Bradycardia

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fishwop
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Bradycardia

Postby fishwop » Sat Feb 17, 2018 5:22 pm

I've just been diagnosed with this at the age of 62. What it amounts to is a slow heart. In some people it is just slow at rest, but in my case it is slow when exercising as well. My resting heart rate is typically 46 but it gets lower at times, ie it reached 26 while wearing a monitor for 24 hours, whereas on a stress test the highest I could get before stopping was 122, at which time I was absolutely struggling for breath. If I could have controlled the speed of the treadmill myself I think I could get a bit higher than this, but not much. I get to 130 when riding on tough climbs but that's it. My Max heart rate should be 158 for my age. Fitbit tells me I'm some sort of athlete for my age on the basis of my resting heart rate, but the truth is rather different. You can't trust Fitbit.

It doesn't mean I can't ride, in fact the cardiologist has strongly advised that I continue riding and walking. But it does limit the power I can put out quite severely. The good news is that I can go just about all day.

The condition is caused by the electrical trigger in my heart being faulty. I will need a pacemaker one day. Heart doctor won't recommend it until I start having symptoms, which could be dizziness, fainting or being unable to do everyday things without losing my breath. He says this WILL happen sooner or later.

Anyone else had this condition? Interested to hear how others have managed while riding regularly.

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MichaelB
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Re: Bradycardia

Postby MichaelB » Sat Feb 17, 2018 6:25 pm

Who says it should be 158 ?

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matagi
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Re: Bradycardia

Postby matagi » Sat Feb 17, 2018 7:49 pm

220-(age in years) = max heart rate

Not an absolute guide by any means but useful as a ballpark figure.

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ValleyForge
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Re: Bradycardia

Postby ValleyForge » Sat Feb 17, 2018 10:25 pm

Very interesting fishwop. Did the cardiologist give you a diagnosis or use the term heart block?

Have you had angiograms or a stress echo yet?
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Kronos
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Re: Bradycardia

Postby Kronos » Sun Feb 18, 2018 1:15 am

matagi wrote:220-(age in years) = max heart rate

Not an absolute guide by any means but useful as a ballpark figure.


Its a rough guide for a level of max excretion for someone with a heart condition, in this case bradycardia. Not an absolute, but something to be advised by if you have a heart condition.

It sucks in this case, can you go on the donor list for a new heart?

RhapsodyX
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Re: Bradycardia

Postby RhapsodyX » Sun Feb 18, 2018 6:25 am

Interesting. My resting is almost always below 60, my lowest observed (I fell asleep during a resting metabolic rate gas capture) was 34 bpm, but the other day while on a short ride, I hit 187 bpm (I'm 49). Now, the caveat here is I've been off exercise for three months (serious back injury).

Uninformed doctors & many athletes are quite happy to throw around the term "bradycardia" for anyone with a resting under 60 and everyone assume that it's associated with fitness, but the reality is that athletic bradycardia and non-athletic bradycardia are worlds apart. When my resting is super-low, I also suffer from premature beats (what people commonly refer to as "skipped"), which is one of the early signs of possible future cardiac issues (atrial fib etc.). But even when super-fit, my max is ~ 174 BPM, and at time-trial pace I'm between 165 and 170 bpm. I'm all good as far as I know - I've had a few stress tests and a few echo's before surgeries -surgeons & anaesthetists don't like brady, and they don't like it when there's a family history of cardiac hypertrophy!

A pace maker doesn't sound too bad in this circumstance. As far as I can tell from reading, the main danger of super-low HR is clot formation, as the blood isn't circulating quickly enough, so a pacemaker might be in order to protect your future.

