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). 

Ben Greenfield
5-minute read
Episode #232

That's right - nearly everybody has a skipped or extra heartbeat every now and then. As a matter of fact, cardiac electrophysiologist and cyclist Dr. John Mandrola wrote a blog post on PVCs saying that PVCs are the second most common rhythm problem he sees (he points out that a related electrical abnormality called an atrial arrhythmia, also known as a "heart flutter," is the most common).

In that same post, Dr. Mandrola also points out a few other interesting facts, including:

  • In an overwhelming majority of people, especially those with normal heart structure, PVCs are benign - which means that the extra beats do not actually indicate heart disease or any other serious and immediately threatening issue.

  • The normal person has about 100,000 heartbeats per day (elite athletes with slower heartbeats would have fewer) and only people with more than 20,000 PVCs per day are actually at risk for developing cardiomyopathy (weak heart). That means about 20% of the time you feel a flutter or palpitations, you're likely experiencing PVCs. 

  • The presence of PVCs might indicate training excess. According to Dr. Mandrola:

"It might happen during a big training block or immediately afterwards. Of course, my theory is that PVCs associate with excess inflammation. The reason I see inflammation as the link is because PVCs often occur in patients who are exposed to stress. The middle-aged person going through a divorce, the doctor embroiled in a lawsuit, the minister who takes care of everyone but himself, the grad student during exams. The theme here is that PVCs tend to cluster at times of high inflammation–be it physical, mental or emotional...

Recently, a cycling friend told me his PVCs had resolved almost as soon as he stopped training for races. He still rides, fast at times, but doesn’t ‘train.’ (I’m not advocating not racing; it’s just an anecdote.)"

While electrolytes may matter less than Gatorade would have you believe, they're certainly important for heart health and electrical conductivity in hard charging athletes. In an era of mineral-depleted diets, excessive stress, and over-exercise, I suspect deficiencies are a much bigger contributor to the problem than many people might think (yet another reason why I slather my body with magnesium oil after every hard workout).

In a nutshell, you can think of PVCs as a canary in the mine. As a matter of fact, in this helpful forum discussion on MedHelp, it's pointed out that two conditions are known to cause PVCs during exercise - one is coronary artery disease and the other is myocarditis (heart inflammation) and both are often aggravated by poor exercise conditions and excess adrenaline (from stress and/or overtraining). But in the absence of these two factors, PVCs may actually be no big deal at all.

Have you experienced PVCs during exercise? What did you do? Share your thoughts over at the Facebook.com/GetFitGuy page!.

Heart exercising cartoon courtesy of Shutterstock.


All content here is for informational purposes only. This content does not replace the professional judgment of your own health provider. Please consult a licensed health professional for all individual questions and issues.

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.