graham418

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I was in the hospital last week for testing and observation after my heart went nuts. I have some atrial fibrillation now, that is currently being tamed with some medication.
Does anyone see have anything similar? How is this going to affect my skiing? especially at altitude?
 

bbinder

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I've got a-fib and I'm on medication for it. It's never slowed me in the least from skiing, but each case is individual, so don't take this as a free ticket. Talk to your doctor.
^^^ This!

I have a friend who flew to Alta the day he was released from the hospital to get a mini-crisis of a fib under control - and he outskied the rest of us. But I view his story as inspiration not as a recommendation.
 
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graham418

graham418

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I'm hoping that I will be in the same category . Doing a trip to BC interior in December to try things out. Hopefully I will have things settled by then. Doing some more trips in February and March to higher elevations, so I hope that will be ok. Also a little concerned about insurance and pre-existing conditions. I've never had to worry about that before
 

Ken in LA

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The atria only contribute ~20% of cardiac output, therefore most people with A-fib can resume normal activity. HOWEVER, most people with A-fib are placed on anti-coagulant therapy aka blood thinners (Coumadin, Eliquis, Xarelto, etc.). This is where the problem lies... injuries while on blood thinners (especially head injuries) can be difficult to survive. Please speak to your doctor before skiing and consider wearing a medical alert bracelet to alert emergency medical personnel.

If you are interested why blood thinners are important for the treatment for A-fib read on... the dysfunctional atria cause a pooling of blood that can lead to the formation of clots. If one of these clots travels to the lungs it can cause a potentially life threatening pulmonary embolism. If one of these clots travels to the brain it can cause an ischemic stroke.
 

Ken in LA

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Also a little concerned about insurance and pre-existing conditions. I've never had to worry about that before
The Affordable Care Act (commonly referred to as Obamacare) prohibits health insures from charging more, limiting, or denying coverage based on pre-existing conditions. For the time being your access to insurance coverage should be unaffected by your preexisting condition (I say for the time being because... welll... I don’t want this to devolve into a political discussion).
 
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graham418

graham418

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The Affordable Care Act (commonly referred to as Obamacare) prohibits health insures from charging more, limiting, or denying coverage based on pre-existing conditions. For the time being your access to insurance coverage should be unaffected by your preexisting condition (I say for the time being because... welll... I don’t want this to devolve into a political discussion).
I am a Canadian, and will be travelling to the US to ski. I usually get full trip insurance, i.e.: full medical, trip cancellation, loss of gear, etc. A lot of policies have a preexisting clause, usually 90 days since any change in condition
 

Johnny V.

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I was diagnosed six years ago at age 60. I went into the hospital with a heart rate of 190. I had two cardioversions with the second one successful. I currently take two medications plus aspirin as a blood thinner. I mountain bike/trail bike in the warmer months and ski all winter with no problems. I occasionally have episodes ( I had a few days this spring where on a mountain bike climb that I usually make with no problem I had to stop 3 times) but overall it doesn't bother me. As others have said, the biggest problem is blood thinners and the potential bleeding problems that can result.
 

Ken in LA

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I am a Canadian, and will be travelling to the US to ski. I usually get full trip insurance, i.e.: full medical, trip cancellation, loss of gear, etc. A lot of policies have a preexisting clause, usually 90 days since any change in condition
Oh dear... sorry. I hope you can continue to enjoy skiing stateside. Luckily you have some of the world’s finest skiing north of the 49th.
 

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A-fib is ideally treated by rhythm control (getting your heart back into sinus rhythm). This can be done with antiarrhythmic medications (amiodarone, etc), cardioversion (shocking your heart back into a normal rhythm), or ablation of the dysfunctional electrical pathway (an invasive electrophysiology procedure). If rhythm control is not attainable, the next best thing is rate control (slowing the rate of ventricular response down to a reasonable level), probably along with anticoagulation. As stated above, anticoagulation is the real bugaboo for folks who enjoy riskier sports. Definitely let your cardiologist know that skiing is important to you, as it may help guide the therapeutic plan (avoiding anticoagulants if possible, for example).

