Atrial premature beats: Nothing to be concerned about?

"Hi Gary,

thanks again for your advice

I visited the cardiologist last week with the results from the holter recording

he said whilst it showed atrial premature beats (a mild form of Rob Wardells condition) it was not enough to worry about, it only happens at rest.

he said I was over medicated, bp used to be regular- 142-148/ 88-95 now 124/62- without  med.

all he can put it down to is mtb and healthy living

see you on the trails"

(Name withheld)

_____________________________

Gary:

Thanks for the feedback - most appreciated!  Your email raises a couple of interesting points:

• Most blood pressure medication does not work at all, or it wears off as the months pass.  If you think you have a problem with blood pressure, get a quality wrist-type monitor and measure it at home and see if the patterns of high or low BP are consistent.  Use this E-book as your guide:  http://www.garymoller.com/Products/Products/E/E-Book-Digital-Blood-Pressure-and-Heart-Rate-Monit.aspx
• What is healthy Blood pressure - when is low too low? Please read this article:  http://blog.garymoller.com/2006/10/blood-pressure-how-low-is-too-low_13.html.  Incidentally, your previous BP of 142-148/88-95 is of no concern.
• Blood pressure ranges: While excessively high or low blood pressure may be of concern, what interests me here is the current reading of 124/62 (bearing in mind this is a single reading, so may be misleading).  The optimum range between the upper and lower readings are about 40 points (eg: 120/80).  In your case, we have a range of 62 points.  This is often closely associated with adrenal fatigue.  Refer here for more about adrenal fatigue:  http://www.adrenalfatigue.co.nz/what-is-adrenal-fatigue/
• Rob Wardell's heart condition is interesting: First of all, it is very, very common in endurance athletes and easily fixed by diet, a few supplements and smart training.  Some years ago I attended a cardiology lecture about this condition and during which Rob Wardell was discussed.  It got me thinking about an interesting pattern that Wardell seemed to portray very nicely: His symptoms seemed to disappear when he switched from hard endurance rowing training to strength training to be a yacht grinder (and presumably he had a drastic change in diet).  His symptoms reappeared spectacularly some years later when he switched back to rowing.  Diet and adrenal fatigue are the obvious factors.
• Adrenal fatigue is associated with low thyroid function and liver stasis.  Symptomatic of this is often the development of unhealthy cholesterol and triglyceride profiles.  The usual medical action is to medicate.
• Even one drug is "over-medication", if the underlying possibilities such as adrenal fatigue are not first addressed.  Think of the current situation of your heart being like a poorly tuned car engine that is idling rough. When the causes of problem are identified and then addressed by non-drugs means the problem of the heart missing beats here and there will spontaneously disappear and you will note an increase in high end athletic performance for no extra effort!

Yes, I'll see you out on your bike!

About this website 

The advice in these articles is given freely without promise or obligation. Its all about giving you and your family the tools and information to take control of your health and fitness.

Why is my maximum heart rate declining as I get fitter?

My Brother-in-law, Ioasa, showing
good heart.

Hey
Have you had much to do with Max heart rates? 
Heaps of conflicting views online - 99% saying so long as you exercise, your Max stays the same. 
pfft
4yrs ago - on both run or bike, i could hit 183
Last year, max 178
4 months ago, 174/5 
Now, 172 

My "theory" - well, i ran basically 6 months of base work - this enlarged the heart, creating a greater a Stroke Volume, Same strength heart as 183 days, but larger = slower. It no longer has the torque to pump as fast due to being bigger. 

Would, a solid 4 months of progressive prep towards track racing (i have done about 6 wks now, and aiming for Gold Coast Pan Pacs in Nov, 800,1500m) would that increase the Strength and torque of the heart, and thereby increase the Max back towards the 180 beats minute barrier? 

I'm finding during training now - to only use the heart rate as a guide - esp now that i've left the O2 only training. 

I would like to do another Concini treadmill test, but mine only goes to 16km/hr... I need to find a faster one. 

Thoughts? 

cheers
Mark
________________________
Gary:
Mark, there is no single answer to your question.  I have some thoughts which are as follows:

• With each year from about 30 years of age, maximum heart rate declines by a factor of about 0.01.  However some people decline faster, others slower.
• As far as I know the heart chambers of an adult do not enlarge with exercise, although they might in a child.  What does make the heart appear larger is the hypertrophy of the muscle.  Excessive hypertrophy may reduce stroke volume such as seen in steroid abusing body-builders.  This is unlikely in a scrawny runner!
• Heart volume is determined partly by the ability of the heart to relax.  The more the heart relaxes between beats, the bigger the volume.  
• ATP formation determines the ability of the heart to relax (same applies to all muscles).  Lack of ATP = cramp.  In the case of the heart this may be felt as a "weakness of heart" and palpitations.  Many factors affect ATP formation, including crucial nutrients such as magnesium, vitamins, Q-10, creatine and a number of other nutrients.  Athletes deplete these at extraordinary rates.
• Toxins like mercury, lead and aluminium can interfere with the metabolic pathways for ATP formation.  Most of us have some of these in our bodies.  Some have excessive amounts.
• Arterial elasticity affects heart rate.  With ageing the arteries tend to calcify and lose their elasticity.  Systolic blood pressure tends to rise, especially during intense exercise.  The heart must contract harder to deliver a given amount of blood.   http://blog.garymoller.com/2011/06/cardiovascular-disease-arteriosclerosis.html
• Venous flow back to the heart also affects the ability of the heart to pump blood.  If flow back to the heart is poor, the heart takes longer to fill with blood before it can pump and when it pumps, the amount may be less than optimum.  Venous flow is seriously affected by muscles that are hard and full of knots.  A muscle is a sponge pump. When it contracts, the old blood is squirted out via a one way valve system back to the heart. When it relaxes, fresh arterial blood fills the muscle. This is the "muscle pump effect" and it is as important for blood flow during exercise as the pumping of the heart muscle.
• Strong adrenal glands fire up all systems for battle, including the cardiovascular system.  When you stand on the start line and you feel your heart beating powerfully in anticipation of the gun firing - that's your adrenals at work!  Weak adrenals = weak heart.  My findings are that all athletes have a degree of adrenal fatigue.  many are severe.  http://blog.garymoller.com/2012/01/running-on-empty-why-athletes.html
• The maximum heart rate of a conditioned athlete may be lower than a totally unfit person.  With conditioning, the heart tends not to beat beyond a point where efficiency is lost.  In your case the optimum for your age and gender may be around 180 beats per minute.  I have found that really unfit people may rev to an excess of 200 beats.  But this is done with a progressive loss of efficiency.  One can assume that the unfit heart is only partially filling and therefore expelling increasingly less blood per beat as 200+ beats are exceeded.

