Hi, Ben. There’s a very strong similarity between our cases, although you’ve been through more of a wringer than I have.
The first time I had the symptoms back in '14, I was in the men’s room at work. I felt like I had been punched hard in the chest. I took my pulse and it was 34. I’ve always heard or read that Afib felt like your pulse is racing, not bradycardia.
The way my MTFN (middle of the night ) episodes feel is like I have two separate pulse rates going. On one of those episodes, I checked my pulse on one of those pulse oximeters and I could see it get slower and faster (I’m a gadget freak - couldn’t resist picking one up for a couple of bucks on Prime Day a month after my gall bladder surgery). I don’t recall it going as low as it did that one time.
Right now, on a normal morning, after 2 mugs of coffee, my pulse is around 58 or 60 and steady.
I started going keto to prevent diabetes. My mom had it and my brother does now. I had an A1c done about 10 years ago that came back at 5.8. “Pre-diabetic”. Just had it checked in August and it’s 4.8. I’ve dropped around 60 pounds since that episode in '14. My cardiologist has never talked about diet in any way. Never said to eat low fat, keto or anything. He did tell me to lose weight, but that was 60 pounds ago, so not an outrageous suggestion.
One of the messages out of that book is that the repetitive stress of always pushing yourself to go faster and pushing well beyond being comfortable is the cause of heart trouble in athletes. With a goal of riding my age by February, it means adding 15 miles/month. On one hand, it doesn’t seem like that much, but I also need to work that message of reducing the stress deep into my head. I don’t want to make this worse by effectively saying, “I’m going to ride 65 miles on my birthday no matter what! If it kills me!”.
Back when I was more of a runner (like many cyclists, I switched because my knees were bothering me after years of running) there was a Tee shirt that said, “Joggers jog for their health. Runners run if it will kill them” and that machismo is probably what causes the athletic heart syndrome.