Okay, let's give him that thread: Colbrelli, you deserve it

Page 6 - Get up to date with the latest news, scores & standings from the Cycling News Community.
Aug 13, 2011
7,883
12,035
23,180
Christian Eriksen has an ICD and has returned to pro football. https://www.skysports.com/football/...-heart-im-safer-on-the-pitch-than-anyone-else

When I had my heart issues, I was under consideration for an ICD. Frankly I would have been happy to receive one!

I didn't see official confirmation that Colbrelli would receive an ICD. Usually cardiologists want to monitor you for a month or so, although I think Eriksen got his within 2 weeks.

As someone who was given a second chance at life after cardiac arrest, I went through all the stages of grief, but to be honest I've been able to return to recreational cycling and most other activities. And I'm enjoying every second. Even if Sonny can't get back to pro cycling, with time I think he'll appreciate life even more.
The riding again with an ICD was an Italian constraint though.

yeah if he got one I’m surprised it was that fast but I could see it as a precaution considering he is going back to Italy or where home is for him so as a “just in case”.
 
Apr 10, 2019
12,075
15,990
23,180
Christian Eriksen has an ICD and has returned to pro football. https://www.skysports.com/football/...-heart-im-safer-on-the-pitch-than-anyone-else

When I had my heart issues, I was under consideration for an ICD. Frankly I would have been happy to receive one!

I didn't see official confirmation that Colbrelli would receive an ICD. Usually cardiologists want to monitor you for a month or so, although I think Eriksen got his within 2 weeks.

As someone who was given a second chance at life after cardiac arrest, I went through all the stages of grief, but to be honest I've been able to return to recreational cycling and most other activities. And I'm enjoying every second. Even if Sonny can't get back to pro cycling, with time I think he'll appreciate life even more.
Yeah, but Eriksen had to sign with another team because you aren't allowed to compete as an athlete with an ICD in Italy, that would be a problem for Colbrelli.
My mother switched to an E-bike last year because she noticed that her heartbeat was all over the place after she went too deep riding her MTB.
 
Dec 6, 2013
8,518
7,794
23,180
Yeah, but Eriksen had to sign with another team because you aren't allowed to compete as an athlete with an ICD in Italy, that would be a problem for Colbrelli.
My mother switched to an E-bike last year because she noticed that her heartbeat was all over the place after she went too deep riding her MTB.
Is that an Italian rule or a Italy FA rule. If its just an IFA rule then it doesn't affect Colbrelli.
 
Apr 10, 2019
12,075
15,990
23,180
Eriksen would be allowed to play in Italy in an away game (say a friendly between Italy and Denmark), right? If so, wouldn't Colbrelli also be allowed to race Italian races?

But he clearly won't race for the national team anymore.
i think having an Italian license is the main problem here, alongside not being able to ride for the national team.
 
Jul 10, 2014
14,992
25,987
28,180
A new article


"The question that many cyclists and fans are undoubtedly asking is – why did this happen to Sonny Colbrelli – apparently so randomly – after many years and thousands of kilometers of racing with no prior issue, and indeed even with a proactive UCI cardiac screening program in place? His near-fatal collapse – less than six months after his highly emotional Paris Roubaix win – although shocking, unfortunately represents a pretty typical storyline in these cases. "
 
Dec 6, 2013
8,518
7,794
23,180
A new article


"The question that many cyclists and fans are undoubtedly asking is – why did this happen to Sonny Colbrelli – apparently so randomly – after many years and thousands of kilometers of racing with no prior issue, and indeed even with a proactive UCI cardiac screening program in place? His near-fatal collapse – less than six months after his highly emotional Paris Roubaix win – although shocking, unfortunately represents a pretty typical storyline in these cases. "
The part about the ICD not being 'smart' enough is misleading. The code could be changed to recognize higher HR. Devices are only as 'smart' as their code.
 
  • Like
Reactions: Sandisfan
Jul 10, 2014
14,992
25,987
28,180
Its a common misconception that ICDs/AEDs 'restart' the heart. They monitor heart rhythms and react as needed.

Interesting. Does it just give the hart a generic jolt or is it more scientific than that?

