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  1. #1
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    Cardiac concerns later in life...

    Recently, a discussion amongst a number of us older riders of the Mendocino Coast Cyclists got going after a recent article in Velo news regarding arrhythmia.

    Cycling to extremes - VeloNews.com

    As we have several biking friends here in our small community that have experienced similar cardiac issues; could the medical professionals weigh in here?

    I found the article interesting, but fear that this could put a damper on my level of exercising. I ride three to four days a week for 3 to 5 hours at a modest pace. I do not race, but enjoy the push on the climbs. Climbing here on the coast is a fact of life if one wants to go for longer ride of 15 to 20 miles with 2,500' feet of elevation gain per ride.

    I'd like to hear more from the biking medical professionals or exercise physiologists in our greater biking community ​who could bring some objectivity regarding this article. I, too, may be in denial...

    I do not see most of us pushing the envelope that these higher level athletes mentioned in the article. Does stress bring on these conditions as well? Can others who are somewhat fit continue to exercise at their current level employing a modicum of common sense? What is obsessive training, versus dedicated training regime or even intermittent training (unscheduled training regime)? It is a given that the heart muscle needs exercise. At our average ages (mid sixties) what is considered healthy exercise versus excessive?

    Please contribute your thoughts. Maybe this is a chance to bring about a degree of objectivity in our dedicated biking lives.

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    Not to be facile at all, I just don't worry too much about such things. I'll never train to death because I'm a bit lazy and have lots of things I do. If I am pushing too hard, I can feel it. I might get light headed, especially in the heat, or just feel like my head, heart, etc is working too hard and take a rest.

    If something sudden and unexpected does kill me on the trail, so be it. Better than almost all the alternatives. Just don't let it be a mountain lion. Now there's something to worry about.

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    Agree, it's not hard to keep your heartrate at a reasonable level for your age. Better to be going at it a bit that sitting on a couch letting all the chronic conditions of old age creep right in unabated. Your body tells you all day long if you're stressing it too hard, don't need a scientific report by an armchair genius to keep yourself five by five.
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  4. #4
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    Yeah, I had some bouts of atrial fibrillation on my last two big--60/10K and 57/6K--mtb rides a few years ago. I just rode 30/5800 in Ashland last week with no problem, but, luckily, I'm more interested in jumping and technical riding now. It doesn't take 8+ hours of that to feed my fix!

    My advice: Check with your doctor, keep up with the research, drink quality beer, and do what you need to do so that you can ride for as long as you can.
    Last edited by dirtvert; 07-31-2015 at 10:20 AM.
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  5. #5
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    I am not a physician...but I work at a medical device company that has developed a device for use in electrophysiology procedures (arrhythmias). As an old guy (49) I've been following the discussion about this topic for a few years now. Sadly, like most medical things, there really isn't a straightforward answer other than the vague: everybody has a 'too much' whereby excessive amounts of exercise can be harmful, but it varies from person to person based on factors no one really understands yet. One person who exercises 2 hours a day is fine, the other one develops a-fib or something. From a public health perspective, *too little* exercise and activity is still a bigger problem than too much, but that is little relief to someone who is already active and wondering "is this too much?" And it's also worth noting that there are still debates in the medical community whether there is really a connection between a-fib (for example) and excessive exercise; and as we all know when the experts are still debating that is a sign that people still don't really have things figured out. And there is plenty of a-fib in patients who are obese, inactive or who have hypertension, etc.

    My advice though is that if you are exercising and older, it wouldn't hurt to get a cardiology evaluation. A former work colleague started a practice in San Francisco dedicated to cardiology in athletes, called athletic heart SF: Athletic Heart of San Francisco | The Center for Cardiovascular Health. There are probably others who have similar specialization.

    Good luck.

  6. #6
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    I started getting a-fib last year. I noticed it when I was sitting calmly in the evening, or even when I was sleeping. I haven't noticed it during exercise, but sometimes I'd get it in the evening several hours after a hard workout.

    I take a half dose of a beta blocker now (atenolol), and almost never get a-fib or tachycardia. I often ride with a HR monitor just to be sure.
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  7. #7
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    Time will tell

    Thanks for posting this. I saw the article and debated whether or not to start a thread around it.

    With seven years of, at least, six events annually, consisting of 8, 12 hour and hundred mile endurance races, beginning @ age 49, I'm probably to some degree at risk. To date, I haven't had any cardiac symptoms and I count my blessings for that. A number of my contemporaries, have been profoundly injured or wound up with now life long health problems from pushing well beyond what is prudent in these types of events. Pancreas' and kidneys don't take too kindly to this kind of fun and frolic either

    As the writer states, time will tell what the long term consequences will be.
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  8. #8
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    I did a shorter ride today......

    read that too, thanks JMS !

    you got me freaked out man........

  9. #9
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    I'm not sure that if my doctor told me I was not healthy enough for mtb or sex I would be satisfied with puttering around.

    I'll go ride.
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  10. #10
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    Cycling to extremes

    Quote Originally Posted by RooHarris View Post
    ...I ride three to four days a week for 3 to 5 hours at a modest pace. I do not race, but enjoy the push on the climbs. ...
    You are not "cycling to extremes." Your heart will let you know if you are overdoing it. Try a HR monitor once in a while to see where you are at.

  11. #11
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    I have this discussion going on our listserve at the moment. One of our club members (name deleted) chimed in with the following:

    Roo,

    I have expertise in exercise physiology and personal experience with the issues covered in this interesting and potentially concerning article. At 63 years of age, I have been a serious competitive endurance athlete for the past 48 years, first as a runner, then a competitive triathlete and cyclist for the past 35 years, including many 24 hour races and frequent all day hard and fast rides over all of those years. Over the last few years, I developed episodes of dizziness and weakness during rides, which gradually became more frequent and severe. Finally wearing a heart rate monitor, revealed heart rates of greater than 250 by the monitor, but a much lower actual pulse rate, which was far weaker than normal, during these episodes. As best as can be determined, these are episodes of V tach, as described in the article, where the heart cells fire rapidly, but the heart can't respond with appropriate coordinated contractions, resulting in poor blood flow.

    In discussing this problem with dozens of fellow masters endurance athletes, many report suffering from similar events. In researching the topic, it appears relatively common in endurance cyclists. Years of endurance riding, intensity of usual riding, and increasing age all appear to factor in. I have researched this topic extensively and I believe the VeloNews article covers the topic well, based upon current knowledge. Most of the reports in the literature cite cyclists with a racing history and relatively high volumes and intensity of training. I ride with many older fit riders, but the only ones who have reported arrhythmias to me, have fallen into the very highly trained racing class.

    As the article states, anyone who suspects that they may be experiencing symptoms of arrhythmias should be evaluated. It appears that those with a lesser cumulative endurance exercise history, may be at less risk of developing this problem, even though they may be currently be exercising at a relatively high level and duration at an advanced age.

    In my case, I was consuming high amounts of caffeine, getting 5-6 hours of sleep, and often riding hard and long on consecutive days. For the last 15 months, I have had no caffeine, increased my sleep, rarely ride 2 hard long rides in succession, and am very careful to maintain good hydration throughout my rides. All of these factors are thought to be potential contributors or triggers of cardiac arrhythmias. Since these changes, I have gone from weekly episodes to only 2 in the last 9 months.

    As older athletes, besides avoiding excessive exercise (whatever that may actually be) good rest and recovery ( and not crashing too frequently) are probably the best things we can do to avoid an adverse impact on our health from the activity that we all love. Unfortunately, we are largely pioneers in this area, as we are venturing into levels of physical activity and endurance fitness that past generations didn't approach at our age, but at least we can enjoy the ride.

  12. #12
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    Quote Originally Posted by Berkeley Mike View Post
    I'm not sure that if my doctor told me I was not healthy enough for mtb or sex I would be satisfied with puttering around.

    I'll go ride.
    I hear you bro...!

