Episodes of AF interrupt marathon training

Since experiencing exhausting episodes of atrial fibrillation (AF) while exercising, Andy has been battling uncertainty, wondering when it might occur again. Despite this, he is determined to complete his goal to run the Rotorua half marathon.

Having re-trained in his late 40s to work from home as a personal trainer, Andy had spent the last decade or so maintaining his fitness. It was something that came easily after a life spent working out, running and playing football.

Last November, Andy had begun training to run a half marathon in Rotorua.

“One day I went out for a training run, and I just felt absolutely shattered, no energy whatsoever. My breathing was fine, but I just didn’t have any energy. I ran a little bit, just shattered, walked, ran a little bit, shattered, walked.”

Once home, Andy’s wife, a nurse, checked him over but couldn’t find anything much amiss. He just looked a bit pale, and she told him it might be ‘one of those things’.

Two days later after running for just a kilometre, Andy felt the same devastating fatigue. He headed home for a rest before getting on the treadmill in his studio. By then he felt fine, so he thought little of it. Again, his wife couldn’t find anything wrong, so she suggested he make an appointment with the doctor.

Sent to hospital

With his wife away in Perth for a conference, Andy headed in to see the doctor on his own. After seeing the results of his electrocardiograph (ECG) at the doctor’s surgery, the nurse asked Andy to wait while she sent his ECG for review by a cardiologist.

“The nurse looked at the ECG and said, ‘That’s a really weird rhythm, I’ve not seen that before.’ She told me it was a good thing I was so fit, otherwise I wouldn’t be walking around.”

Sure enough, the cardiologist asked for Andy to come in to hospital for monitoring. Andy found a quiet corner to call his wife in Australia and break the news that he was heading into hospital.

Within 12 hours of monitoring on the emergency ward, Andy’s heart skipped into atrial fibrillation (AF) - something Andy himself didn’t notice.

“I didn’t know I’d gone into AF, I didn’t feel that my heart was beating irregularly or anything."...

Diagnosis of atrial fibrillation

Andy was told that he has a type of irregular heartbeat that comes and goes, called paroxysmal atrial fibrillation.

“The first thing I thought, being a personal trainer, keeping fit all my life and looking after myself, was ‘why me?’

To check there was nothing else going on with his heart, Andy went on to do a stress test on a treadmill and various blood tests, all of which showed nothing untoward.  

“The only thing was the echo [echocardiogram] showed an enlarged left atrium, and again, I’m looking at the research and endurance athletes even in their 20s have enlarged left atria.

“After the stress test I was allowed home to return as an outpatient for a CT coronary angiogram (CTCA) scan. Once back at home I started to do some research on AF and specifically what I had experienced.

“I’ve done a lot of reading and research since then and this sort of AF can appear in athletes. They’ll have a couple of weird attacks and then nothing.”

A dose of his own medicine

Andy went back into hospital as a day patient for a CTCA scan. This is a test where contrast fluid is injected into your blood vessels which the CT scanner can track as it flows through the body’s circulation.

“They use a big motorised syringe to inject contrast fluid into your blood stream. Obviously the CT scanner is going all the time scanning your heart. The contrast fluid lights up your coronary arteries, so you can see if they’re blocked or restricted in some way.”

In the past, as a Biomedical Engineer, Andy had worked on many types of medical equipment. He’d not expected that one day that same equipment would be used for his benefit.

“It was quite funny because I used to service the injectors that they use, so I was getting my own medicine back.”

Andy is still waiting for the test results, and in the meantime, he’s been put on a beta blocker medication to further slow his heart rate down.

“Because my wife’s a nurse, we sat down and talked about the AF. Obviously I had it twice when I was running, something weird when I saw the doctor and once in hospital, but the fact is, I’ve only had two episodes that affected me and they could have been one-offs and it may not happen again. And with the medication I’ve been given, that’s relaxed my heart so it might not happen again. But we don’t know.”

Easing back into exercise

“Every time I do any exercise, I’m thinking to myself, ‘Is it going to happen now, is it going to happen now?’ That’s obviously something that psychologically, I’ve got to deal with. So it’s always in the back of my mind.”

“I’ve started running again, I’ve been running on the treadmill fine at home. I’m quite lucky that I’m a personal trainer, I’ve got the gear here in the house so I can get back to running in a controlled environment. And also, my wife’s been with me every time that I’ve run on the treadmill.

“The big thing for me was to actually go outside again for a run because you think, ‘Is it going to happen again?’ I went outside for a run the other day, I only did 5 ½ km and I was fine. When I went out my wife actually followed me in her car and stopped every so often to check I was all right. So that was good. Now I feel more confident to go out and run.”

