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I read up on all the heart rate zones when I was very concerned about it. After spending hours and hours reading that kind of thing I settled on an empirical approach - what works for me.

Once I warm up my heart rate is typically about 100 bpm.

As long as I stay below 160 bpm I can ride all day. My threshold was measured at 165 but I find that my monitor is a 'trailing indicator'. By the time my HRM shows 165 I have been anaerobic for a time, however short. And bouncing in and out of anaerobic seems to hit me harder than staying on one side or the other.

As part of all the reading, I read that an 'average person' athlete has about an hour a day of anaerobic effort in them. An "elite athlete" may bump that to about 2 hours. I save my 60 minute to expend when I need them. On a big climb or going over a big ledge. For example during the EB I ride up Courtyard until I hit 160 bpm heart rate. Then I get off and walk the rest. Typically my heart rate stays right at 160 the rest of the way up. Jester I can ride slow enough to ride over the top below 160 bpm. I am using those 60 minutes on the HOL, St Eds, Thumper, etc. not the road climbs.

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59 minutes ago, cxagent said:

I find that "heart chart" interesting. I say that some information is better than no information. But the 'one size fits all' raises more questions for me than it answers. The "average maximum heart rate" column looks to match the old rule of thumb that your maximum heart rate is 220 minus your age. (At least the couple of ages I checked matched exactly.) Since I was seeing a heart rate that was rarely below 220 - should my age have been zero? Or negative?

When I had it measured my aerobic threshold was 165 bpm. But that chart says my maximum heart rate should be 160 so I need to back off if my heart rate goes above that. By that logic I will NEVER go anaerobic. Maybe that works for the 'average American' but it does not work for me. I save my anaerobic efforts on long rides (EB, MS150, etc.) but I regularly push to anaerobic zones.

Think of it more like the Pirate Code. that is, "guidelines" more than rules. There are always exceptions.

Your observation may only mean that you are exceptional! :classic_biggrin:

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@AntonioGG & @cxagent and others...

Sounds to me like you're 'doing it all wrong' 😉  Seriously, you're basically seeing a plumber when you may have an electrical problem.  Instead of a cardiologist (aka plumber), you should see an electrophysiologist (aka electrician). 

At the risk of being both offensive and an alarmist, many, many cardiologists are too arrogant or ignorant to refer someone to an electrophysiologist, even though they may treat someone together.  It's like going to see a surgeon when you may not need surgery - they're far more likely to recommend surgery over therapy, because that's what they know and what they do and how they approach 'problems'.  Some are dishonest about their biases, but most are just ignorant about the alternatives (in terms of breadth and depth of options).

I endured A-Fib for 10 years and while ymmv, my lifetime of experience with specialty docs has confirmed this time and again.

A-fib and flutter risks are primarily associated with strokes, while various tachycardias just straight up kill you.  So, may be low probability, but worth checking out in my opinion.  FWIW, in 10 yrs of treatment, I never had a stress test and I think I had just one CT scan before a procedure. In other words, it's gotta be the right test.  There's a whole helluva a lot even EP's don't understand about arrhythmia, so a Cardiologist will be of little help unless you're elderly with typical persistent a-fib.  They don't have a complete grasp on triggers or risk factors.  My EP would tell me it's nothing that I'm doing that was causing my episodes, but that was bullshit.  Dehydration was the main factor for me.  Stress/lack of sleep was another and what led to my first recognized episode (going for a run the day a really late nighter).

