Heart Rate Monitor Instead of Ablation? Atrioventricular Nodal Re-Entrant Tachycardia in a Leisure-Time Triathlete: 6-Year Follow-Up

This study describes a triathlete with effort-provoked atrioventricular nodal re-entrant tachycardia (AVNRT), diagnosed six years ago, who ineffectively controlled his training load via heart-rate monitors (HRM) to avoid tachyarrhythmia. Of the 1800 workouts recorded for 6 years on HRMs, we found 45...

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Main Author: Robert Gajda
Format: Article
Language:English
Published: MDPI AG 2020-06-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/10/6/391
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author Robert Gajda
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author_sort Robert Gajda
collection DOAJ
description This study describes a triathlete with effort-provoked atrioventricular nodal re-entrant tachycardia (AVNRT), diagnosed six years ago, who ineffectively controlled his training load via heart-rate monitors (HRM) to avoid tachyarrhythmia. Of the 1800 workouts recorded for 6 years on HRMs, we found 45 tachyarrhythmias, which forced the athlete to stop exercising. In three of them, AVNRT was simultaneously confirmed by a Holter electrocardiogram (ECG). Tachyarrhythmias occurred in different phases (after the 2nd–131st minutes, median: 29th minute) and frequencies (3–8, average: 6.5 times/year), characterized by different heart rates (HR) (150–227 beats per minute (bpm), median: 187 bpm) and duration (10–186, median: 40 s). Tachyarrhythmia appeared both unexpectedly in the initial stages of training as well as quite predictably during prolonged submaximal exercise—but without rigid rules. Tachyarrhythmias during cycling were more intensive (200 vs. 162 bpm, <i>p</i> = 0.0004) and occurred later (41 vs. 10 min, <i>p</i> = 0.0007) than those during running (only one noticed but not recorded during swimming). We noticed a tendency (<i>p</i> = 0.1748) towards the decreasing duration time of tachycardias (2014–2015: 60 s; 2016–2017: 50 s; 2018–later: 37 s). The amateur athlete tolerated the tachycardic episodes quite well and the ECG test and echocardiography were normal. In the studied case, the HRM was a useful diagnostic tool for detecting symptomatic arrhythmia; however, no change in the amount, phase of training, speed, or duration of exercise-stimulated tachyarrhythmia was observed.
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spelling doaj.art-80edf027ec254c268764cc5cbb5c036a2023-11-20T03:26:30ZengMDPI AGDiagnostics2075-44182020-06-0110639110.3390/diagnostics10060391Heart Rate Monitor Instead of Ablation? Atrioventricular Nodal Re-Entrant Tachycardia in a Leisure-Time Triathlete: 6-Year Follow-UpRobert Gajda0Center for Sports Cardiology at the Gajda-Med Medical Centre in Pułtusk, ul. Piotra Skargi 23/29, 06-100 Pułtusk, PolandThis study describes a triathlete with effort-provoked atrioventricular nodal re-entrant tachycardia (AVNRT), diagnosed six years ago, who ineffectively controlled his training load via heart-rate monitors (HRM) to avoid tachyarrhythmia. Of the 1800 workouts recorded for 6 years on HRMs, we found 45 tachyarrhythmias, which forced the athlete to stop exercising. In three of them, AVNRT was simultaneously confirmed by a Holter electrocardiogram (ECG). Tachyarrhythmias occurred in different phases (after the 2nd–131st minutes, median: 29th minute) and frequencies (3–8, average: 6.5 times/year), characterized by different heart rates (HR) (150–227 beats per minute (bpm), median: 187 bpm) and duration (10–186, median: 40 s). Tachyarrhythmia appeared both unexpectedly in the initial stages of training as well as quite predictably during prolonged submaximal exercise—but without rigid rules. Tachyarrhythmias during cycling were more intensive (200 vs. 162 bpm, <i>p</i> = 0.0004) and occurred later (41 vs. 10 min, <i>p</i> = 0.0007) than those during running (only one noticed but not recorded during swimming). We noticed a tendency (<i>p</i> = 0.1748) towards the decreasing duration time of tachycardias (2014–2015: 60 s; 2016–2017: 50 s; 2018–later: 37 s). The amateur athlete tolerated the tachycardic episodes quite well and the ECG test and echocardiography were normal. In the studied case, the HRM was a useful diagnostic tool for detecting symptomatic arrhythmia; however, no change in the amount, phase of training, speed, or duration of exercise-stimulated tachyarrhythmia was observed.https://www.mdpi.com/2075-4418/10/6/391AVNRTendurance trainingHRMtriathlonexertion cardiac arrhythmiaHolter ECG
spellingShingle Robert Gajda
Heart Rate Monitor Instead of Ablation? Atrioventricular Nodal Re-Entrant Tachycardia in a Leisure-Time Triathlete: 6-Year Follow-Up
Diagnostics
AVNRT
endurance training
HRM
triathlon
exertion cardiac arrhythmia
Holter ECG
title Heart Rate Monitor Instead of Ablation? Atrioventricular Nodal Re-Entrant Tachycardia in a Leisure-Time Triathlete: 6-Year Follow-Up
title_full Heart Rate Monitor Instead of Ablation? Atrioventricular Nodal Re-Entrant Tachycardia in a Leisure-Time Triathlete: 6-Year Follow-Up
title_fullStr Heart Rate Monitor Instead of Ablation? Atrioventricular Nodal Re-Entrant Tachycardia in a Leisure-Time Triathlete: 6-Year Follow-Up
title_full_unstemmed Heart Rate Monitor Instead of Ablation? Atrioventricular Nodal Re-Entrant Tachycardia in a Leisure-Time Triathlete: 6-Year Follow-Up
title_short Heart Rate Monitor Instead of Ablation? Atrioventricular Nodal Re-Entrant Tachycardia in a Leisure-Time Triathlete: 6-Year Follow-Up
title_sort heart rate monitor instead of ablation atrioventricular nodal re entrant tachycardia in a leisure time triathlete 6 year follow up
topic AVNRT
endurance training
HRM
triathlon
exertion cardiac arrhythmia
Holter ECG
url https://www.mdpi.com/2075-4418/10/6/391
work_keys_str_mv AT robertgajda heartratemonitorinsteadofablationatrioventricularnodalreentranttachycardiainaleisuretimetriathlete6yearfollowup