Palpitations and ECG

johnmiosh

Didn't notice that. He must have recovered.
If its AF you will need a lot of background knowledge when talking to the professionals. I will post details of some resources this weekend

bendertherobot

Went to the shop. Walked a mile there and back. Got up to 80 rock solid now.

johnmiosh

Hi Bender,

Unfortunately AF is generally a progressive condition; once you have it, it continues to get worse. Sometimes the first incident is a one-off, and you may never be affected again. Hopefully you are one of the lucky ones and are now over it.

The root cause of AF is prolonged inflammation of the heart muscle from endurance exercise, alcohol, stress or a combination of these. Cyclists and triathletes are particularly at risk. A few principles to reduce your chances of AF.

Remain hydrated, particularly while riding. Don't ride after a binge drink.

Get good sleep.

Check your teeth, poor dental health has an effect on the heart

Use a HR monitor, note any excess readings. If you notice you are exceeding your max HR even for a few seconds, this could be AF. Go to your doctor. Get a Kardia to show Dr. the readings under exercise. For four years I thought high HR spikes were a problem with the sensor, but it was the start of AF.

Have rest days, don't max out two days in a row.

Reduce alcohol (down to NHS recommended limits), coffee and stress


Useful resources

https://healthunlocked.com/afassociation AF Association
https://afibrunner.com/ Blog
https://afibandcycling.wordpress.com

John

graeme_s-2

johnmiosh wrote:

Use a HR monitor, note any excess readings. If you notice you are exceeding your max HR even for a few seconds, this could be AF. Go to your doctor. Get a Kardia to show Dr. the readings under exercise. For four years I thought high HR spikes were a problem with the sensor, but it was the start of AF.

Presumably you'd feel the difference between a faulty sensor and actually having a ridiculously high heart rate? I'm wondering because I used to occasionally get very high readings (over 200bpm when my max was ~185ish) on my Garmin just after starting a ride. Doesn't seem to have happened in a long while, but I always assumed if it really was my heart I'd feel it? When I used to suffer heart palpitations as a side effect of medication it was always obvious.

I was about to say I know it's not still happening as I wear an Apple Watch and it's never picked it up. Except I've just checked the history and found a 200bpm reading from October last year. Looks to have been after doing parkrun on a Saturday. My heart rate was normally high during parkrun according to my Garmin data in Strava, but my Apple Watch recorded 200bpm within 30 minutes of finishing.

johnmiosh

Graeme_S wrote:

johnmiosh wrote:

Use a HR monitor, note any excess readings. If you notice you are exceeding your max HR even for a few seconds, this could be AF. Go to your doctor. Get a Kardia to show Dr. the readings under exercise. For four years I thought high HR spikes were a problem with the sensor, but it was the start of AF.

Presumably you'd feel the difference between a faulty sensor and actually having a ridiculously high heart rate? I'm wondering because I used to occasionally get very high readings (over 200bpm when my max was ~185ish) on my Garmin just after starting a ride. Doesn't seem to have happened in a long while, but I always assumed if it really was my heart I'd feel it? When I used to suffer heart palpitations as a side effect of medication it was always obvious.

I was about to say I know it's not still happening as I wear an Apple Watch and it's never picked it up. Except I've just checked the history and found a 200bpm reading from October last year. Looks to have been after doing parkrun on a Saturday. My heart rate was normally high during parkrun according to my Garmin data in Strava, but my Apple Watch recorded 200bpm within 30 minutes of finishing.

When my AF first started, it was only for a few seconds at a time and as it progressed, for a couple of minutes. My HR would go to 210 (once 223) and drop straight back down. I assumed it was a flapping shirt or something. Later when it continued for several minutes, I assumed it was the strap and threw it away. I couldn't feel any difference between a normal max of 170 and an AF of 220. My only symptom was going slower, but this only became noticeable when the arrhythmia became quite severe.

Also Apple watches are not that good at picking up AF, I think because they work on the colour change in the skin due to blood movement not electrical signals like the chest straps. Kardia produce an Apple watch strap that takes a medical grade single lead ECG, but you have to touch the strap with your other hand, so won't do constant monitoring.

bendertherobot

Thanks!

It's all going fine. Drugs brought it down. Had some to take away, ditched those on Saturday, on advice, as they took me to 35bpm. Took 2 days to get over those.

