Chuck M 

I got a call back from my GP today and will have a follow up Thursday to discuss the findings from my Holter monitor. I'm guessing that due to the lack of urgency that my GP is not overly worried or he is not worried enough. I suspect it may be the former and not the latter.

But going back to the magnesium, I have been taking 420mg daily for about a week. Within three days, I quit having dizziness. In the last two days I've had no chest pain. I have not been running the distances I was when I was experiencing problems, but I've been running at a faster pace and I ran this morning. This could all be psychosomatic, but I do feel better when running than I had previously. My ride Sunday however, while not particularly physically hard, was unenjoyable. In fact I have not been able to get into a ride since early August when I had COVID.

Carbonfiberboy 

Well, yeah. It never gets easier, you just go slower? How old are you? IME the only way to get fit on the bike as one ages is to have a well thought-out program and just stick to it. The occasional ride is usually a bummer. I think it takes at least 4 rides/week for quite a while. Start at an easy pace about every other day and gradually increase the pace over time. OTOH, if you'd rather run, do that. Different muscles, different range of motion. Also, Covid can be a factor. There seem to be more long Covid cases than are reported in the literature and they vary a lot in what's affected and how badly.

Cardiologists seem to be very busy, too. I have life or death thing and couldn't be seen for 2 weeks. How it is. I'm just being a little more careful. While I'm not looking forward to it, people die all the time.

Chuck M 

My problem on the bike isn't that I'm overly stressed or can't physically do it. I just can't seem to enjoy it. I used to enjoy 40 mile or so rides, but Sunday morning I just wasn't motivated to do more than 10.

GhostRider62

Maybe try a different activity until the desire to ride returns?

My son was very sick with 103-104F fever and then my wife got sick. No idea what they had nor did the Doc. I did not get sick but my morning heart rate variability was awful and when I went on the bike, I had no power or desire. It lasted about a week. Maybe Covid has a similar effect? Weak and no mojo? Alternatively, start with shorter rides than 10 miles. You have probably lost all of your fitness.

Chuck M 

Saw my GP to discuss the results of the Holter monitor today. There were things that made my GP refer me to a cardiologist so that will be my next stop apparently and he wants me to take baby aspirin daily.

gobicycling

If it has anything to do with your rhythm of your heart, forget the cardiologist and go directly to electrophysiologist who has much more knowledge in this area.

Speedskater

Book Review: Haywire Heart

April 5, 2017 By Larry Creswell, MD
Check out the recently published “The Haywire Heart” by Chris Case, John Mandrola, MD, and Lennard Zinn.
This is a book about electrical problems in the heart–the various arrhythmias. Case, Mandrola, and Zinn are in a unique position to bring this topic to life because each has dealt personally with some form of arrhythmia

Book Review: Haywire Heart

peterws

One's early morning rest HR is meant to be variable. That is good, and indicatesa resilience to stress and the argy bargy of life. A precise HR in the morning imndicates a lack of resilience.
During exercise however, the situation is reversed. I just read that on Google when attemptinng to find out what VHR was . . . Cadiology is so fascinating!

philbob57

Or a pacemaker.

Chuck M 

I had an enjoyable ride this morning for the first time since I had COVID in August. My rides have not been hard since COVID like my runs have. They have just been unenjoyable so I was happy to have a good time. I rode a 16 mile route I often ride and the climbs were not terrible. In fact Strava said that I'm trending faster. My run yesterday was a disaster though.

peterws

Anybody on a low sugar diet, through necessity or choice? That can bring on AFib.

GhostRider62

So, if my morning HR averages 50 bpm and HRV averages 65 and I wake up the next day and my HRV is 30, this is good?

As my original post indicated, both wife and son were sick. I did not get sick but HRV was terrible. My submax power was also terrible, in other words my HR was elevated at a modest power.

What I was trying to convey is that if your heart is talking to you......listen. See the right Doc(s)

peterws

Since I've done a little research into these things (my heart has been missing rather a lot o' beats lately which makes me wonder if they're necessary at all, since I feel good) that I'm fast becoming an expert on these matters.
I'm not quite there yet, and I don't know what a terrible HRV might be, but I'm pretty sure I have one.
But Google said that's good first thing in the morning (early afternoon; no need to be pedantic about this stuff) and you just know they can't be wrong.

