BIG Heart Rate Training Index

I am a 53yr old nurse who has been running for fifteen yrs.I belong to a local running club.Icompleted the London Marathon in 3HRS 50 last year.My problem is this,last October after an 8 mile hilly run I developed an horrendous tachycardia 200bpm.Luckly for me Iwas on duty at the hospital when it happened and they could see at first hand what it was.
Iwas diagnosed with right ventricular outflow tract tachycardia.
Iam unsuitable for beta blockers as my resting heart is too low usually 46bpm.I was admitted
to the cardiology unit in bristol for an abalation in Feb which was unsuccessful they couldn't
keep the heart elevated enough to see where in the heart this abnormality was coming from.

The cardiologist suggested taking Verapamil when I saw the side effects I was reluctant to take them.After a long discussion with my GP he agreed with me.I have gone back to running
but my heart rate is all over the place.Please could you suggest a running programme for me.
I have started running again.If I am sensible and run the first mile at 9.30-9-45 minute per mile I usually run the second mile a minute quicker and feel ok for a few miles as soon as I try to run anything quicker say 8min per mile I get very breathless and tachycardiac.
Any advice would be very welcome as I would eventually like to return to running with my club mates and to enter some races again.


Posted: 16/04/2009 at 10:13

I have had similar problems for about 6 years, starting in my mid 40's.  My cardiologist constantly reassures me that my arrhythmia is not life threatening but sometimes just for a second i can feel a hairsbreadth from passing out    Sometimes the problem seems to disappear; I'm sure emotional issues play a significant part in how severe the condition is from day to day. I have tried entering a couple of races again but the adrenalin kicks in and my hearts starts flipping.  I've learnt to be content with the joy of just running because I can.  I have taken beta blockers for a while but then stopped and it doesn't really seem to have made any difference.  My resting heart rate is also slow and my blood pressure low so I'm interested to find out whether the medication was actually appropriate.  It would be very interesting to find out how other people deal with the problem.  It's a real bummer but one has to be consoled by the fact that so many of us are prevented from running by so many things, the older we get.
Posted: 16/04/2009 at 13:57

Hello Toni, I was diagnosed with Atrial Fibriliation 6 years ago aged 42 and have subsequently taken up running for the last 2 years. Prior to to this diagnosis my resting bpm was around 35 and my blood pressure was also very low. Initialy my Cardiologist gave me the lowest dose of Atenolol tablet, this did the trick, my palpitations reduced and all was fine. My bpm dropped a couple of points but my Cardiologist told me not to worry unless it goes below 30bpm. Then I started running. Within 6 months my bpm was below 30 and a trip back to the Doc was required. I'm now  taking Atenolol oral solution, just 2.5 ml a day, roughly half the smallest tablet dose and again this suites me fine. My resting bpm is around 35 again. I have odd occasions when my heart goes a bit haywire but that's when a heart rate monitor comes in handy, I just reduce the intensity of my run or just stop. The highest bpm that I have recorded is 222. So now  I run to bpm rather than pace, 140 bpm is roughly 9 minute per mile for me.

Why do you say that your heart rate is to low for a beta-blocker? A small dose might only reduce your bpm by a couple of points, It has done wonders for myself and I feel fitter than ever.

   

Posted: 16/04/2009 at 17:07

Thank You for all your responses they are really helpful.Atrial fibrillation is quite different from sinus ventricular tachycardia.I did try the lowest dose beta blocker sotol 30mgs but ended up passing out on several occasions,so the cardiologist told me to stop taking them.Iwould really like a response from a doctor.Is there a Doctor in the house!!


Posted: 16/04/2009 at 18:17

I should have a good idea being a Cardiac Physiologist with a degree in Pharmacology... but I'm really not sure.  I take it that it is caused by an ectopic pacemaker starting at the RVOT (not sure if I made that abbreviation up ) its actually a common cause of tachycardia?

 Definitely not an additional pathway between the RA and RV causing a re-entry tachycardia?

I will ask around the Cardiology department tomorrow and see what they suggest.

(You're a nurse and you trust a doctor's opinion??? )

Posted: 16/04/2009 at 22:21

I'm a 58 year old who has also been diagnosed with atrial fibrillation. It first manifested itself 4 years ago when I was out jogging etc.etc. I was initially put on beta blockers but whilst they controlled the tachycardia my other condition of severe bradycardia kicked in. A successfully cardioversion later I took up jogging again. Unlike a majority of runners who contribute to this magazine I normally record an average of late 9 minute miles when "competing" up to 10k. I do run up to half marathon ( a distance I really enjoy). At rest my hr drops to around 38 bpm but if I am pressing on I can easily hit up to 200bpm. I can max at over 230bpm - the problem being I am never sure by that time whether I have thrown a wobbly or am just working too hard. The only limit I have found is that my body tells me when I am going too hard. Some times my hr can be 170 and I run out of steam - others it can exceed 200. I just listen to what it says, and walk until I feel good enough to go again. The big irritation is that I can keep a low (140bpm) hr when using a cross trainer yet travel faster than I do on the road. C'est la vie.
Posted: 16/04/2009 at 23:53

