Cardiac Arrhythmia
 

So today I finally went to see my doctor as for the last three or four weeks on long runs, I have been experiencing dizziness about 10 miles into the run. I have found that if I keep my heart rate down below 160-165 I can manage. My doctor checked me in the office and gave me a diagnosis of cardiac arrhythmia. The next step is going to be a Holter monitor that I will wear for 72 hours to take recordings. I've also been finding I can't ride as hard as I used to so it has affected that too. It is my hope that this can be managed without medications or procedures as my doctor told me that I should be able to continue running if I watch the HR as I have been so I take it I may not be in too bad of shape.

I'm curious what others have experienced with cardiac arrhythmia and how have they have managed. Thanks

Supra-ventricular tachyardia (SVT). Its when the node that sequences the heart's beating function goes whacky and a chamber or two starts beating out of sequence and at a high rate (160 BPM) for no reason. I think I was experiencing it for a few years in short bursts, especially while working out, and I just chocked it up to age or 'having a bad day in the saddle'. Then at work it hit me and I ws having trouble breathing, it kept going on-and-on for extended periods. I went to the emergency room and the ER doctor almost immediately knew what it was, ran a few tests and confirmed it. Its controlled with inexpensive prescription medication and once I got the dosage adjusted I've had no more major instances. I still can get a short 'burst' of rapid heartbeat that I might not even notice per the cardiologist I see 2X per year. No problem with bicycling or other activities since then.

Getting older sucks, doesn't it?. :(

Atrial fibrillation about 15 years ago. Couldn't stand the meds, and had an ablation, which cured it until about 2 years ago. Last year had another ablation and I'm in normal sinus rhythm. No meds except blood thinner. There's a new procedure called The watchman which can eliminate the need for the blood thinner. I am considering it. I will be 83 in November.

I take my HR and HRV every morning. I use my phone, which has a visual display of my heart's activity. A few months ago, I was doing that, lying on the couch, feeling normal, and was shocked to see that I was experiencing SVT, except I didn't know that's what it was. Scared me a good bit. I got up and went downstairs with the phone, still at it, still feeling OK. I drank a glass of water, and poof, it stopped. Went to my PCP, did an EKG, all normal (for me). Never happened again. I think I was dehydrated. I have a very strong riding buddy who has SVT events frequently. He says they're not dangerous. My PCP also said not to worry, but from what you said, probably not a good idea to ride hard when that's happening.

"Cardiac arrhythmia" is a generic term that covers a pretty wide range of conditions. It could be supraventricular tachycardia, paroxysmal atrial tachycardia, atrial fibrillation, atrial flutter, etc.

I ran tonight, only three miles. But I tried to push a bit harder than I have been on my long runs taking the HR up about 10 beats per minute more than where I've experienced dizziness with no problem. My problems though on the long runs have been coming at about 8 to 10 miles. The doctor probably should have told me not to run because I'm apt to do something stupid running like this.

What is the common treatment for this?
Lifetime meds?

As noted above, we don’t know what “this” is.

Personally, I developed atrial flutter a couple of years ago. I had to undergo what is called a cardioversion. They put me under general anesthesia and basically defibrillated me. “Clear!” Problem solved.

I've had something similar a couple times at age 51 and 52 - maybe not what the OP is experiencing. Mine were followed by a huge adrenaline dump, which made it difficult to complete the ride due to extreme fatigue. I went through lots of testing, nothing showed up. I have not had it since, and I'm 58 now.

Exactly, and the entities covered by the term range from benign and safely ignored to cardiac arrest and bye-bye Charlie.

Hi, have your Doc check your Magnesium levels.

Hy heart misses a beat often enough, but lately, it's been down to one beat every two, which is a tad strange.
Must've had it before when I saw the quack when it registerd 32bpm. I felt ok. He was young, and told me to come back if any other oroblems arose.
Lately, same thing. Had an ECG at the hospital, and the doc said everything's ok. She told me to continue with my gym work and biking.
That's why I've ordered a HR tracker!
I'm like an old sports car. Love being cranked up, but tick-over is useless.

Finished my 72 hour Holter monitor test today with a 6 mile run and logged two chest pain events. After the run my wife's dog expects a walk and I had a chest pain event during it as well. My general practitioner isn't concerned enough that he suggested I not run or ride, so hopefully the Holter monitor will show this is just post COVID wonkiness and not a heart problem.

I've had a few minor arrhythmias over the past decade: the occasional little flutter in the chest, a good several minutes of PVCs (google), not SVTs as I said in an earlier post. Drinking a glass of water stopped them. A few other minor things. Saw a cardiologist, got a full workup, found to have a partial left bundle blockage. Then I had the PVCs, fairly recently, saw another cardiologist who said I had a right bundle blockage instead, but . . .

