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Exercise Concerns with Arrhythmia
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Exercise Concerns with Arrhythmia

I joined the community last year in quite a disparate state of mind. I was undergoing large amounts of stress and concerns of SVT which have since then been worked out.

I no longer experience SVT and I have been taken off my medication (diltiazem). My cardiologist took me off my medication in the middle of June and I seem to have been doing fine except for the occasional instance of a palpitation here and there.

What is concerning me lately is that when I've been exercising, I have started to experience more sensations of a skipped heart beat (probably a PVC or PAC) and somewhat shortness of breath. I'm not quite sure if it's shortness of breath as I've had this feeling since I was first diagnosed with SVT, but sometimes when I breath I feel as if I can't get a full breath. I can still breath, just not as deeply.

For the past 8 months I've been exercising with callisthenics (pushups, brisk walking, planking, etc) and haven't had too much trouble. I would experience palpitations but not to the extent that I experience them now. The only difference I see is that I've begun to work out in a gym and have moved on to running and lifting weights. When I run my heart rate gets up to 170-180 at the highest (usually around 15-20 mins in at 8 mph). At the 15 minute mark is when I started to notice the skipping/fluttering of the heart. My heart beat skips when I breath in and try to take a deep breath, so this leads to mild anxiety for me which probably contributes to my palpitations.

I am wondering if it is normal for someone with a previously diagnosed SVT problem to experience palpitations whilst running/exercising? My heart rate stays somewhat high during the duration of my work out and weight lifting. I've had two ekgs done, a holter monitor, and an echocardiogram and all have turned out fine except for the holter which recorded a bout of SVT back in the beginning of my troubles.

The only thing that my echocardiogram reported was that my left atrial is mildly enlarged, besides that nothing of importance. My cardiologist said that it is safe to exercise and that I should continue but to take it easy when I feel a palpitation. She referred me to an electrophysiologist whom also said there was nothing to be worried about and that it is normal to feel palpitations and that it is safe to continue exercising.

Regardless, the increase in frequency of palpitations has brought back my worrying concern of whether or not I'll be safe to exercise.

How do you know what shortness of breath is? I brought this up to my cardiologist and she said it was stress/anxiety since she ruled everything else out, but I would still like some reassurance.

What do other members here who have similar heart conditions have to say? What is your experience with exercise like and how do you deal with your palpitations? Are they benign? Does it seem that my palpitations are benign or should I vie for a stress test and another echocardiogram?

Thanks for your time, I appreciate your response!
14 Comments Post a Comment
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Avatar_m_tn
I am 22 by the way incase anyone was wondering. I had a past with some nasty substances and cigarettes which I have been abstinent from for over a year now.

One other thing that I've been experiencing pretty much ever since my first experience with SVT/Arrhythmia is that I get a light chest discomfort now and again. It's hard to describe but it occurs if I move in a certain way or am lying in a weird manner. When I wake up in the morning the top of my chest feels tight, not painful but there's tightness in my upper chest below the collar bone. Is this related to heart disease and is it anything I should be concerned about? Does my symptoms require a 2nd/3rd opinion or can I rely on the tests already done and accept my cardiologists prognosis?
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Avatar_m_tn
Can anybody comment on my situation please????
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1423357_tn?1414258965
I am very framilar with mixing athletics and SVT.  I competed for many years in track cycling, and short track ice and inline speed skating.  I can only describe my situation and what you're experiencing may or may not be the norm.  That said, I never had any warning of an impending SVT event, and extended periods of high physical output were never met with PVC's or fluttering of any kind.  I had some pretty tough, almost forced workouts that went on until failure, literally crawling off the rink surface with heart rates exceeding 220 bpm.  I never knew if a particular day was the day I was going to have SVT.  It just hit.  Some days, most days were fine.  But then one seemingly normal day, sometimes durimg a simple warmup, I'd feel my heart suddenly take off at speeds of 250bpm

My physicians were aware of my physical activities, and went so far as to bring my bicycle and my rollers in the EKG lab and had me pedal my brains out in an effort to provoke an SVT event.  Ablations at the time were open heart affairs, and I,wasn't willing to do that.  Their advice was to know my stopping point, know when enough was enough, and to never exceed that.  Most SVT's are harmless, but they sure are a pain in the neck!  My advice to you would be what my physicians told me.  With a green light to work out, STOP! when you start to feel the fluttery feeling.  In my opinion, that isn't normal.

One other comment. Most of the time, SVT does not go away on its own, and it's responds with mixed results to medication. I was told at 6, 12, 18 years of age that I would probably "outgrow" it.  It only worsened as I ahed.  So do not be surprised if you experience episodes later on down the line.
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Avatar_m_tn
Hmm, I don't actually experience SVT anymore (it was drug induced), I only experience palpitations or the sensation of an extra/skipped heart beat when I breath in. My heart rate doesn't exceed 180 bpm, so it is still 20 beats under my max heart rate.

