Viatcheslav vs. Chicken Little

NOT Viatcheslav...myself, heart intact, circa 2005...photo: ©Marco Quesada (velocitynation.com)

If there is a paramount of self-sacrifice in the name of sport I am not it. Countless cyclists have trained harder, longer, faster for more years and to more effect than I could ever boast. So why am I saddled with what appears to be the cardiovascular equivalent of a repetitive motion injury?

Dr. Francis Marchlinski has a few ideas. After my surprise introduction to the defibrillator last week, Marchlinski gave me an extra-long bedside consult. In a nutshell: For some cases a cocktail of conditions seem to brew the perfect cardiac storm. First is a genetic predisposition. I have not yet been tested for this anomaly myself, but research currently being done in Italy has linked a certain gene with a predisposition to cardiac scarring. Second is a reason for scarring. Among things that lead to scarring of the heart are viruses and bacterial infections. If one has the genetic predisposition one can end up with scarred heart tissue from a simple influenza virus. Third is the stress an endurance athlete puts on his or her system. Taken as a totality -genetic anomaly, exposure to disease, year-in-and-out physical stress- one MIGHT (and I cannot overly stress the MIGHT) develop an acquired arrhythmia.

Some media outlets have taken this to Chicken Little extremes. A widely disseminated article by Agence France Presse (here carried on the Discovery Channel of all places) almost seems to be telling us to retreat to our couches and TV sets, or else... "Most athletes pay a physical price for their love of the sport, but the ones who engage in endurance sports may be pushing their bodies to the brink of heart failure, according to a new study", we are told. This is alarmist. A more balanced, if a bit technical, consideration of the infamous Heidbuchel study is here.

So who needs to worry? If acquired arrhythmias were solely a function of elite cycling performance then I certainly would rule myself out. I'm not your typical recreational cyclist, but I am not a Viacheslav "Nails" Ekimov - who belted out 400+ mile weeks 52 weeks a year from his debut in the Soviet sports system at age 15 to his retirement from Team Discovery Channel at age 40. I did spend probably too many years trying to "make a go of it" for my level of talent, six years as a New York City messenger, four years of full-time racing, eight years in France, all told it probably amounts to something in excess of 100k miles, but I couldn't be sure. What I am sure of is that I was never particularly smart or cautious about riding while sick or injured. I was a foolish follower of the "Euro-tough" mentality so many competitive cyclists consider nescessary for success. I've ridden through colds and landed myself with bronchitis on several occasions. Is that what set me up for my V-tach? Again, nothing is clear. But knowing what I know now I would certainly encourage everyone to STOP RIDING while sick or over-tired.

Other things: It is certainly worthwhile being alert to any feeling of palpitations or missed beats. There are plenty of opportunities to rule out the possibility of having a dangerous arrhythmia, so by all means take them. It starts with a basic EKG, and for 99% of the population it stops there. Plenty of people have perfectly benign arrhythmias. If you have any doubts, make sure yours is one.

Finally: Be alert to "sycope" (pronounced sin-cope-ee). This is the phenomenon of fainting or nearly fainting. The combination of syncope and palpitations may indicate something more serious. I attributed some rare moments of passing out and frequent near-pass-outs to the low blood pressure that comes with being fit, but it turns out that these were clues to my larger problem.

I would never tell someone not to ride or race for fear of getting what I got. The sport is good, the sport is healthy, enjoy it to its fullest and, for chrissakes, "ne paniquez pas!"