Yesterday I was riding my rollers out in the shop, just doing an hour of steady-state below VT1, HR about 115, when suddenly I felt a discomfort in my heart, followed about a second later by light-headedness, followed a couple seconds later by passing out and coming to on the floor with my wife standing over me. My Garmin showed no HR for 11 seconds, maybe true, maybe not. Turned out I have both right and left bundle blocks, which left only one operational. When that one fails, heart fails. Syncope. My doc says maybe I did my own cardioversion when I hit the floor. Owing to my almost infallible luck, I was not out on the road on the tandem with my wife. My face and neck aren't so good, but no permanent damage. Good thing I was passed out and limp when I went down.

Went to the hospital, got a full workup. Going to see a better cardiologist who'll put one of those recording patches on me for a couple of weeks, then install a pacemaker. My doc says I should be safe to do whatever then. Nothing seems to be wrong with my heart other than the electrics and everything else still works. Maybe I'll still be riding at 80 after all.

that’s a frightening one! my main fear in cycling is syncope due to VT, but i’ve lived with various arrhythmia for so many years that the signs are immediately recognizable. my theory is that i’d be able to stop and get off the bike.

make sure you see a good electrophysiologist. my (long) experience is that traditional cardiologists are not strong on the electrical side.

Carbonfiberboy , you were very lucky that you were not out on the road as you said. Even luckier that you were not out alone. I hope the pacemaker takes care of any future issues for you.

your GP likely wouldn’t know the difference between a “harmless” arrhythmia and the widow-making type. as others have noted, get more detail from the doc (hopefully an electrophysiologist!) before continuing any strenuous activity. what you describe could be harmless PVCs, life-threatening VT/VF, or anything in between or something else!

I just checked my daily multivitamin and it is only 50mg of magnesium. What I read after seeing this post suggests males over 51 need 420mg. I also went to the google clinic and read that I have some of the other symptoms of low magnesium other than arrhythmia (and I check off all the boxes for symptoms of arrhythmia). My wife just so happens to have a 420mg magnesium that mixes with water that I'm going to try starting tomorrow.

It happened so fast that I couldn't even brake to a stop. I started to do that, but then boom. However my issue with the bundle blocks is probably not your issue. Thanks for the advice. I'll ask my PCP for a referral to an EP, too.

I will be seeing a doc who is a cardiologist and an electrophysiologist and an internist. He has more letters after his name than anyone else in his group and is board certified. Should be good.

I take a calcium/magnesium in the evening every day, plus when I exercise I also take calcium before and a magnesium after.

You're in the "wishful tinkling" stage of aging. The bottom line - your heart has become older and is signaling its stress by failing to keep rhythm during efforts.
My heart lost rhythm several years after having a valve replaced. I "babied" my heart for several years and avoided any additional treatment other than beta blockers.
Inevitably - I slipped into full blown constant AFIB last spring, I had a Maze procedure done and I am back in normal rhythm - but this isn't a cure - its just a chance for a failing heart not to beat itself up as quickly.

Like yourself - I wanted to ride long and hard - but eventually reality sets in and wishful thinking subsides.

Why at those particular times?

The Cal/Mag in the evening because my wife thinks it helps her night cramps. There are a couple studies which seem to show that endurance athletes can reduce their chance of bone loss by taking calcium before sweaty exercise and then the magnesium after to keep the cal-mag 2/1 balance. Though some say 1:1 balance is better . . .

I agree that there is likely a great deal of wishful thinking. But I still feel this is possibly more of a post COVID symptom than the beginning of the end. Up until a couple of weeks ago, I was training for my first full in five years with two 17 year old kids. We were running a manageable pace but after COVID I could no longer keep with them. Since then I also dropped from the mentoring program that I'd been with for 15 seasons that trains with at risk youth for a half marathon. I was able to drop my full registration to the half for 5 bucks and I've continued to train for it. Three weeks ago I had to stop and let my heart slow down about every mile. By the time I had to bail on the full, I was up to two miles before I had to do that. Saturday I ran 6 miles with no real issues at about a 30 sec/mile improvement over what I was doing with the kids. When I ran my first half marathon, there was a lady with a shirt that said there will be a day I can't do this, but today is not that day. I guess November 20th may be that day for a full, but I'm determined to not let it be that day for a half. Of course when my Dr. gives me the results of my Holter monitor I may have to rethink that. But for now I'm keeping positive.

And not riding hard is not a problem. I've been at peace slowing my rides down or not riding as many hills.