Medical advice needed:LBBB ___Competitive Athlete

From: Pierre (pi.erre_at_email.it)
Date: 11/20/04 

Date: 19 Nov 2004 17:19:16 -0800

Let me introduce myself.
I am 37. Height:175 cm, Weight:71 kg.
Resting heart rate: 35* bpm,
Max heart rate: 198* bpm
(*determined with Holter monitoring)

Last twelve years I was practicing sport. From 92'-93' MTB, 94'-97'
Triathlon mid distances-severe inflammation of right tibia forced me
to stop for 2 years.In 1999 I turned to road cycling world
(20.000-25.000 km /year)
In last three years I made great progress. I finished in top 100
(3000-6000 participants)in some very demanding amateur cycling events
in Italy (150-220 km).

During period Nov 03'-Feb 04' I had very good and demanding weight
lifting preparation. I had love romance with 22 year old girl in that
period too.
She didn't come to dinner on St. Valentine's Day and I was veeeeery
upset because of that.I have to say that I am very emotional person.

Then it happened. On 15th of February 04' I had Atrial Fibrillation.
After unsuccesful medicine treatment with Rytmonorm infusion, I had
electro conversion in the morning.
Since then I don't feel O.K. First three weeks I had strange chest
pain and discomfort.
Passed 4 ultrasounds that showed no abnormalities. Passed normal
Stress test in March (max stress at 154 bpm=275 Watts). It should be
max stress test but the doctor stopped it because I reached age
maximmum. He ignored request of my cardiologist for max stress test.
24 hour Holter monitoring after stress test
didn't demonstrate abnormalities.
I started with easy training knowing that my season is over. I felt
great.
Sometimes I had discomfort in my chest but...
In July-Avgust I started with more demanding hill training (<170 bpm).
Chest discomfort (like a huge load om my chest) occured next day after
such training. My cardiologist suggested me to avoid that kind of
training untill we clarify what is going on.

On 3rd of September I performed max stress test.
Blood pressure at start of the test: 110/65, 54 bpm.
I reached maximum load at: 450 Watt, 185 bmp, Blood press: 180/100.
Honestly I could reach 500 Watts but the bike was falling apart.
I went into LBBB at 250 Watts load (165 bmp).
Few minutes after test my heart turned to normal sinus beat.
The day after test I felt awful with heavy feeling in my chest.
Four days after test I performed 90 km training session with Holter
monitoring.
I reached my max (198 bmp) at the end of 1. category climb.
Bad sleep the night after training but without discomfort.
On 26th Of September I stopped cycling because of discomfort in chest.
No sport for over 7 weeks.

On 17th of November I went through myocardial scintigraphy.
Stress test results: I went in LBBB at 150 Watts (125 bpm).
At the end of 250 Watts (170 bpm) load the MD stopped the test. (no
need for proceeding)
He was surprised because I didn't even sweat.
3 minutes after test my heart returned to sinus beat.
Scintiogram demonstrates LBBB.

What is next? Electrophysiology?
Why I went so early (at 125 bmp) in LBBB?
Is my heart failing?
How serious is my medical state?

I am very concerned.

Any professional opinion is appreciated. Thanx in advance.

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