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Chronotropic Incompetence after COVID
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Essentially, the inability to appropriately increase HR in response to physical activity and defined as the inability to achieve at least 85% of age predicted HR max on a max aerobic test. I think that I may have it.

I had a relatively mild case of COVID about 9 months ago but have had significant issues with exercise tolerance since. I have been tracking my HR more carefully with a chest strap over the last few months as I have attempted to initiate some more structured training and intervals. I am 54, just prior to COVID during hard intervals on the bike and run I could achieve a HR of 162-168. Now I can only achieve a HR of 124-130 and my average HR during long rides is only about 95-99 yet it feels like I'm riding at threshold pace. My resting HR has dropped slightly since COVID even though I am probably less fit and I frequently have lightheadedness upon standing.

I came a across a few small observational studies on this phenomenon recently.
Article 1
Article 2

I was just wondering if any of you have had a similar experience? If so, did it ever improve and was there anything specific that you did that lead to that improvement?

As of now I am assuming that it is something I may have to deal with moving forward and just try to increase my fitness as able despite this limitation. I feel fine otherwise during the day, it just makes exercising less fun because it never feels good or easy and I can't keep up with my riding buddies anymore.

Thanks for any insights or experiences that you may have.
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Re: Chronotropic Incompetence after COVID [jacksonk] [ In reply to ]
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At first I read "incontinence." :)

I didn't have the COVID version, but my symptoms with really bad overtraining were similar, dramatic drop in ability to raise HR, and also pretty bad orthostatic hypotension (dizziness when standing).

So maybe this long COVID thing is another type of stress with similar symptoms.

My only advice is continue to do something, even if just walking, slow-rolling on the bike, or gently cruising the slow lane in the pool. Don't track power or pace at all. Just "let go" of all competitive instinct for a few months. That kind of overtraining takes months to resolve. Could be similar with the COVID thing.
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Re: Chronotropic Incompetence after COVID [jacksonk] [ In reply to ]
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Just curious if this is constant over the entire workout, or if there's any improvement as you go along.

I had an ablation for afib 5 years ago, and one of the aftereffects is that it takes a long time for my HR to catch up with my effort. I have to gradually build up my HR, usually taking 45 minutes and then I'm good to go. If I do any kind of harder effort in the first few miles of a ride, my HR remains constant and I just go anaerobic with my HR as low as 110-115bpm. 45 minutes later, I have no problem getting up to the upper 160/low 170s, it'll drop quickly when I back off, and then shoot right back up with the next hard effort. But if I try to ride hard before I've slowly worked up to it, I can never get there. So for trainer workouts, I need a long gradual warmup before I can even handle the workout's warmup...

"I'm thinking of a number between 1 and 10, and I don't know why!"
Last edited by: Warbird: May 17, 23 10:02
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Re: Chronotropic Incompetence after COVID [jacksonk] [ In reply to ]
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I know a guy who had this very similar scenario. He was miserable for 2 years and just got a shiny new pacemaker and now he’s back riding and living life again. Go see a cardiologist.
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Re: Chronotropic Incompetence after COVID [jacksonk] [ In reply to ]
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Thanks for the comments and input so far!

I have spent the last 6-7 months just trying to just build my base endurance and can ride up 3hrs with a HR around 95 but sticking to bike paths so effort is not dictated by terrain. Trying to add intensity has really exposed the issue. I do a good 20 minute warm up before the intervals and still have the problem.

I have been a bit apprehensive about seeing a cardiologist thinking I would end up getting $40,000 worth of testing with my $8000 deductible to be told there is nothing we can do about it and just exercise to your tolerance. After hearing that your friend benefited from a pacemaker I may need go ahead and make that appointment.

Thanks!
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Re: Chronotropic Incompetence after COVID [jacksonk] [ In reply to ]
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While not associated with COVID I did have parasympathetic overtraining a few years ago.

Could not get HR up and felt like I was going hard all of the time.