  13. #13
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    Quote Originally Posted by RooHarris View Post
    I have this discussion going on our listserve at the moment. One of our club members (name deleted) chimed in with the following:



    In discussing this problem with dozens of fellow masters endurance athletes, many report suffering from similar events. In researching the topic, it appears relatively common in endurance cyclists. Years of endurance riding, intensity of usual riding, and increasing age all appear to factor in. I have researched this topic extensively and I believe the VeloNews article covers the topic well, based upon current knowledge. Most of the reports in the literature cite cyclists with a racing history and relatively high volumes and intensity of training.
    I think key here is "based upon current knowledge." My sister is an ER doc and tells me everything is constantly changing. How they treat patients for a heart attack in the ER is entirely different than 10 years ago. The bottom line is that if you are having issues, see a cardiologist and make sure they are up on the latest literature and research on the subject.


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  14. #14
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    An easy thing that helps is to cut out (or greatly reduce) caffeine or any other stimulant (even large quantities of sugar). Sometimes there are triggers that get the heart started in arrhythmia. Poor sleep can be another contributing factor.

    It's not easy getting old
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  15. #15
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    Haven't read the story yet. But last year, my roommate for an Arizona trip was Lennard Zinn. He said he was going in for a heart operation after the trip as his heart would race out of control during very hard efforts.

    Anyway, he talked to me for hours about the subject and he said the problem is very real among elite athletes. They are old, very fit and mask any underlying issues until they just die.

    Anyway, I'll read up and check in later. His operation was unsuccessful as they tried to burn all the bad circuits in his heart that were causing the short-circuits. So he has to slow down. Page 1 Strava to to page 20 in the hillclimb standings from here on .

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  16. #16
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    Quote Originally Posted by fc View Post
    Haven't read the story yet. But last year, my roommate for an Arizona trip was Lennard Zinn. He said he was going in for a heart operation after the trip as his heart would race out of control during very hard efforts.

    Anyway, he talked to me for hours about the subject and he said the problem is very real among elite athletes. They are old, very fit and mask any underlying issues until they just die.

    Anyway, I'll read up and check in later. His operation was unsuccessful as they tried to burn all the bad circuits in his heart that were causing the short-circuits. So he has to slow down. Page 1 Strava to to page 20 in the hillclimb standings from here on .

    fc
    I have a friend who had AF and got ablation therapy (to burn the bad circuits as you say). He is athletic but not like a wacky endurance fanatic. Some people just get it, unrelated to exercise.
    Anyway, it took 3 separate surgeries before they stopped it. From what I remember reading, ablation is usually successful, but not usually successful on the first try.

  17. #17
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    Quote Originally Posted by smilinsteve View Post
    I have a friend who had AF and got ablation therapy (to burn the bad circuits as you say). He is athletic but not like a wacky endurance fanatic. Some people just get it, unrelated to exercise.
    Anyway, it took 3 separate surgeries before they stopped it. From what I remember reading, ablation is usually successful, but not usually successful on the first try.
    That's it... ablation.

    Zinn has given up on the procedure as it was his brutal second try. He got the best surgeon in the business and they shot him with adrenalin to get the 'short circuits' to happen. Problem is he is so fit that they couldn't get it to happen. 6 hours and enough adrenalin for an elephant so they had to stop and give up for good.

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  18. #18
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    Roo and fellow riders,
    I am by no means a medical professional but have much experience in the field of obsession and the very excessive use of the bike as described in the article. While I don't expect to answer most of your pertinent questions about what to do now with regard to a normal exercise regimen, I think I can show you what it's like to take a good thing and make a great mess of it. The heart issues of our fellow riders notwithstanding, I believe most of us are on a balanced and healthy course with a routine that includes the bike for exercise and enjoyment. And now, here's my story -- cover the eyes and ears of the children, please...

    Things like these -- bad habits, obsession, addiction, what have you -- can start out innocently enough, like a grain of sand received into an oyster and allowed to grow over several years...eventually becoming a big lump of coal in your Christmas stocking.

    So, about 12 years ago I was just riding along...you know, the usual -- commuting to work, fun rides on the weekends. Then I thought I'd try the spin class at the health club to bring my fitness up a notch. I came to like the classes for the people, the hard exercise, sweating like a pig, spinning it fast, then faster and faster and longer and faster. My performance on the bike improved and my addiction-catcher took hold of this like every other matter to which I've attached in life.

    It was going okay even though I'd become too much into it, that is, until I started using the heart-rate monitor. It was the two-piece Polar unit -- strap one around the chest and wear the other like a wristwatch. The instructors, particularly Janet Belisle, were very helpful in describing how the monitor could aid training by keeping one in a prescribed zone for greater benefit from exercising. I listened and understood but wasn't really paying attention. I wanted to know how high I could get the thing to go and how long I could stay in the heart rate max zone. The chart which Chris shared shows the optimal zones and theoretical maximum heart rate (220 minus age). By age 46, I had produced max of 216 bpm (I had the heart of a 4 year-old!) and could ride in a range of 195-205 for 30 minutes but felt like I could go much longer. I never went totally all out in my efforts and figured I could get to 225. There was never any sudden spiking of the heart rate. It would move up and then down gradually, directly corresponding to increased workloads and normal recovery. I've not had any arrhythmias. And, strangely enough, moving into the ultra-red zone -- well above lactate threshold -- would produce a relaxation in breathing. No great need to breathe excitedly when going all anaerobic, I suppose.

    Typical resting pulses were between 50 and 60, B/P 110/60. I made fairly big workouts in the spin class quite often. I'd read that the body could adapt to using lactic acid as an energy source and could work at high-levels of output beyond the normal point of slowing due to the presence of the lactic acid. In order to get to that point, you have make a long sprint and push against the tiring and slowing. Very few would want to run real hard like that, where they try to find their limit at top effort, trying to continue past the point of exhaustion. That's how I'd ride my bike.

    I was fairly obsessed with numbers and logged every mile and benchmark in my journal. My metrics mattered to me. I'd time trial kilometers on roads by my house. Everything could be raced. I had a 1170 watts reading on a trainer. I clocked my spin at 248 rpm on a Lifecycle, not really the ideal machine on which to sprint. My HCT read at 47.4. Every stop on the road became a race to accelerate again, perhaps racing a truck from the stop.

    I did not have a goal in training. It was not a means to a competitive end but I was training to become very fast for no particular other reason. Without being part of an overall plan for health, I likely rode too hard and too often to benefit from rest. I was also setting personal records for insomnia, smoking weed, and drinking coffee.

    Such speed training is not useful for the basic recreational group ride. What can you do with that? Blow up the pace line? Run away from the group for no good reason and end up suffering more later in the ride? I'm pretty much a laggard on mountain bike rides, preferring to ride at the back to stay out of the way of better downhillers and to use others to set pace and show better lines and technique. Once I went to a velodrome to test my speed. I worked all afternoon and evening and left Fort Bragg at midnight to get to the track in San Jose. By morning I was ready on no sleep, a lot of weed, coffee, and doughnuts. I really felt like I was in my element and rode pretty fast, winning all the races the track supervisor could devise. That only showed me that I'm a fish out of water - training for something that I really could not do or enjoy because I live and work too far from a velodrome. And, who needs a track sprinter in his late-forties, now mid-fifties.

    I got out of the spin classes when I left the health club in 2008. I stopped my regular time-trialing of kilometers and pursuit distances. I gave up journalizing rides and mileage. I have no metrics or interest in knowing anything to do with the bike or my body except that we're okay. I still ride every day and take a hard charging sprint whenever it suits me but that's usually just for fun. The insomnia and pot-smoking are no longer the constant edge and jagged feeling I'd been so accustomed to taking with me on the ride. I sleep now and look forward to good rest. A four to six hour session is very refreshing compared to the very little sleep I ever had for my first fifty years.

    Like Craig, I've found that the rest and recovery are about the most important things I can do as a bike rider. I feel so much better and able to enjoy my rides now. I'll say, too, that our cohort of older riders appear to be doing it right. We accept a gradual slowing with a grace and dignity befitting our age and experience. The "book club" meetings on the ride allow folks a good little rest and keep any jackrabbit tendencies at bay.

    I might be a test case to watch in the long term. To have pushed overly hard and tested my body in an unusual manner certainly puts me in the category of those in the article who have suffered ill-consequences. We still go on the long ramble. Just yesterday, Stanley and I rode dozens of dirt miles for about seven hours. The question as to when it's time to scale back or even come to a halt still remains but we keep doing it so long as we're able and enjoy what we do.

    It's not about the fool-hardy notion of "dying doing the thing he loved" as much as it is about living doing the things we love.

