High Heart Rate - 226 BPM ???

[Alexandra]

in the case of AF this is a very common condition and WPW is a rare cause of it. Endurance athletics is a not uncommon cause, particularly in older athletes. Most people with paroxysmal AF need very different treatment from those with WPW and the outlook eg chance of cure is also very different and depends on a whole number of variables.

Thanks for this very useful and interesting post. I hadn't heard endurance exercise cited before as a cause of AF. Could you give a source? Also, could you expand on what you see as the outlook and chances of cure of AF? And, since you seem to know a lot about this, do you distinguish between tachycardia and AF? So far, since it has not been possible to do tests while I am actually having an episode, the consultant seems to be reserving judgment as to whether my "palpitations" do amount to AF.

[julianbramley]

Good grief, this thread makes me feel better!
I am a relatively fit 43 year old, don't smoke, hardly drink, do a lot of cycling and a bit of running
I had AF in Oct 2009 out of the blue and had a cardioversion within 48 hours which put me back in a normal rhythm.
The following months I was so anxious but I've gradually returned to exercise, it took months to see a specialist who seemed fairly unconcerned, a 24hour trace revealed a few seconds of irregular activity but there is nothing else wrong.
I do think I have now become oversensitive to my pulse, I just can't stop listening to it all the time just in case!
I do catch it hopping and skipping but only for a few seconds at a time, my only fear is these episodes will become longer and more frequent.
In the meantime the specialist told me I can exercise as hard as I like, so I have no excuse.

It feels good to know there are others out there having the same little struggle.

Cheers

[Flopsy]

Absolutely Julian. I think it is easy to become overly sensitive to your heart rate.

Most people will throw off what are called ectopic heartbeats, which feels like your heart skipping a beat or fluttering, These are entirely normal. However, when you become aware of them it can become self perpetuating as the more you're aware the more you're gonna have them due to becoming more stressed.

Generally I try and ignore what my heart is doing. That only becomes difficult when it is really playing silly buggers and very rarely does it start to alarm me. But that's cause I've had years to get used to it. When I first got ill it terrifed me and so I'd end up getting really panicy and that made me feel even worse. I was permanently taking my pulse and avoided doing loads of stuff in case it triggered an attack. TBH that wasn't helping.

I decided that the heart is a muscle, I know my heart is healthy from all the tests, it just has faulty wiring. I figure the fitter my heart the more it will cope with the episodes of irregularity. Works for me!! :thumbup:

[IanDarkpeak]

First the awful shocking news, I had a letter last week from the specialist, I am no longer listed as an endurance athlete, I am now a Veteren Athlete!!!!! That as really knocked me....

Thanks for this very useful and interesting post. I hadn't heard endurance exercise cited before as a cause of AF. Could you give a source? Also, could you expand on what you see as the outlook and chances of cure of AF? And, since you seem to know a lot about this, do you distinguish between tachycardia and AF? So far, since it has not been possible to do tests while I am actually having an episode, the consultant seems to be reserving judgment as to whether my "palpitations" do amount to AF.

A I mentioned this in an early post, It is common in quite a few endurance sports Paticularly in Xcountry skiing and long distance running, It's also pretty well known in pro cycling, I believe it is caused by the heart becoming more "muscly" due to the extra excerice. Tachycardia is the same as Palpatations, the heart is beating very fast. AF(Afib and Aflut) are more about the heart vibrating so there fore not actually pumping much blood, this can cause blood to stagnate in parts of the body and if not treated can cause the blood to clot therby causing a stroke.!

As Paulo mention there are Differing causes but I get the impression both from listening to Doctors, researching on the web and talking to others who have the same or similar problems that it can't be totally cured, they can remove the main cause by ablations etc but it is some thing that IS going to happen any way the older we all get. It is something that is expected to happen to 60-70 year old, we're just lucky to get it earlier!

I've always coped and managed my Palpatation but the AF was some thing much worse....

Absolutely Julian. I think it is easy to become overly sensitive to your heart rate.

Most people will throw off what are called ectopic heartbeats, which feels like your heart skipping a beat or fluttering, These are entirely normal. However, when you become aware of them it can become self perpetuating as the more you're aware the more you're gonna have them due to becoming more stressed.

Generally I try and ignore what my heart is doing. That only becomes difficult when it is really playing silly buggers and very rarely does it start to alarm me. But that's cause I've had years to get used to it. When I first got ill it terrifed me and so I'd end up getting really panicy and that made me feel even worse. I was permanently taking my pulse and avoided doing loads of stuff in case it triggered an attack. TBH that wasn't helping.

I decided that the heart is a muscle, I know my heart is healthy from all the tests, it just has faulty wiring. I figure the fitter my heart the more it will cope with the episodes of irregularity. Works for me!! :thumbup:

Agreed Flopsy I just get on with it now, I know my heart is strong but with these occ blips. Following my AF I was very nervous but now I train as hard as I did before. Although I've reduced the number of sessions I do train as I'm picking up other injuries.

I Too was aware of my heart hiccuping/skipping etc and have lived with it all my life(although I did fear it would one day come back and bite my ass) so to speak.

To finish where I started though with the letter, I have to under go a procedure called Adenosine ECG which is a chemical stress test on the heart. I've got no date yet but it doesn't sound fun. This is a modern test to confirm WPW, from here they are talking about having an Ablation....... Phew!

[Alexandra]

[QUOTE=IanDarkpeak;372328

A I mentioned this in an early post, It is common in quite a few endurance sports Paticularly in Xcountry skiing and long distance running, It's also pretty well known in pro cycling, I believe it is caused by the heart becoming more "muscly" due to the extra excerice. Tachycardia is the same as Palpatations, the heart is beating very fast. AF(Afib and Aflut) are more about the heart vibrating so there fore not actually pumping much blood, this can cause blood to stagnate in parts of the body and if not treated can cause the blood to clot therby causing a stroke.!

