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Images in clinical practice
Diagnosis of arrhythmias in athletes wearing heart rate monitors
  1. David Hunt1 and
  2. P Tanto2
  1. 1St George's Hospital—General Intensive Care Unit, Blackshaw Road Tooting, London, UK
  2. 2St George's Hospital—Emergency Department, London, UK
  1. Correspondence to David Hunt, St George's Hospital—General Intensive Care Unit, Blackshaw Road Tooting, Blackshaw Road, Tooting, London SW170QT, UK; davidmichaelhunt{at}hotmail.com

https://doi.org/10.1136/jramc-2016-000696

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    We wish to highlight the utility of sports watch HR monitors to facilitate the diagnosis of arrhythmias. A 34-year-old male who had an established history of paroxysmal atrial fibrillation was 5 miles into a planned 12-mile run. He was wearing a Garmin 630 wristwatch HR monitor which captured the following episode of tachycardia:

    During the episode, he experienced ‘palpitations’ and felt light-headed (Figure 1). He stopped running, sat down and performed a Valsalva manoeuvre to try and abate the episode. This was successful, and is clearly demonstrated by the HR data (Figure 2). The palpitations stopped, he made the decision to continue the run at a slower pace and suffered no further episodes. While we appreciate that this is not diagnostic, it does highlight a potential role for personal HR monitors to be interrogated with a view to establishing information about the timing and duration of potential arrhythmias as well as the maximal HR captured which may provide useful diagnostic information.1 The use of these devices appears to be ubiquitous throughout the armed forces, and this may prove particularly useful to the Regimental Medical Officer operating in an austere environment either on operations or during adventurous training activities.

    Figure 1
    Figure 1

    Maximum HR captured during the exercise period.

    Figure 2
    Figure 2

    Minimal HR captured during a Valsalva manoeuvre.

    Reference

    1. ↵
      1. Mussigbrodt A,
      2. Richter S,
      3. Wetzel U, et al
      . Diagnosis of arrhythmias in athletes using leadless, ambulatory HR monitors. Med Sci Sports Exerc 2013;45:1431–5. doi:10.1249/MSS.0b013e31828ca1bf
      OpenUrl

    Footnotes

    • Contributors Both DH and PT worked together and contributed equally to the article.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.