Briefly, I was diagnosed with A-Fib 2002 at 35, by an electrophysiologist (EP). I went on a medication, fleccainide, initially bc it had virtually no side-effects and the pulmonary vein isolation (PVI) procedure that was recommended was only about 2/3 effective, though it was new and they were improving their techniques (on others!).  However, by 2008 I had passed out 2x and was ready to fix it and be done.  It's a progressive condition since the heart basically re-models when it's in arrhythmia - 'arrhythmia begets arrhythmia'. After 6 years, fleccainide just wasn't as effective.  Had a PVI in June 2008 (and a hernia repair, since I was outta commission anyway), but by Oct-Nov I was recovered but still having episodes.  Squeezed another PVI in just before EOY (a freebie!).  That one worked only well enough to effectively reset the clock some and I went back on the med since it was effective again.  But by 2011 I was having more frequent episodes again and cardioversions can really cramp your style.  This time I had the #1 EP in world for a-fib do the procedure and have been asymptomatic (still hard to say "cured") for 7 years!  This doc, Andrea Natale, had just come to Austin when I had my 1st two in 2008 and I would've had to wait many months.  I was already at the same practice, Texas Cardiac Arrhythmia, he joined so he was involved.  It may have cost me some heart function, but it's good to have back pocket excuses.

Hope this helps.  I know getting diagnosed im/properly is at the very least a PIA, but certainty is an awesome thing.  You may not have any actual heart problems and the occasional skipped beats and/or palpitations are fairly common and innocuous; however, you may also be nagged by the fear that something could still be wrong and, of course, much worse.

Also, Charlie Rioux is also another resource, as he dealt with arrhythmia too. 

-Scott

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@ssorgs - they thought I was having A-fib when I first saw a cardiologist. They put me on a drug I call a "heart rate limiter". (I can go find it but I don't remember what it was.) I hated that stuff. I thought if I got close to the "limit" it would just hold me there. Not a chance. If I hit "redline" it knocked me down to 50 to 75% and I could not recover for a while. I was glad when they decided that was not the problem.

I agree with your main point. I am supposed to see a "real cardiologist" next week I will ask about the electrophysiologist. After only a month of waiting after my other doctor 'got me an appointment'. I would think when the blood bank won't take my blood because your blood pressure is "too high" and your doctor says you need to make a blood donation because your blood is "too thick" - it would not take a month to see the doc. I am starting to think the doctors don't want to see you unless you have survived a month before the appointment. (Can you tell my opinion of the medical profession is not very high?)

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7 hours ago, CBaron said:

What were your "episodes"?  What was happening?

-CJB

For starters, I'll say that the exact condition I had may feel completely differently in someone else... Episodes are when you're out of (normal) sinus rhythm, or in atrial fibrilation (or flutter, etc).  In my case, I could tell instantly when I 'flipped', but sometimes if I was in it for extended periods, it could be difficult to tell whether I still was. 

What's happening is an electrical storm in your atria and they just quiver instead of pump, so blood can pool, which leads potentially to clots and potentially strokes.  Symptomatically, it can manifest a several ways:

1) irregular heartbeat - when not active you can have a handful of normally spaced beats and then an oddball one (think of an electrical signal that makes it out the atria and into the right (?) ventrical for a real beat) and that repeats periodically but not at regular interval - this can be detected with a heart rate monitor (hrm) and I'd feel it - an extra thump;

2) flopping feeling in your chest - this is more than the occasional thump, but can be like a flutter (like atrial flutter, which is very similar in treatment too), but mostly like there's an out-of-water little fish in your chest; and

3) elevated/spiking heart rate - resting hr which may be in 60s or low 70s for me, but in mid- to upper-80s in a-fib, but would shoot up to 120-130 getting up and walking around, or going upstairs; in the extreme, I'd pass out when it shot up but this only happened 2 times, I think. Once, going upstairs to the dentist while I knew I was in a-fib but thought if I went slow enough...(funny story though - passed out on the stairs, came to went to the dentist and after my appointment stopped in the bathroom outside their office and had fresh blood cut on my nose - nobody said nuthin!). The other time was playing Ultimate, which I did competitively for 15 yrs till I had to give it up after passing out during a game when I went into a-fib but tried to finish the point (more blood on nose again!)

4) really goes with 3, but you get out of breath easily, like getting up from seated

5) sometimes I'd see very high spikes ~220 on my hrm after run or ride, even though I never felt 'in' it; but, jury is out on whether those were really short episodes or even a palpitation that got misread by my hrm (this was back with an older polar chest strap and watch). Misreads would happen a lot and they'd usually be multiples of my actual hr - sometimes the hrm would say my hr was 35 or 220, but reality was more likely .5x or 4x, etc.  I've got an optical now, and a watch with 24 hr tracking, that's much better. Can't recall anymore if an ekg/ecg ever gave weird readings like that.

