Supraventricular Tachycardia (PSVT) and Running

Hi Jan, and thanks for the post! My real name is Frederick; I've adopted Fritz in honor of my father.
Since I wrote my story, I did manage to run two more marathons. My goal was to hit 70 by age 70 and then do 1 per year. I got up to 76 but had to stop. The SVT became more and more frequent in both running races and when training. So much so that an activity I loved over the years became painful and tiring. Long runs (20 miles) took 4 hours and I had to walk frequently. I rarely reached the point where the long run did its job. I think I believe the SVT diagnosis, although I often thought of getting a second opinion.
Unlike your situation, I have never had an episode during any activity other than running. I was prescribed Metropolol which would act as a "governor" on my heart and was to take a dose one hour before running. It did work as a governor, all right - so much so that I could not really train; my pulse could not get above 120 or so and I was accustomed to a high of 140-150. I was never told of any other remedy like the ones you mentioned and never heard of a pacemaker for runners.
I am now 78 and have given up any serious running. I do walk/run for up to 8 miles, but limit the length of the run portion to about a mile, but usually .25 or .5 mile.
The only other remedy I've heard of for our condition is ablation; the doctors do not recommend that for me and I'm not interested in taking the risk.
Again, thanks for the reply; I hope you find a solution for your issue.
Fred H

HI Sue
Thanks for your reply; it's encouraging.
I might have a cardiologist. I am part of a club here in Toronto, and a few are of my age. One of my friends has indeed a heart issue, and I have the contact of his cardio. Also, his partner is an anesthetist who explained in detail the issues listed in my first report, and this helped a lot. Not out of the woods, but it sounded less depressing than when I first came out of my consultation.
Keep you posted

Thanks

Jan

My friend who was a distance runner was having bradycardia issues when he was in his 40's, and got the same reaction from his cardiologist. He joined a local "senior" running club to connect with other long-time runners with the idea that one or more of them must have found a sympathetic cardiologist - and it worked!
He found one who was a runner & coach, and they worked out a safe training plan for him. He was also able to find a new cardiologist through networking when he was transferred by his employer. He was monitored every 3 months by both docs.
The good news is that it got him 10 more years of running - and is still active playing golf and travelling in his lates 70's. The bad news is that eventually he had to give it up because there were too many faulty electrical signals in his heart. but because he was monitored carefully, the outcome was a happy one.
Can you find a running group or gym where you might be able to connect with a sports-minded cardiologist?

Hi Sue
Thanks for the recommendation, but I have a follow-up question. I am an avid runner and have about 13 marathons under my belt so far. I am in the process of getting checked out what causes my palpitations, which seem to come and go unrelated to my training. (currently carrying a heart for 14 days and scheduled for an MRI). My issue with my cardiologist is that he, in general, doesn't understand running at this level (I did a treadmill test, which was a breeze), and I would like to find a solution that allows me to continue as long as possible without limiting me in the sport I love. I understand that safety comes first, but trying to educate myself as much as possible so I can ask the right questions at my next consultation. the results of my last holter (14 days in dec) was as follow :
1) Sinus rhythm with the average heart rate of 51 bpm (min 31, max 142 bpm), 52% of bradycardia.
2) Occasional ventricular premature beats - 388 isolated, 2 couplets and 5 runs of nonsustained ventricular tachycardia - longest 12 beats long @ 150 bpm and fastest 6 @ 187 bpm.
3) Rare supraventricular premature beats - 8 isolated and 4 runs of atrial tachycardia - longest 6 beats and fastest
4 @ 124 bpm.
4) There are 77 episodes of long R-R intervals due to sinus pauses, 17 of them are (> 3 seconds) and the longest pause lasted for 3.71 seconds @ 8:29pm.
5) The patient reported symptoms of palpitation, correspond with sinus rhythm/bradycardia, one of them right after a short run of ventricular tachycardia.

