Sinus Arrhythmia and exersice

Back in November I was hospitalized for severe heart palpitations, it felt like my heart was going to explode out of my chest. The ER staff did an EKG among other tests and discovered a pronounced sinus arrhythmia. I am a 22 year old female, non-smoker who until recently was pretty active. Since the diagnosis and the prescription of Bystolic from my primary care physician I've attempted to get back to my previous level of exercise. However whenever I do any cardio my heart rate shoots up and stays there for hours on end, making me feel dizzy and sick; even walking to and from my classes at university causes this. Reading that sinus arrhythmia is supposedly a good thing in young people I am worried that perhaps something else is wrong with me. I just want to be able to get outside and be active again, is there anything special I should be doing? Thanks!

[is_something_wrong]

Hi,

Sinus arrhythmia is normal and completely benign. When you inhale, more blood is flowing to your heart and your heart speeds up to get this blood into circulation. In some individuals, under certain conditions, it can be pretty pronounced, with more than 50% change in heart rate (from my own experience) and this may be perceived as skipped beats or double beats (extrasystoles) when switching from inspiration to expiration.

I doubt your exercise intolerance is caused by sinus arrhythmia. When exercising, you are stimulating the sympatethic nerve system and sinus arrhythmia usually is less pronounced. Exercise intolerance in young individuals may be caused by:

- Anxiety with high heart rate adding to the physiologic HR increase when exercising (most common, I've got this myself)
- Anxiety causing imbalances in your autonomic nerve system, further causing blood pressure changes and heart rate changes
- Poor exercise condition
- Overfocusing on your heart rate causing anxiety.
- Arrhythmias such as SVT or multiple PACs

There are also some uncommon, more severe heart diseases that may cause this condition, although in young individuals, they are very rare.

Have you done a stress test? Echocardiography? If not, you should probably ask your doctor to do this, just to capture the arrhythmia on ECG and rule out structural heart diseases, which I cannot stress enough that are VERY rare and unlikely. However - knowing that everything is allright is often enough to reduce the symptoms you have. In addition, warm up slowly in a safe environment before exercising. This will reduce the adrenaline surge in start of exercise and reduce your symtoms (symptoms).

[Mom2four85]

did you have this problem before taking meds? could be the reason; or could be something else entirely - talk to your dr and see what they say :)

[Bippy87]

Is_something_wrong: No, I have not yet had a stress test, or an echo-cardiogram though I did have an EKG done in the ER showing the arrhythmia. I will be sure to bring this up with my primary care physician the next time I see her.

Lisa: before taking the medication my arrhythmia was so bad and so pronounced I was unable to sleep at night because I would literally lay in bed throbbing...needless to say it was an uncomfortable experience. However upon my next doctors visit I will be sure to bring up potential side affects of bystolic in regards to exercise.