How long for high heart rate to cause damage?

[wingtip]

I am a 38 year old male with permanent a-fib.  I was diagnosed three years ago after a forty pound weight loss, but I had had symptoms for eight years prior to that with a pounding chest or dizziness while under high stress (big eight auditor) or while playing intermural sports coupled with a beer or two.  

After two failed attempts at cardioversion, I was put on cartia, digoxin, coumadin and lipitor.  I decided exercise was my best bet and started walking, then running, and now I am doing distance running.  My last race was 10 miles in 1:45, so I'm slow and steady.  But during these runs I have a heart rate exceeding 200 (per Poler monitor) for five or ten minutes at a time, with it dropping back to 180 after I slow to a 5 mile an hour pace.  I don't get dizzy or uncomfortable, but I can feel something.  When I spoke to my EP, he felt I should do my best to keep it under 200 bpm, and with the great strides they are making in heart damage reversal, by the time I do any damage, they will have a cure.  I plan to try my first marathon at the end of May, is there a place where I can read about potential problems or what to look for.  I feel better than I ever have before.  When I have taken stress test the doctors always stopped me within two minutes for a heart rate >190, but I felt I could have kept going

[mrsm1]

A related discussion, high heart rate was started.

[celestial]

Hi, I recently had 2 spells with my heart beating very rapid and lasted about 1 hr. also had skipped beats off and on.  at both times I was very congested and sick. My cardiologist now says I am having Afib but chose not to put me on medication at this time but increased my aspirin from a baby aspirin to adult. He says it is not life threatening but after reading all posted I am even more afraid. someone help me thru this please.

[wingtip]

Thanks Mapin,   In Buffalo, we arn't loaded with EP specialists.  THe first time I saw him, I was set up for the cardioversion.  He left the group I was using, but I tracked him down after I experienced a heart rate of >200 for several hours during a low stress euchre tournement.  I never felt faint, just a little off.  He put me on dijoxin.  After seeing a new cardiologist, he did another holter, and fould episodes of a fast rate, but was only concerned about three second pauses during sleep, so he sent me back for  a pacemaker study.  The EP felt pauses weren't that important in someone my age, and said that the fast rate will only be a problem if I get symptoms.  Since I have never stopped running ( 30 miles a week now) , he felt that I was fine, just do not over do it.  Nobody has said why I need to fix the problem with ablation, because it isn't causing symptoms.  Even the doctors statement above didn't state that I was causing damage to my heart by continuing to exert myself.

[mapin3d]

Regarding the recent post on AFib. There are several hospitals in the US that are actively treating AFib with RF ablation. The thing to determine is what type of Afib one is experiencing. The most common is paroxsysmal Afib which can occur in patients as young as 30 y/o. It is important also to determine if the Afib is associated with cardiomyopathy,vavular disease, pulmonary HTN or any other underling disease process. Paroxsysmal afib can sometimes and is often associated with a focal initiation point arising from within the pulmonary veins although  left or right atrial focal points is not uncommon. The trick to treating these types of arrythmias is to be seen by someone that is familure with the etiology of AFib. Many advances and theories have been made in the treatment and mechanisms of Afib over the last year or so. Additionally, treatment  options continue to advance as specialized mapping catheters and therapeutic products hit the market. As PV mapping becomes easier, less than a 3 hour procedure, more and more centers will likely look at offering it as part of their treatment plan. Most of the major academic hospitals with strong and aggressive EP programs are currently providing a cureative treatment option to those patients with paroxsysmal Afib. On the other hand, chronic Afib is much harder to treat due to the mechanism itself. With atrial enlargement the substrait for having Afib is likely to increase. It provides a larger mass for the fibrillatory waveletts to propagate throughout the Atria.It usually involves the right and left atria. There are surgical procedures that help to reduce or stop the propagation of the fibrillatory wavefront. Currently, many companies are working on catheter based products that help to isolation  portions of the atria to terminate the mechanism.
Speak with your electrophysiologist and find out what the  current treatment options are. Ask for a referal to a center that is actively and aggressively treating AFib patients. Good luck.
Mapin3d

[debra21784]

