10/21/15 3:53 PM

This was originally on the "On Position" thread. I think it is important so I am separating it out. I hope that Nick does not mind. Here is what he said in the other thread:

I reckon spending most of your time on the bike meandering around is good. I put in the occasional hard effort, but most of my riding is at a pace that feels like no more than a medium level of effort. As I and most of my cycling friends are now in our 60s - some in their 70s - I've noticed that quite a number of them now have heart problems from a lifetime of hard training and racing. There are at least half a dozen of them who suffer from arrythmia, atrial fibrillation, tachycardia, etc, and several of them are now riding around with implanted pacemakers or defibrillators.

I'm probably lucky in that though I've been riding continuously for the past 45 years or so, I've only raced for about a dozen of those years, in short segments of a few years at a time. For the rest of the time I've just been a touring/commuting cyclist.

There have been a few articles I've noticed lately on this topic of whether lifelong intense exercise can cause problems. e.g.

http://velonews.competitor.com/cycling-extremes

http://cyclingtips.com.au/2010/10/exercise-is-good-for-the-heart%E2%80%A6-but-is-there-a-limit/

http://well.blogs.nytimes.com/2011/03/09/when-exercise-is-too-much-of-a-good-thing/?_r=0

10/21/15 3:54 PM

I developed AFib in my early fifties. I raced for 18 years and really pushed myself when training and racing. I have a masters state time trial championship and 17 Empire State Games medals for time trails and road races. I never expected to have any heart issues as I looked at the heart as any other muscle, the more you use it the better it gets (notta). I am lucky as my AFib is relatively easy to live with as I just have a lumpy rhythm and no extreme racing heart. I am on a beta blocker to control max rate and Coumadin to prevent clots and can live a fairly normal life including about 100 miles a week of riding. My max speeds are down around 15% and I seldom push to that level. My wife reminds me weekly on what I have done to myself but neither one of us expected this outcome. The enlarged heart from the training provided extra pathways for the electrical signals which messes up the rhythm. In the VeloNews article that Nick posted it mentioned that 20% of the masters endurance athletes develop AFib. I wish I was in the other 80%.

Leonard Zinn posted a good article tonight that does a good job explain AFib. He has the scary type where his heart will beat at 220+ for long periods of time.

http://velonews.competitor.com/2015/10/bikes-and-tech/technical-faq/the-heart-and-masters-cycling_388002

Here is a report written by cardiologist that is/was a marathon runner.

http://www.eplabdigest.com/articles/Endurance-Exercise-it-Proarrhythmic

This is the conclusion of Dr. Gilligan's article:

"Despite the foregoing concerns, any possible risks of prolonged endurance exercise must be put into perspective. So far the data is largely observational, relatively new and applicable to only a fraction of the population who participate in endurance exercise. As a public health issue, inactivity and lack of regular exercise should remain our major focus. Our priority as healthcare professionals must be to encourage regular, moderate exercise for its many benefits, and we should set an example in this regard. Moderate exercise such as brisk walking up to 30 minutes most days a week is enough to obtain most of the reported benefit from exercise. On the other hand, we should be aware and counsel the minority who are engaged in long-term, serious endurance exercise of some possible risks. I think we can say that high-volume endurance exercise carried on into middle and later life is associated with an increased risk of atrial fibrillation and possibly both benign and malignant ventricular arrhythmias. Having done this review, I now ponder whether I should run another marathon. I may consider the advice given by Hippocrates, a contemporary of Phidippides: ‘if we could give every individual the right amount of nourishment and exercise, not too little and not too much, we would have found the safest way to health.’ "

10/21/15 4:40 PM

Thanks for raising this issue, which I agree is important. I have known of some serious cyclists (including a local guy) who developed heart issues and similarly have to limit the top end, but I never really made the cause - effect connection. It is sobering. I had a slightly irregular EKG years ago (maybe before hip replacement), but nobody thought much of it and I have no noticeable symptoms. I also have never trained at a level approaching that of a serous racer, but it is still something to think about @65 and enjoying some difficult events. I just learned that I am disqualified from D2R2 next year as my niece is getting married that day, but maybe there is an upside to that...:)

This seemingly is an enormously complex subject, with huge individual varations in both physiology and training history and many unanswered questions, eg, is intensity or volume the bigger problem?

So I expect precise answers will be elusive, and perhaps the quote from Hippocrates is about as close as we can get, or "moderation in all things."

But all of us will be better off thinking about this, so again thanks for raising the issue.

10/21/15 4:55 PM

I am glad I asked the question. Except I think now the better question is "How do I not keep the switch on?"

