5K Race at Age 82

I have a pm 2 years now and continue resistance training and running. Yesterday ran a hilly 5 K in 42:32 and placed 103 of 203. I was the second oldest guy. Two years ago did it in 37 minutes but, since them my Metoprolol was increased and that slows the heart rate.

The bad news is that, as I have continued exercising, I have developed more symptoms. First AFib and now ventricular tachycardia. My electrophysiologist says that, since I am symptom-free during exercise, he considers me a low-risk patient.

But I am going for a consultation because I wonder if I am overdoing it and hurting myself.

Len

4 Comments

staying fit

by Tracey_E - 2014-06-09 08:06:59

If your dr is comfortable with your continuing to exercise, then I would continue to exercise as long as you can! it's unlikely the running caused the afib to get worse. Things like that tend to get worse over time whether you're active or sedentary. Have you had a stress echo? That's the easiest way to verify your heart is handling the exercise well.

Beta blockers will slow you down! they won't keep us from being active, but they do make it more challenging.

STAR OF THE WEEK......

by Tattoo Man - 2014-06-10 06:06:11


............Len, I cannot answer your question but I reckon that you are an inspirational character, here on PM Club.

Keep on running !!!

Tattoo Man

All Timer

by Computerized - 2014-06-16 03:06:50

Len... Good on you. Life is a journey, enjoy every mile.

I am 64, a competitive cyclist and also looking for answers. I have researched training with a Pacemaker and from what I can gather, the physical effects on intense training after Pacemaker implantation has not been researched, I would imagine due to the wide range of conditions causing pacemaker implants.

What has been recently researched is exercise induced Bradycardia. I was told that exercise did not cause Bradycardia. A heart rate below 50bpm is Bradycardia, even in elite athletes. Therefore, it is obvious that exercise does cause Bradycardia. (Slow resting heart rate)

My research has shown endurance athletes exhibit sinus bradycardia, associated with a higher incidence of sinus node (pacemaker) disease and electronic pacemaker implantation. Here it is shown that training-induced bradycardia is not a consequence of changes in the activity of the autonomic nervous system but is caused by intrinsic electrophysiological changes in the sinus node.

After lifelong physical endurance training, veteran endurance athletes have a higher incidence of sinus node disease and artificial pacemaker implantation than normal individuals and it is likely that this is a consequence of the marked remodelling of the sinus node. It may also help explain syncope (loss of consciousness) in the young athlete.

Other rhythm disturbances beset the athlete (for example, atrial fibrillation, heart block, bundle branch block and even sudden cardiac death and it is likely that they are a consequence of an analogous remodelling of other parts of the heart: the atrial muscle, atrioventricular node, Purkinje fibres and ventricles (perhaps in combination with a pre-existing heart condition in the case of sudden cardiac death).

Exercise is undoubtedly beneficial for the cardiovascular system, but at the same time intense endurance training can have harmful effects, and findings highlight the fundamental changes taking place.

My symptoms occurred post exercise whilst relaxing. Initially I felt the effects of heart pounding (Tachycardia),on further tests it was found that I had a rest heart rate of 35bpm (whilst asleep) with missing beats. A sure candidate for a pacemaker, which was subsequently fitted.

Will further training cause additional problems and will the pacemaker intervene making the situation low risk? Who knows. Altering my training program to include more rest days I'm sure will help prolonging additional symptoms. I am currently training 5-6 days per week which includes 2-4 days of high intensity training..

Computerized.



Thanks to Commenters

by len613 - 2014-06-16 04:06:36

After posting that message I had a consultation with an electrophysiologist listed in Castle Connelly's Top Doctors in America. He said that, while Ventricular Tachycardia can lead to sudden death, it is far less likely for people with strong hearts. He put me in that class based on my exercise regimen and lack of symptoms.

On checking my pm he found that the last tachycardia episode was 6 months ago, in December, and that was a brief one of only 116 bpm. He thought that trivial and said even people with healthy hearts can sometimes have an occasional tachycardia episode.

He advised me to keep exercising but to be sensible and not overdo the exertion. That applies to healthy people too.

