Fairfield

Took the heart fell walking in the Lakes. Beautful weather for a change. I was planning to keep my BPM below 140 but got a bit competitive going up Fairfield and ended up in the 160 range. Still, no problems but it took a long time to regain resting pulse after getting back to the van.  I'm guessing he's still feeling a bit bruised after being poked and frozen just over five weeks ago.

Suspecting that I might have a problem, I kept a log of AF symptoms for 12 months prior to getting diagnosed. See below:

St Sunday Crag

Dove Crag and High Street in the background

Dollywaggon and Helvellyn

 AF Log

July 2013. Got strange ectopics starting a walk from the top of a cable car in the Alps. Only lasted a couple of beats (big ones) but made me stop in my tracks. Same thing happened  the next day. For the rest of the trip started walking very slowly at the start of the day.

23/07/2013. Fractured back L3 in climbing accident.

August 2013. While recovering from back injury developed multiple ectopics whenever heart rate got above 120bpm. Went to see cardiologist (Dr Swan) privately in Rochdale. He did echocardiogram and said no problems. He also did tread mill test, ectopics kicked in at 120. Test was stopped and cardiologist said I might have coronary heart disease. Went to see my GP in Aviemore with letter from DR Swan. Arranged to have follow up tests locally on NHS. Symptoms did not reoccur

December 2013. Got AF symptoms in gym. Felt like ectopics every other beat. HR jumped to at least 20 above what I would expect for exercise level. (Did not actually know it was Afib until 9/07) Warmed up very fast because feeling fit. Lasted a few hours.

April 2014. Went for treadmill test to NHS Raigmore, Inverness. Managed to stage 5 of Bruce Protocol without any problems. Some ventricular extrasystoles in stage 2 which abated as exercise went on. Dr Clarkson said he was confident I did not have coronary artery disease.

May 2014 Had a couple of strange episodes first thing in the morning. Felt dizzy, faint and agitated. I could feel ectopics. One of which caused a panic attack. Went to health centre but ECG was normal. Was told to lay off coffee and alcohol.

15/05/2014 Got AF symptoms on treadmill at gym. Warming up too fast. Lasted 3-4 hrs.

31/05/2014 Cycling on logging tail with Pat. AF symptoms started with a flutter. Kept cycling over Ryvoan to Dorback. Seemed to ease during the ride. Lasted 3-4 hrs. Suspect coffee at Druie was the cause.

03/06/2014 Tuesday night ride up Meal a Bhuchaille. Very steep start from cold. Heart rate went up very fast. Got suspected AF. Lasted until 10pm.

15/06/2014 Felt very tired and dizzy in morning. Went for walk, which helped. Felt better in afternoon and had bike ride with Pat.

16/06/2014 Had big training day. Gym, run in woods, cycling with Pat. Felt fine but started with multiple ectopics in the evening when cycling up steep hill. Might have pushed heart rate too much too soon a start of the ride.

18/06/2014 (Had two pints as test night before). Went for run up ‘The Hill’ in the morning. Got spike in heart rate as it reached 150-ish after around 20 mins of running. All the usual feeling in chest and dizziness. Thought AF was going to set in but it settled as soon as I turned back downhill.

09/07/2014 Went walking/running in Cairngorms. Got an AF attack half way up the March Burn 2.5-3hrs out. Heart rate around 140 at the time. Hadn't drunk or eaten much. Happened shortly after a 10 min rest where heart rate would have dropped to normal and then been pushed back up very quickly. Decided to continue up rather than come down, hoping it would pass. By the time I reached level ground heart was above 180bpm. Felt grim. No phone signal. Eventually walked very slowly up to MacDui path and headed back. Heart still between 186 and 160bpm. Took a couple of hours to get back to the car park. Went straight to health centre who confirmed AF. Suspect I might also have had AFlutter at that point. Night at Raigmore, converted to NSR around 5am with help from amiodarone.

The Following Week. Had some ectopic/PVCs/PACs (not sure which) everyday but gradually feeling better. Woke with what might be A- Flutter on a two mornings, disappeared in less than a minute in both cases

15/09/2014 Over the last few weeks I have had minimal ectopics during the day or before going to sleep. I have been exercising up to about 150bpm which seems fine so long as I warm up VERY slowly. Walking up hills from cold brings on a feeling of pressure in throat/chest followed by faint ectopics. Almost feels like my heart won’t respond to the increased demand. This is the feeling I got back in August 2013 when I went to see Dr Swan. See Alivecor printouts.