regards

Jan

Hi Fritz, (I assume)
I am 58 and training for marathons, too, so I am very interested in your post. Over a few years I had sometimes had heart palpitations, but last summer, during a hill training, my HR went up to over 200 and didn't come down till 30 minutes later; however, I have not yet been able to determine what that cause is, it could come up even if I am relaxing on the couch or just walking in the park. This summer's event was the moment I went to see my doctor, who, after a 48h holter test, didn't think it was too concerning (she mentioned Afib and Ventricular tachycardia) but put me through to a cardiologist and there I have been put on a treadmill, had an ultrasound and two weeks holter. This cardiologist was still unsure what my issue was so I am back on a holter for two weeks and scheduled for an MRI. During my last consultation, we discussed medication, but with a low resting heart rate of 42, it seems to be problematic, but also potentially a pacemaker. Have you had any of these suggestions? Have you heard of pacemakers for runners, and if they can still exercise to the same intensity? Cheers, Jan

I appreciate your suggestion. I already have an appointment next week with cardiologist and decide not to go to this marathon.
Last month (before discovering SVT), I practiced more than 30 km for three running and have no problem with it. Your warning is valuable and change my view for long running. I won't run more than 10 km if I don't have opinion from cardiologist. Thank you so much

Welcome to Mayo Connect - I do have a recommendation, if you have a cardiologist this is a question for them. If you do not, you probably should consult one before you undertake your first marathon.
There can be a number of causes for SVT, and exercise is still an excellent idea when you have it. A marathon (especially a first time) is not "exercise" - it is a great stressor of your body. Changes such as pushing yourself, electrolyte changes due to long distance running, possible dehydration, fatigue, etc could bring on an episode - which might bring you down in a crowd.

My recommendation is that you get cleared by a cardiologist before you try a marathon.
Sue

I just know I have SVT and I plan to have a first marathon in November 2022. I have no any symptoms of chest pain or palcipation. I can run with pace 4 or 5 for quite a long time (20 km) with no difficulty since I can still talk and sing along the running journey. If you have any recommendations, I would love to hear

Yes, I have exactly what you describe and it, also, is called SVT, I was, also, a long distance runner (much to my joy of just doing it)...I especially enjoyed running at night under a clear and star blasting sky, I no longer do it much to my sorrow.

Now I have a fully expressed MS but it is being called Secondary Progressive MS...I can't even walk without falling especially if I must do a quarter turn or bigger. No running now but, even with aided walking, I still have SVT. The most rapid it has been is 120 bpm. I have no idea what to do with it, either. It is constant, too. The VA had me wear a heart monitor and that has proven to be worthless.

In fact, before all this started, my then husband and I worked very hard to avoid readily apparent deficits. We were successful for probably 15+ years. Then I fainted exiting an elevator. The consequent MRI showed white matter plaques. I ignored that and began fast walking with the same SVT problem.....

But now at 82 I am tired all the time, often exhausted, and still expected to do the jobs I have done all my life. I try but am not successful. Frustrating.

What about you?

Hi everyone. I have recently been having investigations into what I believe may be SVT. I have frequent episodes, usually in the evening, where my heart rate hits about 130bpm and I become very breathless and lightheaded. I often feel wiped out afterwards. I have had the following tests: 24 hour holter monitor, echocardiogram, stress echocardiogram, barium swallow, ct pulmonary scan, chest xray, ct angiogram, 7 day holter monitor and a couple of emergency room ecgs. When I wore the holter monitor for a week, I had a great week (of course) with only one episode. My cardiologist said that my heart beat was a perfect sinus rhythm and that when I had the episode, the chambers were beating in correct sync and he doesn't believe I have SVT. I feel like my symptoms are very much like SVT and my GP suggested that it could be. The symptoms came on very abruptly about three months ago and it coincided with quite a big night out with colleagues, we drank way too much champagne (teachers at the end of term after remote learning). About a week after I started to notice the symptoms. My GP did say that a big drinking session can bring on SVT. Can anyone provide some insight into my symptoms, causes and whether or not this can be cured. I am on calcium channel blockers and they seem to help but I feel awful. I am experiencing slight symptoms on them most days. Thanks in advance.