An Excited Heart

It’s no big secret that I was not feeling super great heading into my last race. It was the perfect storm in many ways. I had a stressful week at work two weeks prior working on a massive deadline followed by a heavy training volume week where I nearly doubled my weekly mileage and then fell behind in sleep the week leading into Quad Rock. I was super stressed out heading into Quad Rock due to the distance and vertical gain. I felt comfortably trained up to the 35 mile distance, but I had failed to put in the back-to-back days in training that would have given me confidence to make the jump to 50.

The night leading into my race I had some significant arrhythmia while I was lying in bed. The feeling was not new to me. 10-years ago I was diagnosed with benign PVC’s. The condition takes place when nodes in the ventricles fire off signals that interfere with the main SA pace-making node in the heart. The result is a feeling of a skipped heartbeat followed by a hard thud in your chest as you heart catches up. While the condition is extremely common (over 90% of the population has these from time to time) it tends to be recognized by athletes more often due to our slow resting heartrates and being attuned to our bodies. Most of the time, PVC’s are benign and should simply be ignored. Triggers are typically caffeine, stress, lack of sleep, excessive exercise and alcohol.

So anyway, I did what the docs 10 years ago told me to do and just ignored them and raced Quad Rock through the heat and elements.

The day after Quad Rock, I came down with a head cold and decided to rest up. I didn’t run the first part of the week, and on Wednesday, the PVC’s came back with a pretty regular frequency. I decided to go see a doctor on Friday since it was worrying me a little. I fully expected them to send me home and tell me not to worry.

I found myself in the Doctor’s office on Friday afternoon with an EKG strapped up to my chest and my heart rhythm was going crazy. PVC’s were showing up every 3-4 normal heartbeats which I had never seen before. I don’t think I would have freaked out quite so much, but the PA just “calmly” looked at me and told me I needed to see a cardiologist ASAP. The bad news is that their cardiology office was closed on Fridays and that their cardiologist was booked way out. She told me that she was concerned about the frequency of the beats and told me to go to the ER right away if it got any worse. She also ordered no running until they figured it out.

PVC's from first office visit.

So… yeah…. I left the doctor’s office terrified that the worst was around the corner.

I headed home and cried my eyes out in my wife’s arms. So many things going through my mind. Was I going to die? Was my running season over? Would I never be able to do sports again? My son?

I made a few phone calls to some people I knew that would pray for me during this time. I am pretty prideful when it comes to asking for help, but I am so blessed to have other Christian friends that were willing to pray for me. I needed peace of mind during the storm, and they were more than I could ask for.

After several sleepless nights I made my way to the cardiologist’s office on Monday for an Echocardiogram and to get hooked up on a 48-hour Holter monitor.

The Echocardiogram is an ultrasound of the heart and takes about 20-30 minutes for them to complete. I laid shirtless on my side hooked up to a bunch of wires as they scanned my heart. It was freaky to see my heart beat live on the monitor and even freakier to see the PVC’s happen on the screen. I tried to relax the best I could.

Echo

They then put me on a Holter monitor, which is a somewhat portable EKG machine that records every heartbeat over a 48 hour period and scans for problem rhythms.

Holter Monitor. Can they make this any more cumbersome?

Wednesday I got a call from the Doctor letting me know that my Echo came out totally normal. This was a concern as often athletes have enlarged hearts and wall thickening that increase the risk for A-Fib and sudden death. The fact that my heart was structurally sound was good news.

Next back were the Holter results. The Holter report showed ‘frequent benign PVC’s at an 8.9% rate’. I didn’t really know what all that meant, but the doctor reading the report told me that a follow-up with a cardiologist was a good idea, but I was okay to run. Another good sign.

I finally got in to see a cardiologist/electrophysiologist last Friday. Electrophysiologists deal with electrical issues in the heart so I was in the right place. Dr. Jordan at South Denver Cardiology sat down with me for over an hour and explained to me that I was in no danger of cardiac arrest. My heart echo was fantastic and I had no structural or underlying health issues that would have been cause for concern. He told me any course of treatment would be for my peace of mind. Treatment options include:

1. Do nothing. Ignore the PVC’s when they happen. Cut down the caffeine, alcohol and other stimulants. Know that it may feel funky but I’m okay and won’t die.
2. Add Magnesium supplements to my daily diet. This not only helps with electrolytes, but there is some research out there that Magnesium helps quiet PVC’s.
3.  Drug therapy in the form of beta-blockers. Not recommended for athletes since it lowers blood pressure and your resting heart rate. My resting heart rate is around 40, so drugs are a no-go.
4.  Catheter ablation. This is a procedure where they put a fiber optic cable into your heart and map out the electrical function. If they can get PVCs to show up during the procedure, they can locate the tissue firing the extra beat and cauterize it- permanently killing the source. This is typically done on people with a high burden of PVC’s.

We are going to do one more test to see what my heart is doing at load in the form of a treadmill stress test. Other than that I am cleared to race. According to the cardiologist, there is no risk of these turning into something worse, and my running and endurance sports are not to blame for the problem. 

It may just be something I have to live with for now. I plan on ignoring the PVCs the best I can and start up on a magnesium supplement. The good news is I have had a solid 2-3 weeks of body rest, and I’m ready to get back out there and train. Never Summer 100K is coming up in 6 weeks.