First time I felt it, though, wasn't really like any of these.  I was really sleep-deprived and went on my regular neighborhood run, but just felt 'bad' no energy and was struggling to get up a slight incline during my run.

And to add to the episode description... I could go into a-fib playing Ultimate - quick unexpected sprints, etc - but, it also happened following a sneeze, standing at the sink doing dishes, waking up, and lots of otherwise innocuous circumstances.  Fortunately, mtb never put me in a-fib, though there were some spikes I'd see in my hrm.

Lastly, episodes can last from moments to hours to days.  They suck for many reasons, but then again, you're not immobilized or anything. It's like a raining cloud over your head, but then when the episode ends, you still have the cloud that could open up at any time.  Getting out of a-fib can vary a lot too.  It can happen "spontaneously" (it's a term), with an additional dose of fleccainide, one of many mostly bs for me home rememdies (I did try the ice cold head dunk once - didn't work, neither did trying to sneeze while holding your nostrils closed), or via chemical or electrical cardioversion.  Both are done in a hospital and take 2-4 hours and require someone to drive you home - huuuuge pia.  I've  had mostly electrical (ie paddles where they restart your heart) and in 3 different states. 

Edited by ssorgs
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1 hour ago, cxagent said:

@ssorgs - they thought I was having A-fib when I first saw a cardiologist. They put me on a drug I call a "heart rate limiter". (I can go find it but I don't remember what it was.) I hated that stuff. I thought if I got close to the "limit" it would just hold me there. Not a chance. If I hit "redline" it knocked me down to 50 to 75% and I could not recover for a while. I was glad when they decided that was not the problem.

I agree with your main point. I am supposed to see a "real cardiologist" next week I will ask about the electrophysiologist. After only a month of waiting after my other doctor 'got me an appointment'. I would think when the blood bank won't take my blood because your blood pressure is "too high" and your doctor says you need to make a blood donation because your blood is "too thick" - it would not take a month to see the doc. I am starting to think the doctors don't want to see you unless you have survived a month before the appointment. (Can you tell my opinion of the medical profession is not very high?)

I can sense it ok. Not so sure about the relationship(s) between bp or thick blood and electrical problems, though - does seem more a plumbing-related issue.  I have pretty low bp and it would typically be lower while in a-fib.

Best advice I can give is don't give up on it.  You know you better than anyone and if there's something amiss that you can't definitively explain, chase it down.  I was 35 with a 1 year old and didn't want to be that tragic guy that dropped dead on a different run, before my wife could ask, 'did you ever get that checked?"  While I did have to give up Ultimate, I hardly stopped biking, even while on blood thinners. I still drink caffeine and alcohol, etc., but even quitting all of those would be worth being with my family.

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27 minutes ago, ssorgs said:

2) flopping feeling in your chest - this is more than the occasional thump, but can be like a flutter (like atrial flutter, which is very similar in treatment too), but mostly like there's an out-of-water little fish in your chest; and

That's what got me to the cardio 2x.  This was always a single event, not a string of them.  After all the tests, while in fluoroscopy they caught it.  It turns out to be spontaneous reflux and it just gives a weird feeling in my esophagus/chest.  My episodes were always tied with atypical heartburn.  I had two ER trips within 2 weeks in two different states in addition to a whole bunch of tests before they figured it out.  My HR has always gone high while working out...steady climb, not sudden jump.  RHR as low as 45 and normal BP for me.  My Dr. did recommend I keep up with salt intake and my brother (an M.D. who is an athlete as well) also told me to make sure I'm getting enough calcium.  Oh yeah, after drinking milk all my life, it took this streak of problems for me to figure out I've grown to be lactose intolerant.  That's what I used to drink if I thought I had heartburn!

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4 minutes ago, AntonioGG said:

salt intake and ... calcium

Looks like an anti-dehydration elixir.  Dehydration is one of the most nefarious (often preventable) conditions. I guess that's because we're mostly water, duh.