    R

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  19. #19
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    Cycling Past 50

    Cycling Past 50 by Friel has great tips on staying fit and having fun on your bike as you get older -

    http://www.amazon.com/Cycling-Past-5.../dp/0880117370

  20. #20
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    I started at age 50

    Quote Originally Posted by Jack7782 View Post
    Cycling Past 50 by Friel has great tips on staying fit and having fun on your bike as you get older - ..
    I started riding at age 50, 16 years ago. Unless you are racing you don't need a book. Just go out and ride at a reasonable pace and listen to your body. It will tell you when you need a rest. And once in a while check your heart rate on rides. And don't compare yourself to much younger riders.

  21. #21
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    I do fear as I get older that one day my heart will stop

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    Quote Originally Posted by TahoeBC View Post
    I do fear as I get older that one day my heart will stop
    supposedly you get a little warning before that like nausea or dizziness, which in itself is problematic cuz you don't know whether to stop or ride through it and then if you ride it can suck as you are thinking you are about to check out. More sleep less coffee does sound like a better plan.

  23. #23
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    Quote Originally Posted by TahoeBC View Post
    I do fear as I get older that one day my heart will stop
    If you find yourself alone, biking in the green fields with the sun on your face, do not be troubled. For you are in Elysium, and you're already dead!
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  24. #24
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    Quote Originally Posted by TahoeBC View Post
    I do fear as I get older that one day my heart will stop
    I fear getting hit by a car on the way to the trailhead much more.

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    I'm guessing most if not all folks hearts will stop once they get a bit older

  26. #26
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    There but for the grace of god.......
    Rider dies at Leadville Trail 100 MTB race - VeloNews.com
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  27. #27
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    Quote Originally Posted by jms View Post
    There but for the grace of god.......
    Rider dies at Leadville Trail 100 MTB race - VeloNews.com
    55 years old and 19 times racing Leadville? My co-worker is an 11-time Leadville finisher and he is soooo fit that he is scary at 53 years old.

    So this guy Scott Ellis must have been even more fit. He was probably a physical specimen that masked some hidden heart problems. I bet all the cholesterol and blood pressure levels all read ok.

    The more we understand about his situation, the better off we will be. He died doing what he loved but that is NOT GOOD. He should have died of old age at about 105.

    RIP Scott Ellis.
    Attached Thumbnails Attached Thumbnails Cardiac concerns later in life...-scott-ellis-leadvile-2010.jpg  

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    On this note, what do we do to detect, diagnose and treat these problems? What are the questions we should be asking our doctors?

    EKG is the one for sure, testing the circuits of the heart. - An electrocardiogram (EKG or ECG) is a test that checks for problems with the electrical activity of your heart. An EKG shows the heart's electrical activity as line tracings on paper. The spikes and dips in the tracings are called waves. The heart is a muscular pump made up of four chambers.

    I heard riding with a heart rate monitor is good as you can detect any irregularities during a ride.

    It is obvious that living healthy is not enough. And simply slowing down to 80% of your max aerobic ability is not a great option for most.
    Attached Thumbnails Attached Thumbnails Cardiac concerns later in life...-ekg4.gif  

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    Quote Originally Posted by GuruAtma View Post
    I started getting a-fib last year. I noticed it when I was sitting calmly in the evening, or even when I was sleeping. I haven't noticed it during exercise, but sometimes I'd get it in the evening several hours after a hard workout.

    I take a half dose of a beta blocker now (atenolol), and almost never get a-fib or tachycardia. I often ride with a HR monitor just to be sure.
    How does a HR monitor show a-fib or tachycardia?

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    Quote Originally Posted by fc View Post
    I heard riding with a heart rate monitor is good as you can detect any irregularities during a ride.
    How can a HR monitor detect these irregularities?

  31. #31
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    Quote Originally Posted by jms View Post
    There but for the grace of god.......
    Rider dies at Leadville Trail 100 MTB race - VeloNews.com
    Wow, that's really quite sad, and disturbing.

    The CEO of my first real job was a cardiologist and radiologist at Stanford group. He was always telling me the heart only has so many beats. He told everyone in the office this as he saw/hear us exercising. I always thought he was a kook with this mindset, even though he is incredibly brilliant.
    He better not be right!

    As for wearing a HR monitor on rides, I almost always wear one, and have done since 2005. Other than seeing your redline and extrapolated LT HR, I don't see how any of this would give me any warning.
    When they ran me on the VO2max test way back when, they had no issues pushing me past 214 before i finally gave them the middle finger. They told me some people just have naturally high HR, it doesn't mean anything(i wasn't in good fitness). In my fit SS days, I'd see 205 on the monitor on a hard effort. I'd think my heart is ready to explode in the 200s, but never thought of backing off. Now a days, fat and slow, I ride in the 170-180s. At ~185 it feels like my old days' 200s. The monitor just allows me to know when to back off in case I want to sustain the current effort, rather than continue and get off and have to walk.

    I'd guess the gentleman in the story was doing his normal effort on that hell climb and the body does what it does. I wonder if he has had a predisposition to heart disease like Jim Fixx did before his massive heart attack.

  32. #32
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    I've been reading and pondering this thread and share the concerns and questions you ask fc. As I'm now nearing my 54th birthday and am considered to be very fit for my age and have low cholesterol, low blood pressure, great resting heart rate, etc... I'm just not sure how to approach it.

    Maybe we should all get a cardiac stress test to see if we're as fit as we think we are, or if we have an undetected underlying problem.

    You have to wonder though, did this guy get up in the morning and say "I don't feel great, but it'll pass and I'll feel better after a ride" and ignore a tell-tale sign? Or did he get up feeling like he was going to win Leadville on his 20th attempt?

    I've spoken with a cardiac nurse about it, as I was concerned when my heart rate hit 192 on a climb one day (I was 48 years old at the time). It came right back down as soon as I crested the top and I felt fine, so she said not to worry about it. It enters my head from time to time though, particularly after incidents such as these get publicized.
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    Quote Originally Posted by bikebum View Post
    How can a HR monitor detect these irregularities?
    So when Lennard Zinn first experienced the problem, he said his hear would 'race' to ungodly levels during Strava efforts. Something like 250 bpm (when his max was around 190.

    He was in denial for a few months and as he got the first few corrective treatments. But he said he could see this problem as it occurred during hard efforts.

    He said it didn't feel that bad (or uncomfortable) and that backing off when this occured may have saved him.

    fc
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    Tachycardia and ablasion

    Tachycardia - Mayo Clinic

    Video is interesting.
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    Quote Originally Posted by fc View Post
    So when Lennard Zinn first experienced the problem, he said his hear would 'race' to ungodly levels during Strava efforts. Something like 250 bpm (when his max was around 190.

    He was in denial for a few months and as he got the first few corrective treatments. But he said he could see this problem as it occurred during hard efforts.

    He said it didn't feel that bad (or uncomfortable) and that backing off when this occured may have saved him.

    fc
    I forget if it was my garmin or my polar, but it would give erroneous readings every once in a while and give me 250 HR. That always seem to be on crazy steep climbs with transmission power lines around.

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    At 57 I have been around plenty of people who have died old and some young. I don't mean to be callous but suddenly dying at 55 while doing what you love is as good as it realistically gets. Not easy on the family but it never is.

    If folks are afraid of dying while doing something that is fundamentally healthy and enjoyable then they should be terrified of dying in most other ways. Age matters much less than how much you have lived.

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    When did someone decide 49 was old? I'm rising 71 and should the riding kill me, I'll die happy. I mean it is Dust to Dust isn't it? How can anyone, medicos too, think that lying in the box regretting; 'I should have pushed harder up that climb" etc. is even a consideration. You either ride or rot!

  38. #38
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    I agree. It hasn't changed the way I ride. I push. I love it! If I drop, I'll have dropped happy.
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    This story hits really close to home. My hockey teammate Dean, died one night on the ice while playing hockey from a heart attack caused by a soft plaque rupture. The thing is the guy was pretty healthy, playing hockey and mountain biking. He had just run the muddy buddy the morning he passed away.

    As you can imagine, his wife was devastated but being the person she is, went on to start a foundation to raise awareness about this situation. She made her mission to educate people on how easy and relatively inexpensive it is to get tested. Anyways, I invite to consult her foundation's website and find out more about it at: no-more-broken

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    Is this a good time to start the 50+ forum? "Riding for the next 50 years."

