Background for those that haven't seen my previous ones - 30 year old male, always had ectopics/heart flutters/skipped beats (confirmed pvcs on holder and told they were benign). However in January 2020 (age 28) I had afib episode (following an extended period of drinking alcohol over christmas and new year) that needed electrical cardioversion. No episodes since, but periods of worse ectopics which sometimes correlate with being ill (cold/flu).
I have had a flu type virus (not covid) recently which left me with ectopics every 30 seconds or so for a couple of weeks. These have calmed down as the virus passed but still lingering slightly. Had a routine echo last week which the radiographer/radiologist said looked all ok (no ectopics during test, cardiologist hasn't seen it yet). Currently on 10mg propranolol 3 times a day which seem to help calm and soothe my heart.
My question is regarding exercise, I am fairly fit and regularly do CrossFit which is high intensity and ramps up the heart rate. I have found that exercise can seem to trigger some ectopics (usually single ones every now and then). Especially true when lifting heavy weights. No aversion to exercise or dizziness or extra shortness of breath or anything, just skipped/extra beats. The ones I get at rest actually cause more discomfort. I sometimes find they are worse as I start exercise and my heart rate increases, and settles down a bit with isolated ones when my heart rate is higher and I am warmed up.
I'm happy to live with this if it is normal and not dangerous for an irritable heart such as mine, but just wanted to see if anyone else gets this? Exercise and being fit is very important to me and I really really do not want to have to give up!!! I've read the horror stories from Dr Google about palpitations with exercise being dangerous, but also have heard the opposite, most notably from Dr Sanjay Gupta on his YouTube channel York Cardiology (which is very good by the way and I recommend it highly) who says that they can be normal as long as they don't get worse and worse the more you exercise basically. Anyway as always, any discussion/wisdom appreciated!
Many thanks, Tom
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Tomgunn
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I have a theory that the extra heart beats are caused by the heart trying to help when the body is under stress. In time these rogue signals develop into AFib.
What is it about keeping fit these days? Maybe your 'keeping fit' is paving the way to not being that fit because of over-exercising! Ease off and you may not need the propranolol.
I guess you've learned your lesson about over consumption of alcohol.
Thanks for the reply physalis, I get what you mean that is a great point, however I have found that my heart in general is better now I am fit compared to when I was unfit. And exercise also has the added benefit of being particularly beneficial for my anxiety (which also makes my heart worse), so I feel it's important I try and keep it up!
Exercise is fine, it helps your heart and relieves anxiety. What I don't think is fine is what you call high intensity, pushing your body to do better. I started off with ectopics at least 25 years ago and ended up with AFib half the week.
That's without exercise! Or alcohol for that matter. I suppose I did push myself at times which wasn't a good idea.
I get exactly the same as you I get the odd skip beat when I exercise mainly when I weight lift and at rest I get them a bit I personally think it’s down to the adrenaline we build up during exercise that can cause these skip beats when we exercise or finish I’m currently under investigation with echo stress test and 24 hour monitor I had an abalation for AFIB in 2019
I tend to agree with Physalis - my experience was that ectopics are a red flag that body is under stress = inflammation = AFib for me.
Virus infection is now the only time that I get AFib but when I tried exercising after ablation I had rotten ectopics which made me feel a lot worse than AFib.
Give yourself more time before exercising hard. Exercise is great for the heart - my husband is 88 and still exercises every morning for 30 mins and can still do press ups but like anything else - more doesn’t mean better. Slow down or pause and rest when you feel ectopics.
