Could Too Much Cycling Cause Heart Problems?

[RobertL]

I'd consider giving it a crack. Seems like a free health check if nothing else. I do wonder at times if cycling 6 days a week poses a heart risk or not.

Speaking from experience, Andrew's thinking, IMHO, is the place where we should all start, regardless of how fit we are cardiovascular wise.

The associated five day test being offered is about electrics, a totally different beast to plumbing issues aka atherosclerosis/heart attack. Two different beasts. And the electrical ones are the ones that are almost always fatal, whereas blocked plumbing is commonly survived even without immediate first aid. Indeed, often without the subject even realising that they have had a heart attack.

Even as I was counting down to retirement, in an aorgansisation of 2000 employees I was a well recognised poster boy of fitness and health. Lean, well muscled, six pack, great cardio, seldom sick. It was built on three decases of bike commuting followed by a decade of unicycle commuting. At retirement I was doing over 8,000kms a year which, on a unicycle, equates to a second job. And that did not included gym work and other activity.

But, while the plumbing was close to excellent - no atherosclerosis - the electrics were waiting, un-diagnosed, to hit with no warning.

And THAT IS THE CRUX OF ELECTRICS. Electrical issues are seldom diagnosed until they hit. And that hit is usually in the form of an SCA, a Sudden Cardiac Arrest. And outside of hospital the chance of surviving an SCA is, in Oz, is between 7 and 10 percent. And if there is no immediate first aid those odds fall rapidly with every minute. And even with an immediate response if someone does not get a defib to you pronto then survival is zero, No exceptions. Your heart MUST have a jolt ASAP or you die.

So my advice to all you exemplars of fitness, if there is a free test on offer, sign up for the research. Just as Andrew is considering.

I'm pretty sure that Christian Eriksen was pretty healthy and was actually playing football for Denmark when he had his SCA. Now he is getting a defibrillator permanently fitted: https://www.aljazeera.com/news/2021/6/1 ... -danish-fa

[jules21]

you're definitely correct Luke that there are different factors, but the main concern that's been thrown around is that too much cardiovascular exertion causes your heart to enlargen and then it stops working properly - the valves don't close nicely anymore, there is scarring - I don't know the details.

the TdF study analysed riders who've given their hearts an absolute beating. no one will do worse than them. the results were that they had good life expectancy.

sure, there are other factors at play so you can't draw direct comparisons. but if over-exerting was a risk for the heart, you'd reasonably expect to see problems in that cohort. there was no trend, which is promising for amateur-pros who give it a good go on the bike, but obviously not to the extent of pros.

yes, other factors like riding in traffic emissions is definitely a risk of its own, but that wasn't the focus of the study.

[RobertL]

there was a fairly big longitudinal study on TdF riders. they punish their hearts over many years with very strenuous exertion. the result was that they had better long term health than the average population. I believe there is evidence that too much exertion can have detrimental health effects, but so does not exercising.

There's a whole lot that doesn't really get covered and is quite difficult to detail in one study or multiple studies as you would need a very large and significant data sample and even then that varies from geographical location to geographical location (ie riding in the city vs riding in rural farming areas vs riding in rural areas next to an iron ore mine and loading facility etc). You have to remember they are on specific training plans, pre ride/ride/post ride routines, have people setting out their diet - basically they have a whole side supporting them that the majority of the population don't have or will never have access too. Your more likely to give yourself long term cardiovascular issues if you sit in a office chair for 8 hours and then do a 60 minute ride home with your hr right up there next to the clogged motorway breathing in large amounts of exhaust fumes thinking youre giving yourself a serious workout with no warm up/cool down day in and day out vs what a pro cyclist has become accustom to. And that's because both methods put strains on the heart in different ways and how the heart reacts/adapts in different ways. Infact you can even say how your body adapts aswell.

It's also possible that they get better medical attention and the ones with potential heart problems are weeded out of the sport and so never get included in studies like that.

[ColinOldnCranky]

I know a racing cyclist in his 60s with AF. He was tested with a VO2max of >80 but took the sport up later in life. he is an absolute beast.

