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.
Saturday, January 10, 2009
Extreme Cardiac Rehab
After my ICD implant and second ablation someone (I don’t remember who) suggested that I sign up for “cardiac rehab”. I’m not all that familiar with cardiac rehab, and perhaps someone who is can tell me differently, but from a brief investigation I concluded that it involves mostly daintily pedaling a stationary bike, perhaps lifting some purse-sized weights, touching toes and the like. I felt that, despite what I’d been through, perhaps cardiac rehab might be a bit, um, basic.
My version of cardiac rehab began as soon as I could move my left arm over my head again, about six weeks after ICD surgery. Basic fitness returned pretty quickly. I got back on the bike and went from a barely catatonic 45 minute-ride to a sprightly three-hour jaunt in about two weeks. That lasted for a month or so until it all broke down again as my condition deteriorated into September. Finally, three weeks after my third ablation , with the heart beating like a Swiss watch (sort of), I resumed a right proper training regime: Extreme Cardiac Rehab.
For six weeks beginning the first week of November I ran or rode every day. My minimum run was half-an-hour, the minimum ride was one hour. Most days that was all my schedule would allow; occasionally -once I got some miles under my belt- I’d try for 2 to 3 hrs. The idea was to get my heart used to a light endurance load; nothing like what I used to do when I raced, just enough to spark a training effect and put these past months of neglect and deterioration (some would say care and recovery) behind me.
This was as much a mental exercise as a physical one, to prove to myself that I was fixed, and to gauge my “new” heart’s ability. In the darkest moments of the past months I felt as if I was never going to be able to do more than walk up a flight or two of stairs, and I should learn to be happy with just that. Now it seemed that I might have a whole heart again I wanted to use it as much as possible.
The other goal of the six-week Extreme Cardiac Rehab program was to get myself prepped for a return battery of testing, the one I failed so miserably last time . Approximately eight weeks after an ablation they call you back in to run the treadmill, and get knocked out and electro-stimulated – the dreaded NIPS test. I wanted to arrive at that day with “confidence in my heart.”