Yes! Thanks, forgot that important tidbit...warm up your heart like any other muscle before excercise! The downfall of many power lifters and body builders. A brisk walk is all that is needed to get "into the zone" 🙂
People have different experiences with AF. I've had AF for about 40 years although it wasn't diagnosed as such back then. In my late 30s I was Orienteering, cycling and, running over 2,000 miles a year. Much later a Bruce Protocol test identified that I flip flop between fibrillation and flutter during exercise. In my 60s I was a Spin fanatic, plus rope work etc in the gym; a Spin sprint could see a heart rate of 190. None of that prevented pulmonary toxicity and later, a stroke; but it may have been a cause too. I changed to a Concept 2 rowing machine and to date have logged over 2000km (I'm a member of the Million Metre Club). Not rowing at the moment as the vaccinations appear to have created cyclic colds. When I'm in hospital (not related to heart), an ECG will show flutter. The pleth display on my oximeter always shows irregular heart beats.
If it helps my cardiologist said that exercise was beneficial (I had an ablation in 2019) and loads of ectopics after but no Afib (touch wood). He said take it easy if you feel you are over doing it at a specific point but otherwise continue.
Check out the link, excercise hard and as much as you can. Ignore the lazy types who make excuses not to excercise. It will prolong and improve the quality of your life, end of.
Or it could kill you - only person I know who died of AF was someone who exercised hard and ignored their symptoms - but they do say what doesn’t will make you stronger. Moderation in everything and not everyone is capable of exercising hard, I certainly can’t.
It cannot kill you, you are wrong. They would have died from eg heart failure not AF per se.
You are also wrong in saying you can't excercise hard. As I said people who claim this are just plain lazy and refuse to accept responsibility for their condition. Whatever you've done yesterday you can do more today, even if that's a short walk or a few flights of stairs if that's what's hard for you.
I am not lazy but I am exercise intolerant and I often cannot do more the day after. I’m not anti exercise - when you do so within your tolerances. When younger I have competed at county & national level. I’ve competed in Round The World Yacht Race and I would love to be able to exercise hard but it would kill me now.
I would refer you to the parents of an acquaintance whose young son died because he would not accept that he should moderate his exercise because he was in permanent AF.
You cannot apply your standards to everyone and I find it offensive to call people lazy with a blanket judgement when many people on this forum really struggle to climb upstairs.
Great if it works for you but we all have different circumstances.
It matters not to me if you are 'offended', It's now very common to hear people say, 'I'm rather offended by that.' As if that gives them certain rights. It's actually nothing more than a whine. 'I find that offensive.' It has no meaning; it has no purpose; it has no reason to be respected as a phrase. Give it fancy medical name if you like, I'll still call it lazy.
I would be more than happy to discuss the matter with those parents. The benefits of excercise significantly outway any potential risks, they need to be aware their son died doing what was right.
My EP was supportive of excercise, running in my case, but he knew I was doing 2 x 6 miles week, a 50 mile cycle ride and an hours circuit training not hundreds of miles a week or 20 hours of circuits.I am almost 4 years past ablation and have no afib since the ablation but still get ectopics. I have had runs post ablation that have lasted days and thousands of "skipped" ( actually extra) beats. I eventually decided to ignore them . They don't worry me at all now and the more I have tried to ignore them the the less I notice them. However I was only able to do this after I was convinced they were benign, which took time from my part, but also a lack of concern from my EP. Everyone gets ectopics, they are normal, people with atthythmia issues are more sensitive and notice every thing then worry. Not medically trained but excess worry causes ectopics (stress causes palpitations) - so don't worry. When I had afib I was so focused on my heart I could hear my heart beat, especially when trying to go to sleep, which stopped me going to sleep- more stress and a reduced ability to cope with it!
If I get a bug, I also have more ectopics, again I suspect that happens to everyone, but most just think it's a symptoms of being ill so don't generally focus on missing/extra beats as they have no idea of what an ectopic or a PVC is! If they are bad they perhaps say they are getting palpitations . And when they recover from the virus, all is forgotten.
Excess Alcohol causing AFib is well known. It is "holiday heart" , called because people who have 2 drinks a week normally, then go on holiday and drink lots of wine and spirits and get afib. Again, not medically trained, but believe for most it is not permanent. But its a warning. For more than a few people, alcohol can be an afib trigger, even in small amounts.