GhostRider62

Missing beats can be benign or a serious condition.

I miss beats. I get up slowly. Bandaids are so expensive nowadays and my wife gets mad when I fall on things.

The electrophysiologist said I was fine, told me it was stress listening to Mr. Google

peterws

I guess there's a bit of adifference between missing a beat, and having the odd extended beats. There's certainly a difference in my ECG now I've started back on sugary stuff. Dark Choc Ginger biscuits and marzipan are indeed good for me at this moment.
But my ECG is far less interesting as a result.
Can't win 'em all!.

MoAlpha

Missed beats (heart block) needs to be evaluated, since there are two types, one of which is malignant.

There is no cutoff for HRV and it is not used by the clinical mainstream. However, you can look up age norms and if you're below the norm, that's not a good sign. Be aware that raw HRV parameters, such as rMSSD, are not normally distributed, so you need to use a log-normalized measure, like the readiness indices used by HRV apps and not all of them have great population data, especially for older age groups.

Carbonfiberboy 

I quit using morning resting HR as a workout guide when I was 71. I hadn't been getting the daily variations according to stress level that I had been seeing when I was in my 60s, so I started using HRV instead. It's much more sensitive. I now have records of over 2000 consecutive readings. I use a phone app (Elite HRV) with a Polar strap. That combo tests as good as an ECG for that particular thing, HRV, which is really unknown among cardiologists and electro-physiologists. Works for me anyway. I pay little attention to any one reading, but rather to trends. Any one reading can just be nuts for no apparent reason.

High HRV = good. Low HRV = bad. That said, what an app displays as HRV varies with the app. My app shows balance between sympathetic and parasympathetic systems. I also watch my RMSSDs - I take both resting and standing HRV, both with my app and my Polar watch. They mostly agree. My app also gives me sympathetic and parasympathetic power, the strength of the electrical signals which operate your heart, which I also find valuable, not for training so much but for general health assessment. Probably TMI for most folks, but I'm a data junkie.

peterws

Bet your bike shed's got loads of old stuff in it . . . .

GhostRider62

I started paying more attention several years ago because it seemed so many older riders were getting aFib and although the MDs say my 8 second pauses in HR while sleeping are not a big deal, it is a little scary and then when I broke 10 bones in a crash, the Docs said it would take at least a year for someone "my age" to recover. Thus, I felt watching trends in HRV made sense because my body was already working hard to heal.

I'm mostly interested in resting HR in order to do a linear interpolation to my lactate threshold HR and a certain percentage of that difference added to the resting HR is a good zone 2 effort and also a good HR to check submax power. I only do a hard interval session is all systems are a go.

canklecat

After my thyroid failed and I had to take levothyroxine, my heart rate and heart rate variability were no longer useful metrics for monitoring my fitness, or estimating my exertion during a workout -- cycling or running. HRV was all over the map and had no correlation with how I felt or performed during a workout. My heart was constantly skipping beats and it felt like anxiety, even when I had no reason for anxiety. It was hard to sleep, with the erratic thumping and occasional lapses in heartbeat that sometimes lasted a few seconds. All of it seemed to correspond with my thyroid problems.

I had old prescriptions for beta blockers to help prevent migraines -- propranolol and metoprolol -- but disliked using them because they made me sluggish and drowsy. I never adapted to them even after taking them for several weeks. If I took one only on days when I felt a migraine coming, they took up to an hour or longer to begin working, and I still felt sluggish for a day or two afterward. So I quit using them.

But a few months ago I got a trial of carvedilol. Seems to work much better for me. It works much more quickly, within 30 minutes, and has no residual effect. I don't feel sluggish or drowsy so I can work out as usual. My primary care doctor wasn't enthusiastic about prescribing it for this "off label" use, but agreed to continue a trial using a fairly small dose, and check up on my later.

His concern was that my resting heart rate during my annual checkup was 60 bpm. That's pretty normal for most people who work out regularly, especially long term, long distance, long duration exercises like cycling and running. But my resting HR has never consistently been below 70 bpm, even when I was younger. If I drink coffee or take a sudafed for sinus congestion pain, my resting HR is around 80-90, and usually spikes to 130 bpm as soon as I start walking or bicycling at a leisurely effort. And the skipping and spikes in my pulse drive me nuts, even from a single cup of coffee or caffeinated beverage. I don't consume much caffeine from any source anymore, but it didn't matter.

