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Unusual pulse behavior

Old 06-23-23, 10:47 PM
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Found out I have moderate hypertension, scar tissue on the ventricles, and ventricular tachycardia. Monitoring my HR, I was being careful to keep it below 130 or so, but sometimes when approaching that threshhold the ventricles would go arrhythmic. While I could not observe this in real time on my HRM, my workout history would show max HRs in the 180-200 range. Now that I'm on meds (atorvastatin, losartan, and metoprolol), I'm running out of breath and just walking up stairs or doing garden chores, and on my last ride I couldn't breathe beyond a few seconds at 127 BPM, and I had a hard time holding 115 afterward. The rest of the ride was pathetically slow. The workout history showed a max of 191 BPM. I think my cardiologist is more concerned about my blood pressure than a return to a normal life, but I'm waiting for him to return from vacation.
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Old 06-24-23, 06:40 PM
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Thanks for updating us.
Glad you at least got an answer without anything catastrophic happening,
I think your cardiologist is more concerned with your survival.
I would definitely discuss all this with him when he returns, based on what you have told us I think it is likely that you can get a regimen that will interfere less with your desired lifestyle.
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Old 06-24-23, 08:55 PM
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Metoprolol sapped my energy. There are other beta blockers that put limits on heart rate, and one might work better for you. Have you looked at the side effects, BTW? I found them daunting even with a pacemaker. If your doc mentions a pacemaker, talk about the combination pacer/defibrillator(?) - I mean the type of device that limits both tachy- and bradycardia.
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Old 06-24-23, 09:11 PM
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I would like to know what you mean by "recently". Are you talking just this season or in the last few years?
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Old 06-25-23, 07:20 PM
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A lot of things can go wrong with your heart. Ask me how I know. See a doctor.
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Old 06-27-23, 02:04 PM
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Your current reading sound normal to me; what doesn't sound normal is for your HR to drop to 90 on a short downhill. HR doesn't drop that fast considering that with your amount of vertical, hills can't last very long.
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Old 07-16-23, 10:24 AM
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Originally Posted by oldbobcat
Found out I have moderate hypertension, scar tissue on the ventricles, and ventricular tachycardia. Monitoring my HR, I was being careful to keep it below 130 or so, but sometimes when approaching that threshhold the ventricles would go arrhythmic. While I could not observe this in real time on my HRM, my workout history would show max HRs in the 180-200 range. Now that I'm on meds (atorvastatin, losartan, and metoprolol), I'm running out of breath and just walking up stairs or doing garden chores, and on my last ride I couldn't breathe beyond a few seconds at 127 BPM, and I had a hard time holding 115 afterward. The rest of the ride was pathetically slow. The workout history showed a max of 191 BPM. I think my cardiologist is more concerned about my blood pressure than a return to a normal life, but I'm waiting for him to return from vacation.
Well, I'm not the only one! 70 y/o, meds for high cholesterol and BP, ride a 16-mile loop where my average heart rate is in the high 120's (perfect). Had a ride 10 days ago where 70% of the ride was in the low 140's, with spikes in 180's (I was too dumb to realize that this was problematic). I felt nothing irregular in the ride. Strava categorized the ride as MASSIVE effort, and after studying a bit, I called the doc and a stress test was arranged. At the 8 minute mark, I hit 200 bpm and the tech said my rhythm had "flipped" at about the 140m mark, whatever that means. Waiting for orders for a heart monitor and echocardiogram - a bit concerned about what this might all mean.
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Old 07-16-23, 11:08 AM
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Originally Posted by Melliman
Waiting for orders for a heart monitor and echocardiogram - a bit concerned about what this might all mean.
Wait till the heart doctor and other healthcare professionals tell you what it means before you get to imagining all sorts of bad things. You should be concerned enough though to take their advice on what additional testing should be done.

I routinely hit 180 bpm on my rides. Or at least I did till last year when I turned 64 y.o. But I still get close. And I envy any that can ride and keep their HR below 130 bpm. For other reasons, I've seen several cardiologist and specialist. I've even had a loop recorder installed in my chest to monitor my HR 24x7. During the almost three years it was in there, they said I was pretty much normal with no issues other than some minor tachycardia, arrhythmia or some other type irregularity that was involving a ventricle of my heart that was the better, if there is a better HR issue, to have than if it involved the other ventricles or such.

So your net take away should be that HR bpm in itself doesn't tell you much. Its the rhythm's and other things that have to be looked at.

Oh... you did mention heart monitor. If this is a heart monitor that you wear externally for several weeks or have installed in your chest for years, check your insurance and make sure what you get is going to be covered. I had both. The external one they gave me initially wasn't from a provider that was covered by my insurance very well. It cost me more for the four weeks I used it than the internal loop recorder that they put in my chest later that lasted almost 3 years. And that includes the bills for regular monitoring of it and removing it when the battery ran down.

