respiratory sinus arrythmia
neeb
Posts: 4,473
I know this is normal and supposed to be a sign of a healthy cardiovascular system if anything, but does anyone else my age (41) notice this a lot? Often when I am relaxed I can detect quite an extreme variation in my heart rate between breathing out and breathing in. The slowing down when breathing out is particularly noticeable, it almost seems to miss a beat. The variation itself seems to change a bit from one breath to the next depending on the stage my heartbeat is at when I breath out. It seems to be particularly pronounced when relaxing several hours after a bout of extreme exertion. The arrythmia is definitely closely tied to my breathing, and I don't get any other symptoms. I know forums aren't the place to ask medical questions, but I don't want to bother a doctor with something that would appear to be completely normal. It would just be reassuring to know that other +/- "trained" people my age also have this. I do worry slightly that this is supposed to be characteristic of young people and that at my age it could be a sign of something abnormal.
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Yes I get this too. Had pericarditis 12 years ago. Scary but not linked. My arrythmia has mde me faint once. if it happens again I will seek more medical advice.
I was told back then that as long as it didn't make me feel unwell I shouldn't worry. I try not to, climbed Alp passes last year - no probs but too much very hard intervall training definitley makes things worse.
If it worries you I'd get it checked - if only for your peace of mind.0 -
I\ve never had any other adverse symptoms such as fainting, so maybe it\s the sort of thing to mention to the doc next time I\m there for something else. All references to respiratory sinus arrythmia I\ve come across seem to indicate that it\s benign, however.0
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Ah, respiratory sinus arrhythmia, that's what its called! I was wondering what was happening to me.
Yes, I guess it must be fairly normal as I get the same type of symptoms, especially when I'm about to drop off to sleep, where my respiration slows and then 'thud', ah that'll be my heart not stopping then! This seems to happen whenever I'm relaxed or sleepy and I just put it down to my resting heart rate now being quite low and having always had a problem with low blood pressure.
As always, anecdotal advice is no substitute for a consultation with a doctor.0 -
As far as I can tell from trying to find out about it, it's a good thing. It means that the muscle tone of your heart is good and it is able to respond to the altered pressure in your chest when you are breathing. There seems to be an inverse relationship between RSA and some health/heart problems, and it is more pronounced in athletes. On the other hand, other potentially bad arrythmias are also more common in elderly althletes than in sedentary people, so it's swings and roundabouts (the athletes are still better off overall though). I think the really dangerous sinus problems that are likely to make you drop dead without warning are more subtle to detect (ECG required).As always, anecdotal advice is no substitute for a consultation with a doctor.
I agree and doubly re-emphasise!0 -
I went to the doctor with these symptoms. I am 28 and fit and the doctor urgently referred me to a cardiologist.
Go to your doctor as it may not be good health, not that I want to worry anyone.
The apparent "skipped beat" is actually a very weak one and the thud is your heart compensating the next beat. For me when this goes on for a while it is quite uncomfortable. My symptoms come and go, at the moment it doesn't happen but some weeks it's all the time, expect when I'm pushing myself!
I had several ECGs one showed (the initial one) that one of my ventricles was showing a weak signal, electrically that is. Later at the hospital they showed "large complexes" this basically means a high amplitude signal that generally can be caused by:
1. Structural Heart Disease which can cause the heart walls (muscles) to thicken
2. I'm very fit and the heart walls have thickened
3. I'm thin and they get a good signal.
2 and 3 are true so the hospital are sure I'm not about to drop down dead but they are still following up with and echocardiogram to ensure 1 isn't the case and that the structure is intact i.e. no holes between left and right and that the valves are functioning correctly. A hole in the heart can be unnoticed for years until you start training.
I have been told to cut out caffeine as well as these are a type of heart palpitation rather than good health, this has made no difference though. I have good sinus rhythm according to the ECGs and most likely I will live with the occasional "skipped " beat with no ill effects but you definitely should get it checked out.
