Irregular heart beat affecting performance?

cheers drive

A few months ago my heart beat started getting irregular during and after some rides. My cheap heart rate monitor showed lots of double beats and pauses. My GP referred me to a cardiologist who ran a 24hr and an exercise ECG which didn't show anything as the 'episodess' are sporadic. He advised me that it is atrial fibulation and it is not dangerous and prescribed me Flecanide to take to calm my heart down when it happens. I also get episodes after excessive alcohol intake.

I'm glad that it's not dangerous but I convinced that when an attack happens it restricts my performance. I've also used all of my Bupa cover would have to join an NHS waiting list if I want further investigation.
Has anyone experienced something similar?

DaSy

Yes, I have had something similar for about a year now. I get bouts of big heartbeats that I can feel, followed by a gap as if I have missed a beat, but I think it is actually followed by a much weaker beat.

This happens a lot to me now, and i can notice it in particular on my Fortius when using Catalyst program as it shows a continuous heart trace, and i can see it just drop then pick back up. It is most pronounceable when going through zone 2 heart rates, and seems better when working hard.

I also notice it a lot at night, but much of it seems to relate to stress, then more I notice it the more it comes on. i have not been to the doctors about it for fear of being told not to cycle! Ridiculous I know, but there you are.

I rode across the Alps last earlier this year, from Geneva to Nice, and haven't had anything that troubles me when I'm working hard, so I've tended to just ignore it, I really must get it looked at though.

I don't drink alcohol , smoke, drink caffeine, so most of the worst contributors don't apply.

Moaner

DaSy wrote:

I also notice it a lot at night, but much of it seems to relate to stress, then more I notice it the more it comes on. i have not been to the doctors about it for fear of being told not to cycle! Ridiculous I know, but there you are.

I don't want to cause undue alarm, but AF is sometimes caused by an underlying problem. In that case it's important to get it checked out.
If there's no underlying problem then again it's as well to know because it saves you from worrying unnecessarily. In turn this will reduce the stress levels that you think are a contributor.
In either event it's very unlikely that you will be told to stop cycling.
In my own case, AF came out of the blue - HRM reported a pulse of 190 when I should have been cooling down. It wouldn't slow down and I went into hospital and had my heart rebooted, which did the trick. Consultant advised me not to stop doing anything and if it happened again then he would control it with medication.


Anyway, my advice is to get it checked out.

Moaner

DaSy wrote:

I also notice it a lot at night, but much of it seems to relate to stress, then more I notice it the more it comes on. i have not been to the doctors about it for fear of being told not to cycle! Ridiculous I know, but there you are.

I don't want to cause undue alarm, but AF is sometimes caused by an underlying problem. In that case it's important to get it checked out.
If there's no underlying problem then again it's as well to know because it saves you from worrying unnecessarily. In turn this will reduce the stress levels that you think are a contributor.
In either event it's very unlikely that you will be told to stop cycling.
In my own case, AF came out of the blue - HRM reported a pulse of 190 when I should have been cooling down. It wouldn't slow down and I went into hospital and had my heart rebooted, which did the trick. Consultant advised me not to stop doing anything and if it happened again then he would control it with medication.


Anyway, my advice is to get it checked out.

DaSy

Moaner - i know your right, and I have been meaning to go, but I seem to manage to make time for everything else except that...

Maybe it will be my new years resolution, thanks for the advice.

nanox

DaSy wrote:

I get bouts of big heartbeats that I can feel, followed by a gap as if I have missed a beat, but I think it is actually followed by a much weaker beat.

Sounds a lot like what I have.. Extrasystoles

It's some electrical impulse gone wrong. This means that the heart doesn't pump out enough blood for a beat, so it compensates by pumping out more blood at the next beat which is why this beat feels harder.

It is not dangerous unless you have some underlying condition, but it sure is annoying.

Nevertheless, go have it checked out. But don't worry, if it is extrasystoles, then the doc won't tell you not to cycle

dewei

Was it a private or NHS consultation you had with the cardiologist?

Was the fleicanide prescribed as a regular daily medication or only when required depending on the symptoms?

My concern is that the apparent diagnosis (atrial fibrillation) is not usually treated with fleicanide. Fleicanide is an anti-arrhythmic with a significant side-effect profile. In general, any treatment for abnormal rhythm should be taken on a daily basis to prevent the irregular heart beats... it may be too late to wait for the symptoms and then take the fleicanide.

Atrial fibrillation (AF) can occur without any apparent reason but is most often due to a cause: hypertension, ischaemic heart disease (angina/heart attack), alcohol excess, lung disease etc). AF may also have serious consequences eg stroke.

Extrasystoles (occur in bouts lasting just a few heartbeats), however, are very common and harmless. We all get it from time to time without always being aware of it. It is made worse by fatigue, stress, caffeine, alcohol etc. It usually disappears DURING exercise though.

In the case of cheers drive, I am not happy that the symptoms, diagnosis and treatment make any sense. AF is a SERIOUS diagnosis although I am not convinced you have it. Get checked by the NHS, it may be slow but you may get a better assessment than private medicine.

