Re: Low BPM

Just my opinion, but I think the NHS route would be preferable if I were in your position. The thing is that, for many things the NHS is going to entail long waiting times, but for serious conditions such as this it can be the best in the world.

As Meg suggested too, ablation would not be something I'd choose if there were other options. Destroying parts of the heart, albeit small areas, has a sound of finality and no going back!

No running sounds good advice, but moderate exercise is good, I'm sure. In my case, on the other hand, I expect advice to include more exercise... much more exercise, as have what you term a 'sedate lifestyle'. I do bugger all!

As you mentioned later on, you are loath to put anything at risk by unnecessary surgery or medication, and I feel just the same. If there is an non-invasive option, I think that's what I'd take too.

Anyway, whatever is advised and whatever you choose (it is, of course, entirely up to you whatever the quacks say) I wish you the best of luck for the future.

At the risk of accusations of flippancy, the forum wouldn't be the same without you!

Re: Low BPM

Ah!

I didn't realise OGF exercised in his Flippers!

Re: Low BPM

Thanks JB, you make some good points and It's the way I'm thinking also.
Since I stopped running I've been walking five miles most days and I've been feeling so good, by accepting some kind of treatment I could end up worse than I am now and lose my mobility. As far as I can see there are limitations with each of the suggested methods; Medication will 'dumb me down' to prevent excessive overwork of the heart, so no exercise that raises the heart rate will be tolerated. A defib would provide a serious jolt if the heart exceeded a certain limit. (I've spoken to an ex runner who has a defib and it's impossible to run with one) And as you mention, ablation seems a bit permanent, and can be detrimental and risky. Apparently they don't always work and repeat procedures are often required.

It is possible to exercise with a pacemaker, however, they are accompanied by medication, and in all these instances these treatments could have implications on my ability to drive.
By constantly monitoring my heart while exercising (wearing my monitor) I believe it is possible to avoid over taxing my heart and following further investigations by the NHS (which have not been forthcoming thus far) I may prefer to stay as I am for the time being. I consider myself to be too young for such limiting medical intervention at this time. Perhaps when I get old....

Thanks for your compliment and support JB and I hope you can sort out your own problem and keep producing excellent posts. I would strongly recommend taking up some gentle walking on a regular basis, because despite your protestations I think you have always been a very interesting and important member of the forum... (man hug)...

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Mrs Fox gets turned on by a man in a wetsuit and flippers Ted....

You should see the result when I'm going down with my snorkel...

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Hi

Foxy, it ia all about life in your days, not days in your life.

I am still putting things in order for my son.

Once done, I will be out doing things that I want and enjoying life to the full.

Re: Low BPM

Thanks OGF.

Re. driving, I have resolved not to drive again, at least whilst there is still a risk of my fainting/collapsing again. If that happened whilst I was driving, I'm afraid I'd have nothing more to worry about ever again! Sadly, the same would be true of anyone in the car with me.

I had blood tests and an ECG on Thursday and got the results yesterday. Nothing of concern in the bloods (as far as I'm aware), but the ECG suggests sinus bradycardia (and that's with a heart rate of 59 - didn't think that was too slow?) and right bundle branch block.
I'm hoping to be able to get past the receptionist on Monday and see the doctor who arranged for the tests. He did ask to see me after the results are in, but you know doctors' receptionists!

Re: Low BPM

I've tried to sum up how I'm feeling and how I should respond to the story so far. Thought you might be interested....

The Theory
I believe that a mature long distance runners heart can be misdiagnosed, and be a concern to most cardiologists after they have seen the unusual results of various tests including ECG’s and 24 hour monitoring. I have been warned about the response long distance runners might receive after this unusual and erratic activity of the heart is observed by the professionals.

The Symptoms
I became a little worried, when relaxing following a hard five mile run, the readings on my pulse oxy meter read 35 beats per minute. I was further alarmed when I spoke to an old Ex long distance runner who explained that my problem was probably Atrial Fibrillation which is apparently common in long distance runners, and he suggested I should get it checked out by a specialist cardiologist. After a short layoff from running due to Gout, and then buttock pain probably caused by piriformis syndrome, I had found it very difficult to return to even short stretches of sustained running, and had to walk often after shortness of breath and severely tired legs had ground me down. Walking while on a scheduled training run is something I have resisted doing for over forty years of running except during some marathons and ultra distance endurance events. I’ve always had an irregular and slow heartbeat and it’s got steadily more noticeable after two heart attacks, the first in 2004 and the other in 2014. I’ve also been experiencing extreme tiredness when not running, but wear and tear and a less efficient heart is presumed the most likely cause.