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Old 07-16-23, 11:20 AM
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Originally Posted by Melliman
At the 8 minute mark, I hit 200 bpm and the tech said my rhythm had "flipped" at about the 140m mark, whatever that means. Waiting for orders for a heart monitor and echocardiogram - a bit concerned about what this might all mean.
Be careful with that. Follow your cardio's orders assiduously. The "flipping" sounds familiar. My stress test ended abruptly around the mid-130s. It was similar to what I'd been experiencing on my rides, only only my arrhythmias were were so brief they only showed up in the workout history. Did they give you a Zio Patch monitor?

I went back to the hospital after doing some yard chores last week. I thought it might be pneumonia. Turned out to be pulmonary embolisms. I'm back at home now, sucking oxygen and taking blood thinner and pain pills. But I will be back to cardiology after we get the embolisms sorted out.

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Old 07-16-23, 08:22 PM
  #35  
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Originally Posted by oldbobcat
Found out I have moderate hypertension, scar tissue on the ventricles, and ventricular tachycardia. Monitoring my HR, I was being careful to keep it below 130 or so, but sometimes when approaching that threshhold the ventricles would go arrhythmic. While I could not observe this in real time on my HRM, my workout history would show max HRs in the 180-200 range. Now that I'm on meds (atorvastatin, losartan, and metoprolol), I'm running out of breath and just walking up stairs or doing garden chores, and on my last ride I couldn't breathe beyond a few seconds at 127 BPM, and I had a hard time holding 115 afterward. The rest of the ride was pathetically slow. The workout history showed a max of 191 BPM. I think my cardiologist is more concerned about my blood pressure than a return to a normal life, but I'm waiting for him to return from vacation.
I took lisinopril for BP and am taking a calcium channel blocker, verapamil, for v-tach. The lisinopril didn't have objectional side effects for me, but the verapamil makes me feel a bit weird sometimes. Neither affect my HR except that the verapamil lowers my resting HR.. I'm going to get an ablation for the v-tach, won't need the verapamil then.

But every case is different, and a cardiologist may make different recommendations in what might seem to be quite similar cases.
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Old 07-17-23, 03:32 PM
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Originally Posted by Carbonfiberboy
But every case is different, and a cardiologist may make different recommendations in what might seem to be quite similar cases.
True. That's why I've switched to a more team oriented cardiology clinic.
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Old 07-17-23, 04:07 PM
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Originally Posted by oldbobcat
True. That's why I've switched to a more team oriented cardiology clinic.
You bet! That's what I had to do after 2 cardiologists told me there was nothing wrong with me. Well, nothing except that I kept passing out on my rollers (ouch). That started in October and I still don't have a definite diagnosis, but we're pretty sure it's an electrical issue of some sort. Working on it, 2 more appointments this week.
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Old 07-18-23, 01:29 PM
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Originally Posted by Carbonfiberboy
You bet! That's what I had to do after 2 cardiologists told me there was nothing wrong with me. Well, nothing except that I kept passing out on my rollers (ouch). That started in October and I still don't have a definite diagnosis, but we're pretty sure it's an electrical issue of some sort. Working on it, 2 more appointments this week.
It's hard being so far above the norm as far as cardiology patients go. I've been lucky; a cycling cardiologist stented me, and when he retired, he passed me on to another cyclist.
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Old 07-23-23, 06:41 PM
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A bit of an update on my situation: the verdict on the stress test was sinus tachycardia, and if one has to have something, it's the something to have, I guess. Despite topping out at 200 bpm, my rhythm was fine - I'm going to have to wear a monitor for two weeks and get an echocardiogram re the spiking. I might have to do nothing; I might need meds; I might need ablation - we'll see.

In the interim before the testing, the doc cleared me to ride, so long as I keep my heart rate around 130. I've ridden twice since - once around 130 and today a little higher - I felt great and there were no spikes. I'll tell you this - my maximum heart rate has to be above 150 (220-70) - I could have pushed it past the 150 range. Not sure if this is bad or good.
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Old 07-23-23, 07:51 PM
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Originally Posted by Carbonfiberboy
You bet! That's what I had to do after 2 cardiologists told me there was nothing wrong with me. Well, nothing except that I kept passing out on my rollers (ouch). That started in October and I still don't have a definite diagnosis, but we're pretty sure it's an electrical issue of some sort. Working on it, 2 more appointments this week.
Update: diagnosis is bradycardia. What's been going on is that my atria operate normally so one sees a steady HR on a simple HRM, but at higher efforts, the atria don't send the message to beat to the ventricles about every other beat. So as effort increases, oxygen supply is cut in half, and I pass out. Solution: pacemaker installation is this coming Friday.

I'll get that installed and then see what else is wrong, if anything
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Old 07-24-23, 05:45 PM
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Originally Posted by Carbonfiberboy
Update: diagnosis is bradycardia. What's been going on is that my atria operate normally so one sees a steady HR on a simple HRM, but at higher efforts, the atria don't send the message to beat to the ventricles about every other beat. So as effort increases, oxygen supply is cut in half, and I pass out. Solution: pacemaker installation is this coming Friday.

I'll get that installed and then see what else is wrong, if anything
IOW, second degree heart block. Glad it wasnt something worse.
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