He's obviously had it all checked out, but when his AF kicks in (due to strenuous efforts, such as when racing) he just pulls out and waits for it to subside. obviously I don't know that's going to work for everyone so seek medical advice.

but I guess the point is - AF doesn't mean the end of any exercise, necessarily. this bloke has survived some stuff though so he has a bit of a live life at 100% attitude.

I'm not going to offer advice to your friend as, with his history, he already has advice on hand and will be well informed anyway. Though if he ever goes into a Sudden Cardiac Arrest, he will probably not have any warning at all and will pass out in seconds.

Your friend will know all that and, short of an implanted defib (ICD) and other than diet/medication there is not much he can do about it day to day anyway. Heart stress such as a heart attack or a clot can trigger an SCA and a fit heart should be less likely to go into such stress. So regular riding makes sense for him while avoidance of any exertion does not.

I'm curious Jules, how does your friend determine he is in AF? I am sometimes aware when my ICD goes into pacing mode (takes over electrical control of my heart which it does every 21 hours). And my ICD does report to my cardiologist AF incidents. But I do not know how I would be aware of AF as it happens.

[ColinOldnCranky]

Whoever did your CPR saved your life and your brain function.
They did it well.

Yes, in view if the details it cannot be doubted that the two police officers concerned saved my life. They performed a miracle on that day. In view of the time taken to get a defib onto me, my cardiologist reckons my odds were about 10,000 to one.

I have no memory of the hours before and the days after but over time I have been filled in on the details by my wife, my kids and the two officers who attended.

One of the officers has drawn my attention to a happy co-incidence. The two cops were finishing their final duty together (running a booze bus). They had been reminiscing during the day about their first day together years before. On that day one of them was involved (nothing untoward) in the death of a motorcyclist doing a runner. They had opined that their final day together should be better than their first.

Anyway, they had closed up the bus for the day and were on the way to Maccas in Mt Lawley when they picked up the ambo call. They forwent their tea and took the call and diverted to me about a kilometer away. One officer, a bit overweight and in his fifties took over CPR from another first responder and worked on me FOR EIGHTEEN MINUTES!!! until an ambulance arrived with a defib. They then went to my home to escort my wife to the emergency ward. They impressed upon her that they needed to get herself and my two daughters to RPH immediately as I was in a coma and, without directly saying so, that it was going to be a last goodbye.

One of the officers has told me that at that time they were convinced that their last day working together was going to be every bit as bad as their first.

Clearly I DID survive. I left hospital a week later still with strong body and strong heart and in charge of my wits with the specialist's OK to continue riding the unicycle as soon as my broken ribs could stand so. I wrote to the Police Commissioner to ensure that it appeared on their records of service and have met and bumped into one of them a few times since. I make a point every year on the day to let them know how I'm going. This July it will be five years since their actions.

[Comedian]

I am fortunate (thanks god like medical care) to be cured of AF - at least for now.

If I had any suspicion that I had an issue like this I would consider getting an apple watch. They have for a while now had an ECG function. I gather it's not anywhere near as good as a proper ECG machine - effectively being a 2 wire ECG but it's pretty good at picking up AF I believe.

When I was having AF issues the Australian regulators had prohibited Apple enabling this in Australia. They've since removed this.

https://support.apple.com/en-us/HT208955

[warthog1]

Whoever did your CPR saved your life and your brain function.
They did it well.

Yes, in view if the details it cannot be doubted that the two police officers concerned saved my life. They performed a miracle on that day. In view of the time taken to get a defib onto me, my cardiologist reckons my odds were about 10,000 to one.

I have no memory of the hours before and the days after but over time I have been filled in on the details by my wife, my kids and the two officers who attended.

One of the officers has drawn my attention to a happy co-incidence. The two cops were finishing their final duty together (running a booze bus). They had been reminiscing during the day about their first day together years before. On that day one of them was involved (nothing untoward) in the death of a motorcyclist doing a runner. They had opined that their final day together should be better than their first.

Anyway, they had closed up the bus for the day and were on the way to Maccas in Mt Lawley when they picked up the ambo call. They forwent their tea and took the call and diverted to me about a kilometer away. One officer, a bit overweight and in his fifties took over CPR from another first responder and worked on me FOR EIGHTEEN MINUTES!!! until an ambulance arrived with a defib. They then went to my home to escort my wife to the emergency ward. They impressed upon her that they needed to get herself and my two daughters to RPH immediately as I was in a coma and, without directly saying so, that it was going to be a last goodbye.

