In March of 2008 I began treatment for a potentially fatal heart arrhythmia whose cause was 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.
After 5 years of fence-sitting on the part of my doctors, I have been given a diagnosis of ARVD/C (Arrhythmogenic Right Ventricular Dysplasia / Cardiomyopathy). I lack the known genetic markers for the disease as well as some of the structural changes 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 who end up with acquired arrhythmias, and a diagnosis of ARVD/C. But by placing these athletes in the ARVD/C patient population, we are potentially ignoring the very real likelihood of an acquired condition, similar, but different, 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
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.