Heart problems with athletics

[hockeyheart]

I am a 29 year old ex division one hockey player.  I consider myself to be in relatively good shape still although I do not work out nearly as much as I did in my college days.  I have been sort of mentally battling a heart beat abnormality since I was around 22.  One day when I was at practice my heart suddenly took off running.  It felt like a butterfly in my chest.  After I was able to sit down for a couple of minutes it kicked back into a normal beat and I kept practicing.  I did not feel light headed or dizzy or anything else.  Just a fast soft heart beat with a mix of fear.  It has happened other times since then as well although it has almost been two years since it last happened.  I have gone through tests in 2005 with my GP and a cardiologist including Cardiolyte (I think), treadmill, Echo, EKG.  All normal with the exception of Incomplete RBBB.  I was told everything was normal and was relieved.  However, it happened again a year and a half ago and it freaked me out.  It turned off on its own after around 5-10 minutes.  It prompted me to see my doc again and I went to an EP Cardiologist at Marshfield Clinic in Nov. 2008.  He had me on the holter and event monitor and nothing happened there.  He also had me repeat the treadmill test and noticed a couple of U waves but he said that they were still of normal length (ie not prolonged QT).  He does not believe I have an athletically induced arrhythmia.  He did not seem to think that there was anything else to explore.  I have been working out still and playing hockey.  I feel skipped beats when exercising at times.  Especially at high intensities like playing hockey.  I am just worried that it might take off on me again or something worse.  I don't know if there is anything else I can do.  I don't want to take drugs and he doesn't think an EP study is necessary.  I fully trust the competency of the doctors I've seen but I'm still afraid.  I would really appreciate some advise.  I am getting better but I am also tired of having this in the back of my mind every time I am active.  Are there any natural remedies to help or dietary changes.  I'm tired of this thing dominating my life and I'm running out of options. Sorry for the length of the post but I feel I have to be as detailed as possible.  

[hockeyheart]

I made an appointment with my ep cardiologist on July 14th.  Hopefully he's able to fill me in about all of this.  Thanks for the encouraging words.  It may be that this is what I have to do.  Do they do the ablation during the ep study if they find something or is that a separate procedure?

[stutterheart1]

I'd advise that you should do the EP study just for comfort. It's not bad at all. If they do something that makes you code on the OR table, then you had something serious and would have died anyway. At least if you are in the OR, they can shock you back to life. And the chances of that happening are 1 in 5000 (or if you take out the old folks, probably more like 1: 100,000). It's very safe.

[hockeyheart]

Thanks for the comment.  It's good to hear from somebody with a similar life experience as me.  I am the same way with jogging.  I may get the odd skip but nothing major.  It tends to be worse with sports or exercises that involve quick bursts of speed followed by periods of rest and then quick bursts again (hockey, sprinting, etc.).  At times when i've been out of it for a while it seems to be worse.  I was told my incomplete RBBB was just an artifact and nothing to do with anything.  I have no family history of heart disease.  In fact I do not know of a single family member of mine that has had a heart attack or heart disease.  My grandfather has a pacemaker but he is 84 years old.  I have had so many tests done and maybe I just have to try to get on with things.  I am probably going to call my EP Cardiologist just to see if I can meet with him again to address my concerns.  Maybe the EP study is the way to go but the whole idea of it makes me a little nervous.  thanks again for your time

[Joshmyboy]

I forgot to add that the chest pain had nothing to do with his heart condition. We found the heart condition due to the chest pain. If this condition went un recognized there was a good chance my son would have lost his life on the ice. One reason being the hockey rinks in our area do not have defibrillators and by the time EMS got there it may have been too late. We used to travel all over the east coast and further but never thought to ask that question. Now we own one and all 5 family members are trained in CPR and AED's. Don't be afraid to ask you doctor questions and do research on your own. You are your best advocate. Also, the FDA approved a device in February called Sleuth AT Implantable Cardiac Monitoring System. WE are considering this for our son. It is a small wireless automated implantable cardiac monitoring system. It gives the physicians the ability to diagnose patients with recurrent, unexplained fainting and abnormal heart rhythms. Check this out as well.        

[Joshmyboy]

I have a 12 year old son who was playing AAA hockey and at the top of his game, All star teams,  MVP one hockey .....until one day he started having chest pain on the ice. We went to see the cardiologist and after ekg, eco, halter monitor, stress test, genic testing (which came back negitive but does not mean he does not have it) he has something called Catecholaminergic polymorphic ventricular tachycardia  CPVT. The heart structure is normal but during his stress test he develops unifocal PVC's  with a right bundle branch block. I don't know how high your heart rate went on your stress test but my son got up to 180-200 bpm his pvc's increased. On One stress test,10 min 26 sec into it, the doctor stopped the test because he had three PVC's. The RBBB is what caught my eye in reading your post and also you experienced this on the ice. Also, when he wore the halter monitor these double and triple pvc's were not there. The reason for that is this is all exercise or stress induced. The other thing that came to mind is Left ventricular fascicular tachycardia. I could share so much on CPVT with you but I encourage you to read about it and and also the LVFT.

[stutterheart1]

Hi HockyHeart,
I'm also a 29yo ex D1 and professional athlete with very similar problems. My heart started 'taking off' at times during exercise. Mine might be different though. If I jog, it's not been a problem (knock on wood) but when I lift heavy weights, my heart will sputter in the recovery period of exercise. It sort of stops for a few seconds and then flutters. I had an EP study and an ablation last summer and it didn't seem to fix much although it did get rid of the exteremly high heart rate and flutter I would feel after those 'sputtering' sessions. They were, like yours, about 5-10 minutes in duration and they concluded that it was atrial flutter. They burned off the tissue with radiofrequency ablation and it seems to have done the trick for that particular problem. But I also had a reentry tachycardia and Wenchebach block so it's very ambiguous.
As for you, I would recommend you get an EP study done. I would bet a few bucks that you have  atrial flutter or a reentry tachycardia that can be cured 70% of the time. If they can't cure it, at least they can poke and prod and assure you that they have replicated the sensation you are feeling and it is not serious and is not the type of thing that can progeress to something serious. For example, as I understand RBBB can have two morpholygies, one in the bundle of Perkinje-His and one at the AV node. Those with ones at the Perkinje-His (almost all have suffered a heart attack and necrosis of the tissue) have a chance of developing more serious heart block while those with it at the AV have no real complications. It's just good to have that piece of mind right?

[oceanminded]

I too am an athlete who has been experiencing constant PVC's/PAC's after exercise. My heart checks out okay so I guess all I can do is trust the Drs. As far as natural supplements some people take fish oil and magnesium to help with their skipped beats. Are you worried about the skipped beats your experiencing or did your heart go into Afib or something?