    I just turned 50 and and we ant to be riding anothere 50. Who's with me??

    The issue here is redline-ing your engine when are 50+. How hard and how often can you do it? Safely? It's an emerging science as we have a new generation of athletes. And retirees now believe they just have more time now to train and push it.

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    Interesting and somewhat scary stuff. I'm 59 and still ride around 5-8 hours a week. But used to be a competitive triathlete back in the beginning days of the professional era. One of my friends and training partners had to get a defibrillator a few years ago. I occasionally skip some beats when resting after a harder ride, especially a hot one. Had a couple resting EKG'S which showed no problems thankfully. I use a Garmin GPS with a heart rate monitor and occasionally get weird spikes I always assumed were just spurious readings but reading this makes me wonder. Hmmmmm.

    My wife was looking over my shoulder as I typed this and wanted me to mention that she always said that while my friends and I were fit back in the day, what we were doing was not healthy.

    I think I'll go for a ride.

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    Quote Originally Posted by bikebum View Post
    How can a HR monitor detect these irregularities?
    With a chest strap heart rate monitor I get indications way above what my max at age 61 should be, something like 220 or so (Garmin wouldn't read higher) when climbing. Since I went to a optical Microsoft Band a more realistic 168-ish.

    I must have been lucky, the first ablation took for the most part.

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    Yeah, it's not really good for you overall to do a lot of high level cardio. Cardiac problems aside, it can also really raise cortisol levels, suppress immune function, increase inflammation, and a few other things you don't really want.

    I like to ride, but I've kind of toned it down since I got into weight training. I lift three or four days a week, and ride two or three. To be honest, if all you do is cardio or train for a triathalon, that usually leads to a body type that a man shouldn't aspire to, at best, you'll just be skinny, at worst, you'll be skinny-fat, and you'll be more injury prone. I definitely like how I'm starting to look, and the fact that weight training will strengthen your joints, bones, and tendons, I feel that makes me less injury prone should I crash on the bike.

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    New forum sounds good...

    Quote Originally Posted by fc View Post
    Is this a good time to start the 50+ forum? "Riding for the next 50 years."

    I just turned 50 and and we ant to be riding anothere 50. Who's with me??

    The issue here is redline-ing your engine when are 50+. How hard and how often can you do it? Safely? It's an emerging science as we have a new generation of athletes. And retirees now believe they just have more time now to train and push it.

    fc
    Why not?

    I'm 68, feeling great, ride 3 to 4 days a week doing 3,000 mile/yr. on my Ripley(s) and having a ball. Like you said it'd be more fun to be able to ride into later life. Meanwhile, I'm loving every spin of the crank whenever I can do so. It makes the IPA taste that much better at the end of the day.

    What I am gleaning from this thread is: there are two categories of athletes. Those who are on a mission to gain excellence in conditioning and results (obsessive training? Ultra athlete?) and the other being the ones who like the feeling of being in good condition, but not hardcore. I am of the latter group who thoroughly enjoys feeling the vibrance of being fit and able to do most things on a daily basis. One indication of my conditioning is my recovery rate after three minutes, where my heart rate is below 100 again.

    I too have heard that the heart has limited numbers of beats over a lifetime. Tell me if this thinking is farfetched, but take the average person whose resting heart rate is 72 BPM. If one conditions the heart and lowers the resting BPM to say 45 to 50 BPM, metaphorically wouldn't this be akin to saving money for retirement. In the long run, wouldn't an athletic individual be using few beats over one's lifetime?

    Not enough research has been done to draw any conclusions at the moment. As my 93 year old mother says: "You got to Keep moving!".

    I gotta fix the squealing of the wheels of her walker as she heads outside for another cigarette. You just never know...

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    A person's history and lineage plays a big role i hear.

    I eluded to Jim Fixx having a massive coronary while running. Not a whole lot of people on earth more fit than he when he kicked it. I was in track in HS and this was big news! But, having looked into him, he was 220lbs and gotten the notice from his dr. He took up running and healthy eating and lost 65 lbs and kept running. Well, when he died, the autopsy showed 2 of his main arterial arteries were almost completely blocked.

    YMMV

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    I am 42 now, and as I was just diagnosed with AVNRT and A-fib, I find it interesting that the velonews and other articles are coming out on this topic. I raced mt bikes (and some road) for about 10 or so years at expert level, and have been doing intense riding for the last 25 years or so. I started having really bad rides where my body just couldn't function. Then I started noticing racing, fluttery heart sensations in the afternoon or night following my rides. eventually I had one ride where my heart was racing, i was dizzy, and couldn't even walk the bike up the hill. I told the doc, and he gave me an EKG, which showed some abnormality. Then I went to the cardiologist and he did a treadmill stress test that confirmed the irregularity and showed my heart going haywire. 8 minutes after getting off the treadmill my HR was at 208 bpm (I never ever saw it that high even in my 20's). So i got a HR monitor after decades of not having one and started monitoring my HR on rides and afterwards. You know things are not right when you are at home, sitting on the couch, with a HR of 215 bpm and you aren't even breathing hard. If you have any of these things happen to you (racing heart or fluttery feeling heart after or during rides) go see your doctor. It sucks that all these big rides we thought were good for us are in fact not so good for us and cause damage to our heart muscles and the electrical system in our heart. From what I hear, the laser ablation often doesn't work the first time, and often takes 2-3 times to work, so I am not going that route. Just going to do less massive rides, and do shorter rides instead, while watching my HR and stopping if it decides to go well above my 188 bpm max..that's all I can do really, besides not drinking massive amounts of coffee before a ride. Coffee, weed, other stimulants can all trigger a-fib. at least I know what's wrong now and have meds on hand just in case, to slow down the heat rate (calcium channel blockers).

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    Quote Originally Posted by RooHarris View Post

    I gotta fix the squealing of the wheels of her walker as she heads outside for another cigarette. You just never know...
    That's hilarious--Go Mom

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    Really awesome post Shosan!!! Thank you for the info.

    Rooharris, an athlete certainly lowers their resting heart rate so the 'number of heart beats in a lifetime' cancels out I think. We have to utilize this heart, mind and body to keep it healthy.

    What has a limit I think is putting the heart in the redline. That has an expiration date. We are now realizing that you can't go anaerobic all the way til we're 90 years old. It's like an old engine. If you're gonna rev it to the max, you better know what you're doing and have a good mechanic.
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    The doctor from the velonews article has a lot of info on his site-
    The Treatment of Atrial Fibrillation in Endurance Athletes; Tough Choices

    I wonder if the heart issues come from extended 60-80% of max HR/endurance rides or if doing interval training is more of factor. Unfortunately, there's probably no way to figure it out with all the variables going on

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    I now wonder if guys like Tinker, etc who have and/or are still racing at the highest level, have the same heart-related issues we do, and just ignore them or think they are normal.

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    I got diagnosed with a-fib earlier this year. When you look at those ekg printouts, the big bump on the line is the ventricle and the little bump in between is the atrium. The ventricle is the bigger one that pushes the blood out to the body. With a-fib the electrical signal that tells the atrium to contract gets screwy and goes super fast, and out of rhythm. The ventricle tries to keep up, and that's why you detect a fast heart rate. The atrium is actually going much faster, but you usually can't measure it with your finger or phone.

    But because it's out of rhythm, it doesn't push all the blood out of the chamber. When blood sits around without moving, it starts to clot. Then your heart starts beating normally and that clot gets pushed out, possibly causing a heart attack or stroke, etc.

    That's why you often get prescribed a blood thinner. Ablation is serious, and is often effective for only a while. I take a half of a beta blocker each day, and I've been mostly symptom free. For some people simply cutting out caffeine can fix it.

    One thing that's helpful is to get one of those heart-rate apps for your phone. You hold your finger over the light. This is good because you then have a record of each event, what you were doing just before, how often, how long, etc. This helped convince my doctor to do more tests.
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    Great thread. This happens to people who are not extreme athletes also.

    I have an aunt, 69 years old, who just came down with this last year. She does not exercise at all, and is probably 30 lbs over weight. The first couple treatments did not work but after 3 treatments spoken of here, she has had no more episodes.