So you think I should get a second opinion then? I've brought it up to my doctors that I experience palpitations while exercising and they don't seem to concerned by it, they say just slow it down but that I will be fine.

Ugh, I don't know who/what to believe anymore.
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1807132_tn?1318747197
I agree with Tom that maybe when they start you should slow down or stop until they pass.  It is possible your heart is feeling a bit taxed and needs a bit of a break.  It is good to be proactive about working out vigorously but sometimes we can over do it.  If you can take a full break take a break for maybe a week but if not try easing up a bit and see if that helps.  I had and svt like Tom and afterwards I got a very bad case of the extra ectopic beats.  Having an svt and doing the ablation really ramps up the heart.  Slowing down my exercise routine really helped to calm them down so it could be a similar situation with you.  You don't have svt but your heart could still maybe use a little bit of a break.  But if you do get a lot of them when you work out that don't resolve it is probably best to ease up on the routine so you don't fall into any dangerous patterns though you may want to consult a doctor about what is going on as well.  Take care.
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1423357_tn?1414258965
Interesting.... I've never heard of drug induced supraventricular tachycardia until now.  I'm certainly aware of drug induced sinus tachycardia and VT, but there is little available to read up on drug induced SVT.  As I know it, the physiology must be in place in the heart to support SVT.

Question:  Were you diagnosed based on an actual EKG recording? In other words, did a professional actually witness your SVT events?

Hope everything works out for you.  In the meantime, if you've got the green light to go, continue to push the wall out little by little, but know your limitations.
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612551_tn?1247839157
Not my area of experience, other than the enlarged left atrium.  This, I believe, increases the possibility of atrial fibrillation - albeit AFib is very uncommon in the young, more common in the older group.

Have you wore a monitor?  A short run of AFib could cause irregular/palpation heart beats and would also likely cause a shortness of breath due to the decreased pumping efficiency of the fibrillation.  

I am not saying I think you have AFib, but it may be something to discuss with your doctor, as is wearing a recording monitor which will document what is going on signal-wise.
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Avatar_m_tn
The first time I experienced heart troubles was on a stimulant drug where some type of tachycardia was induced. I felt my heart start beating too fast and out of control and the heart rate kept rising. Eventually I started feeling my first real palpitations that same night and then I thought I felt my heart stop for a beat two, then return with a vigorous rhythm.

It took all night for my heart to calm down, but I was able to sleep it off. Stupid me decided that it wasn't big deal and 3 weeks later I took the same stimulant and the same thing happened. This is when I knew there was a problem and I completely stopped my drug usage. I never went to the hospital during these experiences but I was real damn close to panicking/calling 911 but I was able to bring my heart under control through intense mental concentration.

Shortly after this experience I started feeling palpitations more regularly. I was also smoking cigarettes at the time and my condition got to the point that I had an experience where I felt a heaviness in my chest after smoking and bending down to tie my shoe. I felt a sense of weakness and my chest felt heavy. I immediately panicked after this moment and I felt my heart jump/skip then start racing. I was walking at the time so I didn't know what to do but continue walking/freaking out in my mind. Eventually it calmed down and that was the last day I smoked cigarettes.

Still, however, I continued to experience palpitations and a sense of increased heart rate. After my drug/cigarette experiences, every time I visited my cardiologist, my heart rate was in between 90 bpm to 109 bpm. My cardiologist recorded this and told me that I was close to the limit of not being safe to discharge but that she felt that I would be fine and she prescribed me fast acting medication to take when an episode sprouted.

She ordered an echocardiogram and a holter monitor. The echo picked up a sinus arrhythmia and a mildly enlarged left atrial. The monitor reported a bout of SVT that I experienced while mowing the lawn. My heart rate shot up into the 170s. When I asked her what I had, she said SVT, I think maybe even PSVT since it happened infrequently.

Eventually the medication and abstinence from smoking and bad habits, my heart calmed down. It's been a year now since my experience, and I've been off my medication for 2 months. I feel that my heart is stronger than what it was before as I've been doing daily cardio for the past 10 months, but I still experience palpitations, just not as intense or frequently.

Lately however, with exercising in the gym and pushing myself harder, it seems to have triggered more palpitations. I had atleast 5 during a 30 min run so I'm guessing that's telling me something. I just want to know if it's necessary to get a second opinion because I read all these stories of people getting 2nd, 3rd even 4th and 5th opinions with the same results yet the worries remain. I've been given the greenlight by 3 different doctors and there wasn't any concerning abnormalities in my echocardiogram.

