If you sprint, does HR stay in that 145ish range?

Besides the “sticky hr” it sounds like you might either have some sickness still in your body and that’s causing the elevated HR, or maybe just a but untrained still

It seems strange to say since you bought a new one, but maybe the HR strap could be wonky too?

This would be a good one for Dr. Toce.

I had a *very* similar thing after my first two rounds with COVID. I wound up taking it very gingerly for a long time as it seemed like a chance of post-COVID myocarditis. Seemed to only resolve after 6-8 weeks of putting a very hard HR cap on for any exercise and sticking to it.

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Tbh I haven’t pushed much. But I do know that prior to this there are some small uphills that I could easily get the HR up 15 beats, and up these same sections there is not an appropriate reaction even from the now higher base

I’ve tried an optical, the polar, the wrist based (I know not all that accurate) and simply counting beats manually and have not found that any of those produce a different result

I’ll ping him.

I really don’t have a way to cap anything. If I walk hard to get over 115 or so even uphill (I mean I guess I could walk harder). When I “run” can’t keep it below 140. There’s literally no in between

sounds like some of what you describe is typical post covid (or any viral illness) hit to your fitness-happened to me too and took over 3 months before my resting HR came back down to normal and my top end fitness was just terrible...

for most athletes recovering from covid, it seems the recovery is quite variable, but some of my patients have struggled up to the 6 month mark, even with mild not severe covid (as evidenced by pulmonary sx etc)

some patients do have myocarditis or cardiomyopathy and never know it--I've done lots of echo testing and see it (DCM-dilated cardiomyopathy=weak heart muscle) more frequently than reported-as with most viral myopathies, recovery usually occurs with time and treatment

your HR going up and staying sounds more like it may be an arrhythmia than just deconditioning though-do you own a Kardia mobile device?
May need to wear a monitor--



FTR, I do believe it's best NOT to push intensity during recovery from all illness but moving in any way is certainly ok

try the TM-
at least with that you can vary speed and incline to find if there is a sweet spot in between-but as I noted, you may need an echo and monitor of some sort...

Curious, did you get vaxxed?

Physician here and sometimes coach (don't need the money so I'm pretty picky who I take, usually para-olympic athletes).

I've tested a number of athletes with similar symptoms utilizing a metabolic cart and lactate meter. So far the symptoms have all been due to lack of fitness. Given the layoff you had I'd suspect the same.

I did take time off but was running off and on in December and started more regularly in Jan - Feb. I just wasn’t on any formal training. Two days before I got sick i ran over an hour at ez pace at 125 bpm average. 2 weeks later 145 bpm ave

Curious, did you get vaxxed? //

A good question because the morons that didnt get vaxxed certainly have much worse outcomes with covid, especially athletes getting stuck with long covid. But pretty sure Chris is one of the smart guys, like most here and got most if not all of the vax's that were on offer.. But even with all on board, covid has been a slippery virus, and the long version of it is way more common and debilitating than was once thought. Thanks for the reminder for everyone to get vaxxed, it is the single most important thing you can do to help prevent this shit from happening...

That's unfortunately misinformation. I wish it weren't so.

https://www.ncbi.nlm.nih.gov/...rticles/PMC10143044/
"Thus, vaccines alone are incapable of slowing the pace of evolution of immune evasion, and vaccinal protection against severe and fatal outcomes for COVID-19 patients is therefore not assured."

From what I understand the data shows the following characteristics are the most protected (not necessarily in particular order):
1. Low BMI
2. High Physical Activity
3. No Alcohol or other immune imparing drugs
4. Young
5. Above average vitamin D levels
6. Vaccinated and Boosted, with a possible negative immune response to more than one booster.

The benefit if you're in group 1-5 combined is already so high that the added boost from vaccination and boosting has no evidence of improvement. It's entirely reasonable for a person who prioritizes natural solutions, where appropriate and possible, to rely on that. Stastically if a person is in groups 1-5, their risk from covid is so incredibly low we don't need the hyperbole of disaster-blaming or insults.

