Saturday, November 22, 2014

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

1 comment:

Anonymous said...

Wow - good luck with that Andy. Just been reading your blog for the first after searching for winter cycling in the 'gorms. Great posts. Thanks. Mark