Intermittent tachycardia worse with regular exercise

I'm trying hard to fit more regular aerobic excerise into my life but have noticed that the more I do, the worse I get tachycardia during times unrelated to exercise. I had a stress test done which showed I was cardiovascularly fit. My physician started me on beta blockers, but they made me feel terrible although it stopped the tachycardia. When I took a several week break from exercising, the tachycardia occurred substantially less frequently. With regular exercise, the bouts of tachycardia (180+ bpm for 20 minutes to 2 hours about twice a week) are incredibly fatiguing and interrupt my otherwise normal life. Stopping exercise is not a good option. What next? Should I try a different class of antiarrythmics that cause less "yuck, dragging myself around" feelings? Thanks for the help!

[Forum-M.D.-MJM]

Hello,
The first thing is to diagnose the cause of tachycardia.  An event monitor should be able to capture the initiation and termination of the tachycardia and help figure out if it is sinus tachycardia or some other form.

If it is sinus tachycardia and beta blockers worked before, I would try to convince you to stay on a beta blocker for a few months.  MOST (not all) people develop a tolerance to the fatigue side effect in a few months.  This is by far the best option and I think willl be successful.  It may not work but probably will.  This is also the safest option.


If it is not sinus tachycardia, I would opt for an EP study to diagnose the cause and try and cure it.

I agree stopping exercise is not the right option.

[rigish]

Try the beta blockers again and give yourself time for your body to adjust.  I've been on them for six plus years ( very high dose) and they help!  Maybe you can switch until you find one you can tolerate?  I've been on metoprolol, Toprol XL and now I take Acebutolol.  My dr. told me Acebutolol has less side affects then some of the others.  Good luck!

[Bromley]

This might be permanently curable.

If I were in this position I think I would arrange an appointment at the cleveland clinic.  Last I checked it was possible to get to see an electrophysiologist with only about a weeks notice.  If you flew next week, you could get an initial consultation, and maybe get setup with a cardiac event recorder.

If this occurs twice a week, the event recorder would probably provide a basis for an EP study and or ablation.  Hyptothetically you could be done with this whole thing in about a month. It just depends.

Good luck.

[edgeplayer]

I've also been having rapid heartbeats (at night) after exercises and thought that I had tachycardia but now I'm convinced that what I have is Vagally Mediated Paroxysmal Atrial Fibrillation (see www.afibbers.org).