    I also had a buddy I did club rides with, he was in his 50's and a beginner who developed this about 6 months after starting riding.

    I think wearing a heart rate monitor during rides is good advice, and paying attention to how you are feeling after rides is important also.

    Fc, great idea to start an over 50 thread, I turn 50 in a couple weeks, and am planning on doing my longest ride of my life then. Cheers!

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    Just my few cents:

    1) The outcome for all of us is assured, it is just when.
    2) When the inevitable comes is due to a myriad of factors including genetic and lifestyle.
    3) No matter how careful you are, how much care you take, or all the planning you have, you may die tomorrow in a freak accident.

    What do I take from this? Take reasonable precautions, listen to your body, enjoy each day like it is your last, but plan as if you will live until 90.

    Cary

    P.S.- If you find me dead on side of the trail with a smile on my face, it is because my last thoughts will be 1) my son's college is paid for, and 2) the life insurance company is going to have to write a big check.
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  54. #54
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    Just once at altitude

    I've been very fortunate. I began endurance racing when I was @ 50. Trained myself down to @ 145 lbs [6 ft 2 in] over the years, with a resting pulse of 42bpm doing six or seven, 8 hour, or longer endurance races per year. Other than having my fragile ego crushed by the immense mediocrity of my abilities, I've had no health problems.

    Beyond the usual post event misery, the only place I've ever encountered a cardiac problem was following the Kirkwood 9 to 5, where the course reaches @ 7800 ft, which when living at sea level [literally at the time] is high altitude. Post race, I couldn't get my heart rate down to it's normal post race range until the following day when I was heading home and got down below 3000 ft.

    While I've missed racing the Cascade Cream Puff every year since my last in 2012, I think maybe that has been a blessing in disguise.
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    Good words of wisdom...

    Quote Originally Posted by Cary View Post
    Just my few cents:

    1) The outcome for all of us is assured, it is just when.
    2) When the inevitable comes is due to a myriad of factors including genetic and lifestyle.
    3) No matter how careful you are, how much care you take, or all the planning you have, you may die tomorrow in a freak accident.

    What do I take from this? Take reasonable precautions, listen to your body, enjoy each day like it is your last, but plan as if you will live until 90.

    Cary

    P.S.- If you find me dead on side of the trail with a smile on my face, it is because my last thoughts will be 1) my son's college is paid for, and 2) the life insurance company is going to have to write a big check.
    Good words of wisdom...

    ...can I have your bike if I find you on the side of the trail?

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    After turning 60 a few years back, I wondered if it was risky to continue maxing out the heart like we all do sometimes riding & training. So I asked the doctor in my family, and he said it isn't dangerous, the heart will not blow up - which was good to hear. The good news is, I've learned that I get pretty much full fitness benefits when training down around 90% HRMax or even 80%+. Much less grueling, even fun, & can be done for longer intervals even on hot days. You don't have to kill yourself to condition! But everyone should stay alert, never ignore warning signs, get checked out, and live to ride another day, hopefully well into oldfarthood.

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    Great thread and a lot to think about. I like Dr John's blog which has been interesting to read and also easy to relate to since he is a cyclist and racer as well. It's unfortunate that we are fairly early in building up the knowledge base of the effects of the ultra endurance athlete (or extreme athlete) on the heart.

    It would be nice to have a good understanding of what's too much? I like my long all day rides on the mtb or racking up 70+ on the road, I'd hate to give those up. I guess it's a matter of the intensity of those rides? But how do we know when it is too high? The other issue is that it's wayyy too easy and tempting to want to put a lotta power down at times during those rides when you start feeling good.

    I should probably get a HRM and start monitoring and learning about myself.
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    I'm in a hospital bed right now recovering from ablation #2 this morning. The reason I have tried to stop this nasty little arrythmia is I want to ride my bike! I started slow like you - just a few bouts now and then.
    Google AF and you will find plenty on how the disease develops. AF begets AF. It is progressive and you really can't stop the disease in many cases. Ablation blocks the signals that signal AF - it does not curer the reason for the abnormalty. My decison was simple - it will get worse with time, and it will eventually become permanent. That and an aversion to drug therapy due to it's harmful effects on my MTB rides clinched the deal for me. Keep that heart muscle in normal sinus rhythm! Good luck.

    Quote Originally Posted by shosan View Post
    I am 42 now, and as I was just diagnosed with AVNRT and A-fib, I find it interesting that the velonews and other articles are coming out on this topic. I raced mt bikes (and some road) for about 10 or so years at expert level, and have been doing intense riding for the last 25 years or so. I started having really bad rides where my body just couldn't function. Then I started noticing racing, fluttery heart sensations in the afternoon or night following my rides. eventually I had one ride where my heart was racing, i was dizzy, and couldn't even walk the bike up the hill. I told the doc, and he gave me an EKG, which showed some abnormality. Then I went to the cardiologist and he did a treadmill stress test that confirmed the irregularity and showed my heart going haywire. 8 minutes after getting off the treadmill my HR was at 208 bpm (I never ever saw it that high even in my 20's). So i got a HR monitor after decades of not having one and started monitoring my HR on rides and afterwards. You know things are not right when you are at home, sitting on the couch, with a HR of 215 bpm and you aren't even breathing hard. If you have any of these things happen to you (racing heart or fluttery feeling heart after or during rides) go see your doctor. It sucks that all these big rides we thought were good for us are in fact not so good for us and cause damage to our heart muscles and the electrical system in our heart. From what I hear, the laser ablation often doesn't work the first time, and often takes 2-3 times to work, so I am not going that route. Just going to do less massive rides, and do shorter rides instead, while watching my HR and stopping if it decides to go well above my 188 bpm max..that's all I can do really, besides not drinking massive amounts of coffee before a ride. Coffee, weed, other stimulants can all trigger a-fib. at least I know what's wrong now and have meds on hand just in case, to slow down the heat rate (calcium channel blockers).

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    I have paroxysmal a-fib, had it for a few years now. Two ablations; first one (cold) made it worse, second one (hot) got me about back to where I was before. Hated the drugs they made me take before and after the two. Don't take any drugs now, ride mild and have reconciled myself mentally with riding at a reduced state; that was the hardest part.

    I rode with you, Roo at the Mendocino NorCal high school camp.

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    Quote Originally Posted by RooHarris View Post
    In discussing this problem with dozens of fellow masters endurance athletes, many report suffering from similar events. In researching the topic, it appears relatively common in endurance cyclists. Years of endurance riding, intensity of usual riding, and increasing age all appear to factor in. I have researched this topic extensively and I believe the VeloNews article covers the topic well, based upon current knowledge. Most of the reports in the literature cite cyclists with a racing history and relatively high volumes and intensity of training. I ride with many older fit riders, but the only ones who have reported arrhythmias to me, have fallen into the very highly trained racing class.
    I have also had a few years to think about this. I've read everything I could find about a-fib in middle-aged athletes, and talked to several doctors about it.

    • atrial fibrillation becomes more common with age
    • chronic atrial fibrillation is a huge problem for the elderly, sedentary set.
    • The medical business makes a lot of money keeping elderly people with chronic afib and high stroke risk alive, thus the prevalence of the drug solutions. (Which make cycling suck.)
    • At this point in time, the medical business will not make a lot of money figuring out why a tiny slice of the population (middle-aged endurance athletes) also gets afib.
    • There are two schools of thought; one, a lifetime of endurance exercise can cause afib and
    • two, many people have it, but don't push themselves physically hard enough to evidence it. A sedentary life may never evidence it.
    • In the 1960s, when people drank a lot more alcohol, there was a syndrome called 'holiday heart'. There are many factors which elicit the afib response among those with paroxysmal afib. It's not just endurance exercise.


    My heart is enlarged, and I've been riding and racing all my life. I'm 47 and I have been on a bike almost continually since I was single digits. Otherwise my heart is normal. But it beats funny sometimes. My theory is that hearts just don't age well, and that endurance athletes experience paroxysmal afib sooner, but that the same percentage of the sedentary population have it, and just don't know it. (Reminder; our ancestors evolved during a time when life expectancy was 30 years. Our bodies are not designed for old age. Biologically, they just need to mature enough to create and launch the next generation.)

    I will probably die of a stroke; the stroke risk is higher for those with paroxysmal, and much higher for those with chronic afib than it is for those neither. *shrug* I still ride as much as I can, bike commute to work.

