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Predisposition to afib.

Posted by bolimasa 
Predisposition to afib.
August 13, 2018 01:32PM
Does history of arrhthmia when you are young predispose you to atrial fibrillation?
I'm wondering this for two reasons.

A few decades ago, I was told I had an extrasytole, heat murmurs and at that time I was having issues with weird chest pains, fatigue, blah blah... did a bunch of doctoring only to be told "Nope, nothing really seems really wrong with you, and that I either had a bit of chronic fatigue, fibromylagia, or otherwise just some crazy lady syndrome".

Back then I did get sent in for an echo... which confirmed the 2 insignificant murmurs (which my recent echos also show), and the extrasytole plus the tech got all excited about what he described as a cord that ran across my one valve that clearly showed a bit of turbulent flow through that valve. (this was not seen in my recent echos) Nobody seemed at all concerned about anything, nobody recommended a cardiologist, so I didn't worry about any of this.

Now that I have this Afib diagnosis, I wonder it having tendencies to arrythmias and or chest pains when you are young predisposes you to problems later.

The second reason I ask, is for my kids. Both are in their their 20, both have had complaints about fluttery heart kind of issues... My daughter did see a doctor, and was told two things, that she had panic disorder and that she had arrhythmia. Just like when I was young, none of this seemed notable to doctors.

What I wonder is if having these sort of issues when you are young is a harbinger of bad things to come?
Should my kids have their doctors pay extra attention their hearts?
Re: Predisposition to afib.
August 13, 2018 02:02PM
Arrhythmia is hereditary.

I was diagnosed with afib in my early 20’s. My mom developed persistent afib in her 70’s, many years after my diagnosis. My lifestyle most likely led to the early onset. Afib and arrhythmia’s aren’t deal breakers and can be addressed.
Re: Predisposition to afib.
August 13, 2018 02:04PM
What RR says.

I had AF once in my mid-20s, then next at 39 and ever since. Still paroxysmal. My mum started with it in her 30s and went permanent aged 70.
Re: Predisposition to afib.
August 13, 2018 02:45PM
Both my parents had afib. My father left nearly three years ago, the year I discovered afib by myself. My mother is 90, permanent afibber for years.
My sisters are ok. It seems the bad card was for me.grinning smiley
Re: Predisposition to afib.
August 13, 2018 05:05PM
Both my brother and mother have/had arrhythmias, as do/did I. I absolutely believe it is hereditary. I consider myself very fortunate being the youngest child and not being diagnosed (but clearly was present many years ago) until my mid 50's and having the latest treatments and options available to me that they did not.

Seems like a mindful choice to have your children checked carefully, but I think you also don't want to scare them thereby potentially causing anxiety or stress. Afib and anxiety are this ugly circular thing. And if your kids develop afib later in life take solace knowing treatments and technology are only to get better and more effective.



Edited 1 time(s). Last edit at 08/13/2018 05:07PM by AB Page.
Re: Predisposition to afib.
August 13, 2018 05:16PM
Grandfather and mother spent years in persistent afib. My sister has been in persistent afib for about 30 years now. I developed paroxysmal afib at 46 that eventually began to trend toward persistence. Could I have avoided afib with super clean living and all that? I doubt it. Maybe I could have delayed it longer, but I think I was dealt the cards and eventually they were going to get played.
Re: Predisposition to afib.
August 13, 2018 07:08PM
Mother, sister and brother all had afib.

Gill
Re: Predisposition to afib.
August 13, 2018 08:42PM
Yes, it is hereditary. My Mom and Dad both have it.

Murmurs, however, aren’t really related. Valves make noise, and they aren’t involved with arrhythmia - to a first order at least. Valve replacement is certainly a cause for AF, but if the ones you were born with are just rumbling a bit I don’t think that means much.
Re: Predisposition to afib.
August 13, 2018 08:59PM
Quote
wolfpack
Yes, it is hereditary. My Mom and Dad both have it.

Murmurs, however, aren’t really related. Valves make noise, and they aren’t involved with arrhythmia - to a first order at least. Valve replacement is certainly a cause for AF, but if the ones you were born with are just rumbling a bit I don’t think that means much.
I was not under the impression my murmurs had anything by do with my AFib, I just mentioned them as they were part of the reason I had the echo years ago, and they are no different now
But, my dad had AFib... And they seemed to blame his on his murmur, which to they blamed on the rheumatic fever that he does not remember having. I do not know how long he had AFib or what kind of how long he had it. I'm guessing it never bothered him. All I know is that he died suddenly, not long after starting on the latest greatest med for it. Mom reminds my of that every time the lawsuit commercials for that play on the TV. sad smiley
Re: Predisposition to afib.
August 13, 2018 09:56PM
I dont know anyone in my family with afib. I guess I got it all for them.lol..
Heres some good info on kcno1 which is the gene they're designating to afib.

"The KCNQ1 gene belongs to a large family of genes that provide instructions for making potassium channels. These channels, which transport positively charged atoms (ions) of potassium out of cells, play key roles in a cell's ability to generate and transmit electrical signals."

