Cyclists' hearts: Why elite cyclists die in their sleep (7 min video)

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Good question. Highly trained athletes can develop unusual rhythms - but they're generally not of concern. Normal heart rhythm is called 'sinus rhythm' which is the normal anatomical way a heartbeat is created and travels through the heart. Athletes can get not only sinus bradycardia (slow heart) but 'heart block' which is an abnormality in the electrical pathway. The most trivial just means the electrical pulse moves slower through one of the junction boxes. If it moves even slower you can get dropped beats. Some also develop something called a bundle branch block which is another non-worrying electrical issue.

On scans the heart can be enlarged, thickened and it can be very hard to differentiate between a diseased heart and a fit one on scans and heart tracings. Sometimes even if you exercise someone hard it's not always apparent - someone could be very fit *and* have early stages of a disease. So it's a very interesting field.

The second part of the answer to your question is that later in life, endurance athletes have higher rates of something called atrial fibrillation - an irregular heart. This is important as it can predispose to a stroke. We're not entirely sure why this happens.
Very interesting. There have been a number of top cyclists treated for heart anomalies. One of those I can recall was Navaradauskas but there have been others. I also know a couple of people who've been flagged with an abnormal rhythm during routing tests but later told it was typical of highly trained athletes.

http://www.cyclingnews.com/news/navardauskas-back-to-100-per-cent-after-heart-surgery/
 

Ajax Bay

Guru
Location
East Devon
"The world of cycling has been paying tribute to Michael Goolaerts, the 23-year-old rider who lost his life after suffering a cardiac arrest at Paris-Roubaix yesterday."
http://road.cc/content/news/239896-cycling-world-pays-tribute-michael-goolaerts
Sporza reports (Belgian broadcaster) quotes the public prosecutor as saying: “According to initial findings, it seems to be a heart failure, after which he [Goolaerts] fell, and it was not the fall that led to his condition.”
Bump for @medlifecrisis's video.
 
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Milzy

Guru
Hello everyone,

I hope you don't mind me posting this as I am new to the forum, a few people suggested I share it here (my channel is not monetised, just thought people would be interested).

This is a short video inspired by Marco Pantani and that amazing phrase many of you will've heard, about his heart rate being so slow he had to wake up in the night to pedal on an exercise bike: "During the day he lived to ride, but at night...he rode to stay alive". I'm a cardiologist (and lousy cyclist) and try to explain why a couple of dozen endurance athletes have died in their sleep over the last few decades.

Any thoughts sincerely appreciated and thank you for watching!


View: https://www.youtube.com/watch?v=hT8GZlBBv5k

Hello everyone,

I hope you don't mind me posting this as I am new to the forum, a few people suggested I share it here (my channel is not monetised, just thought people would be interested).

This is a short video inspired by Marco Pantani and that amazing phrase many of you will've heard, about his heart rate being so slow he had to wake up in the night to pedal on an exercise bike: "During the day he lived to ride, but at night...he rode to stay alive". I'm a cardiologist (and lousy cyclist) and try to explain why a couple of dozen endurance athletes have died in their sleep over the last few decades.

Any thoughts sincerely appreciated and thank you for watching!


View: https://www.youtube.com/watch?v=hT8GZlBBv5k

I thoroughly enjoyed your video. I’d like you to post more. I’d love to go for a ride with you but you’re probably not that local. Ohh well. Subscribed.
 
OP
OP
M

medlifecrisis

Regular
@medlifecrisis
"The world of cycling has been paying tribute to Michael Goolaerts, the 23-year-old rider who lost his life after suffering a cardiac arrest at Paris-Roubaix yesterday."
http://road.cc/content/news/239896-cycling-world-pays-tribute-michael-goolaerts
Sporza reports (Belgian broadcaster) quotes the public prosecutor as saying: “According to initial findings, it seems to be a heart failure, after which he [Goolaerts] fell, and it was not the fall that led to his condition.”

Very sad news. As I understand he suffered a cardiac arrest whilst actually riding, so it may be that he had some underlying heart condition which was revealed during exertion, as opposed to anything else (doping only tends to increase risk of cardiac complications at rest).
 

Ming the Merciless

There is no mercy
Location
Inside my skull
It is important to distinguish the endurance cyclists the study conclusions come from. It is primarily about cyclists or other athletes who do high volume at high intensity. This is not the type of cycling most of us do. We may do some high volume, we may do some high intensity, but rarely are they combined. If you do the occassional long ride at moderate intensity you shouldn't let the elite endurance athlete studies worry you. Most of us will get nowhere near their volumes, and we do not ride close to out aerobic capacity for extended periods.
 

Milzy

Guru
[QUOTE 5210017, member: 43827"]Last year, while out for a ride, I took a coffee break and was sitting next to a man and his wife and we started chatting. He was about my age and was interested in my cycling and how it helped my fitness. He said he used to ride and run but hadn't done so for a while following a heart attack, although he still had a bike and was thinking about it.

A few weeks later I read that he had collapsed and died from a heart attack on a bike ride near his home after just starting cycling again.

