Riding Rhythms

A quick word on riding bikes and heart issues, notably AF and SVT, something I have some experience of. Maybe it could help you understand and compare if you get similar symptoms.

Born in ’69 and riding bikes since 5, I’ve never stopped riding bikes. And unlike the skinny stereotype cyclist, I have probably carried a little too much weight for much of that time, whether commuting, riding with friends, a single cyclocross race, MTB racing, and even a 10 mile time trial! Nothing of epic proportions, but the big beating organ performed faultlessly up to about the age of 45.

I do however have family history of heart plumbing issues, i.e. thickening of arteries, heart attack, quad bypass, and death. I’ve not had anything that has shown this is an issue fwiw.

My pulse was always usually in the high forties, and blood pressure wasn’t high high – but perhaps it could have been lower for many years – 140/90 was an average.

Mid forties – Super ventricular tachycardia (SVT) begin

I noticed after the crest of long hard climbs, and especially in the Bristol Bike Fest races I was competing in (but not needing effort that hard) I started getting SVTs.

The symptoms were a racing heart, a feeling in the chest that wasn’t normal, and varying degrees of breathlessness. Over a year or so the episodes got more frequent and the bar for effort reduced and they became more and more invasive to the point I was getting short episodes through the day at work, and needed to get something done.

Luckily SVTs are usually pretty treatable. The arrhythmia feels like your heart is beating twice as fast, which in fact is not far from the truth as the signals get confused and result in a short circuit of sorts. It makes you want to cough and can affect breathing and dizziness. Apparently mine were mild, in that they were short lived (usually no more than an hour, often much less, but happening numerous times a day.

The SVT treatment is beta blocker or ablation. Beta blockers weren’t useful for me, and the second ablation finally dealt with them. Now, 6 years on, I have been clear of SVTs as they were in that form. No ongoing drugs at that point too, great!

A New start – a new riding style?

Well, it was obvious that hard rides after ablation didn’t kick off SVTs, but my heart did grumble a little for days after a hard ride. General missed beats and lumpiness. Nothing too bad, but it made me change my riding:

  • Instead of pushing myself to the limit (and beyond), I tried to reduce the efforts to about no more than 80-90%. This is hard when you’ve spent a lifetime going at the speed you want, but it felt the right thing to do.
  • I couldn’t go on group rides as easily, as I would literally be off the back and riding at a different pace, so started riding more at my own pace more.

Less races, more taking in the scenery and more about the ride than the speed. This is a good thing! honestly, and I might even enjoy riding more now because of that.

AF, the start of something new

Atrial Fibrillation is different to SVT. It’s a chaotic beat pattern. Many older people have AF (or Afib in the US) without knowing it. For me, it was very uncomfortable and noticeable – and I went straight to A&E in Bristol after having the first episode lasting for 7 hours through the night.

They checked me over and not being of a pace they would treat with cardio version (restart the heart), I was let go, with AF still in effect, It eventually restored to normal (sinus) rhythm over night the next night. It knocked me out for a few days though.

Since then. I’ve had several instances of AF, usually all starting at night, and usually all settling themselves down some hours later. I take a beta blocker daily: Bisoprolol Fumerate, on a low dose every day.

Apparently, and similar to SVTs, ablation is another treatment for AF, but is more complex and can be more risky, 5 months ago I was at the point of going there, but since episodes and ectopic beats have dropped away, I appear to be ok on beta blockers.

Beta blockers, AF and cycling

Beta blockers are great for my heart, I don’t pretend to know the mechanics, but they tend to reduce the environment that would cause AF, they don’t treat AF itself. I’ve had about 4-5 long lasting AF episodes since using beta blockers, in the last 10 months, which seems manageable.

However I would say Beta Blockers are like having the the brakes on on a bike. It’s more difficult to go uphill, but on this low dose, it’s not that bad.

My consultant recommends that I can train and ride with my AF episodes. Personally though I can’t imagine trying that, as it’s effects appear too bad for me to try, but I ride in a similar fashion after SVT, i.e. less general effort, and not going anywhere near 100%.

I read a paper stating there was a link between Asthma and AF which is interesting, as I also suffer with that chronic lung disease too.

Ectopic beats

These were probably the most notable and annoying symptom during this AF phase (whilst not in AF). Missed beats or pauses that would be amplified climbing a hill.

The pattern would be like this on a climb:

– Bip – Bip – Bip – —- – Bip – Bip – Bip – —- – Bip – Bip – etc

I find that these have come and gone a bit over the months, and more recently they have been in decline, they can come back and even a quiet evening at home (lots of these in covid times) can result in an evening of a noisy ectopic pattern.

What next?

It seems that once you have AF, you always have AF, and episodes generally get longer and more continual as you age. I’m not there yet however, and am able to ride pretty much as I wish.

I am on an open appointment at the Bristol Heart centre now I’m on their records, this is good.

Does stress have a factor? I do wonder if the general stress of covid times may have added to the recipe of changing my heart’s physiological environment to the point that AF started. Certainly possible as a catalyst.

These are my changes to how I used to be in my mid forties:

  • I only drink non alcoholic drinks
  • I ride with spare beta blockers incase I get an episode during a ride
  • I don’t push it to 100%, and am happy riding much easier than I used to
  • I take a low level magnesium supplement. May be placebo – but usage of that seems to be linked to the period of less episodes – who knows?
  • I eat more bananas than I used to, for the potassium, again, not sure if this matters
  • I eat less high-processed food than ever, and try and make the plat as colourful as possible (i.e beetroot, spinach etc)

If you are finding odd heart rhthyms?

  • Definitely don’t ignore them
  • Do get them checked out
  • They may not be a problem, but best to know
  • Hopefully my history here might will help you.
Dorset Gravel Dash 50:50

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