Question

[tester319]

I was an international athlete for many yrs then 3 years ago I noticed by chance my heart beat was irregular when exercising. I saw cardiologist who did ECG, halter, echo, and maximal exercise stres. Test. The irregularity showed up but he said it was fine and apparently at my max heart rate it was regular. He said don't worry, and keep working out to maximum effor (I am 34). Nothing has changed and I have no symptoms but became aware again when out cycling. Do I need more checks and what causes these beats?

[tom_h]

During my competitive days in skating and track cycling, I found that my "everyday" physician and cardiologist couldn't appreciate the gravity of my condition and how it affected my chosen sports.  They saw a young man who liked to ride a "bike" and skate around in circles, whileI had my eyes set on olympic trials, and national titles.  At the time, it was my world.  So I turned to sports medicine doctors and cardiologists who understood the relationship between the cardiac condition and the sporting activity.  At the time, there were no long term monitors, and Holters were gigantic boxes that were carried in a satchel. To test me, ice was out of course, but they had me bring my bike and rollers into their lab, wired me up, and set me loose.  I sprinted like a madman on the rollers until I finally went into tachycardia, and they saw it for their own eyes what I had had since 6 years old when it was first discovered.  At the time, there were a few medicines available and those that I tried slowed me down too much, so I just coped with it.  But in general, I found that sports medicine doctors infinitely more attuned to treating me as an athelete rather than just a kid on a bike.  Unfortunately in my case the results were not as I had wanted them to be.

[is_something_wrong]

Many of us can have heart rate zones where premature beats (in young people usually PACs - extra beats from the upper heart chambers) occur. They can have many causes, and adrenaline excess is the most common. If we start to worry about the heart rhythm during exercise, it can get a lot worse. From what I've heard (and unfortunately experienced myself from time to time) it usually happens in the beginning of exercise, or in the heart rate zones 130-160 bpm. The fact that it goes away with more rapid heart rate is a good sign and a sign that when your normal heart rhythm is higher, the normal beats "wipes away" the extra beats.

That said, top athletes are prone to develop atrial fibrillation, often after or at the end of their careers. If this is the case with you, treatment is necessary. I would ask the doctor which condition you had the last time, and compare the symptoms / check your heart rhythm now. If it just skips an occational beat or you sense a double beat, it's likely premature beats and you can mention it to your doctor. If you have a completely irregular rhythm, you must see your doctor ASAP.