Question from TOUR reader Achim G.: For some years now, my pulse rate has suddenly risen out of nowhere to around 170 beats during normal, constant exercise (120 to 140 beats per minute). It usually drops again straight away when I rest, but it takes a longer time with slightly reduced exercise. I, 53 years old, have this problem on alpine tours lasting several days and during marathons, but also during other sports such as football or jogging. A check-up with a cardiologist has not yet produced a satisfactory result. Can you help me further?
Expert advice from Dr Robert Eifler: Sudden, significant increases in heart rate are classed as rapid (tachycardic) cardiac arrhythmias, both at rest and during exercise. They can be both less dangerous and potentially highly dangerous cardiac arrhythmias. Both can be self-limiting in terms of frequency. The palpitations may originate from the atrium or may be atrial fibrillation or flutter, which quickly spreads to the main chambers of the heart. Another possibility is ventricular tachycardia, i.e. various forms of tachycardia originating in the main ventricle.
Especially if the arrhythmia occurs during exercise, it is imperative that you have the causes clarified in detail. The disturbance should be documented on an ECG (electrocardiogram). This often requires some patience until the moment in question has been recorded. It is usually advisable to record a long-term ECG under real exercise conditions - for example during training. Ergometry up to the endurance test can also lead to a successful diagnosis. The cardiac arrhythmia you describe can also occur even though the ultrasound findings of the heart were unremarkable. However, this examination is always part of the clarification procedure.