[ghr.nlm.nih.gov]
Re: Predisposition to afib.
August 14, 2018 08:27AM
No one in my immediate family or the many relatives have had afib.

Jackie
Ken
Re: Predisposition to afib.
August 14, 2018 08:40AM
No one in my family had/has afib or any heart disease. Just my ablated afib.
Re: Predisposition to afib.
August 14, 2018 09:31PM
I know that Shannon's father died of an afib related stroke and his sister is in a nursing home because of a botched afib ablation.

In my case, neither parent had it, though I saw a short burst of it in my mom at around age 86. She was in a memory care group home & I took her on a walk. I put my Polar r to r (beat to beat) recording monitor on her and took her on a walk. However it was a one off. I didn't use the strip often, but would check her radial pulse. It certainly wasn't frequent or chronic.

Neither parent exercised with any intensity and my father was very sedentary. Chronic fitness was my path to afib, so they may have never activated that genetic pathway.

With 23andMe data run through Promethease, I had 8 good SNP's, 2 bad, 8 unknown and 1 normal risk, so go figure. I have two adult children, I tried hard to compare my SNP's to theirs to see if one of them might have my propensity as they both push hard on exercise. Can't say I figured it out. They've paid some attention to my warning not to push it hard, though my daughter flew to Dublin and ran in the Rock & Roll half on Sunday. She does mostly train with high intensity, which for me seems to not be a trigger.
Re: Predisposition to afib.
August 15, 2018 02:36AM
George, my parents were active but weren't practicing any sport. I did. My first afib episode came at the end of a year l'd ridden 7000 km on my bicycle. I told this to my cardiologist, she said chronic fitness might be a cause, but my heart was perfectly normal. I never checked my HR at rest (l mean nightly in bed), so l don't know if being between 45-50 bpm was new or not, but if it was, it might have been a cause, I presume.
Re: Predisposition to afib.
August 15, 2018 10:42AM
My resting HR is consistently 45-50 bpm. It's not an issue in any way shape or form if it's the result of chronic fitness.
Re: Predisposition to afib.
August 15, 2018 11:17AM
Quote
wolfpack
My resting HR is consistently 45-50 bpm. It's not an issue in any way shape or form if it's the result of chronic fitness.
I've read it's not a problem, but... afib is a strange beast.
I've met the beast at 57. I'm now 60. My father was still fine in his late 70's, but ended with afib at 90. My mother is now 90, and is probably afibber for many years. I don't think she was at 70, but she had high BP. My sisters (67 and 58) are fine. None of them were athletes at any moment.
Has chronic fitness done the difference?
Re: Predisposition to afib.
August 15, 2018 12:09PM
Quote
wolfpack
My resting HR is consistently 45-50 bpm. It's not an issue in any way shape or form if it's the result of chronic fitness.

Except that it is an indicator of vagal tone. Most afibbers whose path to afib is chronic fitness have vagal triggers. In a static sense - your resting heart rate is say 50. For people that don't have a genetic propensity for afib, it is not an issue at all, for those of us with this propensity, I think may be part of what sets us up for afib.

It took me two years to decide that since chronic fitness from endurance training & competition was my path to afib, I decided I should moderate that and pursue different ways of maintaining fitness. I did that, and in addition to my electrolyte repletion, I believe is a material component of my successful afib remission strategy. I now pursue the path of minimum effective dose for exercise, and in my case the product of duration and intensity appears to be the issue. Long duration and relatively low intensity is fine as is short duration very high intensity. Long duration, high intensity is bad news for me.

Prior to coming to this realization, I would still compete. When I would do a long, high altitude race, it was intense enough that my resting HR might remain elevated for several days after. Then my resting heart rate would drop below my prior baseline. This was an afib risk period for me. Then finally, my resting HR would return to baseline and the risk diminished.

Today, I have a subjective sense of how much is too much. When I exceed this, the excess can be a trigger, again likely because the ANS (autonomic nervous system) ends up with more parasympathetic tone.
Joe
Re: Predisposition to afib.
August 15, 2018 05:25PM
Your experience is consistent with this study:https://www.ncbi.nlm.nih.gov/pubmed/26733609
Re: Predisposition to afib.
August 15, 2018 10:28PM
Quote
Joe
Your experience is consistent with this study:[www.ncbi.nlm.nih.gov]

The people in the study were, from what I saw, not fit to begin with. Their BMI was around 28 and their VO2 max around 33. So they would likely not be in the group where chronic fitness brought them to afib. Hence the exercise appeared to help their metabolic markers. When unfit people get more fit, afib usually improves.

"Exclusion criteria were the following: performing endurance training at high intensity for more
than two times a week or at moderate intensity for more than three times a week,
previous open
heart surgery, left ventricular ejection fraction (EF) below 45%, significant cardiac valve disease,
implanted cardiac pacemaker, coronary artery disease without complete revascularization, or
inability to accomplish the exercise program. "
Joe
Re: Predisposition to afib.
August 16, 2018 04:16AM
Yes, good idea to highlight the exclusion criteria!
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