Heart Problem-(VF)Ventricular Fibrillation

Hillside said:

Is anyone out there suffering with this problem(VF) and still managing to ride? Following a heart attack 25 years ago, I was diagnosed with Coronary Heart Disease and subsequently underwent triple coronary artery by-pass graft surgery. Following recovery I took up cycling and have continued with it ever since. Five years ago the electrical side of my heart started giving me problems and I was fitted with an ICD(implanted cardioverter defibrillator), but I still carried on riding. However in the past two months, whilst out on my bike each time, I've suffered Heart Failure(VF) twice. Fortunately the ICD kicked in and brought me back from the brink! :eek:
Does anyone else have this problem and still manage to ride, or is this the end of my cycling? 🙁

Brett Ricchini does. He has a pace maker. He was back racing in the elite division of Triathlon last year.

xbgs351 said:

Brett Ricchini does. He has a pace maker. He was back racing in the elite division of Triathlon last year.

🙂 xbgs351. Thanks for your response, although I don't recognise the name "Bret Ricchini" or what sort of cyclist he is.
One thing though, a pace maker is very different from an ICD. It only helps slow beating hearts, whereas the ICD can deliver electric shocks to stabilise super fast hearts. i.e. Heart rates in excess of 300 beats per minute for example.
So my initial question still remains 🙁

Hillside said:

🙂 xbgs351. Thanks for your response, although I don't recognise the name "Bret Ricchini" or what sort of cyclist he is.
One thing though, a pace maker is very different from an ICD. It only helps slow beating hearts, whereas the ICD can deliver electric shocks to stabilise super fast hearts. i.e. Heart rates in excess of 300 beats per minute for example.
So my initial question still remains 🙁

I haven't seen Brett for a number of years, but his pacemaker limited his heart rate to 180 bpm which was about 30 bpm less than his old max.

Brett is a Triathlete. He was world class in his youth but got hit by a car which smashed up his shoulder. Then he got the heart problem.

There is photo of Brett on this page:
http://www.g-c-t.com/gallery.html#

Here is a good article

http://3athlete.com/cache.php?rid=3650

What's your defibrillator set to?

It's possible that it's set too low now that you're fitter or, if you've had time off the bike then maybe you're not as fit and are maxing it out.

ElRamon said:

What's your defibrillator set to?

It's possible that it's set too low now that you're fitter or, if you've had time off the bike then maybe you're not as fit and are maxing it out.

The defibrillator is set at 220bpm. However on these last two occasions I've tripped it in the high 300's (one was 380bpm. :eek: ) Prior to these episodes my highest rate was in the low 160's and averaged 140/150, as I'd not been off the bike for any length of time over a number of years.

Hillside said:

The defibrillator is set at 220bpm. However on these last two occasions I've tripped it in the high 300's (one was 380bpm. :eek: ) Prior to these episodes my highest rate was in the low 160's and averaged 140/150, as I'd not been off the bike for any length of time over a number of years.

As a cardiovascular tech, I would have your ICD checked. If it's allowing you to get into the high 300's then it has to be readjusted. It is possible that with the exercise, the walls of your heart muscle have thickened slightly. This would mean that you would need a higher coltage on the ICD's initial schock for it to stop the fibrillation. But one question to ask is, how long is it allowing you to get higher than 220 bpm? Is it just a few seconds and then it kicks in, or is it closer to 30? V-fib is very serious, so I wouldn't play around with this. I would schedule a stress test and see if you can induce the V-fib durng the test. You'll get a much clearer look at what's exactly going on between your heart and the ICD. I don't know exactly the nature or origin of your V-fib, but you may want to also look into the option of cardiac catherization. Your fib may be due to a re-entry syndrome. If this is the case, you may want to have the circuit that allows that ablated. The catheterization is invasive, so you may not want to go into that unless it's necessary, but I would definitely book the stress test and have that ICD checked out.

I ride with a pacemaker after suffering heart failure and as far as I'm concerned it need not be the end of the world. You really ought to get it checked out, though. VF is a serious condition, but your doctor might suggest a remedy known as cardiac ablation - this cuts the link between the top half of your heart and the bottom, so that while your atria (the top chambers) can beat away as crazily as they like, the crazy heartrate does not get passed on to the ventricles (the bottom chambers), where such an irregular and super-fast heartrate can do the damage. This procedure does make you pacemaker dependent, but I've not found that too much of a problem. The only trouble is that if you overdo the maximum rate on the pacemaker, it cuts the pace down by half. Mine is set at 180 - if I overdo it, it cuts it down to 90 to stop damage to the heart. This can leave you feeling a little weird for a few seconds, but I've found the fitter I get (on the bike) the less I get to those top rates and the less that happens.