Overcoming uncertainty

“It would be so easy to say, ‘Oh no, this has happened to me, I can’t carry on, if I do it’s going to happen again.’ And that would be wrong. Because as far as I’m aware, all the tests have shown that my heart is healthy and physically there’s nothing wrong with it – apart from the large atrium, and many endurance athletes have got that. On the report it actually said, ‘athlete’s heart’.

“So it would be wrong for me to curl up in a ball and stop doing what I enjoy just because I’ve had these two or three little episodes.”

Training again for the Rotorua half marathon

Andy says he’s just going to keep going and keep his fingers crossed. He’s now training again for the Rotorua half marathon, although he’s not exercising as aggressively as he used to.

“I’ve got my Holter monitoring for a weekend in the middle of Feb, and after that I’m seeing the cardiologist, so hopefully that’ll go OK.

“I’ve got a trail run at Ruapehu at the end of February, that’s what I’m trying to get back to. It’s only 16 km so that shouldn’t be too strenuous because it’s mostly on the downhill.

“And then in May I’ve got the Rotorua half marathon, so I want to get back to running that sort of distance.

“Life’s for living, definitely, and this sporadic thing that’s happened to me, I don’t know if it is going to happen again but I can’t let it rule what I do. I’m going to carry on and pay close attention to what my body is telling me.”

 

Update June 2018

Unfortunately, due to a badly timed arrhythmia, Andy didn’t get to complete the Rotorua half marathon, but he continues to lead his active lifestyle through a mixture of regular running and weight training.

 

Update January 2019

As 2019 begins, Andy is training almost as he used to pre-incident.

“I had a little issue where my heart rate stayed at around 161 while doing an interval training session, but it came back down when I stopped running and just walked.” Said Andy “So I’m learning to adapt, and I always use a sports watch now while training.”

Andy is getting ready for a 10km run in May as part of the Rotorua marathon races, which is all going well. He also did 150km over November 2018 for Movember, in a sponsored run for depression and suicide prevention.

Please note: the views and opinions of the storyteller and related comments may not necessarily reflect those of the Heart Foundation NZ.

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3 Comments

  • Ian 25 April 2019

    My first real episode of AF occurred during a high intensity training session at 50 years of age. I’d been very fit all my life, running, weight lifting, rugby etc etc. I self admitted to hospital as I was breathless, and the episode had lasted several hours. When I was discharged the episode frequency increased and a couple years later it was confirmed as persistent AF. Now 7 years down the track my AF is controlled using drugs, Cardioversion had failed and I was not suitable for ablation. It’s ten years since my first attack and for the last five I have done little fitness training. My Doctor told me to avoid intense exercise. I’m now 60, 15kg heavier and pissed off. I’ve started a regime of walking with an end goal of getting back to 5-10k runs. What happens will happen and I no longer care.

  • Michael 6 January 2019

    This sounds very similar to my experience.  About a year ago, I started getting a funny feeling 7-10 minutes into a race (mainly 5 - 10 km), or fast paced training sessions, and my power would abruptly drop. I would be forced to slow and people would pass me, and then I would recover and carry on as before.  That was until about 3 months ago, when it was like someone had turned off a switch and for the first time I was forced to walk and I felt pretty ill.  The first time this happened, I recovered and eventually picked up the pace and ended as normal.  But on Christmas day on a 5km Parkrun, and then again a few days later, there was no recovery.  Though I started running again, slowly, I finished feeling I had run a long race and spent a couple of hours recovering.  It was as though a switch had been turned off, but there has never been any warning.  Up to the moment it happened, I felt quite comfortable.  I can’t say I have felt any very marked discomfort in my chest, but each time I have been forced to walk, I have also had an ache in my right shoulder.  I have been perfectly fine in my non running life, so was happy to submit a query to my doctor by email.  She phoned and asked me a series of questions and we are reviewing again in mid January.  That was before I had seen anything on the internet,  so perhaps it is AF…

  • Peter 2 August 2018

    Nice story! Life goes on and it is more about management of the condition than worrying too much. I just had my first episode of AF; it lasted 2 hours and then disappears. It happened after I climbed up Mt Taranaki to the Lodge (about 600m climb), came back again without any issues (“easy walk”), but then, while sitting on the couch, the episode started. Now my GP has prescribed an oral anticoagulant for me. I also have an athlete’s heart. Been active my whole life. As I said earlier, life goes on. I am already looking forward to going up the mountain again :).