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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.


Friday, June 20, 2008

Coffee Break


The Heart Beans coffee grinder allegedly grinds coffee to the rhythm of your heart.


The waiting room in the electrophysiology lab at the University of Pennsylvania Hospital is spartan, containing around two dozen double-wide side-chairs (which, to the un-Americanly proportioned, are practically loveseats), a TV tuned to whatever channel carries “Who Wants To Be A Millionaire?”, and a Bunn commercial-grade coffee-maker. This last item is like having an open bar at an Alcoholic’s Anonymous meeting. Above the coffee maker a sign reads “Coffee for family and guests of patients ONLY. If you drink coffee before your EP procedure your procedure will be CANCELLED.”

Fortunately, in my three extended visits to the electrophysiology lab, I spent very little time in the waiting room. It reeks of coffee, a substance verboten to most electrophysiology patients, who are usually putting down pills to slow the heart down.

I, however, continue to imbibe the stuff. I’ve calmed somewhat from the days when I used to boast “sugar and caffeine have made me the man I am”. This, I suppose, is no longer a boast but a warning. Among the bad behaviors I used to practice: doing entire training rides (often of 3 to 4 hours) with only a couple cups of coffee in my system; eating (many) chocolate-covered espresso beans in a race; going to 4 or 5pm in the afternoon on no food, just coffee. I'd like to say I've pulled lots of all-nighters in the architecture studio "grace à café" but when you drink as much as I did by the time the sun goes down coffee has no affect.

I now concoct a blend every morning of ¾ decaf Sumatra and ¼ the genuine article. And I drink 2 cups instead of a gazillion. It works out. My arrhythmia is only somewhat affected by caffeine, and I've been given no specific orders to cease and disist, just a general admonishment to keep an eye on my intake. Thus far I’ve sworn off the juice after each procedure then climbed back on the wagon after my heart settles down from all the poking and prodding in the EP lab, usually in a week or two. In theory I should be in the clear after my final ablation next week. But, in the spirit of Mr. B. Franklin I will aim to be a moderated man.
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