Morning everyone!

Welcome to another edition of the Doctor’s Note where we talk about what’s on our minds when it comes to your health. 

This week we’re going to talk about HEART RATE, (a very important vital sign!)  and ATRIAL FIBRILLATION (an irregular heartbeat). 

I’ve been seeing a lot of AFib  lately, more so in my age group. It’s more common nowadays than it was a couple of decades ago. 

I also see AFib in former athletes, especially endurance athletes. It’s a pretty common condition that we will talk more about later in this Note. 

You need to know if you have atrial fibrillation because it increases your risk of death and a lot of other complications like stroke and blood clots. 


The Importance Of Tracking Your Heart Rate 


When you go to the doctor you should have them check your heart rate as well as your blood pressure. 

Your heart rate is also something you should keep track of at home. I do this with my Oura ring. The new Apple watches are great for this because it monitors your heart rate as well as your rhythm. Some of them even measure your heart rate variability, which is a very important measurement of how healthy you are. 

A normal heart rate for adults is usually between 60-100 beats per minute. In kids it’s usually 70-100 beats per minute. 

In general, the lower your heart rate the better. 

You need some kind of measuring device for your heart rate, because you don’t want to just take it just when you’re in the doctor’s office. 

You want to see it in different situations:

  • When you’re sleeping 
  • When you’re active
  • You want to know how high your heart rate can get when you’re doing extreme exercise. Usually it’s 220 minus your age. For example, a 40 year old should have a maximum heart rate of about 180. As you get older it becomes less. 

You also want to know your Heart Rate Variability, which is that subtle difference between the R to R interval between each heartbeat. It should be more variable at rest. So, you want your heart rate variability to be higher when you’re resting or sleeping. The higher that is during rest, the more healthy your heart is. And it should be lower when you’re exercising. It’s weird, but true. 

It’s a good measurement to monitor, and the more fit you become the better those parameters will get. 


Do You Have A High Heart Rate? 


Your heart rate determines the amount of blood that is pumped through your body per minute. The more efficient your heart is means it can pump slower and pump out more in one stroke. That turns out to be the best thing for you. 

All of us have a certain amount of heartbeats in our lives, so save them up!

The heart rhythm is pretty important too. A lot of people have palpitations that can be caused by a lot of different things. So if your heart rate tends to be on the high side, the causes of that could be dehydration, stress and poor sleep. 

It could also indicate a poor fitness level. Sometimes even an oncoming infection or illness can be signaled by a high heart rate.

As a matter of fact, during the COVID crisis they found that even before people got a fever with COVID-19, their heart rates were the first thing to go up. 

Bottom line…monitor your heart rate. It’s a very important measurement of your health!  In general, the lower the better. 

If you have a high heart rate, there are some other things you might want to check. 

  • Thyroid 
  • Adrenals 
  • Cortisol levels
  • Sleep patterns 
  • Are you eating a poor diet? 
  • Drinking too much caffeine? 

Heart rates are extremely important and easy to measure. It’s a vital sign you need to monitor. 


Arrhythmias and Irregular Heart Rates  


Most people throw a PVC (Premature Ventricular Contraction) every once in a while. It’s a “skipped beat”, so the next beat you get you’ll have more blood in your heart chamber, which means it’s going to be a really hard beat. You actually feel it. Usually a PVC is a normal thing unless you have a ton of them. 

We do things like an EKG, and take certain measurements of those different intervals, which can be important.

There are some weird types of fast heart rates like: 

  • Wolff Parkinson White 
  • LGL Syndrome 
  • PR Interval
  • QT Interval (You don’t want a prolonged QT interval if you look at the QRS Interval on an EKG)

Note: A PR Interval and QT Interval are small measurements on your EKG. 

If you don’t look at these things it’s hard to know what you have, but these are certainly rare. If you have persistent problems, such as fainting or passing out with a high heart rate, you need to get that checked out. 


Atrial Fibrillation


Atrial fibrillation is where the upper chamber of the heart kind of quivers instead of having a normal beat. 

There’s coordination between the top part of your heart and the bottom part of your heart. The top part stores your blood and moves it into the bottom part of your heart.  

The blood is pumped into your body to provide oxygen to all of your muscles and tissues (Remember your heart is a muscle). So if the top part quivvers, that means you’re in atrial fibrillation. You can easily detect it. I can detect it just by feeling your pulse. It’s an irregular heart rate. 

So it’s not regular. It skips around a lot causing each beat to be different. That’s a signal that it could be a very dangerous heart rate that could cause a stroke. That blood is quivering at the top part of your heart. It can form a blood clot there, shoot off, and become a stroke. 

It also increases your risk of heart attacks, and it leads to very poor heart function. You may just be tired or short of breath. I’ve had several people come in and tell me their Apple Watch is saying they’re in atrial fibrillation. I feel their pulse and listen to their heart, and sure enough they are in atrial fibrillation. 

We’ll need to look at this because you need to reestablish a normal heart rate and a normal heart rhythm. You do not want to let this go unchecked because your chances of a stroke are a lot higher. 

It’s definitely something that needs to be checked out. And if you have atrial fibrillation then you need to be on a blood thinner. You also need to see a cardiologist for more extensive testing, because nowadays they can sometimes ablate it (actually burn those different circuits out and reestablish the right ones, depending on what they find).

If an irregular heart beat causes you to be short of breath, your heart won’t slow down, or you’re fainting, you need to go to the Emergency Room. 

Certain medications can control this. You also need to get on a blood thinner to thin your blood so that you’ll be a lot less likely to have a stroke. That’s very important. 

Atrial fibrillation is becoming more common these days.

People are less fit than they used to be. They’re more obese. They don’t take their fitness levels very seriously. I’m convinced that stress comes into play here. I think stress and a poor diet probably cause more health problems than anything that I see out there. 

So monitor your heart rate. You can use an Oura ring, or even an Apple Watch to do this. 

There’s actually a lot of devices for this. I know a lot of times when I bike I’ll put a chest band on, which measures my heart rate during extreme exercise. It also shows what kind of heart rhythms, etc. 

Another measure of how fit you are is how fast your maximum heart rate comes down to your resting heart rate. 

If you’re exercising at a maximum level and it takes a long time for your heart rate to come back down, that is an indicator that you’re not in that great of shape. 

That’s why I’m such a big fan of interval training. Getting your heart rate up, and then letting it come back down. Tabatas are great for this. 

But you certainly don’t want to overtrain. 

Sometimes overtraining can cause too much inflammation in your body. You can do the opposite of what you’re aiming to do. The recovery phase is as important as the exercise phase in my opinion. 

So please measure your heart rate. It’s a very important vital sign!