But nonetheless, it is evident that I do have an arrhythmia of some sort that is being triggered by exercise. It seems my heart is still sensitive... Sometimes if I drink too much caffeine my heart rate rises but not to the point of discomfort.

Are these signs of a something more than just an arrhythmia? I hope I don't have afib, especially this young.

I just want to be able to exercise and enjoy my freedom of movement without worrying about whether or not I'm jeopardizing my life!!
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Avatar_m_tn
One other thing, I look at the heart rate of others running on the machines next to me and mine seems to fall in line with theirs, so my heart's not racing faster than it should be for the exertion I'm outputting. It's just that my heart will palpitate and I sometimes find it hard to grasp a full deep breath. I seem to have that problem generally... difficulty with breathing in a full breath. I find myself yawning alot to breath deeply, so I'm not sure if it's just anxiety and it's exponentiated while exercising or if it's my heart actually working harder than it should be. I don't have this problem while meditating and focusing on my breath.

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1807132_tn?1318747197
Ok, a rate of 109 is not an unsafe rate even if it is sinus tachycardia so not sure about the comment from your cardiologist.  Are you sure you didn't mean 190?  It sounds like your drug escapade may have triggered some sort of inappropriate sinus tachycardia but considering you seem to get anxious when you feel things with your heart it could also be a panic attack as well.    Svts generally tend to start and stop suddenly so the fact that you are able to induce an episode with anxiety and slow it down with effort makes this in my mind more of a sinus tachycardia then svt though unless the episode is caught on a monitor you won't know for sure what it is.  Has anyone offered to do a stress test with you?  Considering you seem to be able to trigger it when you exercise I would think this would be a clear way to tell what is going on.  If your doctor is unaware that you are having symptoms when you exercise then you may want to tell them and see what they say since you say it causes you to gasp for breath.  That said, is it possible you are pushing yourself too hard?  I know not everyone does this but you are suppose to vary the speed you do your cardio alternating between exerting yourself and easing up for an optimal workout. It may be that going flat out 7 mph for the straight 30 minutes is stressing your heart a bit.  It may be that your heart is a bit tired and needs a bit of time to rest and recover.  So if your main issue is only when you do cardio try to vary up the cardio routine and hopefully that will help.  

If you feel the need to go for another opinion then do so pushing to try and get a stress test or 30 day event monitor to try and catch an episode if it hasn't already been documented. This will give a clear picture of what is going on.  That said, you are the one that has to learn to manage what is going on and find peace of mind for yourself.  A doctor can only go by what is put in front of them  If they do not have evidence of an issue they will not diagnose an issue.  But so you can maybe feel a bit better most tachcyardias no matter if they are svt or simply sinus if managed properly (which it sound like you do for the most part) are not a threat to the health of your heart.  Unless a person has unresolved tachycardia for extended periods of time it is likely your heart will have ample time to recover from any fast beat episodes.  This is why I said before to maybe give your heart a bit of rest.  It could simply be worn out a bit from all the goings on and it just needs a bit more time to rest and recover.  Pushing yourself with your workout may be too much for it at this time but the heart is very resilient but it can be slow to recover so we just need to give it ample space and time to heal.  Take care.
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Avatar_m_tn
I'm sure she said my heart rate was 109 when she performed a resting EKG. My cardiologist told me that it's policy to not discharge someone with a tachycardia rating above 120 bpm, so with my heart racing at 109, I was only 11 bpm away from being sent to an emergency care ward. This was when I was first experiencing my troubles. When the electrophysiologist recorded an EKG of my heart, my rate was in the high 50's low 60s, so my heart rate has calmed down quite a bit - probably due to the consistent cardio and exercise I perform.

Thanks for the responses and advice, I appreciate the consideration. I'm going to continue working out, but I will slow myself down if I feel palpitations. If the problem persists I'll insist for a stress test and possible an event monitor so that I may record the palpitations myself.
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Avatar_f_tn
that is kind of incredible.  My resting heart rate has been 160 at my cardiologists office and he had no problem letting me go home.  Now, if this was associated with chest pain or something .....
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Avatar_m_tn
Wow, a resting heart rate of 160 and your cardiologist didn't find an issue with that? I'm in Canada if that makes any difference. I'm sure I heard my cardiologist say that heart rates over 120 bpm are not dischargeable, depending on the situation.

I did have mild chest discomfort at the time.
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Avatar_f_tn
No, it is a problem -- but not one that I need to be in the hospital for.  At the time (when it was 160) the EKG read normal sinus rhythm and it's not unusual for me (he's seen it much higher).   I'm going to be having my sinus node "modified" soon, along with an ablation for SVT.  The majority of my problems are with the sinus tach, though.

Maybe it's different if it's something new it's different.  My high rates, while not right, are not out of the ordinary for me. Chest pain usually warrants some kind of monitoring, though.
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