10/2014

Had two further AF attacks, both exercise triggered with where converted with 'pill in the pocket' propafenone.

11/2014

Stayed very quiet on the exercise front not wanting to induce AF prior to my procedure at the London Bridge on the 19th

First Ski

Took the heart out for a short test run at The Lecht. I skinned up to the ridge behind the tows to where you can view magnificent terrain rolling out towards Ben Avon. Really didn't think I would be back in the hills so soon even if it was a very modest excursion.

Everything seemed to be working well (touch wood). In fact, without pushing my BPM above 130, I don't think my whole cardio system has felt so relaxed for years which makes me think that the short circuit that caused AF had been hampering my fitness for a long time before it developed into full blown AF attacks.

Something else that's changed is my resting BPM is back up to 60ish as opposed to 50ish pre ablation. I'm pretty sure that's where it was back in my early years when I was really fit. I wonder if the substrate that develops to transmit the unwanted electrical activity from the pulmonary veins had been suppressing the natural rhythm of the sinus node for many years. Hopefully the rouge cells will have a ring of scar tissue encircling them soon.

A Becks and a fag at the Lecht

Atrial Fibrilation

A couple of days ago a truly amazing young guy called Professor Richard Schilling inserted a catheter through a small slit in my groin and up the vein into the right atrium of my heart. He punched through the thin wall into the left atrium and proceeded to freeze rings around the four pulmonary veins that enter the heart. The following morning I walked out of London Bridge Hospital took a taxi to Euston and the train home.

I suspected there was a problem with my heart rhythm last year but it wasn't until July this year when I was lying in the small hollow at the top of the March Burn with a pulse of 186, that I knew I was in trouble. I managed to get back to the main MacDui path and descend slowly until I met a couple who escorted me back to the car-park. Once at the health centre they confirmed that my heart was in arterial fibrillation and sent me to Inverness for cardioversion which involves intravenous drugs to return the heart to normal rhythm.

Arterial fibrillation is the most common heart rhythm problem and effects 1% of the population. It is slightly more common in endurance athletes. Cyclist seem to have more of a problem than other sports but that might be just down to reporting. Male, mid fifties is the classic time to develop the disease but it can happen at any age.

Symptoms included breathlessness and dizziness which can be alarming yet some people are totally unaware they are in AF until they have a chance ECG. The other great news is that it gets worse. If you have one attack you are more likely to have a second then a third and so on until you are in permanent AF. AF begets AF.

The Shard from my posh room at The London Bridge Hospital

Treatments included rhythm control drugs, rate control drugs and the procedure I describe above called catheter ablation.  Most people start down the drugs route which may work for a few years but they have side effects. Catheter ablation is the only way of stopping the disease in its tracks but success varies and it is unclear as to how long it is effective for.

The NHS response to my ‘new’ problem was to give me pills that I could take when I had an attack; the ‘pill in the pocket’ solution. These did return my heart to sinus rhythm (normal rhythm) but suppressed my heart rate so much I couldn't walk up hills anyway so, next to useless in a mountain environment. I inquired about ablation but was told that I would have to try the drugs first.

The rest was pretty straight forward. I did a bit of research, found the number one AF guy in the UK and made an appointment. Richard Schilling was rather more upbeat about my prospects. With lone AF (nothing else wrong) he gave me an 80% chance of a cure with the first ablation and 95% if I needed a redo. He even said I was a “slam dunk’ for cryoablation! My health trust wouldn’t fund the ablation so I parted with some cash and got the job done ASAP. Fingers crossed now and hope that its all worked.

I’ll post some more on AF in the coming weeks but here are some useful links if you think you might have it.

The AF Association
The London AF Centre
Dr John - A cyclist and AF expert based in the US

The top European AF experts discuss the latest treatments

Longest Day Ski

Went out with Rob and Neville on the evening of the 21st (longest day), to see how much snow was left in the Ciste Gully. Quite a lot! There's probably a 300M strip which must be at least 3 or 4 meters thick in places. It will make a great base for the first winter snow if it manages to hang on through the summer.