    Definitely go see your doctor. The one other thing I'd caution is that (paraphrasing John Mandrola) many cardiologists and electrophysiologists see this problem in a "box"; they focus on the symptoms and treatment, and are often not interested in the big picture, the holistic 'you'. A 45-year-old mountain biker who likes to drink a beer after a hot ride, and sometimes does 8-hour races can get the same analysis and treatment as a 63-year-old homemaker who hasn't exercised since high school. It's really up to the individual to manage their symptoms, know the triggers and reasonably control them. For me; sleep, stress, dehydration, full stomach, hard training followed by rest. Long, mid-ride breaks with a belly full of food followed by riding can do it. Racing and training are pretty much out. The best thing is lots of sleep and not getting really stressed. Ablations do help. I am considering a third. I am not at all interested in any of the drugs, right now.

    Why does afib happen? Why does a part of the heart suddenly try to send the electric signal for heart beats that normally is done by the av node, the part that's supposed to send the signal? No one really knows. The first EP I worked with told me his theory; the infant heart begins as just a pass-through. The mother's blood passes through the blood vessel where a heart begins to develop. As the infant's heart is being created, the cells forming the av node split from the cells that will form the rest of the atrium. The instructions / mechanism for building an av node exist in those neighboring cells, and for whatever reason, later in life, begin creation of a second av node, or that spot begins acting like one.

    Morgan

  61. #61
    fc
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    Quote Originally Posted by morganfletcher View Post
    I have also had a few years to think about this. I've read everything I could find about a-fib in middle-aged athletes, and talked to several doctors about it.

    ....
    Morgan
    Morgan, that is brilliant. All before my morning coffee too. Sharing is caring.

    You and your kid have been through a lot these past couple a years.

    fc
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  62. #62
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    [QUOTE=morganfletcher;12144999]I have paroxysmal a-fib, had it for a few years now. Two ablations; first one (cold) made it worse, second one (hot) got me about back to where I was before. Hated the drugs they made me take before and after the two. Don't take any drugs now, ride mild and have reconciled myself mentally with riding at a reduced state; that was the hardest part. /QUOTE]

    Awww Morgan, I'm bummed to read this. Beyond the health issues, this stuff does mess with our identities then doesn't it?

    I'll always remember our back and forth during the TS 100. You killed it that day
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  63. #63
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    [QUOTE=jms;12145137]
    Quote Originally Posted by morganfletcher View Post
    I have paroxysmal a-fib, had it for a few years now. Two ablations; first one (cold) made it worse, second one (hot) got me about back to where I was before. Hated the drugs they made me take before and after the two. Don't take any drugs now, ride mild and have reconciled myself mentally with riding at a reduced state; that was the hardest part. /QUOTE]

    Awww Morgan, I'm bummed to read this. Beyond the health issues, this stuff does mess with our identities then doesn't it?

    I'll always remember our back and forth during the TS 100. You killed it that day
    That was the Lennard Zinn difficulty as I talked to him. Being a high level athlete all his life, who would he be if had to ride at 80% the rest of his life.

    That is really at the core of this topic and why it resonates with a lot of us. We ride and improve to the best of our abilities every year. And then at some point, one has to throttle down? Cycling is the fountain of youth. But then there's this aging ticker thing at the heart of the matter.
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    Looks like someone died of a heart attack during a climb at the Leadville 100.. It was his 19th race, so I assume he wasn't a super young guy.
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    Quote Originally Posted by Joe_510 View Post
    Looks like someone died of a heart attack during a climb at the Leadville 100.. It was his 19th race, so I assume he wasn't a super young guy.
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    Quote Originally Posted by fc View Post
    Post #26 and #27
    My bad, skimmed the posts, but missed these ones. Delete the post if it's too redundant.
    East Bay Parks AKA East Bay Cattle Ranches

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    Quote Originally Posted by Joe_510 View Post
    My bad, skimmed the posts, but missed these ones. Delete the post if it's too redundant.
    repeatedly redundant Incident added fuel to this fire fo-sho.
    IPA will save America

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    Quote Originally Posted by fc View Post
    If you find yourself alone, biking in the green fields with the sun on your face, do not be troubled. For you are in Elysium, and you're already dead!
    You must spread some Reputation around before giving it to fc again.

    Morgan

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    Quote Originally Posted by fc View Post

    That was the Lennard Zinn difficulty as I talked to him. Being a high level athlete all his life, who would he be if had to ride at 80% the rest of his life.

    That is really at the core of this topic and why it resonates with a lot of us. We ride and improve to the best of our abilities every year. And then at some point, one has to throttle down? Cycling is the fountain of youth. But then there's this aging ticker thing at the heart of the matter.
    We can all stand to learn and develop our humility, our empathy. This has taught me that I am not how badass I am on the bike. That's not the definition of me. I have found fulfillment in coaching high school mountain biking, in riding for pure pleasure, and you know what, I can still battle it out with the slower guys. I raced road, track, cyclocross, mountain bike and I liked it and I miss it, but now it's about just being grateful that I can ride. Breaking my hip last year further illuminated to me how mortal I am, and how lucky I am to ride.

    Lessons.

    Morgan

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    Quote Originally Posted by fc View Post
    Morgan, that is brilliant. All before my morning coffee too. Sharing is caring.

    You and your kid have been through a lot these past couple a years.

    fc
    Indeed! He's going to college in a sling. Phew. We drop him off Saturday. He'll ride again.

    Morgan

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    [QUOTE=jms;12145137]
    Quote Originally Posted by morganfletcher View Post
    I have paroxysmal a-fib, had it for a few years now. Two ablations; first one (cold) made it worse, second one (hot) got me about back to where I was before. Hated the drugs they made me take before and after the two. Don't take any drugs now, ride mild and have reconciled myself mentally with riding at a reduced state; that was the hardest part. /QUOTE]

    Awww Morgan, I'm bummed to read this. Beyond the health issues, this stuff does mess with our identities then doesn't it?

    I'll always remember our back and forth during the TS 100. You killed it that day
    Thanks, jms. I do miss racing very much! Miss seeing you at the races, too. I loved racing. Coaching kids is the next best thing. I could improve a little. They can improve so much more.

    Morgan

  72. #72
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    This thread scared the sh@t outta me, so I've been digging around, trying to find out more about the causes, here is an interesting article:

    Age Is Irrelevant When It Comes to Fitness | Outside Online

    "If all this insistence on charging harder and exposing yourself to intense bouts of stress sounds scary, particularly in light of several recent stories about heart damage and even sudden death among endurance athletes, those fears are understandable but possibly irrational. Obviously, anyone (no matter their age) just starting on a training program should screen for preexisting conditions and clear things with their doctor. But the perception that high-intensity training is dangerous is overblown."

    Obviously everyone is different, and this is a popular magazine article, not a medical journal, but it brings some light to a dark topic.

    P

  73. #73
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    Quote Originally Posted by Mr.P View Post
    This thread scared the sh@t outta me
    We are all going to die. It's quite good for your body to exercise, and yeah, starting an exercise regimen later in life does have risks, so working with a doctor is good sense. Afib affects a subset of the population. The majority of people on this forum won't experience it.

    Specific to afib, here's a recent bit of news that shows that exercise helps regulate it:

    Exercise May Be Good Medicine for Irregular Heartbeat ? WebMD

    You might think 'Obese? That doesn't apply to me.' The way BMIs are calculated, a lot of people qualify. My BMI is 28, and I ride all the time, commute to work, and ride a bike pretty well. That article says "All had a body mass index (BMI) of 27 or more, meaning they were overweight or obese."

    Anyway, food for thought.

    My advice? Ride your bike to work. It's not just a toy, it's a tool.

    Morgan

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    I have been dealing with what I think is Premature Ventricular Contractions all last week, or generally an irregular heart beat.

    The frequency of them started to decline at the end of last week. I decided to go on a 20 mile ride on road bike Sunday, keeping intensity low, and that seems to have helped it smooth out.

    It's Tuesday and my heart is beating rather smoothly now. The irregular beats are rare and if they do happen the intensity of them seems lower.

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    The answer to all of this in podcast form, from a board certified Cardiologist/athlete:
    The Athlete's Heart - ercast.org
    They specifically cover cyclists and cardiac ablation at ~26:50.


