Cycling on Beta Blockers

A year ago I wrote an article on Cycling On Beta Blockers over on zerosandones.co.uk – and it gets a surprising amount of views. A year on, medication changes and increases, PVI ablation, and a bunch of experience further down the road – I thought I would pull together some updates to that post.

Situation

It is hard to single out the specifics of a given drug when you are on a number of them. Anti-arrhythmia, anticoagulants, beta blockers, proton pump inhibitors are the currently on the morning and evening menu.

However, the timing or absence of one of them has far more impact on the world between the numbers on my screen, and my experience on a bike: The beta blockers (beta-adrenoceptor blocker).

Observations

My generally low resting pulse… lowered. This is without a doubt the beta blocker (Bisoprolol/Zebeta).

My ability to reach where my upper limits were was also curtailed, be this either the beta blockers or the antiarrhythmic drugs (Flecainide/Tambocor).

The reality was a much smaller window of ‘opportunity’ – with a working range for everything from laying in bed to FTP threshold (yes, that is still possible) falling between 40 and 135 bpm. I am 45 this year. Go figure.

Sudden inclines and ‘buddies sprinting for a sign’ were a re-education. Go, did not occur. There was no surge. Efforts needed to be built up to. Warming up took longer to get to this kind of effort.

Missing a dose for a day was likely to mean exercise would trigger an episode of AFib the following day.

While FTP efforts now took place at around 130x BPM and were still possible, silly things like bending over to put socks on, or do up shoes could leave me panting like a steam engine. This was usually due to failing to plan ahead and organize repeat-prescription, as opposed to experimenting with my dosage. It is worthy of note, taking it at different times will affect you differently, as will a GP prescribing you Ventolin for your breathlessness (?!) – which is a Beta-Antagonist. #goteam.

Adaptations

At first – this was mentally crippling. While “yay” I am still here, still able to ride a bike, but “WTaF” this was genuinely Volkswagen Limp Mode (something I have since had to live through ironically!). The feeling of loss – both of ability, enjoyment, and all the knock on’s from that – such as social, achievement, worth.

This was … arse.

I dealt with it badly. Cycling was me. Cyclists were my friends and social group. I was resenting everyone and everything. What was a love-hate relationship had run off with someone else and left me. Fuck.

Dealing with it

Despite panting like a steam engine leaving a station when doing up your shoes, as mutually exclusive as it sounds, you can still achieve a threshold effort. Where this is, will likely need to be revised. For me dropping below 200 watts. Being able to push yourself – hard – albeit to the dizzying heights of (only) 135 BPM in my case – it still feels good. A red line is still a red line – the Italian Tune-Up is alive and well.

In a very happy accident I used the phrase ‘the picture is fine – just change the frame’ in an earlier article – this – very much this.

Cardiac Athletes – the support group – the sense of “wow these people are managing what?!” – many of which were not competing before their diagnosis/surgery/whathaveyou. These people are a real inspiration. The topic of beta blockers is touched on there all the time.

Puffing and pressure in my neck (and being told that the dose you are on is too low to have this effect) – it is crap. But these issues are more than made up for in the holding back incidences of AF. Paroxysmal Atrial Fibrillation (PAF) will become worse with more / longer incidences from what I can ascertain. No one wants that. PAF can be handled with medication or more aggressively through PVI ablation. So this is very much a means to an end – stick with it – like you have a choice – the important part is to realise it is an adjustment not an end to cycling.

Perspective: Still on the dose that caused me to stop riding with the usual suspects – I am able to swim 106x 25m lengths in under an hour – and 3×20 minute efforts at just shy of FTP on Trainer Road in under 90 mins. Take it all on board. Take time to adjust. Check with your Cardiologist/Electrophysiologist. Find your limits. Change the frame – the picture is fine.

Please DO leave your experiences in comments below – articles – experiences – stuff. Someone else, like me, and now you will search for similar in future : )

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