One of the officers has told me that at that time they were convinced that their last day working together was going to be every bit as bad as their first.

Clearly I DID survive. I left hospital a week later still with strong body and strong heart and in charge of my wits with the specialist's OK to continue riding the unicycle as soon as my broken ribs could stand so. I wrote to the Police Commissioner to ensure that it appeared on their records of service and have met and bumped into one of them a few times since. I make a point every year on the day to let them know how I'm going. This July it will be five years since their actions.

Great story.
What an excellent pair of fellas.
As are you for following up.
So lucky they did what they did!
Thanks for sharing.

[warthog1]

I felt a bit guilty, given the study is taking place where I live, and emailed saying I would drag my carcass in if needed.
It was yesterday morning and I've heard no reply, hopefully he has all the participants required.

[Comedian]

Whoever did your CPR saved your life and your brain function.
They did it well.

Yes, in view if the details it cannot be doubted that the two police officers concerned saved my life. They performed a miracle on that day. In view of the time taken to get a defib onto me, my cardiologist reckons my odds were about 10,000 to one.

I have no memory of the hours before and the days after but over time I have been filled in on the details by my wife, my kids and the two officers who attended.

One of the officers has drawn my attention to a happy co-incidence. The two cops were finishing their final duty together (running a booze bus). They had been reminiscing during the day about their first day together years before. On that day one of them was involved (nothing untoward) in the death of a motorcyclist doing a runner. They had opined that their final day together should be better than their first.

Anyway, they had closed up the bus for the day and were on the way to Maccas in Mt Lawley when they picked up the ambo call. They forwent their tea and took the call and diverted to me about a kilometer away. One officer, a bit overweight and in his fifties took over CPR from another first responder and worked on me FOR EIGHTEEN MINUTES!!! until an ambulance arrived with a defib. They then went to my home to escort my wife to the emergency ward. They impressed upon her that they needed to get herself and my two daughters to RPH immediately as I was in a coma and, without directly saying so, that it was going to be a last goodbye.

One of the officers has told me that at that time they were convinced that their last day working together was going to be every bit as bad as their first.

Clearly I DID survive. I left hospital a week later still with strong body and strong heart and in charge of my wits with the specialist's OK to continue riding the unicycle as soon as my broken ribs could stand so. I wrote to the Police Commissioner to ensure that it appeared on their records of service and have met and bumped into one of them a few times since. I make a point every year on the day to let them know how I'm going. This July it will be five years since their actions.

Just wow!

[Comedian]

If anyone wants to see what my garmin thought of that fateful night...

[nemo57]

I've had a response from Dr Wundersitz.
It's a 10 day commitment involving a few trips to Bendigo. 5 days wearing harness pre test, 6 x 50 mins on, 10 mins recovery day of test, 5 days harness post test. No mention of Zwift up the Ventoux or anything like that to keep us amused.
If you can't find his email but are interested, DM me.

[warthog1]

I haven't.
I probably didn't sound too keen in my email and did say my 12 lead is normal.
Good luck with it.

[jules21]

I'm curious Jules, how does your friend determine he is in AF? I am sometimes aware when my ICD goes into pacing mode (takes over electrical control of my heart which it does every 21 hours). And my ICD does report to my cardiologist AF incidents. But I do not know how I would be aware of AF as it happens.

I'm not really in a position to answer for him. but he's said to me that it happens mostly when he's racing and his heart is working hard. he will lose power and become breathless, as it's no longer pumping blood and just focusing on increasing its speed. I think that's how he knows, primarily. He just stops at that point.

[robbo mcs]

I'm curious Jules, how does your friend determine he is in AF? I am sometimes aware when my ICD goes into pacing mode (takes over electrical control of my heart which it does every 21 hours). And my ICD does report to my cardiologist AF incidents. But I do not know how I would be aware of AF as it happens.

I'm not really in a position to answer for him. but he's said to me that it happens mostly when he's racing and his heart is working hard. he will lose power and become breathless, as it's no longer pumping blood and just focusing on increasing its speed. I think that's how he knows, primarily. He just stops at that point.