    Quite bluntly: cycling athletes have a higher rate of A/Fib than other sports.


    Risk factors for dysrhythmias:
    Alcohol
    Caffeine
    Lack of sleep
    Age
    Smoking
    Stimulant drugs [cocaine, meth, some Rx meds]
    Prior cardiac abnormalities [mitral valve prolaspe, etc]


    Some of those risk factors you can modify, but some of the risk factors you cant.
    So cut the crap. That means put the beer down (Yes, YOU). Everything in moderation
    The benefits of exercise far outweigh the risks.
    Be careful what you read in fitness magazines.
    A good place to start is to see your friendly neighborhood family physician for annual labs and a screening EKG.


    PS - For what it is worth my undergrad is in Kinesiology and now I deal with all types of chest pain / complaints in my emergency department. Now give me my pre-ride espresso and post ride beer after my next string of night shifts.

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    A couple years ago, I gave CPR to a mtn bike rider. He was 56 and had been riding for over 20 years. Just a cruiser from what I gather. I passed him going up hill and he was not really pushing it at all. Long story short... He died and now I am one year older than he was. Makes me worry at times.

  77. #77
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    New Leonard Zinn article

    new article on this issue in response to a reader question, by Leonard Zinn again.
    The heart and masters cycling - VeloNews.com

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    A fundamental problem with the VN articles is that there's no mention of the available treatments. I had worsening AF for 8 years and it finally got so bad I had to drop out of half my races (criteriums and track). I took the risk and got a radio frequency ablation that cured the AF, and one year later I won my first of 3 US National Championships.

    I know of more than a few bike racers dealing with AF. Some quit, some get an ablation, and some use various medicines or magnesium to control it, with varying degrees of success.

  79. #79
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    So I feel obligated to reply to this thread being a cardiac anesthesiologist who works with cardiac electrophysiologists several days a week. The reality is all A fib ablation therapy is not equal. Many physicians have coined themselves the best but use outdated techniques and skewed statistics. I have worked at several institutions including Columbia and Stanford and can say the EP cardiologists at Sequoia hospital are truly some of the best in the country. We have doctors regularly fly in from other states to have them do their ablations. For true atrial fibrillation (not another supra ventricular tachycardia) Performing the procedure under general anesthesia increases both the safety and success of the procedure. So being tortured for 6 hours given adrenaline is not the norm. Most patients ask me "when we are going to start?" when I'm dropping them off in the recovery room.

    One other fact that I try to impress upon patients is that just because it takes several procedures does not mean it is a failure. Any cardiologist could increase his first time success rate by burning too much, but this puts you at risk for a real debilitating complication, pulmonary vein stenosis (closing off of one of the blood channels to the lungs). By ablating the appropriate amount, that risk of this is practically zero. The downside is you might need to come in for a touch up.

    Without treatment, the risk of blood clots, stroke, or alternatively need for anti coagulation and risk of hemorrhage with a fall don't really seem compatible with our sport.

    This is getting off track of whether our sport causes this phenomenon but I wanted to hopefully provide an insiders perspective on the treatment. I really hope few of us ever need it.
    Last edited by Dpca10; 10-28-2015 at 09:13 PM.

  80. #80
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    Quote Originally Posted by Dpca10 View Post
    So I feel obligated to reply to this thread being a cardiac anesthesiologist who works with cardiac electrophysiologists several days a week. The reality is all A fib ablation therapy is not equal. Many physicians have coined themselves the best but use outdated techniques and skewed statistics. I have worked at several institutions including Columbia and Stanford and can say the EP cardiologists at Sequoia hospital are truly some of the best in the country. We have doctors regularly fly in from other states to have them do their ablations. For true atrial fibrillation (not another supra ventricular tachycardia) Performing the procedure under general anesthesia increases both the safety and success of the procedure. So being tortured for 6 hours given adrenaline is not the norm. Most patients ask me "when we are going to start?" when I'm dropping them off in the recovery room.

    One other fact that I try to impress upon patients is that just because it takes several procedures does not mean it is a failure. Any cardiologist could increase his first time success rate by burning too much, but this puts you at risk for a real debilitating complication, pulmonary vein stenosis (closing off of one of the blood channels to the lungs). By ablating the appropriate amount, that risk of this is practically zero. The downside is you might need to come in for a touch up.

    Without treatment, the risk of blood clots, stroke, or alternatively need for anti coagulation and risk of hemorrhage with a fall don't really seem compatible with our sport.

    This is getting off track of whether our sport causes this phenomenon but I wanted to hopefully provide an insiders perspective on the treatment. I really hope few of us ever need it.
    It's been a while since this thread was being discussed. Many of the observations and question regarding Cardiac concerns has been illuminating. In light of the recent thread on the 49 year old woman having a possible cardiac event
    ( http://forums.mtbr.com/california-no...rn-999256.html ), I feel strongly that we keep perspective on our mortality and how we exercise daily. In the meantime, keep the wheels rolling into the New Year. Be safe and enjoy your life for the moment.

  81. #81
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    Here is another article from Lennard Zinn regarding heart issues and concerns in Velo News.

    Technical FAQ: Cyclists and heart issues - VeloNews.com

  82. #82
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    Quote Originally Posted by RooHarris View Post
    It's been a while since this thread was being discussed. Many of the observations and question regarding Cardiac concerns has been illuminating. In light of the recent thread on the 49 year old woman having a possible cardiac event
    ( http://forums.mtbr.com/california-no...rn-999256.html ), I feel strongly that we keep perspective on our mortality and how we exercise daily. In the meantime, keep the wheels rolling into the New Year. Be safe and enjoy your life for the moment.
    Yeah Roo, do we have to rain on our parade?

    **Edit-Not directed at you, being in the "at risk age group", just agreeing with the keep the wheels rolling theory.
    Last edited by JMac47; 01-20-2016 at 08:41 PM. Reason: rephrase
    Wait whuuut, who did he tell you that!?!?....

  83. #83
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    I'm not sure what to make of all of this information.

    I raced cross country, cyclocross, and endurance (12 hour solo, 24 hour solo, 100 mile+) races for many years. I have done a ton of road centuries. Backpacked and mountaineered all over the Sierra Nevada. All up until about 10 years ago, at which time I took an extended time off while I focused on other life responsibilities.

    I now have high blood pressure and high cholesterol, and until recently, was fairly over weight. So I started cycling again - for health, weight loss, to decrease blood pressure, and for general mental well being. It has, of course, been working wonderfully. I can't imagine ever taking a break from hiking and biking, ever again.

    But then I read this thread, and a part of me has to wonder if all my plans are going to backfire. Heh.

    I hate you all.
    "An old mountain biker once said. "If I don't ride, I'm just old."

  84. #84
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    Quote Originally Posted by Knucklehead View Post
    But then I read this thread, and a part of me has to wonder if all my plans are going to backfire. Heh.

    I hate you all.
    Do what you love, in moderation. We're all going to die. Better to live well than live afraid. If I sit idle, my afib occurs more frequently than if I ride regularly and sleep and eat well.

    Morgan

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    Quote Originally Posted by morganfletcher View Post
    Do what you love, in moderation. We're all going to die. Better to live well than live afraid. If I sit idle, my afib occurs more frequently than if I ride regularly and sleep and eat well.

    Morgan
    This is all we can work/play towards. Find something active you love doing and make it an everyday part of your life. Sporadic exercise may not be healthy. It's the consistency of exercising that is most important. Not the intensity.

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    On a related note, I have an echo cardiogram/stress test scheduled for later today (1:30pm)

    I was out riding last week when I felt some pain in my chest, to the point where I actually stopped and pulled out my phone in case I needed to call someone, it weirded me out.. Needless to say I made an appt with the doc the very next day, got the referral to cardiologist.

    I've have an ecg done in the last which came back "regularly irregular" (inverted t wave) which they said based on all my other vitals that I shouldn't worry about it, I have good blood pressure and my resting heart rate is good/excellent

  87. #87
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    Quote Originally Posted by f0nz0 View Post
    On a related note, I have an echo cardiogram/stress test scheduled for later today (1:30pm)

    I was out riding last week when I felt some pain in my chest, to the point where I actually stopped and pulled out my phone in case I needed to call someone, it weirded me out.. Needless to say I made an appt with the doc the very next day, got the referral to cardiologist.