Have to say, over exertion etc aside, and not having seen the specialist yet, I'm changing jobs next week. Last day in work today, a wave of emotion overcame me, minor panic attack, came home and now utterly chilled. All symptoms of panic gone. Had a massage at 4, she unlocked a massive amount of tension. So, we'll see how it all goes but, hopefully, a one off. Managed an hour on Zwift at 18mph with my heart rate topping out at 102bpm. Which is nice.

jondavis30

Firstly, an 'ectopic' isn't a missed beat. You've been misinformed / ill-advised.

an 'ectopic' is a premature ventricular contraction (PVC).
This is when the Ventricles (left side of your heart) Contract before the Atrium (right side of your heart) has contracted, leaving 'less' blood to pump out of the Ventricles to the body system, causing a temporary drop in Mean Arterial Blood pressure.

As blood needs to be moved from the right side to the left side of your heart, usually when this happens, it auto-corrects by increasing ventricular response and changing the electrical conductivity across the heart, due to a detection in what is called decreased cardiac output.

The cause of this could be numerous. Electrolyte imbalance, intravascular fluid losses, increased levels of adrenaline (usually due to stress), Coronary Artery Disease, a degree of heart failure, pulmonary oedema or an infection of some kind.

It is not a missed beat (as PVCs are additional beats, because heart beats are only the result of ventricular activity, but pump less blood per beat). This is where the dizziness comes from.

Beats above 180bpm are Supra-ventricular Tachycardias (SVT) which are, and always will be, a normal rhythm in extreme exertion, but never normal at rest. anything above 200bpm is dangerous and should never even be aimed to achieve, as this will lead to Ventricular Tachycardia (VT) and will result in a loss of cardiac output, and as a result, blood pressure and possible collapse if sustained.

bendertherobot

Was that for me?

DavidJB

I had the 24 hour test on when I got made redundant once ha! Then I went out and got hammered to drown my sorrows...the sheet I had to fill in must have made interesting reading

johnmiosh

bendertherobot wrote:

Was that for me?

I wondered whether it was directed at me. Looking back, Ands described his ectopics as missed beats. While this is technically incorrect, it is probably what Ands was experiencing.

The reason PACs or PVCs can sometimes be felt as a skipped beat, is that the heart gets a premature signal to squeeze before it has had time to fill with blood. The resulting heart contraction does not produce blood flow to the body. A pause is felt, and the following heart beat is more forceful than usual. If the PAC or PVC is less premature, and the heart has had time to fill with blood before receiving the early signal to squeeze, an extra beat will be felt rather than a skipped beat. https://www.hrsonline.org/Patient-Resou ... pped-Beats

The first example is exactly what the majority of my ectopics feel like.

Ectopics are not only common, but normal; healthy people have 100s per day. Strangely enough, I never had any (that I noticed) until after my ablation, now I have one per minute.

bendertherobot

I seem to have those, indeed I wonder if I've always had them. It's quite easy, also, to get paranoid about them and think they're a precursor to something!

Anyhow, new job today and a lot of the stress is melting away. So, I'm hoping that helps. Still no cardio appointment though.

photojim

This topic seems to have been resurrected from the OP many years ago. I only noticed it because I have had heart problems.

It could be risky to try and self-dignose based on other peoples experience. There seems to be an awful lot of things that can go wrong with a heart. My symptoms were a much higher than normal HR when under heavy exercise. Sometimes part-way through a TT, usually after about 15 minutes, my HR would shoot up from 165 - over 200 (quite high for a 48 year old). I would ease off for a minute or two then carry on as normal. It also occurred a couple of times when pushing a sailing dinghy up a slipway and into the park. The worst time was out on a steady run, HR around 135, when suddenly HR shot up to over 200 and refused to drop for several minutes even while I was standing still. Quite alarming so I went to the hospital.

To cut a long story short - about three years later, and with the help of an implanted 'Reveal' device, I was diagnosed with SVT - relatively benign. This was cured as a day patient with an ablation to the heart muscle.

Unfortunately though, during my first visit to the A&E after the running incident, I was scanned by MRI and was also diagnosed with Hypertrophic Cardiomyopathy - HCM, which I was told effectively ended my competitive cycling and running. But I'm okay at least. Now tested every year and still enjoying exercise, just not much competition (well two sprint triathlons last year).

