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Are Heart Palpitations During Exercise Normal?

Have you ever experienced heart palpitations or irregularities during exercise? Were you worried? Get-Fit Guy looks at some of the reasons behind most heart problems experienced during vigorous exercise. (Hint: It's probably not a heart attack). 

By
Ben Greenfield
5-minute read
Episode #232

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Last week, you learned about whether exercise can actually make you live longer, and how much exercise is enough for optimal longevity benefits.

In today’s episode, we’re going to look at another critical component of exercise - your heart - specifically, whether you need to be concerned about heart palpitations during exercise.

A new study found that many athletes have electrical heart “issues,” but these issues may not actually be meaningful from a cardiac risk standpoint. The study looked at the criteria for interpretation of electrocardiograms (ECGs) of people’s hearts and noted that an increasing number of sporting bodies report unacceptably high levels of false-positive ECGs in pre-participation cardiac screening. This means that athletes and fitness enthusiasts who have electrical abnormalities in the heart during exercise may be experiencing something that’s completely normal for an athlete, and that doesn’t necessarily reflect a serious cardiac pathology, including a PVC.

And while a PVC may sound like something out of a science fiction novel or a do-it-yourself household plumbing guide, it actually stands for premature ventricular contraction. Here’s how it works:

Every time your heart squeezes blood out to the rest of your body, it requires an electrical impulse. In a normal electrical conduction, impulses originate from an area in the top right corner of the heart known as the sinus node. The electricity then spreads across the upper two chambers of the heart (the atria) and is then transmitted to the lower two chambers (the ventricles) through the atrioventricular node.

During a normal heartbeat, your heart's ventricles contract blood out to your entire body after your heart's atria have helped to fill them. In this way, the ventricles can pump the maximum amount of blood both to the lungs and to the rest of the body.

So how can this electrical misfiring happen? Every piece of tissue in your heart is electrically active.  This means that all heart tissue can conduct electricity. However, all heart tissue can not only conduct electricity, but can also generate electricity.  Normally, your heart tissue is conducting electricity generated by the sinus node. However, occasionally it will generate electricity on its own as well - and when this happens a premature contraction results.

When a PVC happens, your heartbeat is not initiated by your sinoatrial node (your body's normal heartbeat initiator), but rather by special fibers in your ventricles that are triggered by the atrioventricular node, bypassing the normal method of electrical stimulation. This means your ventricles contract first - before your atria have optimally filled the ventricles with blood.

And this not only means that blood circulation of oxygen and nutrients is way less efficient, it also means that you can feel things like palpitations, skipped beats, extra heart contraction, irregular heart rhythm, slight chest pain, a feeling of faintness and fatigue, or shortness of breath.

But here’s what’s important to know, and what the latest research highlights: the occasional PVC is actually common, especially for athletes exercising at high intensities, and it doesn’t necessarily mean you’re going to drop dead of a heart attack.

See also: 6 Heart Attack Risk Factors

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About the Author

Ben Greenfield

Ben Greenfield received bachelor’s and master’s degrees from University of Idaho in sports science and exercise physiology; personal training and strength and conditioning certifications from the National Strength and Conditioning Association (NSCA); a sports nutrition certification from the International Society of Sports Nutrition (ISSN), an advanced bicycle fitting certification from Serotta. He has over 11 years’ experience in coaching professional, collegiate, and recreational athletes from all sports, and as helped hundreds of clients achieve weight loss and fitness success.