One momrning I was getting dressed for a finance meeting at a new position I had just taken with a large academic medical center and the next moment I was on the floor unable to move my left side at all.I was in fact alone,it was 6 AM.I can remember thinking I'm having a stroke and at the same time saying to myself this couldn't be true I was too young for a stroke.It took me 1 and a half hours to crawl to the phone to call 911.They had to break to door down to get in.By the time I got to the ER I had lost my speech and all function on the left side of my body. .I am a master's prepared RN and didn't know what was happening to me.It has only been th last 2 years that I have researched and made myself become informed about cardiac disease and stroke.I do medical journal searches on Medscape and e-mailed each author with my remarks and comments as well as questions.Everyone has responded.This is how I have become informed .Remember that knowledge is power and you have to be your own healthcare advocate.At 25 months post stroke I still have some deficits left.It has been a long,laborouis road back and I'm not there yet. The info is out there,You can access NIH stroke team for imfo as well they have articles on the website.Good luck

[Lyn2]

debra,

Thankyou so much for your encouragement and information.  I am trying to find out as much as possible, but everything seems to get more and more confusing and complicated.  I am so sorry that you had to go through such a difficult ordeal.  What did it feel like when you had your stroke?  Were you alone?  Did you call 911?  It is wonderful that you have taken a very terrible ordeal, and now are using it to inform and encourage others.  I hope to do that as well.  I mean, there is nothing we can do to take back the bad stuff, but we might as well use it for good.  Helping others understand, and support them.  Are you completely recovered now, or have you deficits as a result of your stroke. God bless.

[debra21784]

You are NOT a WHINER.You have serious heart problems and are concerned,this shows a great deal of willingness on your part to be RESPONSIBLE AND INVOLVED  with your physician for your care.Great that you are on Coumadin to prevent stroke(I was not unfortunately),your INR however should be aroung 2 to 2.5 to ensure optimal coverage .You mentioned that you have a hole between your heart chambers.Have you gotten a cardiac surgical opinion about correction? Is this causing the A-Fib?Have you talked with your doc about ablatation for A-fib? Was on Amnioderoine too for awhile before th ablatation. What is the underlying cause of the A-Fib? Hopefully ,you have a great cardiologist who is up on things and is aware of new treatments and cardiac programs in major academic medical centers.It sounds as if he is if he is concerned about stroke and a-fib.There are some great medical journal site out there and as I indicated in my last post some great researchers.I have been in contact with them via e-mail ,they answered and were more than helpful letting me know about research studies,clinical trials, articles and answered each and every one of my questions.When I go to my doc I now feel better informed and can discuss issues and treatment with him.Educate yourself,read ,ask questions,research.Good luck

[Lyn2]

It is scaring me to hear about the high incidence of stroke with a-fib, not that I was unaware but your story debra makes it so real.  I am 34.  I have a-fib, on and off all the time that apparently is interspersed with ventricular tachycardia.  I am on amiodarone and coumadin and cartia, but am completely out of control with these rhythms.  My rate gets over 300 as well.  I don't know what to do next.  I was completely unaware about the v-tach, until my last pacemaker had recorded hundreds of these episodes over the last 60 days.  The doctor increased my dose of the heart medications, and as a result the nurses lowered my coumadin dose, anticipating an increase in my INR. When the nurse checked it this morning it was only 1.3, and I know I am in a-fib.  I don't want to sit here waiting for a stroke, but it is a bit unnerving.  I thought it was strange that the nurse was not going to let my doctor know, she just upped it half a dose for today and that is it.  I know for a fact my EP doc is very worried about stroke, because I also have a hole between my top upper chambers.  I would like to ask the doctor's opinion here, but I feel like I ask too many questions and others should have a chance.  I don't really know what to do.  Wow, did I just vent.  Sorry! I'm usually not a big whiner.

[debra21784]

To answer your question I can only tell you about my experiences with A-Fib.My arrthymia started in 1997 at the age of 44.I would get these episodes where my heart rate soared to 300 plus beats per mintue,I would be drenched in sweat and become short of breath because my rate was so high and irregular in quality.When I said it only takes one run I meanted that you do not have to be in sustained A-Fib but it would come and go .Sometimes converting on its own,other times requiring IV medication,ER stabalization.What happens is the heart is not pumping effectively,the entire body is effected hemodynamically and you may even loose consciuosness.The danger of A-Fib is the possibility of releasing a clot from the heart when it goes back into a normal sinus rhythmn.The blood can pool in the heart resulting in a clot.The way to diagnose A-Fib is by EKG and an EP study.
The last time I went into A-fib 2 years ago it resulted in a massive stroke that has left me disabled.Hope this answers your question.A-Fib is treateable.