I also excercise a fair amount. 4-5k hike every morning, and gravel-road biking 25-30k 5-6 days a week, medium weights/resistance training 3 days a week. I'm 67 so I don't over do it, my HR rarely goes over 155, but it's the HR recovery rate that is more important. I'm on I Dlitiazem and 1 Xeralto daily. I of course checked with my medical professionals to see if I could continue my routine...which has been my entire life, and they said no problem. Having said that, I waited from the time of diagnosis, and finding meds that worked, and all the lab tests, ECG, and a stress test. The last being the most telling for them as to whether I could get back to my daily routine.
I find that exotics, blips, thumps etc happen at rest, after a meal etc.
When I'm cycling hard, the activity that raises and keeps my HR the highest for the longest period of all my activities, my heart seems the most "content" if you will. I don't understand it totally, but the cardio folks explained it to me in a way that reassured me. Basically..."your heart is like your thigh, arm, neck, hand muscles...use 'em or lose 'em, but stay within your age specific HR range."
Of course always consult professionals, as everyone is different.
"Recovery" in terms of HR is how long it takes for your HR to return to normal...whatever your normal is according the usual factors...age/gender/fitness level/medications.So, in a nutshell, if you at your normal resting...not sleeping..rate, of say 80 bpm...you start brisk walking/running/rope skipping..whatever elevates your HR...and you stop. The amount of time it takes to return to your normal is your recovery rate
I had the same problem with intensive exercise. I now do distance running between 5 and 10k every other day to keep fit and it's done the trick. No more episodes
It’s normal for me to experience random ectopics when working out. Sometimes, though, I have a run of ectopics that won’t stop until I rest. When that happens I will go lighter on weights and not expect the best performance level. Learn your bodies’ signals and understand that you may not be at 100% every day. Throwing in the towel and quitting an exercise program is not the answer. The only exception is if you are constantly unable to exercise because an arrhythmia kicks in - in that case an ablation should be considered. I had an ablation over a year ago and that combined with a healthy exercise program have changed my life.
Speak to the cardiologist or arrythmia nurses. In my experience they are extremely keen for people to exercise as a strong heart deals with problems a lot better.I would check you are not breath holding when training either intentionally (valsalva) or not too.
Clinicians also encouraged me to continue cardio exercise after the stroke, because of the oxygenated blood to the brain. One told me not to do yoga shoulder stands, candle, or plough that were part of my warm down in the gym.
That was my brilliant consultant neurologist who directed things when I was blue-lighted into A&E. She told me that when she was in London, she had treated someone who'd had a stroke whilst in a headstand. It makes sense, as if you think of Plough; if you had plaque in the carotid arteries, it could be dislodged whilst your neck is in tension, it also raises your blood pressure. One of my favourites was candle pose: balance on the back of the neck, legs vertical with feet towards the ceiling, and arms and hands alongside your thighs. Think of standing to attention upside down, with your neck on the mat instead of your feet, only your neck supports you. Amazingly calming and easy to stay vertical. My neurologist said that up the wall pose is fine, but no inverted poses. Of course shavastna (corpse pose) would be fine too! There's also a form of yoga where you lie under a blanket with closed eyes, and the yoga teacher tells a story with rich imagery: usually there's the sound of snoring before we get to the end of the tale.
That makes sense. I’ll stick with Corpse Pose 😂😂. My Pilates teacher would do a relaxation 10 mins after class with guided imagery and same sounds emerged.
Me and Yoga...not pals. I've tried...oh I have tried...my wife and daughters have coached and coaxed, YouTube has tried...sorry, no joy. I can bang off 40 pushups easy peasy...hold a yoga pose for 10 seconds? nope. 🙃
I'm so glad you mentioned proper breathing techniques...so very important, as so many people get it wrong without realizing it. Especially when it comes to resistance training such as push-ups, planks etc.
Exactly. When I teach exercise classes my week-in week-out joke is forever "Are you all still breathing?". Usually followed by one of my tastless jokes about how many forms I have to fill in if they have stopped breathing. Boom boom 🤣🤣🤣
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