V-tach: Treadmill Redux

Welcome

My name is Craig Mitchell Cook. In March of 2008 I began treatment for idiopathic ventricular tachycardia, a potentially fatal heart arrhythmia whose cause is unknown. I was fit and healthy, having spent a good part of my adult life as an elite cyclist, much of it racing in Europe.

V-tach, ventricular tachycardia, is the most obvious, and lethal, symptom of my condition. There are a number of diseases and diagnoses that are near matches to my condition, the closest being ARVD/C (Arrhythmogenic Right Ventricular Dysplasia / Cardiomyopathy). Indeed many doctors would classify me as an ARVD/C patient, yet I lack the genetic basis for the disease as well as the structural anomalies that accompany ARVD/C, and my condition has shown no indication of being progressive (yet).

There is a growing population of current and former endurance athletes throughout the world at all levels of sport have exhibited similar symptoms to mine. Some have been diagnosed with ARVD/C, others have run a gamut of varying diagnoses differing from cardiologist to cardiologist and electrophysiologist to electrophysiologist, some have not survived their symptoms. These acquired arrhythmias require different scales of intervention, none of which necessarily match another. I, for one, have undergone numerous procedures and currently sport an Internal Cardioverter / Defibrillator (ICD). Other athletes I have been in touch with have had wildly different treatments and results.

There is a growing body of evidence that would seem to support the hypothesis that endurance sports might have a long-term negative effect on the healthy operation of the heart. While the jury is very much out on this point, the subject is worth more study than it is currently afforded, and the tendency to lump endurance athletes with ARVD/C mimicking symptoms into the ARVD/C patient population is potentially ignoring the very real likelihood of a different, as-yet named non-genetic, acquired condition, apart from ARVD/C.

This blog is written as a resource for athletes with acquired arrhythmias, as well as anyone about to undergo endo or epi-cardial ablation, or the implantation of a ICD. It is also written to help generate some critical mass of interest in support of further research into acquired arrhythmias in endurance athletes and others. Feel free to contact me through the comments page if you have any questions or wish to make a written contribution to this blog.

Tuesday, April 29, 2008

Treadmill Redux

The day after ablation and all is well in the world. Except that Marchlinski has ordered me back on the treadmill. It seems a bit soon after seven hours of cardiac cath., 24 hours with no food or water, and a fitful, uncomfortable sleep. But Marchlinski can do no wrong so I oblige. Afterall he is excited to test his work, and I am excited to prove myself fixed.

The treadmill looms large, This time I fear it. The resistance is ramped up. We get to eight minutes -the point at which everything came crashing down the last time. I cruise right by. The heart rate hits 150 without trauma, I do 12 minutes, the doctor in charge asks me if I want to continue. Feeling out of the woods and anxious to prove it, I say yes. We plod on. At 14 minutes I am at 163. There are PVC's on the EKG readout but nothing terrible. The doctor says it's my call, whenever I want to stop. Just because it is so good to be in control of myself once again I tell him I'll go to 15 minutes. At 15 minutes they shut the infernal thing down. I've reached 172 bpm with no V-tach.

Marchlinski comes by for a consult. He's highly pleased. But there are two caveats. First: because of the speed of my V-tach, and its ease of trigger with adrenaline, he is not recommending an implanted defibrillator until he knows more. He wants me to go home, resume life for three weeks, and come back for another electophysiology catheter study. In the meantime it is Beta-blockers and no exercise.

The other caveat is that I might not be fixed. There are areas on the outside of the heart which may not have been properly ablated but we won't know until things rest up and heal. So the return visit will determine that status. I'm so happy I did so well on the treadmill I can't imagine that I'm not fixed. I make a mental note to start some light exercise as soon as I feel up to it.

1 comments:

Quadzilla said...: I'm amazed they didn't just water-board you at the end so as to complete the Gitmo experience. You were so close!; May 23, 2008 6:02 AM