But after I told him my resting HR was in the 60s only for approx 18-24 hours after taking a small dose of carvedilol, he seemed somewhat agreeable to continuing the trial.

So far I haven't check my maximum heart rate since taking carvedilol. Before taking it my max HR was 173, same as it's been the past three years when I tested it at least once a year. And I've set the audible alarm on my bike computer to sound at 160 bpm, mostly to remind me that after I hit 160 bpm I have about 30-60 seconds to continue at that level of exertion before I gas out. Important to keep in mind if I'm riding in a heavy traffic area where I need to reserve some energy for sprints to safely merge with traffic or change lanes.

Anyway, I've avoided maximum effort brief exertions or workouts while trying carvedilol. But I might gradually increase my efforts after a few more weeks to see how it goes. My average speed has decreased 1-2 mph on my usual 20-50 mile routes, but my maximum speed is still about the same on fairly brief efforts of 30 seconds to 5 minutes with my HR around 160 bpm.

rsbob 

After reading through this thread, I would recommend reading, The Haywire Heart. How too much exercise can kill you and what you can do to protect your heart. I know that most of us, myself included, are not ultramarathoners, or doing ‘Raid’ events, but the book really does a deep dive into heart functions, conditions and treatments. You can do a sample reading on Amazon to see if it might interest you. One thing reading the book immediately made me stop was doing hellacious hill climbs at full power running my heart up to the max for sustained periods. That is a big no, no. No affiliation.

My AFIB has greatly decreased to the point of being nonexistent after I started taking a multivitamin for active seniors.

scottfsmith

Re: post-COVID and aFib, I had an event a few weeks ago and I may have ramped it up too fast in my COVID recovery .. I did 100 miles and then some heavy rock climbing then took a nap and got an aFib on my watch during the nap. This was about a week after I felt pretty much better for normal activity. Anyway the moral is if you get COVID I would go extra slow in building back up. Also hydrate really well, in retrospect I realize I was very dehydrated. Now I feel completely 100% and am back to getting PRs at a similar pre-COVID rate.

I've already done tons of work-up on my heart, Holter monitor, seeing electrophysiologist etc and nothing super major so far.

Champlaincycler

Two yrs back I had some heart issues, first noticed that my resting HR was dropping into the 40's from a normal mid 50's. It was winter and I was riding on a trainer and doing HIIT type workouts 3-4 days a week on the bike and a few days on a rower. It got a bit perverse as I liked the pain and discipline it took when my lungs and chest were burning. Also liked that workouts were 30-40 minutes but intense with max hr intervals of 3 minutes or so. Then the missed beats started, later I came to understand that they were actually pvc's. Holter monitor showed almost 25% pvc's vs normal heartbeats, a very high amount. I saw a cardiologist and he scheduled me for a cardiac ablation, of course that was some 3-4 months later. When I went for my ablation I no longer had pvc's, in fact they tried to induce them with some adrenalin but still none. I'm completely over it. Saw my cardio last week and he said he's not seen anyone have no symptoms at all after having such drastic ones a year back. I'm convinced that my issues were caused by those HIIT type workouts. Cardiologist doesn't see a link, but I'm trusting my instincts. We're all different, but I'm thinking that my 69 yr old heart is not up for that level of intensity, at least not so frequently.
Happy ending is that I'm kind of relieved of the burdon of getting stronger every year, still ride hard and fairly far but starting to smell the roses a bit more.

peterws

Interesting! I do the Les Mills courses and missed heartbeats are almost a regular feature now for me. Some of it is down to fluctuating temperatures day by day which affect me greatly until I get acclimatised. Now, Les Mills stipulates no more than 3 hiit classes per week. Some in my gym do that every day.
You get hot in the gym doing this, and I'm wondering if that's the main culprit in my case. But i felt good doing the Sprint today.
I'm due for a Holter in a couple of weeks.
Fun, isn't it? Not . . .

Chuck M 

Now the thing that is causing my heart stress is the bills. My insurance company says that my Holter monitor test was not a medical necessity. I'm sure that I can get it straightened out, but it is frustrating nevertheless.