... it is some thing that IS going to happen any way the older we all get. It is something that is expected to happen to 60-70 year old, we're just lucky to get it earlier!

I've always coped and managed my Palpatation but the AF was some thing much worse....[/QUOTE]

Thanks, Ian, I do remember now, but I have grasped it all much better after your latest explanation. I'm now hoping my tachycardia is only that and not AF, as I really don't feel that bad when it happens. As for age, well at 68 I AM squarely in the 60-70 range so I guess I had it coming! Like the rest of you, I feel that the best way forward is to train my heart as well as possible (though I'm more careful than I used to be about warming up and down). Surely taking one's heartbest as high as possible in a carefully planned and controlled way will make it easier on that same heart if unplanned fast heartbeating occurs? We all seem to have the same reaction from the specialists - no-one seems to have suggested we give up or even moderate our exercise.

[paulo]

There are a couple of minor misconceptions apparent in the thread, hope this is helpful:

tachycardia - this means "a fast heart rate" (more than 100 beats per minute) regardless of cause - so may be present as a normal appropriate response to exercise, anxiety etc or due to a heart rhythm abnormality ("arrhythmia") which causes the heart to go fast inappropriately eg the various conditions already mentioned in this thread SVT, AF, atrial flutter etc

palpitations - this is not a diagnosis or specific condition - it is a symptom (ie something a patient complains of) and means "an undue awareness of the heartbeat." This sensation may be caused by tachycardia, extra heartbeats (ectopics), bradycardia (slow heart), anxiety with normal underlying heart rhythm, etc


Atrial fibrillation, AF - the ventricles, the main pumping chambers of the heart, are beating in a completely irregular disorganised rhythm so the gap between any 2 heart beats is completely unpredictable and the amount of blood sat ready in the ventricle when it beats varies a great deal so the efficiency of the heart as a pump is diminished. When in AF the heart has a tendency to go too fast (tachycardia) even at rest but particularly in response to exercise where the rate can increase very disproportionately to the level of exercise often leading to a feeling of palpitations and breathlessness. Some people are stuck in AF all the time and they are given drugs to slow the heart down and hopefully prevent or greatly diminish the symptoms. This is very common in the elderly - more than 10% of 80 year olds. Other people (as described in this thread) go in and out of AF (paroxysmal AF, PAF) and their treatment revolves around trying to maintain normal rhythm - this is done with drugs and sometimes ablation procedures.

People with PAF tend to have some degree of physical abnormality (from minor eg the stiff heart muscle seen in old age and athletes to major eg heart valve disease) in the heart itself - this is known in electrophysiology as the "substrate" which predisposes to the AF. There are then certain "triggers" that lead to the episodes of AF in people in who the necessary substrate is present. These triggers can be all sorts of things from exercise to alcohol to a cold/flu and vary from person to person. The relative imortance of substrate vs trigger varies hugely between people eg some people with normal hearts can get AF if they drink ten pints of Old Peculiar, others with more substrate get it from slight exercise or entirely out of the blue. Relaxation can be a trigger in that the natural slowing of the heart that occurs eg in bed can allow "room" for the AF to kick in. Sometimes when people go in to PAF it goes away again by itself and others it persists and can only be got rid off with intravenous drugs or a cardioversion (electric shock delivered under anaesthesia)

Sorry for the complexity - the important point is that every individual with PAF will need assessing for what their substrate and trigger factors are and their treatment and its chances of success are dependent on these - varying from not drinking ten pints of Old Peculiar to all sorts of strong drugs, ablation procedures, pacemakers and sometimes surgery. Generally older people with more indentifiable structural abnormalities in the heart will have a poorer chance of maintaining normal rhythm. People with exercise induced PAF including athletes often respond to beta blocker drugs and may be good candidates for potentially curative ablation procedures so my top tip would be make sure you get referred to a cardiologist with a interest in heart rhythm management if you have this

the Arrhythmia Alliance site is a good resource for patients www.heartrhythmcharity.org.uk/

hope that helps answer your questions Alexandra, and also hope I haven't just muddied the waters :-0

cheers, Paulo

[Alexandra]

Thanks very much indeed Paulo for taking so much time and trouble to write the above (I'll refrain from quoting it, I don't want to crash the site!) It's most helpful and I shall save it elsewhere as well as having already bookmarked the AA site you mention.

[IanDarkpeak]

On my way to the cardiac dept this PM for another ECG. In the new year I'll have to go back for an Adenosine ECG.

[Chris K]

Hope it went well Ian, had my ECG and other tests done back in September - no idea where the results went - and I don't get to see my consultant until February (NHS sent a letter cancelling my October appointment that I haven't had yet)! Hey ho, still live and kicking so musn't grumble.......grrrr!

[IanDarkpeak]

Hope it went well Ian, had my ECG and other tests done back in September - no idea where the results went - and I don't get to see my consultant until February (NHS sent a letter cancelling my October appointment that I haven't had yet)! Hey ho, still live and kicking so musn't grumble.......grrrr!

Yes it did, well I think it did, all the results are to be sent on to the Chief resident!

But it wasn't an ECG like i remember it, they did a 3D scan of the heart, a Dobbler scan! (measures bloodflow/qauntity/speed/volume) took lots of readings. Interesting watching my heart beat on a screen and watching the valves opening and closing and the blood rushing through. Heart rate during the scan was 50 which was abit of a problem as he recorded a screen shot of my beat(like an old ECG) but was only gettin 3 beats on the page and he needed at least 5!

Not got the date yet for the nasty test, new year I suspect. if they have to go in a cut something some time around the end of March would be perfect timing...