Computerized, you may be interested in the following article: "Endurance Exercise – Is It Worth It?"
by Hans R. Larsen MSc ChE, available at:
http://www.afibbers.org/endurancesports.pdf

Excerpts:
"The pace of walking (exercise intensity) was found to be less important than the time spent in walking, and increasing pace or walking time (beyond 1.5 hours/week) did not provide added protection.[2] Clearly, regular exercise is important, but how much is required and what are the optimum ways of getting it?

"An expert panel endorsed by the American Heart Association and the American College of Sports Medicine recommends that all healthy adults aged 18 to 65 years engage in at least 30 minutes of moderate-intensity aerobic physical activity on 5 days each week, or vigorous-intensity aerobic activity for a minimum of 20 minutes on 3 days of the week. Combinations of moderate and vigorous exercise are also acceptable and the 30 minutes of moderate physical activity can be met, for example, by 3 individual bouts of 10 minutes each. The panel emphasizes that physical exercise over and above the recommend minimum can be expected to lead to reduced premature mortality and further health improvements, particularly in regard to cardiovascular health. The panel also recommends activities that maintain and increase muscular strength for a minimum of 2 days each week. Such activities would include stair climbing, weight training, and weight-bearing calisthenics. ---

"[H]ealthy men and women do not need to consult with a physician or other healthcare provider prior to embarking on a regular exercise program. However, those with cardiovascular disease, diabetes, or other chronic diseases should clearly do so. ---

.How Much is Too Much?

"So, regular exercise is clearly a good thing, but like all good things it can be overdone. British researchers followed 20 veteran athletes for 12 years and concluded that high intensity lifelong endurance exercise is associated with altered cardiac structure and function, especially the development of left ventricular hypertrophy (thickening of the muscles of the left ventricle) and profound bradycardia. Two of the athletes ended up having to have a pacemaker implanted.[5] NOTE: Endurance exercise is usually defined as vigorous exercise for more than 45 minutes per session.

"Swedish sports medicine experts found that elderly men with a lifelong history of regular, very strenuous exercise were more likely to suffer from complex ventricular arrhythmias than were men who had been only moderately physically active.[6]

"A recent study involving 134 former Swiss professional cyclists concluded that these former athletes were more likely to suffer from sinus node disease and atrial fibrillation and flutter than were an age-matched group of golfers. The two groups were examined at age 66 years, which for the cyclists was an average of 38 years from their last professional race (Tour de Suisse).

"The Swiss researchers also observed that ventricular tachycardias were more common in the cyclists than in the golfers (15% vs 3%). They conclude that, “The elderly athlete may not be as healthy as believed.”[7]
In 1998 Jouko Karjalainen and colleagues at the University of Helsinki reported that the prevalence of lone atrial fibrillation in a group of elite orienteers was 6 times higher than in a control group of less active men (5.3% vs 0.9%). The first afib episode among the orienteers occurred at a mean age of 52 years after an average training history of 36 years. Although the orienteers were more likely to develop lone atrial fibrillation, they were significantly less likely to develop heart disease (2.7% vs 7.5% in control group) and experienced lower mortality during the observation period (1.7% vs 8.5% in control group). The Finnish researchers conclude that vigorous, long-term endurance exercise is associated with atrial fibrillation in healthy, middle-aged men despite protecting against coronary heart disease and premature death. They speculate that the increased risk for afib is related to enhanced vagal tone, atrial enlargement, and left ventricular hypertrophy.[8]

"Medical researchers at the University of Barcelona have found that men who engage in vigorous physical exercise of many years have an increased risk of developing lone (vagal) atrial fibrillation. A review of the records of 1160 patients seen at an outpatient arrhythmia clinic revealed that the incidence of lone AF among long-term exercisers was 60% as compared to only 15% in the general population of Catalonia.[9] The same group of researchers also concluded that lone afib was about 3 times more prevalent among men who reported former and current sport practice than among men who did not. They observed a particularly strong correlation for men who reported more than 1500 hours of lifetime sports activities."

End quotes.

Dr. Paul Dudley White once said that someone who completed a marathon was virtually immune to heart disease but he later backtracked. Clearly, overdoing the endurance thing increases risk.

Good luck to all.

Len








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So, my advice is to go about your daily routine and forget that you have a pacemaker implanted in your body.