Posted by Editor on 10/25/16
Annie Ewart is one of Canada's rising stars in women's road racing. A former Junior national champion who was seventh at the Road Worlds (ITT), Annie also won a stage of the Tour of the Gila (with Optum) and was third in the Team Time Trial stage of the Tour of California, with her current professional squad, UnitedHealthcare.
While on a training ride in Colorado in mid-July this year, she suffered an irregular heartbeat episode that caused her heart rate to spike at 240 beats per minute, known as ventricular tachycardia (VTAC). For many, this is a one-time thing, but for Annie it turned out to be a life-altering situation that has ended in retirement at the age of 23.
Annie sent out a notice on her Instagram feed - www.instagram.com/p/BLv_wz5B7s3/ - and the dismay and support from the cycling community has been strong.
Annie spoke to us from her B.C. home, explaining exactly what happened, the outcome of months of tests, and how her public acknowledgement has already helped others identify a potentially fatal problem.
2011 National Junior ITT Champion
7th at Junior Worlds 2011
2014 Tour de Delta
Winner, Stage 2, 2015 Tour of the Gila
Canadian Cyclist: Like everyone else, we were shocked to learn that your cycling career is over. Can you explain how did it all come about?
Annie Ewart: I was coming back from a shoulder injury, and down in Colorado training. I went out on a normal training ride, like I had done for the past week, and I was with my boyfriend's little brother [Jonny Brown] - thank goodness - because we headed out of town and there was no more [cell] service, and suddenly my heart rate completely took off.
I knew it had gone up and I looked down at my heart rate monitor, and it showed 230, and I thought 'That can't be right', so I thought that it would just come back down, this racing feeling in my chest. So I just told Jonny to ride ahead, but he said 'No, I'm going to stay with you'.
But my heart rate didn't go down and didn't go down ... So, to make a long story short, since there was no [cell] service, he pushed me for over 12 kilometres at 50K an hour. You hear about these people who, in some sort of crisis, they get this super strength ... he was just killing himself. I finally got back to the closest town after flagging down a car, and I got one bar and was able to call 9-1-1.
No one was in panic, because I wasn't in pain, I didn't have trouble breathing, my blood pressure was normal, and they couldn't get a read on my heart rate, so they thought I was having a panic attack. I don't suffer from those, so I said 'No, I don't think so, it's my heart, it feels like it's fluttering'. Then the ambulance showed up, and they hooked me up to their machines, and this calm situation turned into panic, and it was lights and sirens to the hospital.
CC: And this was in July?
AE: July 20-21. At that point, they shocked me out of the rhythm, and then this journey began. We found out that this sort of thing is not that rare, they go in through non-invasive heart surgery, with a wire through your groin and up through the veins to your heart, where they ablate this extra electric circuit, which hopefully fixes the problem, and you go on and live a normal life, and I could continue my cycling career, no problem.
But it got more complicated, because when they would go in to make sure the ablation had worked, a new circuit would pop up. So I was transferred to Denver and went through ten hours of heart surgery, and they believed that they had fixed it.
So I was sent home, back to Canada, and I was told that they wanted to let it settle for three months and repeat the surgery, and that, hopefully, it was fixed and that my heart was remodeling and going back to normal.
I was lucky to be alive, because they were shocked that my heart rate had been at 240 beats for an hour without any serious symptoms. I was grateful that I could potentially get back on my bike and race. But my main focus was just getting back to being normal so I could go on with my life.
But it wasn't that simple ... I came home and during my recovery I went back into VTAC on two occasions. After the second occasion, I just couldn't live like this; I was constantly worried that if I just went out for an easy walk would my heart rate go up? I'd get off the couch and I'd be worried. It was starting to become this paralysis, and I couldn't live like that.
So, after some more tests, the doctors deemed that it was necessary to put in an ICD [implantable cardioverter defibrillator, to regulate irregular heart rhythm] and have that as back up, and find some really good medication to control the heart arrhythmia. It sits under my collarbone and there's a wire goes into my right ventricle. If the heart rate is under 200 bpms, it puts in extra beats to pace and normalize the heart. If it goes over 200 then it shocks me, and I hope that never happens! [laughs]
I've been paced a few times, but now I've been stable for a month and able to get some of my normal life back. I can go for walks and do yoga again. Little things like even walking up stairs I was worried to do before ... it's so nice to get that sense of normalcy back.
It's not the normal I was used to, of training and racing, but I'm grateful to be back to what everyone else can do in a normal day.
CC: You're an elite athlete, super fit, no health problems, and all of a sudden, bang, this happens ... is there any family history, anything to point to this?
AE: No, and that was the next step, to figure out where it came from. It is idiopathic VTAC; meaning there is no explanation. Initially they thought it was the garden variety, which is called benign and they had fixed it.
We are hoping it's athlete's heart [athletic bradycardia, or exercise-induced cardiomegaly] and VTAC, after years of pushing so hard, and that my heart will eventually remodel and go back to being normal and heal itself ... that's the hope.
But there are genetic diseases that can cause this, so we have also started testing for that. But there is completely zero family history of anything like this.
It could be just really shitty luck.
CC: So at this point, they really aren't sure of where it came from or the prognosis?
AE: No, they just don't know. So that's how I'm dealing with it; it can be managed as it's being managed now and I can live normally. Or maybe in a few years it does heal. That's the hope I have.
CC: But certainly no more bike racing.
AE: No ... no, it's just not worth it. I love the sport so much and it has provided me with amazing opportunities and I've met amazing people. The support has been unbelievable for my racing but, at the end of the day, my health just isn't worth it to continue.
It's been hard because it's been a part of my life for so long, but I am excited for whatever is next and I hope to remain involved in cycling, and to give back in any way I can, because so many people have helped me. Maybe there is a future, but in a different capacity.
At the moment, the focus is just to be stable for a few more months, to get the confidence I need to start school. Hopefully come the new year I will continue my [business] studies, and finish and get my degree.
CC: And what about your team?
AE: The team - UnitedHealthcare - I can't thank them enough. They've been incredibly supportive through this whole thing and concerned, and the doctors on the team have been amazing in helping me go through this, especially when I was in Colorado. So I have nothing but gratitude for them. I will miss all of my team mates, and people that were team mates over the years. But I really hope that I can still remain involved in some level and capacity. So hopefully it won't be the end of seeing all those people.
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