I have worried that my enthusiasm for cycling and its beneficial impact on me influenced or contributed to his decision, and when I read threads like this it reminds me that we should not let our non medically qualified enthusiasm, based on our personal experience, be taken as expert advice about heart rates or any other medical issue. From now on my only advice would be to never give advice on medical matters......no matter how fit or unfit the recipient seems.[/QUOTE]
I’ve climbed up white horse bank at 200bpm fine but I worry that won’t be safe in a few years time. Who knows some peoples hearts are just very strong others flawed. :sad:
 

Alan O

Über Member
Location
Liverpool
[QUOTE 5210017, member: 43827"]Last year, while out for a ride, I took a coffee break and was sitting next to a man and his wife and we started chatting. He was about my age and was interested in my cycling and how it helped my fitness. He said he used to ride and run but hadn't done so for a while following a heart attack, although he still had a bike and was thinking about it.

A few weeks later I read that he had collapsed and died from a heart attack on a bike ride near his home after just starting cycling again.

I have worried that my enthusiasm for cycling and its beneficial impact on me influenced or contributed to his decision, and when I read threads like this it reminds me that we should not let our non medically qualified enthusiasm, based on our personal experience, be taken as expert advice about heart rates or any other medical issue. From now on my only advice would be to never give advice on medical matters......no matter how fit or unfit the recipient seems.[/QUOTE]
That's a sad story indeed, and it's very hard to generalize. And you can never know - it's possible the second heart attack was waiting to happen anyway, and he might have lived longer had he started sensible exercise earlier?

I had a heart attack 11 years ago, and I was strongly advised that exercise was the best thing I could do (and my GP is a cyclist and strongly supports my cycling). But, it was made clear to me that it's a balance... between the increase in fitness improving my chances of greater longevity, and the possibility of something excessive triggering a new attack. The doc reckons that balance is very much in my favour, but it clearly does depend on the individual.
 

Ming the Merciless

There is no mercy
Location
Inside my skull
I can recommend "The Haywire Heart" if you are interested in this subject, but only if you do not over worry about such things. Makes for interesting reading on what is known and not known plus also the different categories of failure as heart attack only covers a subset of failure modes. Good if technical section on how the heart works as well.
 

PK99

Legendary Member
Location
SW19
[QUOTE 5210017, member: 43827"]From now on my only advice would be to never give advice on medical matters......no matter how fit or unfit the recipient seems.[/QUOTE]

Amen to that.

It scares me to see the "medical advice" dolled out here sometimes.
 

Crankarm

Guru
Location
Nr Cambridge
Without the detailed autopsy report for the cause of death it is hard to speculate. A congenital heart defect, poor diet, smoking, drinking, etc? Live each day like it's your last and make a Will.
 

Ajax Bay

Guru
Location
East Devon
It scares me to see the "medical advice" dolled out here sometimes.
Hi @PK99. I thought I 'd see if I could find "medical advice [being] dolled out" that might scare you and be to the detriment of others. I don't visit the 'Training, Fitness and Health' sub-forum so perhaps such advice is widespread there but I trawled back through this 9 page thread and clipped some parts of comments which might be considered 'medical advice'. Please could you offer examples (anonymised if you prefer) which "scares [you]" because, by inference, you suggest such advice should not be offered on these fora.
Sleep apnea is a very serious condition, that is amenable to treatment. See your GP for referral to nearby sleep clinic.
I note that Steve Abraham (highest mileage for a year challenger) discovered that his sleep (16 hours a day riding and 8 for everything else, for 365 days) was being disrupted by sleep apnea to the detriment of his daily 200+ average miles).
Be careful you lot, just because you can doesn't mean you should red-line your heart rate!
Why not? What damage will someone cause to their body or what risk do you envisage if someone pushes for their max? Can you give examples of athletes (any sport) that have dropped dead or caused themselves (CV) injury when pushing up to their max? Pulled hamstring or calf, maybe.
For long term health the priorities are to do an exercise that keeps your HR up, but not necessarily aiming for super high. 85% is a good target - no suggestion of an incremental benefit above this.
I don't think aiming for the highest max HR is unsafe for the vast majority of people, but it will increase risk of several problems in *some* people and there's no evidence it's beneficial vs HR ~85% max.
 
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Colin_P

Guru
@Ajax Bay @Alan O very nicely put.

@PK99

It is like the instruction manual for some new hi-fi or assembly instructions for some flatpack, we have all left them in the box and cracked on regardless.

As has been said many times, anyone can do what they want and ignore any and all advice. Mountains would never have got climbed otherwise but a fair few died trying.

It is those who take that path who create the ultimate "Hold me beer and watch this..." moments. And I salute you!

Did I mention that suffering a cardiac arrest is almost instantaneous and less than 5% come back from one. It doesn't hurt though.
 

ColinJ

Puzzle game procrastinator!
So the figures published in the National Framework (in respect of out of hospital cardiac arrest) and the UK National Cardiac Arrest Audit (in respect of in hospital cardiac arrests) are wrong and you're right? Really?
I think he means that someone suffering a cardiac arrest is still very likely to die. The numbers you posted are much better than the ones that he'd posted, but are still pretty grim!

It is tragic when a young person dies of a cardiac arrest, but it wouldn't be such a bad way for a very old person to go. I watched both of my parents go through slow, unpleasant deaths over a period of several years. Both said numerous times that they just wanted it over with.

I went through about 95% of a slow-death process myself in 2012/13 and it was horrible enough to convince me that I want to die suddenly when my time finally does come.

A friend of mine died of cardiac arrest in his sleep. (At least we think he did, since he was found dead in bed and had made no attempt to summon help.) It was a real shock to his family and friends, but it was comforting to know that he didn't suffer. The bad thing was that he was only 59 at the time. I'd like to get another 20+ years in before something like that happens to me!
 
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