It took 4 months of really easy exercise to get me out of that hole.
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Re: Chronotropic Incompetence after COVID [jaretj] [ In reply to ]
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jaretj wrote:
While not associated with COVID I did have parasympathetic overtraining a few years ago.

Could not get HR up and felt like I was going hard all of the time.

It took 4 months of really easy exercise to get me out of that hole.

It sounds a lot like what I had in high school after pulling a double duty on cross country and soccer teams one year. Had to sit out a full semester of my junior year due to not being able to get the heart rate going at all. It sucked, but I got to read a lot during the downtime.

Next races on the schedule: none at the moment
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Re: Chronotropic Incompetence after COVID [jacksonk] [ In reply to ]
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jacksonk wrote:
Essentially, the inability to appropriately increase HR in response to physical activity and defined as the inability to achieve at least 85% of age predicted HR max on a max aerobic test. I think that I may have it.

I had a relatively mild case of COVID about 9 months ago but have had significant issues with exercise tolerance since. I have been tracking my HR more carefully with a chest strap over the last few months as I have attempted to initiate some more structured training and intervals. I am 54, just prior to COVID during hard intervals on the bike and run I could achieve a HR of 162-168. Now I can only achieve a HR of 124-130 and my average HR during long rides is only about 95-99 yet it feels like I'm riding at threshold pace. My resting HR has dropped slightly since COVID even though I am probably less fit and I frequently have lightheadedness upon standing.

I came a across a few small observational studies on this phenomenon recently.
Article 1
Article 2

I was just wondering if any of you have had a similar experience? If so, did it ever improve and was there anything specific that you did that lead to that improvement?

As of now I am assuming that it is something I may have to deal with moving forward and just try to increase my fitness as able despite this limitation. I feel fine otherwise during the day, it just makes exercising less fun because it never feels good or easy and I can't keep up with my riding buddies anymore.

Thanks for any insights or experiences that you may have.

I gathered what the term meant based on your post, but I never heard of it before. Since your covid case was mild, it would suggest that it didn't cause heart damage? But I'd still get my heart looked at after reading this on pub med:
"Chronotropic incompetence ... is an independent predictor of major adverse cardiovascular events".
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Re: Chronotropic Incompetence after COVID [jacksonk] [ In reply to ]
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Does chronotropic incompetence mean you keep crashing your TT bike in warm temperatures?
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Re: Chronotropic Incompetence after COVID [jacksonk] [ In reply to ]
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Is your "lightheadedness upon standing" accompanied by an increased heart rate? If so, you might want to look into POTS and dysautonomia.
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Re: Chronotropic Incompetence after COVID [jacksonk] [ In reply to ]
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jacksonk wrote:
Essentially, the inability to appropriately increase HR in response to physical activity and defined as the inability to achieve at least 85% of age predicted HR max on a max aerobic test. I think that I may have it.

I had a relatively mild case of COVID about 9 months ago but have had significant issues with exercise tolerance since. I have been tracking my HR more carefully with a chest strap over the last few months as I have attempted to initiate some more structured training and intervals. I am 54, just prior to COVID during hard intervals on the bike and run I could achieve a HR of 162-168. Now I can only achieve a HR of 124-130 and my average HR during long rides is only about 95-99 yet it feels like I'm riding at threshold pace. My resting HR has dropped slightly since COVID even though I am probably less fit and I frequently have lightheadedness upon standing.

I came a across a few small observational studies on this phenomenon recently.
Article 1
Article 2

I was just wondering if any of you have had a similar experience? If so, did it ever improve and was there anything specific that you did that lead to that improvement?

As of now I am assuming that it is something I may have to deal with moving forward and just try to increase my fitness as able despite this limitation. I feel fine otherwise during the day, it just makes exercising less fun because it never feels good or easy and I can't keep up with my riding buddies anymore.

Thanks for any insights or experiences that you may have.

