Episode 2 - Supraventricular Tachycardia

So here we go again. It’s September 2014 and I’m out for one of my regular runs, about 10k, and there’s a noticeable thump in my chest and an odd sensation of palpitations. I stop running and the weirdness stops almost immediately. Slightly puzzled, I continue with no further incident.

I’m quite familiar with the odd palpitation now and again, all completely harmless, and so I think nothing of it. Until about a month or so later when it happens again. As before, a thump in my chest, a bit of a whoozy feeling, but as soon as I stop running it all goes away. OK, I think, if this happens again I will have to get it checked out.

And it does happen again. I’m out with some running buddies in Oxford and thump, there it goes, and this time when I stop running the odd sensation continues. My heart is thumping and my heart rate monitor reads around 240 bpm. This is not good I think and so with the help of my buddies I deliver myself to A & E at the John Radcliffe Hospital. ‘Something weird keeps happening to my heart’ I say, ‘and it’s happening now’.

The medics wheel me in and wire me up to several machines. It seems they're amazed that I’ve arrived conscious and self-ambulatory. I’m in the midst of an episode of supraventricular tachycardia, a potentially dangerous heart arrhythmia. I’m found a bed and I'm given a dose of amiodarone, a powerful anti-arrhythmia drug (I thought I’d seen the last of amiodarone back in 2000). This has the desired effect and with another pronounced thump, my heart kicks back into a normal sinus rhythm.

OK I think. It seems we know what’s happening (that’s good), it seems that incidents are becoming more frequent and more severe (that’s bad), we know a drug that can stop it if it kicks off again (that’s good), but presumably the plan will be to figure out a way to stop it happening again (needless to say, that’s the interesting bit).

My previous history is a complicating factor. The medics can’t agree whether or not the two events are related. Nor can they agree whether or not the damage left in my heart after my cardiomyopathy (this is the first I knew there was any) might alter the effectiveness of the standard treatments. Frustratingly, while this is all discussed the medics are very nervous of letting me out of their sight. This despite the fact that I am now stable, in a normal heart rhythm, and I've made a solemn promise not to go running again until this thing is all fixed!

It takes about a week, during which various tests are run, but eventually a plan is agreed. It seems I have an abnormal accessory electrical pathway in my heart and this can be zapped out by a catheter ablation procedure. Reluctantly, the medics agree that I can wait for this procedure at home.

All-in-all, I'm OK. I can handle this. It seems I have something that is discreet and fixable. I just need to wait 3 or 4 weeks for the procedure. But once again, I can't help but bring a bit of scientific analysis to the table. Some of the medics are clear that this must be related to my previous history. I'm not so sure. If this does relate to damage left behind in my heart by my cardiomyopathy, then why did it wait 10+ years to suddenly rear its head? Equally, however, if it's a genetic inheritance then why did it take 50+ years to show its teeth. These seem to be the only two options under consideration and frankly, neither makes any sense to me.

Anyway, much as I hate loose ends or logical inconsistencies, and trust me I really hate them, I figure I should focus on the big picture. There is a plan and I'm promised a return to normality. I'm going to be well again.

As it turns out I go through the catheter ablation procedure twice. They don't quite get it all the first time. It's quite a bruising process, but of course to my mind it's clearly worth it. I step out into the world with my newly engineered heart somewhat gingerly. It's going to be another exercise in gradually testing new boundaries. How far I can push? No worries, been there, done that before.

And now in the post-Garmin world of personal data logs, I have evidence. Ooh, how I love this. I pick up running again in late March and my heart is as solid as a rock. A nice cluster of max heart rate figures around 140/160 bpm thrown into stark contrast by the four instances of tachycardia recorded pre-procedure in late 2014/early 2015.

There are adjustments to make. My running pace has shifted down a notch from 4:15/4:30 per km to 5:00/5:15 per click. It's like I have a newly fitted engine limiter. But trust me, I'm very happy just to be running. I have no appetite to push it. If slower and more steady is to be the new normal, I can live with that.

There is, however, one issue heaving into view on the horizon. Since before the saga all began, I'd been involved in arrangements for a trip to Nepal. The plan is to attempt the 6400m Mera Peak. I've been told I can resume normal activity, but what do the medics consider as normal? Climbing mountains is normal for me, but this kind of altitude is perhaps outside the scope of what many would consider normal. I've not shared my plans with the doctors, not out of any deviousness, but just because one step at a time seemed wise.

And now the question is do I ask them? Am I prepared for an answer I might not like? Is it better to trust my own instincts and not to ask? Bloody hell! It's a tricky one!