So, what would I do in your case?  I'd be inclined to carefully and methodically explore and address all of the above: Nutrients, toxic elements, skeletal muscle tone, adrenals and thyroid.  Get these right and you will find a steady gain in performance that will accrue over the months and even years.

You could go ahead and take some extra magnesium, pop a few Q-10 pills etc, but I am not going to recommend that because it is hit and miss stuff that often leads to disappointment.  It is better to do some accurate testing and then you can intervene with accuracy and purpose.  For that you will need to organise a consultation.
http://www.garymoller.com/Consultation/Private-Consultation.aspx

_______________________________________

About this website

The advice in these articles is given freely without promise or obligation.  Its all about giving you and your family the tools and information to take control of your health and fitness.

Irregular pulse in athletes - getting to the heart of the matter

Now that Rob Waddell's heart condition is out in the open, we should discuss the issues surrounding athletes who are troubled with an irregular pulse. This is a topic that I am very interested in and have come across many cases of over the years, including myself.

Please read my earlier article about the Drysdale-Waddell clash.

When attending a workshop on heart disease by a cardiologist some time ago, he mentioned that Rob Waddell had a problem with an irregular heartbeat that interfered with his performance as a rower. Apparently, the only options were medication medication for life and/or a risky operation. This heart problem was a factor in his retirement from rowing and becoming a grinder for the Team NZ Americas Cup challenge. What really intrigued me was the observation by the cardiologist that the heart problem disappeared completely while he was with Team NZ and he could not explain why this was other than that some people seem to grow out of these things. I think I know why.

Rob Waddell subsequently made a spectacular comeback in a bid to make the NZ team to the Beijing Olympics, only to fall at the last hurdle with a reported return of his irregular pulse. It now seems his only options, if he wants to stay in rowing, is medication and/or a risky operation that has no guarantees of success. Or does he? I think there are other options that should be explored.

Irregular pulses are very common in high intensity endurance sports like rowing, running and cycling. Most go unreported. I usually suffer episodes about once every year and once to such an extent that I consulted a cardiologist. Interestingly, these always happen to me about this time of year. In fact, I have just gotten over a lengthy episode and consequently posted a 48 second improvement in my seasonal personal best over 5 km! Spectacular! This most recent episode came about when I made a crash return to running and mountain bike training four weeks after breaking both the radius and ulna of my left wrist. With just three intense rides under my belt, I entered the 80km Gentle Annie MTB race. In this event I ran out of gas and even described it in my report that it felt like riding in porridge (Waddell described feeling like rowing in mud). I finished about 20 mintes slower than last year despite being in better condition and a faster bike and tyres. I came 3rd last year and 14th this year.

I think the reasons Rob Waddell's heart problems disappeared was because he reduced the exhausting cardio exercise and dispensed with the carbo-soaked, vitamin and mineral depleted endurance athlete's diet and replaced this with nutrient rich meals prepared by A-grade chefs designed to put on bulk. When he switched back to the previous routine, including a diet that resulted in a significant weight loss, the heart palpitations returned once he hit several days of unrelenting cardiovascular intensity.

For me, the irregular pulse and the sluggish performance during the Gentle Annie signaled that it was time to ease off the intensity and to sort out my nutrition. An irregular pulse in an athlete can be from a combination of physical and nervous exhaustion coupled with one or many nutrient depletions or imbalances. It is a matter of easing off the intensity of the exercise and systematically working one's way through the nutritional possibilities - minerals, B vitamins, amino acids, body salts, fatty acids. This takes time and patience and it is not advisable to just throw in a whole lot of supplements, including the kitchen sink, since doing so makes it near impossible to figure out what is really working and not working. A hair tissue analysis can be invaluable in helping work out the most effective options. Other factors may include excessive use of stimulants, including caffeine and ephedrine. Most athletes overcome these heart palpitations and continue to have successful sporting careers.

Please read my articles here about top cyclist, Hayden Roulston who was advised by his cardiologist to stop cycling after suffering similar problems to Waddell.

Please bear in mind that heart palpitations can be a sign of serious things such as a silent heart attack. Just as I did, there is no harm in getting it checked out by a specialist.