If you go to your doctor the worst they will say is go home and don't worry but will probably add that you were right to question it! I expect I'll be given a clean bill of health and that ECGs and echocardiagrams would be routine if the NHS had the resources to do everything that they could possibly want to do preventatively.M_G0 -
Similar to the post above, I saw a cardio specialist about the arrhythmia i was suffering from in 2003. I had ECG's resting and exercising, plus a ful ultrsasound scan of my heart. This was all before I started cycling, and after about 12 years of sedentary beer'n'fags lifetsyle. I also got an all clear, though one of the ECG traces shows an unusual shape which last year led a paramedic and an A&E department into thinking i had suffered a previous myocardial infarction (heart attack). To my knowledge I had never had a previous heart attack, which was confirmed when my GP compared the two traces, and found the 2007 trace to be identical to the 2003 one!
I was offered drugs to curb/prevent it from happening, but declined it as it is not that nbig a problem. Incidentally, He also told me that I would need to drink about a gallon of coffee for it to have any measurable effect on your ECG trace.
As ever, this provides entertaining reading..I once could tick off most of the classic cause, at least giving up smoking and taking up exercise has removed two of them...0 -
We may be talking about different things here. I don't get a "thump" as such and am pretty sure I'm not actually failing to detect a weak beat. Although I could be wrong.
master_grunthos, were your symptoms clearly linked to breathing, and do you also notice your HR speed up when you breath in?0 -
B*gger, that's me wasted a good hour now trawling medical articles online and being neurotic...
I'm now half convinced I'm at the start of a slippery slope from premature ventricular contraction to ventricular tachycardia, ventricular fibrillation and sudden death.
Yeah, I'd best see the doc sometime. Always a difficult call between being sensibly cautious and being a time-wasting hypochondriac, I can never tell the difference.0 -
It's simple - if you get odd pains or irregular heart beats then Go Straight to Surgery and do not pass Go....0
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No odd pains, no palpitations, nothing except a moderately pronounced change in time between the beats that is very clearly linked to breathing. If I'm really the only person that gets this I'll go to the doc, but try this:
Find the pulse on your wrist when you are sitting down and really relaxed. Take a deep, slow breath in and hold it for a second, then breath out, monitoring your pulse all the time. No slowing of the pulse just as you breath out or just before that? Ever? (try it a few times). This really only happens to me? I've noticed this for years and years. But it does seem to be more obvious when I'm fit.0 -
Nope, I dont notice this, and even tried it with an HRM on. If it varies its by one or two beats nothing more, and seems to be random to be honest.0
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neeb wrote:No odd pains, no palpitations, nothing except a moderately pronounced change in time between the beats that is very clearly linked to breathing. If I'm really the only person that gets this I'll go to the doc, but try this:
Find the pulse on your wrist when you are sitting down and really relaxed. Take a deep, slow breath in and hold it for a second, then breath out, monitoring your pulse all the time. No slowing of the pulse just as you breath out or just before that? Ever? (try it a few times). This really only happens to me? I've noticed this for years and years. But it does seem to be more obvious when I'm fit.
Sinus arythmia - perfectly normal. Most people have it, not all tho'. Mine is very pronounced plus I have palpitations occaisionally, all checked by cardiologist and pronounced different but not sickly.!! Sometimes the palps make me wobble adn one session of which occurred having ascended a very steep small hill in France with a slight cold and a period beginning made me Faint almost without warning. Hasn't happened since tho' and didn't see the doc then tho' I will if it does it again.0 -
Like I said though, a difficult call when it comes to seeing the doc or not. You've had yours diagnosed properly, whereas I'm diagnosing myself over the internet. Not recommended.
Basically, from previous experience I don't trust front-line doctors (GPs etc) to diagnose things properly, especially if you are at one end of the normal distribution for the general population (e.g. abnormally fit and very slim). I know for example that by blood pressure when I'm properly relaxed at home gets down to about 115 over 65, but in a doc's surgery and in other psychologically stressful situations (especially if I know it's being measured) it shoots way up (the higher value especially). Still, the doc dutifully records the 145 over 85 without making any allowances for that huge natural variation. I doubt I'd be able to replicate the pulse phenomenon I'm describing in front of a doctor, as it disappears completely if I'm not relaxed. It's just that it sometimes seems pretty extreme a few hours after a big workout.0 -
There is a test (called work test?) stationary bike ramp test type with ECG and nurse which measures strange heart behaviour during exercise adn afterwards. Done it. Was ok but odd!!!
also a portable ecg which you wear for a day or more to check starnge heart wobbles. This might be what you need to get things checked out. Ask for a referrral - it sclearly worrying you and that in itself is not good.