Jim

bendertherobot

I've been getting back into commuting, rather than Zwift and, so far, all is well. No abnormally high readings and, today, an average of below quite a lot of my 'same speed' commutes. Decided I'll use the BUPA cardio as I have health insurance so will get that booked.

Feeling a bit of 'heartburn' today and noting that the original wobble was after a sugary meal and some of the flutters have been after eating I wonder whether there's a bit of an issue between stomach, oesaphagus, vagus nerve and heart. Wondering whether I have a bit of a digestive issue. But, let's get booked in.

prhymeate

I posted this in the thread about Michael Goolaerts, but it's probably worth mentioning here too. There is a charity that offers free cardiac screenings for those between 14-35. https://testmyheart.org.uk/

bendertherobot

Started taking potassium and magnesium. Potassium deficiency would seem to match my little episode exactly.

6wheels

bendertherobot wrote:

Started taking potassium and magnesium. Potassium deficiency would seem to match my little episode exactly.

Don't forget those bananas.

bendertherobot

6wheels wrote:

bendertherobot wrote:

Started taking potassium and magnesium. Potassium deficiency would seem to match my little episode exactly.

Don't forget those bananas.

It's an interesting one. I'd had a banana only an hour before it kicked off. Did some googling and found some crap on how ripe bananas can cause it. So steered clear after that. WHich is silly.

I'm on it now.

flycop2000

ShutUpLegs wrote:

CRAIGO5000 wrote:

For the last week I've had palpitations come and go and on Monday I had a really bad bout when shopping.

I get the same feeling when my wife suggests going to IKEA on a Saturday afternoon

Steve974

I was diagnosed with arterial fibrillation about four years ago, it's a horrible feeling and I honestly though I was about to die at any moment. ECG's and hospital found I had a good strong heart and the valves were working correctly, I was also advised right at the start that despite it being frightening "It's not going to kill you"... I would add at this point my heart beats were ranging from 30 - 270 BPM in the relatively short time I was on the ECG.

When I reached 65 yrs old I was put onto Warfarin (rat poison!) to thin my blood thus avoiding blood clots, and beta blockers to reduce the errant signal from my brain. In a nutshell, because your heart is fluttering it may not pump all the blood from the heart chamber and the remaining blood may clot before being pumped on through your body. This in turn may move the clot up to your brain and induce a stroke, Warfarin thins the blood to avoid that. Monthly blood tests monitor your blood thickness and how much Warfarin you need to take to maintain the correct dose.

I maybe get an episode about four times a year which lasts a couple of hours maximum, and which I now treat as an inconvenience!

Best wishes for your speedy recovery...

bendertherobot

Ta! So far, some palpitations aside, I've had no afib episodes and returning to normal after reaching 160/170 or so appears normal. I didn't top 200 when I had mine.

Got my private referral today so going to get in touch with Bupa for an echo etc.

bendertherobot

So, had blood tests. Nada.

Had ECG, due to see consultant 5th June.

No more afib episodes but quite a few episodes, briefly, of skipped beats.

Been on lansoprazole for 3 days to rule out silent reflux. And, since then, bags of energy, no skipped beats whatsoever.

bendertherobot

Cardiologist has cleared me. Just fitness basically, may happen again, may never happen again. All because of stretching the atrium a bit far on occasions. But not life threatening and nothing to remotely worry about.

haydenm

bendertherobot wrote:

Cardiologist has cleared me. Just fitness basically, may happen again, may never happen again. All because of stretching the atrium a bit far on occasions. But not life threatening and nothing to remotely worry about.

Great news, must be a bit of a relief!

bendertherobot

Very much so. Hasn't quite sunk in yet. I've been bottling it up for a while. Marmotte here I come.....

veronese68

bendertherobot wrote:

Cardiologist has cleared me. Just fitness basically, may happen again, may never happen again. All because of stretching the atrium a bit far on occasions. But not life threatening and nothing to remotely worry about.

Excellent news.

6wheels

Great news Mr bender. Time for another new bike?

haydenm

6wheels wrote:

Great news Mr bender. Time for another new bike?

Celebratory N+1. Great idea

bianchimoon

bendertherobot wrote:

Cardiologist has cleared me. Just fitness basically, may happen again, may never happen again. All because of stretching the atrium a bit far on occasions. But not life threatening and nothing to remotely worry about.

Good news, thanks for the update, get on and enjoy life!