But as per ValleyForge - a bit more testing would be in order. My mother (74) suffers from atrial fib & flutter, which has now moved into bradycardia (probably the handfuls of drugs she's on ;) ) - but they have never given her an MRI to see what's stuffing up the signals. From what I've read, "usual" echo & CT don't give a huge amount of information re. electrical, but a stress echo sounds interesting.

madmacca
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Re: Bradycardia

Postby madmacca » Sun Feb 18, 2018 10:56 am

Just on the 158 Max hr based on age thing. That is based on population average as a whole, and like most averages, is made up of a range of individual measurements above and below the average. In fact, the 220 minus your age formula has a standard deviation of 13 - in other words, the prediction will be wrong by 13 bpm or more for 1/3 of the population, and wrong by 26 bpm or more for 5% of the population. So a maximum of 130 is not in itself to concerning.

Also, even on tough hills, most cyclists will not hit their true maximum HR's - it's uncomfortable, and you fatigue too fast for it to be an efficient way to get up the hill. Most get to about 95-96% - to get to your true maximum, you really need to push yourself HARD (and I wouldn't recommend it unless your cardiologist says its OK). I hope you have told your cardiologist about how you felt about the stress test, and what numbers you can reach while cycling.

While doctors often raise an eyebrow at RHR's less than 50, a RHR of 46 is not unusual for a regular cyclist. I agree with Rhapsody's comments about athletic and non-athletic bradycardia. The drop to 26 bpm is more concerning, and I'm glad your cardiologist is keeping an eye on this.

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MichaelB
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Re: Bradycardia

Postby MichaelB » Mon Feb 19, 2018 9:20 am

As mentioned by others, the 220-age bizzo is not really useful.

I'm 51, have a resting heart rate of around 50 (sometimes lower but haven't tested recently) and a max (actually observed) of 195.

I'd be relying on a cardiologist's knowledge of whether the 130 is good or not, and what you can do about it (if indeed something needs to be done)

fishwop
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Re: Bradycardia

Postby fishwop » Mon Feb 19, 2018 9:29 am

ValleyForge wrote:Very interesting fishwop. Did the cardiologist give you a diagnosis or use the term heart block?

Have you had angiograms or a stress echo yet?

Yes he said it is bradycardia. He didn't say heart block. I had a stress test but not a stress echo test, and also angiogram, which is clear.

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ValleyForge
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Re: Bradycardia

Postby ValleyForge » Mon Feb 19, 2018 10:05 am

So it sounds like sinus bradycardia where the SA node just initiates a slower than average pulse interval. Huge range of causes (medications, plants, thyroid....) but it sounds like the conduction from that point through your heart is fine - that's the really important bit.

It does sound like you are symptomatic when you exercise and if you heart is structurally normal on echo, perhaps lean on the cardiologist asking about medication to boost your heart rate during exercise. Coffee, a number of medications....

And Salbutamol. :twisted:
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uart
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Re: Bradycardia

Postby uart » Mon Feb 19, 2018 11:31 am

It's good the read these health threads, as I always learn something new.

I'd always thought Bradycardia was an elevated pulse rate accompanied by mild nausea upon hearing the Brady Bunch theme song. "Here's the story, of a lovely lady ..." :wink:

Arlberg
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Re: Bradycardia

Postby Arlberg » Tue Apr 17, 2018 3:35 pm

I have a similar problem, a usual heart rate of about 41 and I'm by no means super fit. It doesn't make me feel tired in the sense that I am falling asleep, but I certainly feel very sluggish.

It makes me very lethargic for every day activities. Getting motivated to do anything strenuous is difficult. However once I do start a strenuous activity/exercising and my heart rate picks up and (I presume) oxygen starts flowing freely through my body, I perk up dramatically both physically and mentally. I liken it to being like a fish in an aquarium with no oxygen pump.

The cardiologist says what seems to happen with me is the reverse of every other case he has ever seen, in that a sufferer with a low resting heart rate will fatigue very quickly once they start strenuous activity, not the other way around as in my case. I feel lethargic when not exercising and 'normal' when exercising. During a bike ride (or any other strenuous activity) I feel normal, but as the heart rate drops back to 'normal' after the exercise has finished the lethargy quickly returns.

I'm still hoping for a 'cure'.

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