As for the others, getting a heart tracing at the GP is harmless. I am sure most of you are just having some harmless extrasystoles. If you do have a more serious heart rhythm disorder, you should not be thinking that going to the doctor will stop you from riding. Rather you should be thinking that late treatment of a heart condition may decrease your wellbeing and lifespan and in this way lead to apremature retirement from cycling.

ut_och_cykla

If any heart rythm disturbance is making you feel unwell or less ok at doing what you normally do (cycling, drinking whatever!) my advice would be to get it checked pretty damn quick - it could be nothing - just stress or too much coffee - but it could be worse - and it wont get better by doing nothing. I had serious arythmia a few years ago caused by a slight heart sac inflammation brought about by a tick borne borellia infection... not funny at all at the time ! And I think Popette on this forum has had heart probs that needed surgery to fix - that started with irregular/fast heart rates and unwellness. (she did complete some serious rides after her op tho' and I assume is fully fit!)

popette

Hi - ut-och-cykla is right - I had atrial flutter. I didn't notice it during normal every day activities but if I was cycling up big hills, I started feeling really out of breath and sick. I saw a cardiologist and I was put on warfarin to thin the blood and reduce risk of stroke (something you are at risk of with AF and Flutter). I had various tests done including a scan to make sure there were no underlying problems within my heart (there weren't) and then had a cardioversion to reset the beat (very quick procedure under GA). That was 15 months ago - there's always a chance that it returns but as time goes on, that possibility is reduced. I was allowed to cycle throughout my treatment albeit at less intense levels than I was used to. Now it's like cycling with a new engine - I did the Etape last year - something that wouldn't have been possible before the treatment.

I would urge anyone who has any suspicions of problems - daft HR readings etc - to get to a Dr and get it checked out. If you can take printouts of your HR, so much the better (it was only when I did that that the Dr started taking notice - I had been told it was a virus on a few occasions previously).

Good luck.

cheers drive

Thanks for the responses.
To clarify the Flecainide is taken only when I feel symptoms, I've taken it twice so far without it helping.
I had a ultrasound heart scan as well as the ECGs and my heart function and structure was found to be normal.
I'm due to check back with the cardiologist in a few months, unless it gets worse I will try cutting my alcohol consumption, especially with 24hrs of a ride.

Thanks

Moaner

cheers drive wrote:

Thanks for the responses.
To clarify the Flecainide is taken only when I feel symptoms, I've taken it twice so far without it helping.
I had a ultrasound heart scan as well as the ECGs and my heart function and structure was found to be normal.
I'm due to check back with the cardiologist in a few months, unless it gets worse I will try cutting my alcohol consumption, especially with 24hrs of a ride.

Thanks

1 in 9 cases of AF is unrelated to a detectable underlying problem. There's treatments other than Flecainide, so if it's affecting your quality of life get them to try you on something else.
Good luck with it.

DaSy

Thanks to all for the advice and peer pressure, I actually booked an appoinment with my GP this morning, and showed her several printouts from my Tacx Catalyst to illustrate the issues.

She took it all very seriously, and I'm booked in on Friday for a blood test for several things, one of which I think is quite possible, hyperthyroidism. I have had a swollen goitre type lump in my neck for a few months now.

I also get a 12 lead ECG, so should know a bit more in the near future.

I feel chuffed that I actually got off my arse and did something, so cheers everyone.

ut_och_cykla

Good on ya! Hope teh blood tests dont show anything 'nasty' - thyroid probs should be fixable!

chrishumes

good post, ive had this condition for 3 or 4 months now, was really scared at first so had ECG/blood test etc but all was fine. i didnt get a 24hr tape tho coz i missed the appointment as it didnt happen for a few days. they have since come back so think i will get checked out.

keep us posted

cheers drive

DaSy - Well done; I was also surprised when my GP took it so seriously

chrismus - it sounds obvious but make sure you do a hard ride when you do the 24h ecg. My consultant wanted me to record a normal 24hr and to the exercise ecg by speed walking on a treadmill. The trouble is that a rise last hrs but 20 mins on the treadmill I only just hit max heart rate before my legs gave up.
I forgot to mention that if the Flecainide doesn't work the consultant suggested a more thorough test by implanting a monitor in my chest for long term monitoring, I wasn't so keen on this!

keep us updated everyone!

DaSy

Just an update on the outcome of my tests by my GP.

I had a blood test, looking for Thyroid irregularities amongst other things, and a 12 lead ECG last week, and went back this morning for the results.

The outcome was that my blood test came back clear, and the ECG did pick up the extra systolles whilst I was being tested, but that all other heart functions were completely normal. The outcome is that I have extra systolles that don't need any further treatment and that won't affect my cycling at all (the importnat bit).

My GP is an ex-triathlete, and I have to say the service from her was excellent. She even sent the ECG trace to one of her colleauges who specialises in heart rhythm issues, to get a second opinion. She said she saw no reason to give any medication if I was happy to live with the condition, which I am, it causes me no real issues, the main worry was that I was going to expire on a mountain climb somewhere in France that would be forever England.

So that's me happy and glad to have finally addressed it. So thanks all once again for the advice.

Bronzie

Dasy - glad to hear you got it checked out and all was OK 8)

DaSy

Cheers Bronzie, now I can put that racing heart at the top of the Col de Bonnette down to trying to show off with a finishing sprint, and not a heart attack that I thought I was about to have!

Garz

Great that you seen this properly through dasy! Happy for you, now get back to happy cycling!

Headhuunter

I have had episodes in the past when my heart beat has been very hard and obvious. Not sure about it missing a beat, but has seemed to beat harder and faster. I could feel it pumping away when sitting still or lying on the sofa at home watching telly etc. I actually had some chest pain earlier in the year which made me panic a bit.

One day at work I mentioned it to a colleague who told me to rush off to the nearest NHS Walk In Centre, which I did. I saw a nurse who said that my heart sounded completely fine but told me to see my GP. GP also listened to my heart and said it sounded very healthy. Them actually telling me that made me feel much better and the problem seemed to go away so I put it down to some kind of stress, I didn't feel stressed at all but I had been very busy, rushing around a lot more or less from 7am til 9 or 10pm everyday.

Anyway, it came back in May or June 09 but went away again a few weeks later and, touch wood, I haven't noticed it since.