I'm 57, and I've had an Afib diagnosis for the last 6 years. On a low dose of metoprolol. Over the last year or so , I just can't seem to run anymore. I can walk fast and all day, and ruck for an hour no problem, but if I run, even at a slow pace, for 5-10 minutes, I feel like crap all day. Light headed and a head ache, etc. Any ideas why? I'm in good shape otherwise, and I'd love to get back to running again.

Are you always in afib? Or does the metoprolol keep it from coming on? Beta blockers essentially block your body's ability to make your heart pump faster, it also blocks your body's ability to dilate your airways, dilate your blood vessels, etc. Essentially it blocks that action of adrenaline, which is usually going when you're working out.

Could consider talking to your cardiologist about switching beta blockers. I think there are a few that are more heart specific than metoprolol, like nebivolol or bisoprolol. But not sure by how much. Could also try adjusting dosage. Could also just be getting older.

I've had A-fib/flutter and was treated with ablation procedure. Over the last 20 +/- years or so it has recurred a couple times. Total of 3 procedures.... So far

Thank you that all makes sense. I started with a calcium blocker, but had a side effect with it. I just want to run like I always have. Especially since the metoprolol doesn't keep me out of afib.

Could look into either the watchman procedure or ablation if you want to get off meds. Some cardiologists might also put people on anti-arrythmics, sometimes just a pill you carry around if you feel yourself going into Afib. But easiest thing might be just trying a new beta blocker.

I had a cardioversion that lasted a week. An ablation might be the way to go

Have you had a heart cath or CT with contrast? It sounds like you may be experiencing blockage, causing the a fib.

2 years ago I started losing energy and finally checked myself into a hospital when my cardiologist kept putting me off. The next day I had a heart cath and 3 days later (16 months ago) I had a triple bypass. Had I listened to the Doc I would be dead today.

Trust yourself more than the doctors. If you are having loss of energy combined with an a fib diagnosis then you should absolutely get a CT with contrast to see whether there are blockages. A stress test WILL NOT show this, you need the CT with contrast. If they show a blockage then they will do a cath and open it up. If the cardiologist refuses to do the CT with contrast then check yourself into the ER and tell them you are having "chest pain and loss of energy". They cannot send you home if you tell them these exact words.


I am not a doctor but I have been dealing with heart damage for 20 years. Loss of energy is a HUGE sign. I was still mountain biking and skiing 2 weeks before my triple bypass but I couldn't do other things. TRUST YOURSELF. If it isn't right, then don't wait for some doctor.

knoxtom said:

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Have you had a heart cath or CT with contrast? It sounds like you may be experiencing blockage, causing the a fib.

2 years ago I started losing energy and finally checked myself into a hospital when my cardiologist kept putting me off. The next day I had a heart cath and 3 days later (16 months ago) I had a triple bypass. Had I listened to the Doc I would be dead today.

Trust yourself more than the doctors. If you are having loss of energy combined with an a fib diagnosis then you should absolutely get a CT with contrast to see whether there are blockages. A stress test WILL NOT show this, you need the CT with contrast. If they show a blockage then they will do a cath and open it up. If the cardiologist refuses to do the CT with contrast then check yourself into the ER and tell them you are having "chest pain and loss of energy". They cannot send you home if you tell them these exact words.


I am not a doctor but I have been dealing with heart damage for 20 years. Loss of energy is a HUGE sign. I was still mountain biking and skiing 2 weeks before my triple bypass but I couldn't do other things. TRUST YOURSELF. If it isn't right, then don't wait for some doctor.

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I'm no cardiologist but I'm almost certain a stress test will pick up significant ischemia.

I had the calcium scan that did show some very slight heart muscle damage. For me it's less low energy and just crappy runs. Other work outs are fine. I get what you're saying about blockages , but that wasn't shown.

Obviously do what your doctors tell you... I am just a guy on the internet. I am just saying you have to trust yourself as well. I would ask myself, what is causing the a fib? What is causing weakness? What is causing lightheadedness when exercising? These things don't just happen.


Do you know that something isn't right with you? Then find out what it is. You know you and if something is wrong, figure it out. If your doc won't test you then go to the ER and say the magic words "I have chest pain and I feel weak when exercising." I promise if you say that they will do the proper tests.

knoxtom said:

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Obviously do what your doctors tell you... I am just a guy on the internet. I am just saying you have to trust yourself as well. I would ask myself, what is causing the a fib? What is causing weakness? What is causing lightheadedness when exercising? These things don't just happen.


Do you know that something isn't right with you? Then find out what it is. You know you and if something is wrong, figure it out. If your doc won't test you then go to the ER and say the magic words "I have chest pain and I feel weak when exercising." I promise if you say that they will do the proper tests.

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A beta blocker will literally do everything you just listed. Aside from causing the a fib itself.

So just a few points. I'm just an ER doctor, but you'd be far better off going to your primary care doctor and just asking for a stress test or coronary ct angiogram (not just a "CT with contrast"), than going to the ER and claiming you have chest pain when you don't.

The ER can send you home if everything is normal and you don't have risk factors. And the ER is also the most expensive form of healthcare. Depending on what ER you go to, you'll likely get an EKG, and some blood work. And then if you have any abnormal findings, or sufficient risk factors, given your age, they'll probably keep you overnight and observe you, and maybe get a stress test the next day. Some ERs do coronary CTAs, but not many.

I agree that a stress test might not show if you have blockages, but it will show evidence of clinically significant ischemia. That being said, you could have a large blockage, or a small blockage, and a 100% normal stress test, and still get a heart attack the next day if that blockage, regardless of size, ruptures.

A calcium score will only show you calcified plaques, which are in general low risk for rupture. And a calcium score is designed as a risk stratification tool to determine if you should be on a statin or not.

ERs across the country are already slammed with patients that don't have access to primary care, or whose primary care doctors don't want to see them, or even whose specialists don't want to see them/have time for them. Using the ER as your primary care just clogs the system even further. And something most people don't see behind the scenes are the ER doctors calling the specialists to see patients in the ER, or admit patients. It is frequently a battle - depending on the hospital culture.

If you're going to try to game the system and abuse the ER, please go to a hospital that is used to concierge medicine, and that pays their doctors well, and if you'll have no trouble getting admitted. But still, you might only end up with a stress test, and not a cath or CTA. You really are better off just going to a primary doc and asking for it the CTA, or getting your cardiologist to do it.