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Old 02-10-2009, 04:10 PM   #11
Andy Shirley
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Re: Atrial fibrillation in endurance athletes

Thanks Bingo. I knew you had some connection to an EP guy, but couldn't remember who.

Also, for clarification, my statement above regarding rate control vs conversion/cardioversion applies to my area(ie the hospitalized neuro critical care patient specifically).

Any idea what the time-course is for clot formation in intermittent A-fib?


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Originally Posted by Darrell E. White View Post
The trend in Afib Rx is to ablate the offending locus in the distal pulmonary artery thereby stopping the aberrant electrical stimulus. Pretty far out stuff (my brother-in-law is an internationally famous idiot savant in this very subject). This would be the preferred strategy in a younger patient since the alternative is a lifetime of anti-coagulation.

FWIW, intermittent afib is the real culprit. Time in afib promotes clot formation and then the clots are pushed downstream when the atrium beats and pushes it into the ventricle.

"Thrombosis" is occlusion of a vessel with a clot. "Thrombi" are clots that have occluded a vessel some distance from the location of their creation.
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Old 02-10-2009, 09:17 PM   #12
Warren Albert
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Re: Atrial fibrillation in endurance athletes

A-Fib is a dangerous condition and it doesn't really matter whether you are young or old, an athlete or not. One of the dangers and probably the most dangerous is clotting. Anytime that blood pools, it is going to clot and without the atrial pump, the blood will just pool and eventually clot. How fast this will happen depends on alot of factors such as their clot potential, are they taking Aspirin etc.

Intermittent A-Fib is probably the most dangerous type to have as it is often not diagnosed until a serious problem occurs. Often people come in for check ups because they were having symptoms, but when they are examined, their heart is regular. It usually takes long term monitoring to find out what the problem is and often this only occurs after a serious problem has already happened and they are ruling out things to find out why.

The probable treatment for the young and healthy would probably be cardioversion first followed by close monitoring and if it comes back, then the ablation therapy would follow.

The other option would be long term anticoagulation therpy, which would not be ideal for the endurance athlete.
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Old 02-16-2009, 06:25 AM   #13
Rich Sabin
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Re: Atrial fibrillation in endurance athletes

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Originally Posted by Andy Shirley View Post
Thanks Bingo. I knew you had some connection to an EP guy, but couldn't remember who.

Also, for clarification, my statement above regarding rate control vs conversion/cardioversion applies to my area(ie the hospitalized neuro critical care patient specifically).

Any idea what the time-course is for clot formation in intermittent A-fib?
Interesting question. I used to be an RN on a CTICU (In Anesthesia school now) and we would begin anticoagulation on new afib patients within 48 hours. It seems as if the clotting cascade and various other lab studies (aptt, pt, inr) were important in this decision.
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Old 01-08-2010, 04:20 PM   #14
Severino D'Angelo
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Re: Atrial fibrillation in endurance athletes

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Originally Posted by Andy Shirley View Post
I strongly disagree. Rate(AF with RVR) is unrelated to the formation of emboli. Time spent in AFib is the problem, I'll have to look up some studies from work later to see if there is any data on how long before the blood in the atria starts to clot in AFib.

I think there's a trend towards rate control vs conversion, but again will look up data later.

Bingo? Robert? Frank? Any thoughts?
I have occasional vagal AFib which lasts a maximum of 1 to 2 hours. What is the probablility that this short duration could cause a clot to form?
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Old 01-22-2010, 09:06 AM   #15
Bryan Back
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Re: Atrial fibrillation in endurance athletes

My view as a person with A fib is odd but perhaps has insight to the OP.
Afib + stress + dehydration = Onset of A fib episode. Any endurance sport stresses the body and tends to dehydrate it(even slightly.) Perhaps they are not more prone to it but their sport lends itself to episodes. I suspect many couch potatoes don't even know they have it.
Learning to listen to my body taught me what caused me to go into A fib each and every time. I had just ended something stress full (no insight there) AND I was always dehydrated. If I stay hydrated my heart doesn't even skip a beat. If I get even slightly dehydrated my heart starts to flutter after I relax. This is of course anecdotal but holds to be a fact for me. Even massive stress from work (LEO) did not kick me into A fib. But minor stress with even a bit of dehydration sends me fluttering. The end of a lot of stress and dehydration sent me to the hospital to be chemically converted. If you have never been converted it feels like your heart is melting back into a normal rhythm. Real freaky. I for one use water like a drug. Working hard not to be a stroke victim and not stressing the small stuff. (:
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