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Irregular beats when exercising
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Questions in the Cardiovascular Disease Prevention forum are answered by Dr. Lee Kirksey, associate professor at The University of Pennsylvania School of Medicine.

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Irregular beats when exercising

I am a 66 yr old male who has had minor bouts of atrial fib since 1992..usually no more than 4 or 5 year. This past year they occur more often, but always resolve themselves within 4 to 6 hours after taking 25 mg of Metoprolol. I had my last nuclear stress test  18 months ago and my cardiologist said that I don't need to take another test for 3 years. I performed at 18 mets and my ejection fraction was 63%. I have hypertension which is treated successfully with a Lotrel 40/10.  I am a daily runner and maintain a heart rate of between 135 and 140 during my runs for approx. 30 minutes.

Recently, I have noticed that as soon as begin my run and my heart rate ramps up, I get what feels like extra or skipped beats. It doesn't affect my endurance whatsoever, but it is a bit disconcerting. When I stop running I return to a normal sinus rhythm within a minute or two. My heat rate also recovers from 140 bpm to around 100 after a minute.
I experimented the other day and took 25 mg of Metoprolol approx 2 hours before my run and the extra/skipped beat sensation seemed almost unnoticeable but I couldn't get my heart rate much above 120 bpm.

I was told that my atrial fib issues might get more pronounced with age, although this doesn't present as atrial fib as when I am in a fib I am definitely unable to exercise and am a bit fatigued.

Could this be benign PAC's or PVC's.....I wouldn't think it would be related to any CAD, since I have no discomfort. i.e.chest pains or feel winded when this is going on.
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Hello
It may be benign pacs or pvs. It does seem to be an acute departure from your previously asymptomatic state. Did you exercise in your stress test. Did this happen?
It sounds like at the very least-you deserve a return trip to the cardiolgist and a new ekg. I would also check your lifestyle features such as caffeine intake, stress etc.

For an exerciser like yourself, b blockage may be a double edged sword as you will know doubt fatigue more easily if you cant increase your heart rate appropriately. Good luck on managing this temporary problem. It sounds like you are very in tune with your body and doing all that can be expected to maintain your health
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