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Yeah, afib is a real issue and could be more likely as most bikers tend to be pretty healthy, but afib has little to do with how healthy you are. 

The difference is pretty stark. Afib is like the wiring getting shorted out on your car, it can happen to a brand new one or one that is meticulously maintained. Other cardiac problems are the result of wear and tear, you can see them develop over time and watch their progress, like when your transmission fluid gets dirty and the car starts shifting roughly before it just stops altogether. 

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11 hours ago, ssorgs said:

) flopping feeling in your chest - this is more than the occasional thump, but can be like a flutter (like atrial flutter, which is very similar in treatment too), but mostly like there's an out-of-water little fish in your chest; and

I had the same thing happen randomly pretty much all of my life but was told not to worry about it unless it was prolonged or regular since the Dr's were never able to observe it.  Strangely the Dr's never considered magnesium deficiency.  As soon as I started supplementing Magnesium to help with sleep/dreams it completely went away. Only then did I learn the two can be linked.

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While I was being treated, an IronMan woman friend developed SVT, which is a potentially fatal arrhythmia - like other tachychardias.  She got hers fixed right away and then went back to school, got a nursing degree, then went to work for that practice...

Anyway, the point is even at the practice treating me, they were seeing an increased prevalence of arrhythmias in endurance athletes.  There wasn't much literature at the time about that correlation, but plenty of anecdotal (though I've stopped keeping up since getting fixed, myself). 

So, if you feel something, say something.

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2 minutes ago, Txduc said:

Dr's were never able to observe it

Did they get you a halter or event monitor??? Otherwise, they're definitely NOT going to see it.  That can be the cardiologist/plumber approach.  Do a stress test, which isn't likely to pick up arrhythmias.  Nevertheless, if you're asymptomatic that should be a good thing, irrespective of why/how.

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3 minutes ago, ssorgs said:

Did they get you a halter or event monitor??? Otherwise, they're definitely NOT going to see it.  That can be the cardiologist/plumber approach.  Do a stress test, which isn't likely to pick up arrhythmias.  Nevertheless, if you're asymptomatic that should be a good thing, irrespective of why/how.

Nope neither but it was really random, only once or twice a year  and only for a few seconds at a time. The only time I picked it up I was getting ready for a run with my HR strap on and it happened.  When I looked at the graph it went from the 50's then jumped to around 200, back down to the 50's and the line from that point forward was normal during the run.  In the 4 years that I've been supplementing with Mg it has yet to happen again.

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Holter monitors* are getting easier and easier to use.  When Mr. JB was dealing with arrhythmia and the doc was trying to sort it out, we had to stop at a pay phone in Burnet to replay the Holter monitor results over the phone after he had an episode.  He did go to an electrophysiologist at St. David's, got the zotz on the misfiring cells in his heart, and has been fine since. 

When I had palpitations recently, they sent me home with three electrodes attached to a small receiving unit.   Got it on a Friday and took the unit back to the doc on a Monday.  They download all the data from the receiving unit. They send extra electrodes home with you so you can easily change to fresh ones.  

At some point this will probably all be done through an app on a smart phone and I suspect they are pretty close to that now. 

*A Holter monitor is a battery-operated portable device that measures and records your heart's activity (ECG) continuously for 24 to 48 hours or longer depending on the type of monitoring used. The device is the size of a small camera. It has wires with silver dollar-sized electrodes that attach to your skin.

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I forgot to mention, part of my experiences that sent me to the ER ended up being panic attacks.  I'd never had one before then.  Whatever was irritating my vagus nerve with the reflux was causing me to panic.  Then I kept thinking the worst thing which would feed back onto itself.  I watched my HR go from 70 to 150 very fast when I put my HR strap before going to the ER.  If you guys watched the Sopranos and you watched/heard Tony S describe what his panic attack felt like, I'd never seen it more perfectly described before or since:  "It's like you have ginger ale in your head" is exactly how I would describe it.  Also, the heartburn symptoms, I used to always wonder how people would confuse that with a heart attack, or a heart attack with heartburn. Now I know!