THANK YOU ALL SO VERY MUCH FOR YOU INFORMATION PLEASED TO KNOW THAT I AM NOT THE ONLY ONE WITH THIS PROBLEM.
I WILL TAKE ON BOARD ALL THE INFORMATION GIVEN AND NEXT TIME I GO OUT FOR A RUN TRY AND PUT IN TO PRACTICE THE IDEAS THAT PEOPLE HAVE SUGGESTED.
TO THE CARDIAC PHYS I DO THINK THAT I HAVE AN ADDITIONAL PATHWAY I AM SURE THAT WAS MENTIONED BY THE CARDIOLOGIST.
I AM STILL WAITING FOR ANOTHER APPOINTMENT TO SEE HIM.I HAVE HAD NO CONTACT SINCE THE ATTEMPTED ABALATION.ANY IDEAS WHERE I GO FROM HERE.
Posted: 17/04/2009 at 12:08

Dear nice cardiac physiologist any suggestions for  paroxysmal AF ? Can you take beta blockers and still run?  What about being able to affect heart rate through massage of neck arteries?  As a runner, how would you deal with the issues if it were you?  When is chaotic rhythm dangerous?
Posted: 17/04/2009 at 12:22

HI HELEN I HAVE BEING TOLD THAT IT IS VERY DIFFICULT TO RUN IF YOU ARE ON BETA BLOCKERS IT REALLY SLOWS EVERYTHING DOWN YOU FEEL AS THOUGH SOMEONE IS TRYING
TO PULL YOU BACKWARDS.
I HAVE TRIED PRESSING ON THE ARTERIES IN THE NECK BUT IT NEVER WORKED FOR ME BUT THAT DOSEN'T MEAN THAT IT WONT WORK FOR YOU.
THE OTHER OPTION IS SOMETHING CALLED THE VALSALVA MANOVURE WHERE YOU TAKE A DEEP BREATH PUT YOUR FINGERS IN YOUR EARS AND BLOW OUT REALLY HARD.GIVE IT A TRY.
IT SOMETIMES WORKS FOR ME.GOOD LUCK


Posted: 18/04/2009 at 19:28

Hi Helen,

 Firstly with pAF you need to be on anti coagulants such as Aspirin or Warfarin (that is whether you are running or not)

Having pAF does not rule you out from running at all but, despite my earlier joke about doctors definitely consult your Cardiologist (don't bother with GP - not that they aren't great btw!)

I'm not saying pAF is completely safe but with good anti-coagulation it needn't be a huge problem. How much are you in AF and how much a normal rhythm?

 You can run with Beta blockers but as the slow your heart rate you would have to take it easy otherwise it can cause you to faint.  

I wouldn't recomment carotid sinus massage (arteries in neck) you can actually faint from that too and if you are in AF I cant actually see it being overly helpful anyway.

Hi Toni,

As a nurse I'm sure you have some knowledge of heart problems which is both a blessing and a curse (knowledge of problems/worry of very worst case scenario!

How long does the tachycardia last? 

I think another attempt at an ablation is really a good idea.

I spoke to a physiologist who works at Harefield (he does lots of mapping for ablations actually)so he is a true expert (sh*t hot is the phrase someone used to describe him!).  He was a little worried about the ectopic focus's proximity to the ventrical as it can cause more serious rhythms.

  If it were me I would run but take it VERY easy... frustrating but safe. 

A successful ablation will give you a solution to the problem whereas drugs cover it so it really is worth pushing for another try.

Sorry my reply took so long.

* Just to edit with this disclaimer... Toni check with your Cardiologist before running!

Posted: 30/04/2009 at 23:51

HI MR NICE GUY
HAVE NOT DONE MUCH RUNNING SINCE I LAST HAD CONTACT WITH YOU.WENT OUT ON MONDAY TOOK IT STEADY EVERY TIME THE HEART RATE GOTTO 170 THOUGH I WAS FEELING FINE I SLOWED DOWN AND THE HEART RATE DROPPED IMMEDIATELY.LOOKS LIKE I WILL JUST HAVE TO RUN MUCH SLOWER THESE DAYS AND BE GRATEFUL THAT I AT LEAST CAN RUN AT ALL.
I AM DEFINETELY GOING TO PUSH FOR ANOTHER ATTEMPT AT ABALATION AS I HAVE A GOOD FOR AGE ENTRY FOR LONDON MARATHON NEXT YEAR AND I WANT TO BE ON THAT START LINE
Posted: 01/05/2009 at 14:19