The Haywire Heart: How too much exercise can kill you, and what you can do to protect your heart

There is apparently an emerging theory (backed up by a growing body of evidence) that excessive high-level exercise can cause abnormal heart rhythms. This fed through into the community in a Velo News article by the authors of this book in 2015. This book explains that theory - beginning with a case study (and with other case studies scattered throughout the work) - going on to explain how the heart works and how exercise affects the heart and how the heart can be damaged (specifically by or contributed to by high level, high volume exercise). The authors acknowledge that the theory is not 'nailed on' and that there is much work to do to understand how arrythmias develop and whether the link with exercise is indisputable. What the work does is identify the issue, explores it, offers some insight and advice about 'best practice' to perhaps avoid damaging your heart 'just in case'. To a degree, I have to say that the book could cause alarm and concern and I recommend also reading the online blog of Dr Larry Cresswell who is a little less alarmist (in my opinion) and whilst he doesn't dismiss the link with exercise, he offers a more conservative view. I thoroughly recommend the book for what the insights it gives, the quality of the writing and the depth. I should emphasise that this is an exceptional work that is perfectly suitable for the lay person; i.e. not requiring any or any detailed medical knowledge.

I've been an elite masters cyclist in Ontario Canada for several decades and have won National and Provincial Championships on both road and track. Recently I lost a good friend who used to be a fierce competitor and continued to keep himself in excellent condition - he just dropped dead one morning from a heart attack. I also have another close friend who is learning to live with severely impaired heart function. Again, a man who kept himself in pretty good shape. As I think back over the years I realise that there have been several other deaths of masters cyclists from heart problems that I know about. I just never really thought much about it because, like many others, I had a mindset that endurance aerobic activity strengthened a person's heart and cardiovascular system. Not sure how I camp across this book but it has been an eye-opener for me and explains so much that was in the back of my mind, unresolved. I suggest you read the epilogue first before you get into the details of the main body of the book. I'm 75 years old now and my doctor tells me I'm doing just fine so maybe I'll be okay. The book explains that most endurance athletes do not have problems with their hearts, but some do, and it is a significant enough risk that we should all be aware of it. Remember, just because something is good for you does not mean that more of it will be better. I heartily recommend this book to anyone who participates in endurance sport, or has a loved one who does.

Devo ancora finirlo, ma non mi pare offra soluzioni concrete per evitre i problemi. Tuttavia apre gli occhi in modo abbastanza divulgativo (e quindi comprensibile ai più) sulle problematiche cardiache degli sport di endurance protratti per tanti anni.

Básicamente se trata de un compendio de los conocimientos sobre el tema, bastante bien desarrollado, basado en muchas fuentes y con un buen nivel divulgativo. Por otro lado, al puro estilo americano, insiste mucho en casos muy concretos, detallando durante páginas hasta los sentimientos de las personas que se citan como ejemplos, volviéndose algo pesado. La calidad de la gráfica, la impresión y la encuadernación de la versión de tapa blanda es bastante pobre.

Having recently been diagnosed with AF I wanted to learn much more about the condition. The British Heart Foundation and some hospital websites like Royal Brompton have some good info and are a good starting point but I wanted a more comprehensive understanding. I am a masters lifelong endurance athlete. I chose three books, two from having read Amazon reviews and the third I had ironically learnt about shortly before the diagnosis. I am reviewing them all together as I like reviews where other books are highlighted, particularly if they are better or have something different to say. One word of warning whether typical of books on AF or not all three can be pretty demoralising for the newly diagnosed particularly the early chapters which explain the how’s and why’s and can make it sound as if nearly everything can be a possible trigger for AF. The first book is ‘Your Complete Guide to Afib’ (2020) by Dr Percy Morales. This is a short (119 pages) book dealing with definitions, causes, triggers, drugs and treatments. Factual, no case studies, and will probably satisfy most people’s quest to find out more about the condition. I give the book four stars as, from my perspective, not much on endurance athletes and the author, genuinely I hope, offers his weight loss course which I don’t think needs to be within the text. The second book is ‘The Afib Cure’ (2021) by John Day and T. Jared Bunch. The publication date should mean the book is completely up to date being one of the reasons I chose it. Their definition of cure might only be remission for some. It is more comprehensive than the first book, with case studies (not too flowery) and the first half is probably more demoralising too. It has a good chapter on ablation and has a comprehensive note section on the research reports the authors refer to and quote should you wish to go even deeper into subjects. I would have given this book four and half stars, with the loss of half a star as I would have liked a separate section on cardioversion, being an early initial procedure for many, which is dealt with but in a number of different paragraphs and not fully. Also, the book does have a small number of helpful paragraphs on endurance athletes with AF but again I would have like a dedicated section. The latter point (as with the first book) is that much of the self-help measures revolve around improving life style choices – diet, exercise, no smoking, but for athletes’ life style is likely to fairly well optimised already so much of these sections in the book are not really applicable. The third book is ‘The Haywire Heart’ (2018) by Chris Case, John Mandrola and Lennard Zinn. Whilst the book does deal with AF it also deals with other heart arrhythmias so not completely dedicated to AF. It has a comprehensive layman section on how the heart works and heart conditions and pulls together evidence and research on how extreme exercise can damage your heart. Again, pretty sobering if you are reading the book post diagnoses or a cautionary tale if not. The case studies are there to show there is life after training/racing. The chapter on treatment options is shorter that the second book but does provide a slightly different take more applicable to athletes. There is also a notes section on the research papers referred to. Again 4 stars as it does fill in some of the gaps in the other two books.