:-)0 -
Yeah, you're right, thanks to everyone who has commented. It's almost as much curiosity as worry though, it's just interesting to know if other people who do the same thing have similar experiences.0
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To reiterate again what everyone else has said, if you're in any way concerned about this do consult a doctor.
I can try to give a bit of an explanation as to what you are describing though in terms of how heart rate changes in relation to breathing, what is known as respiratory sinus arrythmia (RSA). To call it 'arrythmia' is perhaps slightly misleading as the heart is still in normal healthy sinus rhythm, but as you have found yourself, it can change considerably with breathing.
To go back to basics the nervous system is mainly controlled by the two branches, the sympathetic (which speeds things up and gets you ready for exercise), and the parasympathetic (which is dominant at rest). RSA is controlled by the parasympathetic branch of the vagus nerve which will slow down HR when stimulated. What happens is that this stimulation is inhibited as you breath in, hence HR speeds up. One of the current main theories on this is that this helps maximise gas exchange in the lungs by synchronising breathing with HR. Once exercise begins however, the sympathetic stimulation takes over, and this activity is ceased. It is therefore only really something that you will see when relaxed and rested.
I would say it is a very promising sign of a good cardiovascular system that you can notice your own RSA. Everyone has it to varying degrees, and it is affected by a large number of things, including aging, with which it declines. It also seems to have a very positive effect on preventing abnormal cardiac events like going into odd rythms, or having a heart attack. There is a very strong correlation between poor RSA (and associated vagal activity) and increased likelyhood of death/heart attack. Similarly good vagal tone is an effective preventative measure.
I'm currently looking at RSA measures as my PhD so can bore people for a long time talking about it... One poster did mention that it doesn't show on a HR monitor. That's because they generally work by looking at around 5 beats and averaging these for a single reading, hence smoothing this out. You may be able to feel these beat to beat changes in the pulse as you have however.
One other interesting thing you mentioned was that this seemed to be more pronounced after hard exercise. One aspect I am looking at involves a possible 'rebound' mechansim after exercise where RSA/vagal activity is increased over baseline for a time post-exercise.
If you have a dog you could try feeling the pulse on that too when it is relaxed. They have particularly strong RSA generally.0 -
Thanks for that Tom M, fascinating!
Would it be safe to say that any heart rate "irregularity" that closely follows the respiratory cycle is RSA? Or is it possible that premature ventricular contractions (or something else) could predictably correspond with the "slow" point in RSA, i.e. when the inhibitory influence of breathing in on the parasympathetic system suddenly ends?0 -
Well, as some guy off the internet it may well not be safe to assume anything anyone says ever really.... However, it would seem to me that what you are describing is RSA in that your heart rate is speeding up as you breathe in, and slowing as you beat out. This is a normal healthy physiological response. By slowing your breathing down then you are reinforcing the mechanism, and feeling it more.
Any kind of arrythmia is just that, a disturbance of the rhythm. Not a regular pulse as you describe. If it was some other kind of arrythmia you would more likely feel the difference in your pulse, it would not follow any kind of pattern like being linked with breathing, or you have some other kind of symptom.
You sound pretty normal to me...
If you do get any symptoms then get yourself checked out.0 -
You're not kidding. Having heard dog's HR was meant to be 100 or so (dog club member!) I was astounded when I took his pulse when he was asleep - slow (about 60 and irregular)Tom M wrote:BIG SNIP
If you have a dog you could try feeling the pulse on that too when it is relaxed. They have particularly strong RSA generally.
It goes like a steam hammer after he's run around the garden a bit tho' and I believe dogs don't experience discomfort from lactate/lactic acid (or whatever you call it). perhaps he should cycle for me?0 -
It goes like a steam hammer after he's run around the garden a bit tho' and I believe dogs don't experience discomfort from lactate/lactic acid (or whatever you call it). perhaps he should cycle for me?
Not sure if he'd look too great with shaved legs.. 0 -
NO! he's a mini schnauzer so shaved legs and the beard would look dead strange, let alone the bike...?neeb wrote:It goes like a steam hammer after he's run around the garden a bit tho' and I believe dogs don't experience discomfort from lactate/lactic acid (or whatever you call it). perhaps he should cycle for me?
Not sure if he'd look too great with shaved legs..0
