AFib and ASD

I was diagnosed five years ago with AFib and had it ablated four years ago and while I have had short bursts since then I have had no sustained AFib since. While they were doing the ablation, they discovered an atrial septal defect(asd) that was not in a location where it could be easily closed so my cardio put me on eliquis to mitigate potential strokes and said we would monitor it to make sure the pressures stay stable . Again four years later, so far so good except I have been relegated to a lifetime of blood thinners. I have had to stop running because an elevated heart rate over 120 bpm tends to pivot toward tachycardia until I rest. I guess my question is simply if anyone is in a similar situation and whether or not you have simply accepted it, made any particular lifestyle changes or had the asd closed or done anything that allowed you to resume heavy exercise. Thanks in advance for any recommendations and comments.

When you say a heart rate over 120 tends to pivot towards tachycardia, what exactly do you mean? Do you mean your HR will remain high even after you've stopped exercising, or do you mean it goes to an inappropriately high rate?

Also, have you ever sought a second opinion from an interventional cardiologist or heart surgeon regarding the ASD? Has anyone ever done a bubble test to see if that ASD presents a threat at all? Five years is a long time in the cardiology world and a lot of things have changed since then.

My HR will jump from 120 to a rapid 175-200 while I exercise and when I stop and rest for awhile it tends to revert back to regular rhythm. I have had echos and a heart Cath that confirmed the asd and so far pulmonary pressures are stable and there is no reverse shunting. Does this answer your question?

Mostly, yes. Do you recall anyone mentioning a bubble study or having an echocardiogram during which they injected saline into your IV? I would imagine they did one at some point. I have an ASD as well and it's the first test they ran. It was negative so I didn't need to do anything about the ASD.

As for the tachycardia, is it so symptomatic that you can't continue running or do you stop out of fear? Have you ever tried rate control drugs such as beta blockers or diltiazem? I've known several people who experienced similar tachycardia with exertion and it really varies how disabling it can be. Some can just ignore it and continue while others can't.

I am on diltiazem and lisinopril for HBP. For me it’s a discomfort issue as I feel every blip, run or thump and it is just very uncomfortable so I tend to walk 10,000 steps a day with Fitbit. But honestly, I miss sweating and pushing. They have done the nuclear tracing study and so far the asd is not creating a problem. Do you exercise aerobically with your issues?

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Robbiecriss
Do you exercise aerobically with your issues?

Yes, and although I've been in NSR for 3 years now, I never stopped riding my bike, even at the height of my afib and 250 bpm flutter. I average about 100 miles per week in warm weather, and there's no such thing as flat ground around here so every ride is aerobic. The ASD was just an incidental finding on a TEE, and since it's small and my bubble test was negative, it was judged not to be a concern.

Has anyone ever diagnosed the rhythm you're in during the tachycardia? Depending on what it is, it could very well be fixable.

So far never had the tachycardia diagnosed while running recently but it feels like a regular svt type rhythm versus an erratic AFib type rhythm. That’s just anecdotal of course based on my checking my own pulse.