Unscientific (and non-medical person) sample of 1: Some of that sounds like how I was when I became iron-deficient Anaemic and my haemaglobin levels were down - similar age, ended up where my HR wouldn't go above about 125-130 (and I was gaspingfor breath at that, totally blowing out of my arse, even though previously the normal max HR for me was about 178-180 (at age 50 when it 1st happened).
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Re: Chronotropic Incompetence after COVID [jacksonk] [ In reply to ]
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Have you made any progress on your issue? I have exactly the same situation. I can't exactly trace it back to COVID but I have wondered if either COVID or the vaccine caused it. I'm 58 and have always run a pretty low max HR, but last year I started noticing that my actual max HR on the road had dropped but my perceived effort was the same as it had been. I used to max around 158-160 running and 154-155 on the bike, now 140-145 feels like those did and I'm starting to get anaerobic around 133-135. None of my regular doctors (internist and cardiologist) can figure it out and my cardiologist is an ultra runner and triathlete so he appreciates the situation this is causing me. I'm experiencing exactly what you describe - the guys I've always ridden with are dropping me because my heart rate hits the limit and I just can't go any harder. Getting dropped with a 143 HR on the bike is really frustrating. The other day I went out for an easy long run and I had to stop and walk at 130 because I couldn't catch my breath.

I would love to know if you have had any breakthroughs with your situation.
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Re: Chronotropic Incompetence after COVID [JNob] [ In reply to ]
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Your experience closely mimics what I am experiencing. I have always had a low heartrate, but about 12-14 months ago it dropped about 8-10 beats. I am 59, my threshold heartrate dropped from 140's to low 130's. Same for other zones.
Weird thing is, power has dropped but not in a huge way. Just don't have the ability to really ramp it up at the top.

I have had multiple covid19 vaccinations, but to my knowledge I have never had Covid19.
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Re: Chronotropic Incompetence after COVID [jacksonk] [ In reply to ]
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Yep, I had this exact issue. Mine lasted a good 4-5 months. I could still train, but I'm pretty sure my heart was beating 5-10 beats lower than required for the given exercise. In the pool, I felt like I would be drowning on even moderate efforts, but my HR wouldn't be that high.

Mine got distressing enough at one point that I went to the emergency room for persisting shortness of breath (turns out it was probably a superimposed mild virus, likely). I normally have a low resting HR in the 30-35 range, but even with the chaos of the ER, my HR was averaging 26-28 on the monitor. It was so low that even though I insisted I'd been seen by cardiology in the past for low HR, they wouldn't let me go to the bathroom without being attached to a cardiac monitor (which requres someone to roll it to the bathroom with you and monitor it).

It went away by itself gradually at around the 4-5 month mark, I've made a full recovery. Was annoying as heck though.
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Re: Chronotropic Incompetence after COVID [lightheir] [ In reply to ]
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Did you do anything for it like rest, diet, or change your training, or did you just train through it?
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Re: Chronotropic Incompetence after COVID [JNob] [ In reply to ]
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JNob wrote:
Did you do anything for it like rest, diet, or change your training, or did you just train through it?

Just trained through it. I couldn't push as hard for sure though and there were a lot of Strava posts bemoaning my suckdom until it went away!
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Re: Chronotropic Incompetence after COVID [bootsie_cat] [ In reply to ]
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Are you doing anything about or just slowing down by necessity?
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Re: Chronotropic Incompetence after COVID [JNob] [ In reply to ]
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Yes- I recalibrated my zones. That is what I have for now. I don't feel sick and I can still train well. It is just that Heartrate does not hit the levels from a year or so ago.

Not sure if there is anything that can be done about it.I guess I could take a month off or something (and I certainly would if I felt fatigued). But then if my heartrate increases is that from "a true rebound" or " a los of fitness/blood volume?"
Last edited by: bootsie_cat: Apr 9, 24 14:54
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Re: Chronotropic Incompetence after COVID [bootsie_cat] [ In reply to ]
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Thank you. I would appreciate if you would post here if you have any major breakthroughs. I feel like my ceiling just got lowered several feet.....
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Re: Chronotropic Incompetence after COVID [lightheir] [ In reply to ]
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Thanks
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