Question: I read your article this week about the book The Haywire Heart. You say that the book’s authors suggest using a heart rate monitor to monitor for problems: “Another suggestion is to wear a heart rate monitor at all times while training. This can help detect problems we may not be aware of, and can serve as useful information to a doctor should an episode occur.” Specifically, what should I look for in the heart monitor info? Anything other than a racing heart rate? —Richard G.
Coach David Ertl Replies: Thanks for the question, Richard. The book really does not get into much detail about the issue, beyond saying that the things a heart rate monitor can validate are a racing heart rate, skipped beats, if they are erratic enough, and brief periods of fast heart rate.
I coach an athlete who occasionally has blips – times where his heart rate will jump about 40 beats per minute for a few seconds, and then return to normal.
Many of these symptoms you can feel when they happen, but having a heart rate graph can be something to show your doctor to illustrate and document that what you are feeling is real.
However, a limitation of a heart rate monitor is that the graphs just show a trend line. If you skip one beat, it probably won’t detect it. But mainly it can be evidence to back up what your feeling. My athlete can feel his blips – he says they feel like a lump in his throat.
If you do feel or discover something going on, your doctor may give you a heart monitoring device – kind of an EKG machine – to provide more specific information that will assist in a diagnosis.
Gabe Mirkin, M.D. Adds: Should people with A-fib use a heart rate monitor? They can if they want, but they should also listen to their bodies, which is far more dependable than a heart rate monitor.
People with atrial fibrillation may have no symptoms at all, but they should stop exercising immediately if they develop severe fatigue, palpitations, shortness of breath, light-headedness, dizziness, chest pain or discomfort, or feel like fainting.
Today, they have to depend on their doctor’s recommendation whether they are to cut back on intense exercise, but the most frightening concern about A-fib is increased risk for forming clots. Exercise is supposed to help prevent clots from forming.
Read More About Heart Issues and Exercise
Angina: Unexplained Chest, Neck or Arm Pain When You Ride a Bicycle or Exercise
A Cautionary Tale: How Cycling Saved my Life
Guide to Atrial Fibrillation A-fib for Cyclists
Irregular Heartbeats in Senior Athletes
High Resting Heart Rate Unsafe
Book Review: the Haywire Heart
Dr Carl says
FWIW, in the last few years I’ve diagnosed a. fib. twice while on the road, in part because the people were wearing HR monitors. One (mid 60s) had no symptoms, but noted some high, and fluctuating, numbers. I let him go on his way (downhill) with advice; he eventually underwent ablation and is riding strong again. The other (late 50s) was feeling weak and his monitor was showing >200. I went with him to the ER, where EKG tracings confirmed the clinical diagnosis, and he soon underwent ablation and is also riding strong again.
Morris Marks says
I am reading your End Notes in today’s 11/28/2019 newsletter thinking I could be the author. Over the last year+ I have experienced the same exact elevated HR’s, looking down at my Garmin while cycling to see my heart rate in the 220bpm – 235bpm zone. Quite surprised I tried to get a pulse eading by putting my fingers on my neck but while riding it was difficult and I didn’t think my pulse nearly approached 220+. I was ready to conclude my HR chest strap was in need of cleaning, new batteries, or broken. Fast forward to this past summer, as I continued to have HR’s in the 220’s on my typical 20-25 mile rides, I decided to visit my GP, he sent my to Mass. General Hospital for an appointment with a well known cardiologist and they conducted a cycling stress test. It was unable to get my HR above 175BPM during the test, I didi well for my age (61). The Dr. then had me wear a HRM that is attached to your upper chest for two weeks. Once he received the results and we discussed them, he diagnosed Supraventricular Tachycardia. There are probably many cyclists out there with he same condition. I’m presently in the middle of reading the Haywire Heart as my interest in the issue has of course been heightened. My cardiologist has advised I should continue cycling and riding through the high HR’s. but to keep him advised should I experience any other symptoms, pain in chest, tingling, swelling, dizziness. I’m now very conscious every time I exercise and elevate my HR where it will go beyond 160bpm. The point of me writing back is that while you may think your HR belt is in need of new batteries or broken, chances are it probably isn’t, and you should visit a cardiologist for testing to diagnose your high HR while exercising/cycling. As I am learning from reading the Haywire Heart, there are many different electrical issues the heart can experience, best to get yours diagnosed.
Road Bike Rider says
Thank you for your comment. I was still getting the reading on the Garmin as I took a simultaneous reading with my blood pressure machine, and the blood pressure machine came back at 90 beats (having walked in directly from my ride). I always ride with a monitor and switched to a different one, so if I see that happen again I will certainly take it seriously. Your comment is exactly the scenario I was imagining that had me on the verge of a panic attack. I’m 100 percent paying close attention.
Morris Marks says
Glad you confirmed it’s your HR belt, hope it never happens to you again , I don’t enjoy being fixated on my HR every time I go out for a ride, but it could always be worse.