Not wanting to get technical, but you need to specify what type of AF you are talking about. By AF people almost always mean atrial fibrillation. However, there is also atrial flutter, rarer, which is a different beast altogether. Also, some people have a heart rate that is similar in AF and sinus rhythm, whereas others who get AF go into a fast AF rhythm etc.

So apples and oranges. Quite plausible that many people know or have an inkling something is wrong when in AF, whereas others cannot tell at all

[jules21]

I don't know robbo as it's not me it's a friend. All I know is his HR increases to a high speed and it stops pumping blood properly, so he has to wait for it to settle down. Presumably he's had medical advice that it's not a high risk of triggering more serious outcomes, or he's just willing to take the risk.

[rowdyflat]

My experience is that it certainly can uncover existing problems when men get too competitive in older age.
About 10 out of 40 of our riding group have had problems.

[nemo57]

Reviving this to report on Dr Wundersitz' Bendigo study. Went up last Weds to do FTP test. A first for me. Weaker and lower max heart rate than I imagined, but surprisingly decent result on VO2 max. Especially since I'm still on the darts.
Worn heart monitor since then, written down every morsel of food & drink, daily reports on sleep quality.
Not allowed on the bike in the interim, but back up there bright & early this morning for various measurements, bloods taken, assessment of artery quality - and then onto the machine, wired up for motion monitoring, power, cadence and so on.
50 minutes on, 10 minutes off for 6 hours, just spinning steady wattage (very low in my case) and absorbing blue liquid on demand. Pulse measured every 10 mins or so.
He aims to run it at about 70-80% of FTP test results. Nah, mate, I'm here for a long time, not a good time: best dial it back a bit.
At 4 hours I'd had enough.
At 5 hours the arthritic knee was giving me plenty.
At 6 hours I was ready to throw up. There wasn't much left in the tank.
Back there 3 more times in the next 5 days for bloods & observations, filling out paperwork, holter heart rate monitor.
At the end of all this he hopes to be able to report on whether recreational cycling leads to irregularities in the heart: a worthwhile study, I think.
And will tell me all sorts of incomprehensible stuff about my own physiology, no doubt.
But right now I need a warm bath.

[foo on patrol]

Foo

[Retrobyte]

At 4 hours I'd had enough.
At 5 hours the arthritic knee was giving me plenty.
At 6 hours I was ready to throw up. There wasn't much left in the tank.

I do hope there was a big screen with Netflix available. That's a long time to be on a stationary bike

[g-boaf]

At 4 hours I'd had enough.
At 5 hours the arthritic knee was giving me plenty.
At 6 hours I was ready to throw up. There wasn't much left in the tank.

I do hope there was a big screen with Netflix available. That's a long time to be on a stationary bike

6 hours on a stationary bike, how on earth does someone do that without being in excruciating pain. A ride on Zwift with about 135km and 3600m+ is my longest (multiple laps of Innsbruck climb). I resolved never to do that again if I could avoid it.

Nemo - you are a monster for managing that!

[Mr Purple]

Yeah, that's amazing! I did 111km at an average 197W over 3 hours in a Zwift race once.

By the end my shins were literally crusted with salt and my toes went wrinkly. I think if there had been another decent hill I would have quit and taken up golf.

[nemo57]

I suspect some of you are imagining that I went at it harder than I did. My output is distressingly low; I mean, if I were running a toaster I doubt I'd have browned a single slice. Nevertheless, I think I did enough to strain the popliteus in my bad knee.
We did watch a bit of NFL, but otherwise yacked a lot. Good company makes the hours pass easier.

[g-boaf]

I suspect some of you are imagining that I went at it harder than I did. My output is distressingly low; I mean, if I were running a toaster I doubt I'd have browned a single slice. Nevertheless, I think I did enough to strain the popliteus in my bad knee.
We did watch a bit of NFL, but otherwise yacked a lot. Good company makes the hours pass easier.

It's not the power, but the time! 6 hours is a long time to be sitting on a stationary bike, ouch!

[warthog1]

Glad they had enough participants and didn't need me.
Not interested in that!

[redsonic]

Good on you for participating Nemo, and thanks for filling us in!