So, reading up on all this 2 years ago would have totally triggered a panic attack, but now I'm able to deal with reading about this without having that issue.

Now, smelling toast...I always go check if there's really toast!

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On 5/2/2019 at 1:57 PM, ssorgs said:

...Dehydration was the main factor for me.  Stress/lack of sleep was another and what led to my first recognized episode (going for a run the day [after] a really late nighter).

 


This has been my experience as well.

Lack of water and lack of proper amount of sleep stresses the body... And then you dump the stress of the day on top of it.

Bad formula for healthy living.

Edited by RidingAgain
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  • 4 months later...

I know this is an old thread, but I wanted to update my experience with my heart arrhythmia.

As I indicated in an earlier comment, back around April I had to see a doctor about a heart arrhythmia problem that was becoming an ongoing issue. Although I've had on and off problems with heart arrhythmia for a couple of decades, finally getting to a point about ten years ago where I saw a cardiologist about it, after a scan and wearing a monitor for a few days, she just increased my dosage of metoprolol (a med I was already taking for high blood pressure) and within a year or so, the continual arrhythmia went away and I had only experienced an occasional event since. Some years ago, because of the risks associated with long term use of metoprolol, my doctor took me off it, replacing it with Losartan, which is a milder med for high blood pressure. 

Unfortunately the arrhythmia came back with a vengeance this February.

I also have Type 2 diabetes, and in February my doctor changed one of my meds to a med called Trulicity... And within a couple of weeks I started having really intense arrhythmia again. My blood pressure would increase, and as this happened the arrhythmia would intensify. I was told that it might have to do with the Trulicity, but I should give it a chance. By April I was at the end of my rope waiting for things to subside and went and saw the cardiologist. He thought it was a node problem and didn't prescribe me anything right away for it. After another month I went back to see him and was prescribed metoprolol again. Metoprolol lowers your heart rate and he prescribed it because there seemed to be a correlation with the intensity of the arrhythmia and my having increased bold pressure levels.

As much as I didn't want to have to resort to another medication (I see it as covering up the problem and not really dealing with it), the arrhythmia was really bad and I just wanted it to calm down.

Fast forward... The metoprolol helped, but the arrhythmia didn't go away. Now during the months I had been taking Trulicity I had also noticed that my intestinal tract, including stomach, was having its own issues, and the intensity of the arrhythmia seemed connected to this. At the end of August I told my doctor that I was not going to continue taking Trulicity, and stopped doing so. Within ten days of me doing so my arrhythmia events/intensity decreased to almost stopping. And so had the burning type sensation I had in my gut.

Are these two things linked?

I was going to speak with my doctor about it when I go in for my quarterly visit... But then I took Aleve three days in a row (joint aches) and noticed that the burning in my gut was back... And my arrhythmia started up again... Not as intense as before, but definitely increased from where it had been for the ten or so days after stopping taking Trulicity.

Now Trulicity is know to have bad effects on the intestinal tract... Great at lowering blood sugar... But side effects are not so good for some.

Before taking Trulicity I'd never experienced any ongoing got problems. Some indigestion/heart burn now and then... But nothing like the constant irritation I had been experiencing since starting the Trulicity. Could there be a link between this gut irritation and the heart arrhythmia I'd been experiencing?

Research is showing that there might just be.

No doubt the Trulicity totally messed up my gut... I know this physically. And I think that taking the Aleve may have caused some irritation to an already sensitive problem, which is why the arrhythmia started up again after subsiding when I stopped taking the Trulicity.

Man can these things get complicated.

Anyway... I just thought that there may be a couple of folks out there that are struggling with a heart arrhythmia problem and that taking a look at intestinal issues might be helpful in figuring out how to deal with it.
 

Edited by RidingAgain
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On 5/6/2019 at 8:58 AM, RidingAgain said:



Lack of water and lack of proper amount of sleep stresses the body... And then you dump the stress of the day on top of it.

Bad formula for healthy living.

I need to drink and sleep more, but sometimes  a bit difficult.

Edited by jcarneytx
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