The Probabilities
Because I’ve only just started monitoring my heart I wonder how long I’ve been running with this?
When taking the treadmill test back in 2004 it was shut down prematurely when my heart apparently went into distress, after discussing the results with Doctor Payne at DRI, when asked, I explained that there was no chest pain prior to the test been aborted. Is it possible that this unusual rhythm is normal for my heart? Is it a natural response from my body following the heart attack to adapt to the loss of muscle, to find new electrical connections through scar tissue, and produce a network of new arteries, which I have been told, the heart will do to try and restore the demands made upon it in the future, especially following a regular exercise routine.
Could they have witnessed the same results as Doctor Mercer did, and they have both panicked not being used to seeing the normal functioning of a long distance runners heart, especially one that has recovered from two heart attacks. Remember the absence of chest pain following the premature shutdown of the treadmill.

The Facts
After performing an ECG at my first consultation, Doctor Mercer concluded from the graph that my heart was adding extra irregular beats and this could explain the extremely low heart rate that I had experienced. He believed my heart could have been beating at twice the rate but the pulse oxy meter would not necessarily be able to read the extra beats, and besides, it was reading the pulse at the end of my arm, and it would not necessarily be a good representation of what the heart was doing. It was decided that a 24 hour monitor and an ultra sound investigation would be the next step.

Meanwhile I had taken delivery of a heart rate monitor with chest strap, apparently a more accurate way of measuring the heart rate, and following my first run using it, I was surprised and shocked to find that after only just a few hundred yards of my early morning run it had leaped to 163 beats per minute, where it remained for about three quarters of a mile before I was forced to stop running and walk. I later found that I could run and walk keeping my heart rate within acceptable levels. Acceptable to me anyway. Perhaps the extra beats that Doctor Mercer identified on the ECG were now assisting my heart to supply the oxygen needed by the muscles to sustain the pace, like some kind of a sixth gear or turbo. Could it be that this has been normal for my heart all along. In which case, intervention by drugs, ablation or treatment by mechanical/electrical means would not only be unnecessary, but detrimental to my hearts performance.

The Conclusions
The results of the 24 hour monitor were well outside normal readings and I was told to stop running immediately and was prescribed a beta blocker 2.5mg Bisoprorol, which I took for three days until I found the side effects intolerable probably due to my already normally low blood pressure and heart rate. We discussed the alarming results of the monitor and the suggested course of action to be taken. I was surprised to learn that Doctor Mercer wasn’t too concerned about my very low heart rate, which was the main reason for my visit, but the seemingly fast and erratic heart rate he had identified from the results of the 24 hour monitor. He suggested ablation, pacemaker, defibrillator, or medication, but due to my intolerance of medication he would probably rule that out. Due to financial constraints it was decided to pass me over to the NHS at the Northern General Hospital Sheffield where further tests would be conducted and courses of treatment advised.

My Overview and Summary
Ablation comprises of preventing unwanted electrical signals in the heart using heat or extreme cold to burn out the scar tissue providing a path for these unwanted signals. It seems a bit hit and miss, with some patients having to return for subsequent procedures or ending up worse off than they were before. Very risky, and there’s no reversing the treatment if anything goes wrong. It all sounds a bit final.
An implanted defibrillator would prevent any kind of strenuous activity as the heart would be shocked into normal operation if the heart rate wandered out of acceptable limits.
A pacemaker would allow exercise, but would probably be used in conjunction with medication.
And calming the heart using medication alone would dumb down the patient and reduce the quality of life.
All these treatments may also impact on the future ability to drive.
I might decide that I’m too young and active to accept any of these treatments, and could possibly control my exercise, diet and lifestyle to prevent excessive use of my heart. I will make a decision after considering what the specialists at the Northern General have advised.

Re: Low BPM

I found all of this very interesting, OGF.

Like you, I would really not want to have any ablation in the heart, and may have said so before.

I'm glad that you are having all the necessary medical attention, though. A pacemaker does sound a safe option, the more I have read up on the matter. Should I ever be advised to have one, I'm sure I'd take the advice willingly.

Just one comment, I'd add, and that is that we are all growing older and, much as you'd like to continue to be able to run for miles (I wish I could!), the time will come when you'd be well advised to take life much easier. Sorry if I'm sticking my nose in where not wanted!

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That's quite some summing up Bob
Looks like you will go well armed to the consultant but prepare for battle , they don't like patients who form their own opinions I was dropped from my yearly checkup at the arrhythmia clinic because I refused to consider an ablation . They said come back if anything changes in other words my mind

Assuming you have AF and not some other heart condition.
My philosophy when dealing with my condition is ...
''And always keep a-hold of Nurse
For fear of finding something worse.''
The treatments on offer (treatments not cures)appear to hold the prospect of 'something worse' so I 'hold on to nurse' ie my current situation because at least I have some quality of life most of the time for now.
I do take some medication though because my 'risk score' for a stroke is high.

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Hi JB I have heard good reports from those with a pacemaker in my support group. they seem to work very well for suitable patients .