Dirty old snow

Loch Morlich in the distance

Approaching through the remains of the Ciste chair lift

Winter Round Up

Not a great winter for touring. Huge amounts of snow in the Cairngorm ski area at times while the plateau was completely bare. Wind was the overwhelming feature of the whole winter period with just a couple of settled high pressure spells.

I spent most of November/December battling up to the Ptarmigan in dreadful conditions, lured on by the prospect of a fried egg roll and a chat with the ‘Hill’ maintenance guys. I even got the train down a couple of times, it was so grim.

The theme for the early part of the winter

With no end to the bad weather in site I bailed to Les Gets with Mike, Malcolm and John. Great conditions over there with some fantastic deep powder day.


My first significant tour wasn’t until 24th Feb when I traversed the west Dromochter hills from Geal-charn to Meal na Leitreach (see previous post). Despite great snow conditions the mist was down the whole way requiring some tricky navigation around the summit plateaus.

A week latter I traversed the east Drumochter hills from south to north on nordic skis. There was huge amounts of snow in the vast bowl that feeds down towards Sronphadruig Lodge.

A few nice afternoons in early March allowed Pat to sample the delights of Scottish ski touring. Lurcher's (of course), was her first journey outside the ski area. Like cycling, she prefers ascending to descending and likes it best when there’s no one else around, which isn't difficult to achieve.

Pat braces against a big gust on the way to Lurcher's

There were a few days of settled, and very warm weather in mid March. I booked a flight to Malaga the day before the forecast updated to high pressure. Despite feeling slightly frustrated that I was heading in the wrong direction I had a great trip to the El Chorro area with Cog and Cynthia.

Climbing at Turon

My last long tour of the season was along the ridge from Carn Liath to Creag Meagaidh, then on to Beinn a Chaorainn. I would liked to have continued on to Beinn Teallach but the snow line was too high.

Trackless travel between Craig Meagaidh and Beinn a Chaorainn

And the back? Amazingly good considering its only a few months ago that I could barely walk. Strangely enough, all my other long term back and pelvic stiffness has completely disappeared. Rob Edmond was telling me about some new research into back injuries which suggests that a general anesthetic may have a more beneficial effect that the actual surgery because it completely relaxes every muscle in the body. Several days on morphine can have a similar effect. I’m wondering if that’s why my old injuries seem to have disappeared (for now at least).

I don’t have any trips planned at the moment. I’m enjoying work and generally taking each day as it comes while not forgetting the frustration of lying in a hospital bed on the evening of July 23rd when I could have been down the pub having a drink with my wife.

West Dromochter Circuit

I manged to take advantage of a break in the weather to get round the Drumochter Munros west of the A9. Despite the relatively mild temps there's still loads of snow above 500M; just a 20 minute walk from Balsporran Cattages to reach skin-able snow. Touring conditions above 700M were really good with a light covering of fresh snow on a firm base. Unfortunately the clag stayed down all day which meant that navigation on the narrow summit plateaus of A'Mharcnaich and Sgairneach Mhor was tricky and time consuming. There was continuous snow cover for the long run off Sgairneach Mhor to the bridge in Coire Dhomhain.

I tried unsuccessfully, to hitch back up the A9; the walk wasn't too bad in TLT 6's. A bike would have been useful. The whole trip took about 6hrs including the walk back up the A9.

Looking towards the A9 from Sgairneach Mhor

Carn Liath

I had a drive west in search of some soft snow. The Cairngorms look good from a distance but they are very icy right now. Probably good for climbing but terrible for ski touring.

Creag Meagaidh was plastered but I kept driving to Fersit. Surprisingly there seemed to be less snow on the hill around Loch Treig so I procrastinated for a bit before driving back to Aberarder. If I'd had an earlier start the Creag Meagaidh circuit would have been possible. As it was already 11am and the weather was changing I settled for Carn Liath; the shallow south east coire just east of the summit looked like it might have some good snow. I followed the main Coire Ardair path for a couple of K's before cutting steeply up right and onto the ridge west of the summit. There was some very nice fresh snow on the descent and I managed to heather hop down to about 450M. A quad track gets you back to Aberarder farm.