me to run marathons and also triathlons. One cardiologist told me that my heart is so strong that it laughs at A-fib and that I have the heart of an olympic cyclist. For the first 6 months of this year my heart was in constant A-fib that no drugs or multiple cardioversions could put it back into normal sinus rhythm. On July 9, 2013 I had the “Wolf Mini-Maze” (at the International A-fib Center of Excellence in Indianapolis) operation done on my heart. It was a great success and my heart has been in constant normal rhythm ever since (nearly 6 months now and I’m not taking any medications). In the Mini-Maze they removed my Left Atrial Appendage (LAA) so that if my heart ever goes back into constant A-fib I will NOT meed anticoagulant therapy. As you likely know life threatening blood clots tend to form in the LAA when your heart is in constant A-fib. The risk of stroke over the life time of an A-fib patient is huge. 3 out of 5 A-fib patients will suffer a stroke in their life even while taking anticoagulation meds like coumadin. That is a statistic that your doctor will not likely tell you about. Coumadin is over rated and is simply not very effective for some people which should be a terrifying realization to anyone dealing with A-fib. Anyway, as much as I love marathons, I’m laying off the long distance jogging for a while and am just jogging 10K’s (one per moth and 3 sprint triathlons this Summer) as well as several other physical activities.
Good health to you!
Lon

I have lamented that atrial fibrillation has made me slow, while openly admitting that I started out slow – I’ve only ran, as far as I know, one six minute mile in my entire life – and that was thirty years ago.

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Finish Line – Eugene Marathon

My understanding about atrial fibrillation is that the atria no longer preload the ventricles, and most people have a decrease of about 20% of their cardiac output. While sedentary people might not even notice this athletes certainly would. I do!

But I have heard that in some patients, certain athletes, there is little change in cardiac output and atrial fibrillation will not affect performance much. Lon seems like one of these fortunate people. Lon’s point about the increased risk of stroke (even if you take your Coumadin, Pradaxa, or Xarelto) is well taken – and I’m guessing that that is why he continued to pursue an effective treatment for his atrial fibrillation.

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Finish Line – Haulin’ Aspen Marathon

But after all those marathons Lon states he is no longer running endurance events – he goes on to elaborate:

Here’s a little more. I tried not to make a long story short above. I left out mentioning that I had a radio-frequency catheter ablation in June 2010 in Seattle that worked great in keeping my heart in normal rhythm until December 2012 when suddenly for no apparent reason went into persistent A-fib. (During that 2 1/2 year period I finished 9 full marathons and 8 sprint triathlons) My heart stayed in persistent A-fib even after 4 cardioversions and large doses of amiodarone. My cardiologists in Seattle told me that I should accept my persistent A-fib and they offered to ablate my hearts pace makers (AV and SA nodes) and give me an electronic pacemaker so that my heart rate can be controlled. That told me that I needed a second opinion so I started communications with Dr. Randall Wolf in Indianapolis about his Mini-Maze procedure. After consultations with an E.D. doctor (and a championship Iron Man triathlete) who had the Mini-maze operation and was very happy with the results, I decided to get the Wolf Mini-Maze and of course I informed my Seattle cardiologists of my intentions and they said to go for it. Absolutely the main reason that I went for the Wolf Mini-Maze is that it removes the left atrial appendage which brings my risk of stroke down to that of a healthy person with a normal healthy heart while not taking any anticoagulation drugs. The fact that I now enjoy a normal heart beat is just a huge plus factor.

From 1983 until December 2012 I completed 61 full marathons a most of which ran with all out efforts (I’ve averaged sub-6 minute pace all the way). I’m now finding out that long distance running is simply not good for the heart and most likely caused my A-fib problem.

Google Dr. John Mandrola’s 18 minute video called “Cycling Wed: I told you so…”. It is very illuminating and a must see for all endurance athletes. Please check that out.
Cordially,
Lon

I don’t know much about the Wolf Mini-Maze procedure and don’t necessarily advocate it for everybody, but clearly it worked in Lon’s specific situation. Here is some information regarding the Wolf Mini-Maze.

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Finish Line – Lake of the Woods 15K

No need to Google the video by Dr O’Keefe (posted on Dr Mandrola’s blog) I have the link right HERE.

Here’s the video:

If you don’t feel like watching the eighteen minute video I will summarize it for you – Exercise is good for you but in moderation. Too much or too intense exercise causes chronic inflammation of the heart and can ultimately harm the heart (atrial fibrillation, among other risks).

But if you are an endurance athlete dealing with atrial fibrillation you already know this – surely you have had a dozen or so friends and relatives, possibly sedentary and/or obese, kindly forward you information about the study he refers to – as if to justify their seemingly wise choice to avoid marathons and triathlons and replace it by watching other people play sports on television. Yes, this study was in all the newspapers and magazines last year.

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Finish Line – Avenue of the Giants Marathon

Please understand, and I paraphrase here, that Dr O’Keefe states that exercise is good for your heart, and being obese and sedentary is bad for your heart – but that overdoing it is a problem. He didn’t say people should avoid exercising.

My choice – I understand the concept of the “law of diminishing returns” as well as the next guy; but for me, well, I enjoy long, slow trail runs and mountain bike rides more than just about anything else I can think of – so I chose to continue.

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Finish Line – Bizz Johnson 50K (I completed the 50K in atrial fibrillation)

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