Now, you can't suddenly choose to be young, have low bmi or undo a Lifetime of alcohol/drug induced immune damage. It makes perfect sense to depend on vaccination as one of the key factors to immune health, as that's also where the evidence suggests. (Risks and side effects of vaccination play more of a role in that 1-5 group person as at some point the scales start to equalize in risk of side effect injury vs marginal benefit gained).

But as I suggest, it's entirely reasonable for a person in the cohort with higher risk factors to receive a greater benefit from vaccination.

The suggestion that those opposed to vaccination for themselves are exacerbating this mess is unfounded. Indeed, if you want to point fingers evidence actually shows super spreaders are old and have a high bmi:
https://sph.tulane.edu/...id-19-super-spreader

Annecdotally, which could explain why I shared a car with 3 coworkers across country with covid (didn't know till after and this was before vaccination roll out to younger groups) and no one got sick.

I wasn’t going to address the question as, for better or worse, I didn’t take it as a sincere inquiry but a chance to derail into vax arguments, as already demonstrated here. If the poster did have a sincere interest, my apologies but not my first day on the internet.

Suffice to say IMO the timing that issue has a very low relevance here to me. I make all health decisions based on discussions with my GP.

At any rate. I was able to get a Kardia device and have several (probably … likely…. too many) readings. Mix of “normal sinus rhythms,” “possible a fib,” and “unclassified.” So, at least mentally I’m no further along (in reality behind)

I read about people being “in a fib.” What is that? High HR? Pounding? I have not noticed anything other than the specific HRs indicated in my post and even then I don’t feel anything. Haven’t experienced any racing or pounding HR incidents

It was me who asked and I did NOT have ANY ill intent.

I understand and appreciate it is truly none of my business, but I was genuinely curious.

I’m tolerant of people doing what’s best for them, vax or no vax, this is one thing that is really missing in the world, no tolerance for anyone or anything if they don’t agree they are just “morons”. Why can’t I be vaxxed and accept others that deem its not for them? Or the other way around?

Anyway, I hope you get it sorted, and all the best.

Thanks. I was vaxxed fairly early and have done a LOT of racing and training since that time incl an Ironman, two half’s and two long course swim-runs last year and have had none of these symptoms. I did have one booster last year but my history indicates it’s much more likely to be the recent illness - which literally flipped a switch if you compare my HR from the day before to every run since- than any vax effect

OP -

I had a similar situation. I tested positive in Nov'22. Went through the 'very ill' and 'basic recovery' phases in roughly 2 weeks and when I tried to return to very easy exercise I went through similar things. Not only that, but just moving around the house, going from sitting down to walking around, I could feel that my heart rate was very elevated compared to normal. Example, going from sitting on the sofa to standing up to walking up 8 steps - my heart rate went from mid 50's to 130. A month before getting covid, for reference, I was doing easy running around 7 minute pace in the low 120's for heart rate, and was not in particularly great condition at the time. When trying to run after covid, I was literally running slower than I ever had in my life, including after long layoffs, and my heart rate was far elevated beyond normal easy pace running. When I get sick, I tend to get very ill. Always been that way since I was a kid. I've come back from illness and felt the 'I'm unfit now' feeling more times than I could count. I am not a doctor, I will not pretend to understand the mechanics of why this happened, but what I was feeling was not simple aerobic deconditioning. Any athlete who has had this feeling after covid will understand what I mean.

The way I described it was, like my heart is trying to beat its way out of my chest for no reason. Chopping down a Christmas tree with my wife in early December had me quite literally huffing and puffing, which is far from typical for me. My doctor referred me to a cardiologist, who did ekg / echo / 48 hour HR monitor, with no significant findings (besides athlete's heart). I repeated the echo a little over a year later, again with no other findings.

What I did was basically no intensity besides swimming (even that was very limited) for 6 or 7 weeks. Eventually, the heart rate came down and things went back to normal.

For more info, check out the 'Covid is kicking my ass' thread. Others in that thread have longer bouts of this than I had and there are many more anecdotes there.

Hope this helps.

Saw the cardio yesterday. Dx of atrial flutter. Never even heard of it as I'd convinced myself it was afib with the Kardia device, and communicating with dtoce.

EKG showed otherwise. Atrial flutter, upper atria beating at 300 bpm, lower at 80. Cardiologist basically (politely) washed his hands of me and sending off to an EP.