[debra21784]

Let me be blunt:You need another cardiologist.They do ablatations and pacemakers in children at major academic center in the US.Cleveland Clinic,Johns Hopkins,Washington Hospital Center to name a few.A-fib is nothing to treat in such a cavilier manner.As I said I had several runs and converted with IV medication in the ER,it only takes one time though.I want to impress upon you it is not necessarily the rate at the time but when the heart returns to normal sinus rhythmn that a clot can be ejected from the heart ,travel to the brain resulting in stroke.Researchers are now recongnizing that stroke does occur in younger adults 40's plus who have A-fib.I guarentee you if you talk with a good cardilogist he will recommend a more aggressive course of action.A stroke can kill you, leave you mildly to severly disabled even at age 45.You may want to do some better rsearch with some experts around the country about treatment of A-fib.Harold Adams at U of Iowa,Louis Caplan ,Sturat Connollyat McMaster's University, Greg Albers to name a few are considered experts in stroke and its relationship to atrial fib.You don't want to spend years trying to recover from a disorder that could have been prevented by treating the a-fib with ablatation or other means

[wingtip]

Once I was assured that the high rates wouldn't convert to v-fib, I put it out of my mind.  I did get anti-arrithmics before the second cardioversion, didn't help.  If the doctor hadn't told me I was in a-fib, I wouldn't have known.   Ten years ago, I used to feel the heart flipping around, beating hard, or going on at such a high rate I had to lay down, and it caused problems at work.   But this was always during high stress, so the HMO dismissed it.  The persistant a-fib doesn't have any symptoms that I can feel, and when I was in rythem for a few days after the cardioversions, I had terrible headaches.

The last trip to the EP was recommended by my cardiologist , not because of the high rate during activity, but because I had pauses over three seconds during sleep, and he though I might need a pacemaker.  The EP said they do not like to do that in young people, and that it wasn't that abnormal.  He also said that I should wait a few years to see how the ablation technology was progressing, my ef was still 55%, so I have plenty of time.

[sabrina]

Hi,

What does a-fib feel like? I once had a totally fast irregular heart rate and i felt a fluttering sensation, like a twitching. Is that what a-fib feels like??  What do you mean you only had a single run?? How long did it last?

Thanks,
Sabrina

[sabrina]

Hi,

What does a-fib feel like? I once had a totally fast irregular heart rate and i felt a fluttering sensation, like a twitching. Is that what a-fib feels like?? What do you mean you only had a single run?? How long did it last?

Thanks,
Sabrina

[pikamom]

Yeah, I can't believe you're doctor is letting you continue with such a high heart rate. I was diagnosed with a chronic tachycardia, resting heart rate 120-140 and was told my heart would eventually weaken if I didn't get it lower. With cardizem it's now under 100.

[debra21784]

Read your post and got concerned.I am glad to hear you have dropped the weight, but sustained a-fib is very dangerous.Why aren't you going to see about an ablatation? A-fib is a very high risk factor for stroke.I sure hope you are on Coumadin or at least asprin for anticouglant effects.Iam suprised your physician is so laid back about this. My stroke was at age 46 WITH OUT SUSTAINED A-FIB but only a single run.It has taken 25 months to recover .I think I would get another opinion and take this a-fib seriously.

[CCF-M.D.-CRC]

Dear wingtip,
The answer to your question concerning high heart rate is really more academic than practical.  Heart rates >150's for several weeks can lead to a cardiomyopathy (muscle damage) that is sometimes reversible after the heart rate is controlled.  

From a more practical standpoint I would agree with your cardiologist that rates >200 bpm are probably not the best idea so I would limit exertion to keep the rates lower than this.

From a more global standpoint I would suggest that 2 failed attempts at cardioversion without antiarrhythmic drugs in a young person is not an adequate attempt to maintain sinus rhythm.  You may want to get a second opinion from another EP concerning antiarrhythmic drugs and/or ablation attempt.  In the long run I think you would feel much better in sinus rhythm and not have to worry about these high heart rates.