The main concern with clots from a-fib is embolic stroke (blood clot traveling to the cerebral blood vessels), as well as embolism to the kidneys, gut, or even feet. Clots in a-fib form in the left atrium or left atrial appendage and are much more likely to go to the arterial side of things. Pulmonary embolism (venous/right heart problem) is much less likely (as opposed to blood clots from the legs) as this would require a very specific set of circumstances to occur (hole between the left and right sides of the heart e.g. PFO, ASD, VSD, etc as well as actual left-to-right shunting of clot material).
 
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graham418

graham418

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A-fib is ideally treated by rhythm control (getting your heart back into sinus rhythm). This can be done with antiarrhythmic medications (amiodarone, etc), cardioversion (shocking your heart back into a normal rhythm), or ablation of the dysfunctional electrical pathway (an invasive electrophysiology procedure). If rhythm control is not attainable, the next best thing is rate control (slowing the rate of ventricular response down to a reasonable level), probably along with anticoagulation. As stated above, anticoagulation is the real bugaboo for folks who enjoy riskier sports. Definitely let your cardiologist know that skiing is important to you, as it may help guide the therapeutic plan (avoiding anticoagulants if possible, for example).

The main concern with clots from a-fib is embolic stroke (blood clot traveling to the cerebral blood vessels), as well as embolism to the kidneys, gut, or even feet. Clots in a-fib form in the left atrium or left atrial appendage and are much more likely to go to the arterial side of things. Pulmonary embolism (venous/right heart problem) is much less likely (as opposed to blood clots from the legs) as this would require a very specific set of circumstances to occur (hole between the left and right sides of the heart e.g. PFO, ASD, VSD, etc as well as actual left-to-right shunting of clot material).
Currently, I am on the rate control plan, with the idea once my rate is under control, they can think about rhythm control. The cardiologist didn't want to do a cardioversion right away as the chance of my aortic valve (replacement pig valve) throwing off some clots would be too great. It would be better for the thinners to work for a while. I'm going back for another echogram in a while to reassess heart function, and then consider cardioversion.
 

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For those of you on thinners, there is a relatively new proceedure called the Watchman device. It is placed ito the Left Atrial Appendage, where most clots form, and blocks the blood from entering the appendage. It is deployed through a catheter, so is an outpatient procedure. Successful deployment of the device allows patients at risk for clots to come off their blood thinners.
 

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newfydog

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A friend of mine, a physician, suffered from fibrillation, particularly during XC ski races at high altitude. He thought it could be treated by ablation, but they needed an EKG of an event, and all attempts to trigger one while recording EKG failed.

He finally got a portable EKG, when to the California Gold Rush race in Tahoe, drank a few cups of coffee and took off like a bat out of hell. He succeeded in triggering the fibrillation, stripped off his top and gasping for breath, wired himself up. Various people were freaking out, but he just kept saying "I'm a doctor, I know what I'm doing".

The EKG he recorded increased the chances of successful ablation from something like 20% to 80%. He had the procedure and it worked. He just got married (in his 60's) and danced all night.
 

Castle Dave

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Right now it sounds like a pacemaker isn't being considered. I have had one for 3 years and in case that happens I wanted to reassure you that the procedure is straightforward and the technology is absolutely amazing
 
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graham418

graham418

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Had a Cardioversion this morning. Was zapped 3X. First 2 unsuccessful, 3rd attempt was transient success, 4 seconds. Woo Hoo! Will now try change of medications, with another attempt at a later date.
I did go skiing on Friday, at the local bump. Was comfortable for the most part, out of breath at times. Hopefully things will improve!!
 

Blue Streak

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One of my best friends has afib and skis his ass off fwiw.
Good luck!
 
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graham418

graham418

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Just got back from a pre season warm-up to Silver Star in BC. I pretty much sucked. The first few days especially, heart was going nuts, very short of breath, even though its a low elevation resort (Top at 6300'?) I struggled with it for most of the time. The 3rd and 2nd last days, it seemed my heart went into sinus rhythm for a while and it got easy, and skied well . The last day , again, not so much. I did manage to ski the last few days almost to the end of the day.
Our hotel didn't have an elevator, and that was quite a kicker!
I saw my cardiologist on Monday when I returned, and He has prescribed some new meds and says we will retry with the cardioversion.
The bad news is, he told me to cancel my ski trips to Big Sky ( I was going to go to the Gathering) and to Steamboat and Winter Park in March.
Which has me totally bummed out.
 
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