So now I am sucked back into the US medical system, working the phones and trying to get earlier appts than July. I've a request into Dan's expert Dr. Buch at UCLA, apparently he runs a screening process to determine if he will see me or not. Wondering if I will make the cut. I have other local EPs I'm trying to get into as well. Just want to get this done and move on with my life, as the recommendation is super easy workouts, at most.

All told, other than having to cancel a dive trip to the Philippines next week, and Casco swimrun, I guess it could be worse. Ablation is supposed to be very effective at curing atrial flutter, so hopeful that will take care of it, whenever it occurs.

Sorry to hear this Chris, this heart stuff can be a real where's Waldo in trying to figure out exactly what is going on, and then what to do about it. I think Dan's guy has done him good, I got to LA cardiology in downtown LA, they are all pretty good there too. Let me know if you need a name there, and of course one to drop...(-;

ChrisM wrote:

Saw the cardio yesterday. Dx of atrial flutter. .

so A-flutter is sort of like a variant of afib-it's just a tiny bit more organized and somewhat easier to fix with ablation Rx

good of you to follow through and get the monitor which clearly showed the arrhythmia and you knew something was wrong when your HR just kept 'pinging' 140-which was likely atrial flutter with 2:1 block, like I saw in your strava files

I just wish you could get the cardioversion for short term Rx early then they can debate on meds and definitive long term Rx with ablation therapy (which is 90% long term effective); and cardioversion is like ~95% short term effective (closer to 99% in my practice)


because it's like afib, you should re-read the afib thread and my last comments...
https://forum.slowtwitch.com/...athlete._P7696945-2/

as always, I wish the system was better, but it is what it is and you've got to be forceful to get what is needed sometimes---get your wife on it-
general cardiologists now do more clinical cardiology and do less procedures like TEE, cardioversions etc now-times change


I'd consider a second opinion for someone who could do a TEE/cardioversion as a combined procedure. We do them all the time here in CT, which I know is behind the times usually, but may not be the case IRL RHRN

I think in a perfect world and I could get into an EP quickly, I might say sure let's to the cardioversion and see if it works (although maybe it's not the same, I was reading that I would be completely under, so raises other issues of two procedures if the ablation has a great chance...) But in reality, it's going to likely be weeks even with working the phones before I can see an EP to discuss the options, so my view is sorta let's just fxcking get to it. Unless, of course the EP recommends a different approach.

I'd be curious to know what the mechanism is of a 2:1 block that causes the HR to rapidly accelerate yet stay in a narrow zone. In my old recording studio days, I'd say the HR was compressed bottom to top.

At any rate, you are a huge benefit to this site, and I'm grateful for the resource, remote tho it is.

Your name is good there?? :) I've got three irons in the fire, a local guy that is in my group that I saw years ago, Dan's at UCLA and one at Cedars. Could always use another if you want to shoot me the name, increases my odds.

The cardio took one look at the EKG and said "oh you have atrial flutter." Having gone thru issues before with dx, I was actually quite pleased he was able to ID it so quickly (assuming it's correct). Much different than my 8 week saga over multiple docs trying to find my pulmonary emboli 14 years ago...

the jumps occur because the AV node is the 'gate keeper' of the HR for the heart

AV block with atrial arrhythmia occurs in clumps with atrial flutter--2:1, 3:1, 4:1 are most common--so

when the top chamber is going 280-300 bpm, the AV node slows it down inherently *(normally I would impress people with cool words like decremental conduction...but whatever...) and you'll see actual heart rate (ventricular pumping response) of 140-150 for 2:1, 95-100 for 3:1 and 70-75 for 4:1 block

and there will be jumps in the HR from 70>95>140

and because you were in persistent atrial flutter, you would increase your HR to 95-100...then jump to 140

oh, and please tell me someone did CHADSVASC and decided on whether AC is needed or not............

With a couple google searches and a small brain, I think so!

So the ":1" in the ratio is the readout on the HRM as I am understanding it. Atria going at 280-300, ventricle reporting at 140-150....

Actually very interesting and explains a lot

yes


you are learning Daniel-san

LOL... Well i you stop talking all doctorly this process might go faster