Strange heart rate

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Comments

  • bflk
    bflk Posts: 240
    I've had tons of ECGs (rest and exerise) both NHS and private plus 24h halter testing. If you have really confirmed it via multiple devices I think I'd just get an exericse ECG or VO2 max with ECG done privately sooner rather than later, its not that expensive. I have had such tests in the NHS when I was fit but that was when I had chest pain and a family history of CAD. Locally to me Hampden do rest and exercsie ECGs and then you are only paying for the exact test you want. I've used the BUPA fitness tests too but they tend to be all in packages.

    At home I now have one of those Biosync finger pulse oximters handy along with Polar and TomTom HRMs but you have to be still when you use the oximeter and the pulse drops off so quickly when you stop its of very limited use for exercise issues.
  • numbernine
    numbernine Posts: 8
    Definitely get a stress test (ECG whilst exercising) organised. It is not possible for the heart rate to immediately drop from 150 to 80. It is, however, possible for the pulse to drop immediately if there is a conduction problem within the heart. It is possible that the atria (upper chambers of the heart), where the conduction usually begins, are beating at 150 and then increase to something way above that (eg 300). The heart recognises that there is a problem and not all of these conductions are passed down to the ventricles. If the atria are contracting at a rate of 240 but only 1 in 3 of these are conducted to the ventricles, the pulse will be 80. Having said that, this would usually make you feel very unwell if it occurred for a prolonged period. But, in some people, they can have a problem for only a few seconds before the heart reverts to normal. They may not feel dizzy but but they usually dont feel quite right. It may be nothing but if it has happened repeatedly, best to be sure
  • bflk
    bflk Posts: 240
    numbernine wrote:
    Definitely get a stress test (ECG whilst exercising) organised. It is not possible for the heart rate to immediately drop from 150 to 80. It is, however, possible for the pulse to drop immediately if there is a conduction problem within the heart. It is possible that the atria (upper chambers of the heart), where the conduction usually begins, are beating at 150 and then increase to something way above that (eg 300). The heart recognises that there is a problem and not all of these conductions are passed down to the ventricles. If the atria are contracting at a rate of 240 but only 1 in 3 of these are conducted to the ventricles, the pulse will be 80. Having said that, this would usually make you feel very unwell if it occurred for a prolonged period. But, in some people, they can have a problem for only a few seconds before the heart reverts to normal. They may not feel dizzy but but they usually dont feel quite right. It may be nothing but if it has happened repeatedly, best to be sure

    http://imgur.com/a/A5lxw

    is a sample of my heart doing that after a long ride. Given a holter to investigate but of course couldn't reproduce it.
  • CptKernow
    CptKernow Posts: 467
    I can't imagine the HR is dropping that rapidly and significantly.
    What I would guess is that whatever is measurable is somehow dropping, i.e. only half the electrical signal(s) is being measured.

    Whether this means some kind of electrical anomaly with the heart or some kind of artefact that causes standard measurement techniques to fail I have no idea.
  • Gromson
    Gromson Posts: 100
    A couple of things spring to mind:

    Is the radial pulse rate is an accurate reflection of the heart's actual atrial and ventricular contraction rate?
    - Placing a finger tip in the left 5th-6th rib gap more or less level with where the middle of the collar bone falls on a line from top to bottom will tell you what rate the heart itself is doing. Using the other hand to measure the pulse at the wrist at exactly the same time would tell you if every beat is being conducted to the edges.

    Somebody above measured conduction defects - Electrical blockades preventing some of the (faster) atrial contractions being transmitted to the ventricles. Most GPs will distantly remember things about A-V Nodal block, but most wont remember anything about Mobitz 1 (Wenckebach phenomenon) or Mobitz 2 blocks. Having said that, the ECG was said to be normal, and I cant conceive of a part-time AVN block condition that only manifests during exercise.

    Heart rate, in part, responds to changes in forward pressure load and venous return. Normally, as we warm up and keep going, systemic peripheral resistance drops, which means that the heart pumps faster to try and keep a blood pressure up in a system that's becoming increasingly lower pressure due to more bits of peripheral circulation being called into action. I can conceive of a process (but cant recall a disease) whereby increased venous return would lead to increased ventricular filling, leading to increased forward movement of blood that corrects the low resistance pattern. As I say I can conceive of it, because it's the opposite of what does happen. Whether or not that's what's happening, who knows.

    The fact that she can continue to exercise with an apparently low HR means that she's clearly oxygenating the tissues appropriately, including the brain.

    A treadmill test would seem sensible, and a chat with a cardiologist perhaps.

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