10/21/15 4:58 PM

My brother in law is a lifelong cyclist, marathon runner, and XC skier extraordinaire. He developed AFib at about age 55 and had to have an electrical procedure to sort it out. Appears to have worked but there was significant consternation for a year or so as he worked through it.
As for me, I am indestructible and so don't have to worry about any health issues :)

10/21/15 7:39 PM

quote:

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I had a slightly irregular EKG years ago (maybe before hip replacement), but nobody thought much of it and I have no noticeable symptoms.

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10/21/15 9:17 PM

cardiac ablation, My non cyclist sister had it. She landed in the ER 2-3 times a year with a 220+ HR that just would not quit prior to the procedure. So far so good.

10/23/15 8:18 AM

When I was younger, I had such conditions that came and gone. Focusing on some more TLC care for my body, the condition self corrected/went away. When I lapsed such focus, the condition would reappear. Irrespective of age, to minimize your chance of experiencing such heart conditions, you should make sure you warm up/ease into before and cool down after going full throttle on the bike. Those warm up/cool down periods should be longer with greater age. I think a bit more attention to such will help greatly. Likewise, plenty of rest/sleep, laying off the caffeine, helps, too. If you suffer from seasonal allergies, substituting a netti-pot for an antihistime allergy pill (which will elevate your hear rate) will help as well. An elevated resting heart rate, which is a signal of being over trained, will make you more inclined to have experience such heart condition.

10/24/15 8:25 PM

I have an enlarged heart due to excessive cycling. And it sets off alarm bells whenever I have a chest x-ray. A few years ago, I was referred to a cardiologist, who prescribed a number of hospital visits for scans. He said I checked out okay. I imagine the heart size could turn out to be a problem if I turn into a couch potato.

10/25/15 5:00 AM

Me too.

At my 35k mile tune up (.mil 35 physical) I presented a level 2 heart murmur, PA freaked, sent me straight to the cardiologist, ECG, X-rays and echocardiogram followed.

No issue, a flow murmur (skinny chest wall, heart like a blue whale from cycling with no reflux through the valves at all).

While waiting for the test results the cardiologist limited my HR to some silly low numbers. He took about two weeks to leaf through the data. When the office called and stated I need to come in I freaked out.

So, the doc tells me, "You have a heart I like I would like to see in all my patients, keep it up and I will see you at your 90k mile tune up if you keep exercising."

I took a silver medal that following weekend in the Grand Canyon State Games road race. :) and a teammate won.

I still have taken note of the issues these articles highlight and will BOLO for extended high HRs that have no explanations.

10/28/15 12:46 PM

Be on the lookout for the acronym police too! ;^)

A hard jam a few times a year is proof of our strength. Decades of the weekly regimen of intervals and hour upon hour at LT, watt meters and strava virtual competition is something our stone-age forebears didn't prepare us for. Back then after a few years we taught the kids to hunt and there was no organized masters' category. In a lifetime it was a temporary enlargement and our hearts were young enough to recover.

I'd probably be 'guilty as charged' myself but that back surgery in '92 ended my days of intervals. Let me tell you, I'd trade my squats bragging rights for 1.5" of lumbar-sacral disk in a heartbeat (subject noted!) Basically it taught me to put racing into perspective, i.e. exactly who am I beating or being beaten by, world class? national? regional? the club? It was fun. My fitness was lost when the wife insisted I stop commuting. So now I'm trying to find the fitness and you better bet I still use an HRM. Only it's a governor these days!

11/12/15 4:46 PM

At 78 yrs old!

Hr record holder for 75 yr olds
http://cyclingmagazine.ca/sections/feature/giuseppe-marinoni-hour-record/


http://pedalmag.com/marinoni-the-fire-in-the-frame-film-review-and-6-life-lessons-from-giuseppe-marinoni/

11/15/15 6:42 PM

This is a great resource for AFib sufferers:

http://a-fib.com/

After reading much of this information over several days, I realized that my cardiologist was wrong in treating my AFib with drugs (and their bad side effects like dizziness and fainting). This site used to recommend 7 or 8 locations that were best to have an ablation done. I was lucky that a fellow cyclist was the best friend of one of those listed EPs, and I was able to quickly be approved for ablation treatment under my insurance plan before I retired and lost that great insurance. Made a huge difference in my life.

Note that Cardiologists who treat just with drugs may not play nice with EPs who do ablations. My cardiologist of 2 years even tried to falsely claim I had sick sinus syndrome (that is not treated with ablation). You are better off just scheduling with an EP on your own and see what makes sense for you.