The very best of luck to you.

taras0000 said:

As a cardiovascular tech, I would have your ICD checked. If it's allowing you to get into the high 300's then it has to be readjusted. It is possible that with the exercise, the walls of your heart muscle have thickened slightly. This would mean that you would need a higher coltage on the ICD's initial schock for it to stop the fibrillation. But one question to ask is, how long is it allowing you to get higher than 220 bpm? Is it just a few seconds and then it kicks in, or is it closer to 30? V-fib is very serious, so I wouldn't play around with this. I would schedule a stress test and see if you can induce the V-fib durng the test. You'll get a much clearer look at what's exactly going on between your heart and the ICD. I don't know exactly the nature or origin of your V-fib, but you may want to also look into the option of cardiac catherization. Your fib may be due to a re-entry syndrome. If this is the case, you may want to have the circuit that allows that ablated. The catheterization is invasive, so you may not want to go into that unless it's necessary, but I would definitely book the stress test and have that ICD checked out.

Thanks 'taras 0000' and 'slim jim' for your comments. After each "event" my ICD is routinely checked for any malfunctioning and as at the last check six weeks ago it was working okay. The problem with my V-fib is that it can kick in at any high rate, it isn't a gradual build up and this is why my ICD is set to trigger at any rate in excess of 220, and this it does within a couple of seconds. I had a hospital cardiac stress test last November four days after an "event", and what that showed was that the V-fib is not necessarily stress related. i.e. it can happen at any time and in any situation. In the year 2000 the consultant Cardiac Electro Physiologist who gave me my ICD, ruled out ablation techniques as a solution, as my V-fib is not the result of one particular cause. It's more the general degenerative state of my heart following over 25years of coronary heart disease. The real downside of all of this is that as I go into V-fib I lose consciousness, and as I'm riding my bike, I fall into traffic and end up as a road traffic accident and it's this that might kill me not the V-fib. 🙁

Hillside said:

Thanks 'taras 0000' and 'slim jim' for your comments. After each "event" my ICD is routinely checked for any malfunctioning and as at the last check six weeks ago it was working okay. The problem with my V-fib is that it can kick in at any high rate, it isn't a gradual build up and this is why my ICD is set to trigger at any rate in excess of 220, and this it does within a couple of seconds. I had a hospital cardiac stress test last November four days after an "event", and what that showed was that the V-fib is not necessarily stress related. i.e. it can happen at any time and in any situation. In the year 2000 the consultant Cardiac Electro Physiologist who gave me my ICD, ruled out ablation techniques as a solution, as my V-fib is not the result of one particular cause. It's more the general degenerative state of my heart following over 25years of coronary heart disease. The real downside of all of this is that as I go into V-fib I lose consciousness, and as I'm riding my bike, I fall into traffic and end up as a road traffic accident and it's this that might kill me not the V-fib. 🙁

there seems to be some confusion as to what VF actually is. it is very difficult to give VF a quantifiable rate as by definition this heart rhythm is a complete disorganization of the electrical impulses in the ventricular chambers of the heart. the muscle in essence just quivers and has no effective contraction therefore no cardiac output(blood pressure). Ablation is an option for ventricular tachycardia, but VF is a completely different rhythm... it is not associated with re-entrant pathways as atrial fibrillation is. the ICD is the treatment of choice. when cycling your body has changes in electrolyte balance. these changes especially in potassium and calcium are extremely taxing on the sick heart. you do have a sick heart and i wouldn't term your episodes heart failure, more accurately death! given your history of CABG and then VF i would not recommend cycling....there are many other activities that are lower stress on your CV system. the details of your surgery would be of benifit, what age were you when you had bypass. what is/was the grade of your ventricle, what is your ejection fraction, what is your age now, and which vessels were bypassed. all of this needs to be taken into consideration when looking for advice on this problem... i don' believe this forum is an appropriate place to get this information. Consult your Cardiologist/surgeon.

rippitupp said:

there seems to be some confusion as to what VF actually is. it is very difficult to give VF a quantifiable rate as by definition this heart rhythm is a complete disorganization of the electrical impulses in the ventricular chambers of the heart. the muscle in essence just quivers and has no effective contraction therefore no cardiac output(blood pressure). Ablation is an option for ventricular tachycardia, but VF is a completely different rhythm... it is not associated with re-entrant pathways as atrial fibrillation is. the ICD is the treatment of choice. when cycling your body has changes in electrolyte balance. these changes especially in potassium and calcium are extremely taxing on the sick heart. you do have a sick heart and i wouldn't term your episodes heart failure, more accurately death! given your history of CABG and then VF i would not recommend cycling....there are many other activities that are lower stress on your CV system. the details of your surgery would be of benifit, what age were you when you had bypass. what is/was the grade of your ventricle, what is your ejection fraction, what is your age now, and which vessels were bypassed. all of this needs to be taken into consideration when looking for advice on this problem... i don' believe this forum is an appropriate place to get this information. Consult your Cardiologist/surgeon.

hi rippitupp. from your comments you seem to be one of the few who have an understanding of my situation. to answer your questions... age at bypass- 34; grade of ventricle-don't know; ejection fraction-<30; age now-59;vessels bypassed-circumflex and two others which i don't remember names of. what other activities would you advise? yes, i do consult my cardiologist and all he recommends is to do what i feel comfortable with.