    I've have an ecg done in the last which came back "regularly irregular" (inverted t wave) which they said based on all my other vitals that I shouldn't worry about it, I have good blood pressure and my resting heart rate is good/excellent
    Keep us posted...

  88. #88
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    I know a couple great cardiologists that ride. One is a road rider and one mtb's all the time. Did Leadville a couple years ago. If anyone needs to see one pm and I'll get the info to you. Great guys mid 40's.


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    any chance...

    Quote Originally Posted by sfgiantsfan View Post
    I know a couple great cardiologists that ride. One is a road rider and one mtb's all the time. Did Leadville a couple years ago. If anyone needs to see one pm and I'll get the info to you. Great guys mid 40's.


    Sent from my iPhone using Tapatalk
    Any chance these guys would be willing to contribute to this thread?

    Thanks!

  90. #90
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    According to several studies, extreme athletes do apparently have a much higher chance of developing A-Fib problems later in life. However the chance of developing a debilitating condition are still relatively low and the benefits of good cardiovascular health definitely outweigh the risk in my opinion.,You are going to die, and there is nothing you can do about it. Get over it and live life to the fullest.
    Consciousness, that annoying time between bike rides.

  91. #91
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    I have a-fib, but exercise doesn't seem to trigger it or make it worse. My episodes don't usually last very long. My cardiologist gave me the ok for the Boggs surrogate 8-hour race this year. Maybe do an ablation after that.
    功夫大师喜欢骑着他的自行车在山上。

  92. #92
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    Information is key to helping those who maybe experiencing these conditions.

    Quote Originally Posted by Lopaka View Post
    You are going to die, and there is nothing you can do about it. Get over it and live life to the fullest.
    I think once one passes the age of 30, we realize we are no longer immortal. At least, this was when I discovered my mortality. I would like to feel that this thread is more of a service for those who have concerns or are experiencing cardiac issues, than whining as you intimate. "Get over it" is not the answer some of us are looking for.

    A number of my fellow riding friends are exactly in this spot, experiencing A-Fib and have given thoughtful advise to those of us who have been lucky enough not to experience this condition. If anything, it led me to a meaningful conversation with a competitive biker friend who is also a physician at UCSF. Many of the questions brought out in this thread were addressed in a helpful and meaningful way.

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    stress test done yesterday, doc says everything is good, while t wave inversion is present, based on all other information i should be very low risk, i had a stress test done 3 years ago by the same doc and i ended up going faster and longer than last time.

    a bit of background, for as long as i can remember ive always felt a weird phenomenon with my heart, it seemed to be totally random, but happened enough to know it kept happening so to speak, basically i felt my heart "skipped a beat" which then was followed by a strong contraction right after the contraction i get that "lump in throat" feeling along with the need to take a deep breath, sort of almost feels like a small shot of adrenaline, it usually only lasts a few seconds then it goes away. I never really went ot the doc to check things out, that is until 3 years ago when my 1st daughter was born. I explained this feeling to the doc who ordered an ecg right on the spot, lady came in took it then left, she then came back and said there was some "weird stuff" going on and wanted to make sure they got the right reading, so they took it again and essentially got the same reading, Doc came back in and thats where they explained the inverted t wave reading, Doc said based on blood pressure, weight, my exercise level, that i should be fine and thats just the way my heart beats, anyway, they ordered a complete blood panel and some other tests, results came LDL was low; good. HDL was also low; bad, so thye suggested a bit more exercise, better eating, etc etc.. they also ordered a Hs-CRP ( high-sensitivity C-reactive protein) which is a test sometimes used to evaluate risk of heart disease risk.. test came back, high, really high, normal levels are from 1 (low risk) to 3 (high risk) i came back at a 12, needless to say this scared me. I asked the Doc about the test and they were a bit dismissive of the results, stating that this was a very sensitive test and any other inflammation ( i was just getting over strep throat) at the time could skew the numbers, doc said i should put much weight in results and considered me healty and relatively low risk for heart disease. So i left it alone.

    Fast forward about a week ago, i was out riding when i started feeling pain in my chest to the point were i felt i needed to stop and pull out my phone in case i needed to dial for help,it weirded me out... after a minute or so pain subsided and i resumed riding, got home told my wife and she urged me again to check with the doc about my issues, hence new treadmill test.. based on the results doc pretty much said to keep exercising, keep eating well, hes not too concerned about my cardiovascular health, i feel somewhat relieved.

    so up until about age 33 i really never was proactive about my cardiovascular health.. ill be 37 this year and now with 2 daughters.. things change

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    Quote Originally Posted by RooHarris View Post
    I think once one passes the age of 30, we realize we are no longer immortal. At least, this was when I discovered my mortality. I would like to feel that this thread is more of a service for those who have concerns or are experiencing cardiac issues, than whining as you intimate. "Get over it" is not the answer some of us are looking for.

    A number of my fellow riding friends are exactly in this spot, experiencing A-Fib and have given thoughtful advise to those of us who have been lucky enough not to experience this condition. If anything, it led me to a meaningful conversation with a competitive biker friend who is also a physician at UCSF. Many of the questions brought out in this thread were addressed in a helpful and meaningful way.
    Sorry, my advice was more self therapeutic than anything else. If one has a cardiac issue, by all means take action to protect your life. I wonder how many casual cyclists could read this thread and reduce their commitment to something they love out of an unfounded fear of a condition they will never develop.
    Consciousness, that annoying time between bike rides.

  95. #95
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    Worry has never solved anything...

    Quote Originally Posted by Lopaka View Post
    Sorry, my advice was more self therapeutic than anything else. If one has a cardiac issue, by all means take action to protect your life. I wonder how many casual cyclists could read this thread and reduce their commitment to something they love out of an unfounded fear of a condition they will never develop.
    I guess this is why I began the thread. Many good folks worry too much and don't directly do something about the issues. The more I delved into it, the more I found friends and fellow riders experiencing several of the issues discussed in this thread. For me, worry has never solved anything. Instead, I wanted to get a discussion up and running for the great NOR-Cal folks over 50 who may be noticing some cardio abnormalities or just thinking ahead. Plus, there is so little research on the subject that it was time to get the elephant off the trail and light on this important issue.

    Hopefully, as you say, we do not stop something we love out of fear or worry. Ultimately, biking's benefits outweigh the alternative. When I'm done with my usual 4 to 5 hour ride, I never feel guilt popping an ale. At the end of each day, the quality of my life has been enhanced because of a bike.

    We have a ride this morning at the End of Pavement Rd 409 at 11AM, come join us...

  96. #96
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    Quote Originally Posted by f0nz0 View Post
    stress test done yesterday, doc says everything is good, while t wave inversion is present, based on all other information i should be very low risk, i had a stress test done 3 years ago by the same doc and i ended up going faster and longer than last time.
    Great news! Pro-action has given you peace of mind. Well done!

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    Im in no way affiliated, and I just stumbled upon this Docs blog site, but thought Id share as I liked what I saw right off the bat...

    He's a cardiac electrophysiologist and cyclist....

    Dr John M – cardiac electrophysiologist, cyclist, learner
    Velofix.com for mobile bike repair in Sac

  98. #98
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    Quote Originally Posted by ryanxj View Post
    Im in no way affiliated, and I just stumbled upon this Docs blog site, but thought Id share as I liked what I saw right off the bat...

    He's a cardiac electrophysiologist and cyclist....

    Dr John M – cardiac electrophysiologist, cyclist, learner
    Thank you for the link. It's another great source of information. The more material we can come up with to further this discussion is great, while lending to the dissemination of information to allay fear and worry for all of us.

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    man, so freeride legend Kelly Mcgarry passed away, reports are coming back... cardiac arrest, dude was only 33 years old!

    Kelly McGarry Has Passed Away in New Zealand - Mountain Bikes News Stories - Vital MTB

  100. #100
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    Quote Originally Posted by f0nz0 View Post
    man, so freeride legend Kelly Mcgarry passed away, reports are coming back... cardiac arrest, dude was only 33 years old!

    Kelly McGarry Has Passed Away in New Zealand - Mountain Bikes News Stories - Vital MTB
    Has the cause of death been confirmed? It sounds like cardiac arrest but I haven't seen an official report.

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