The article says this:
"The decision to compete in higher intensity sports, however, has much higher stakes, and should only be made after a thorough consideration of the fact that an ICD can deliver both appropriate shocks – to restore normal heart activity in the event of a life-threatening arrhythmia, and inappropriate ICD shocks – that can sometimes result from “normal” elevated heart rates during intense competition.

Despite the sophistication of ICDs, most are simply triggered by specific heart rate cut-off zones programmed into the device and are not “smart” enough to actually diagnose the specific heart rhythm. S-ICDs like Colbrelli’s can actually evaluate the heart rhythm, but tend to have difficulty doing so at very high heart rates, as is typically seen in competition."
 
Dec 6, 2013
8,518
7,794
23,180
Interesting. Does it just give the hart a generic jolt or is it more scientific than that?

The article says this:
"The decision to compete in higher intensity sports, however, has much higher stakes, and should only be made after a thorough consideration of the fact that an ICD can deliver both appropriate shocks – to restore normal heart activity in the event of a life-threatening arrhythmia, and inappropriate ICD shocks – that can sometimes result from “normal” elevated heart rates during intense competition.

Despite the sophistication of ICDs, most are simply triggered by specific heart rate cut-off zones programmed into the device and are not “smart” enough to actually diagnose the specific heart rhythm. S-ICDs like Colbrelli’s can actually evaluate the heart rhythm, but tend to have difficulty doing so at very high heart rates, as is typically seen in competition."
Disclaimer, I am not a cardiologist.

Those quotes were what I was talking about. The parameters can easily be set to work for him (assuming it is safe for him). The one that they implanted at the hospital was obviously the one that anyone would get because the doctors were thinking about his life, not getting him back on the bike. Look at Eriksen, he probably gets his HR up to 180 bpm during a match so his ICD must be programed to accept that value without shocking him.

As to your question, that depends on the unit. All of the AEDs that I'm familiar with deliver the correct amount of shock based on the input they get from the person. I am way less familiar with ICDs, but as I discussed upthread, I know two very active (not world class) people who have them.
 
Aug 13, 2011
7,883
12,035
23,180
I actually thought it would only activate when there is no heartbeat.
Not the no heartbeat that you think of. It will only allow shock for pulseless ventricular tachycardia or ventricular fibrillation. Neither of those you would feel a pulse if you check like the arms, legs, or neck but on an ECG or heart telemetry it will show a beat of 180 plus. So the heart is pumping too fast to properly refill and circulate in the body.

Asystole (flat line) and pulseless electrical activity you don’t shock because that might make it impossible to restart the heart. In all 4 cases the person would get CPR, oxygen/airway resuscitation, and epinephrine but the AED will not allow you to shock the last two rhythms, no matter how hard you try. Then you could put someone from the first two into the last two with the defibrillation and/or medication given to stop and slow down the heart.


Interesting. Does it just give the hart a generic jolt or is it more scientific than that?

The article says this:
"The decision to compete in higher intensity sports, however, has much higher stakes, and should only be made after a thorough consideration of the fact that an ICD can deliver both appropriate shocks – to restore normal heart activity in the event of a life-threatening arrhythmia, and inappropriate ICD shocks – that can sometimes result from “normal” elevated heart rates during intense competition.

Despite the sophistication of ICDs, most are simply triggered by specific heart rate cut-off zones programmed into the device and are not “smart” enough to actually diagnose the specific heart rhythm. S-ICDs like Colbrelli’s can actually evaluate the heart rhythm, but tend to have difficulty doing so at very high heart rates, as is typically seen in competition."
It gives the shock in joules that the doctor preset, to slow the heart down and basically reset it to synchronize with patient’s body. So I guess technically generic. It just sees the heart rate is past the perimeters set so delivers the shock to slow it down. It doesn’t care why the heart rate is higher or if that’s okay or not, it just shocks. I don’t know the joule range that they use for ICD or the specific technicalities of it but for the AED the joules they usually start out with is 120-150 and go up from there.

It is like a pacemaker. The pacemaker will go off whenever the heart rate goes below the set limit, so let’s say 60 beats per minute. For athletes, their resting heart rate will go below that frequently so it would have to be adjusted to their situation.
 
Dec 6, 2013
8,518
7,794
23,180
Update: one of the people who I know (my sister in-law's friend) who has an ICD said that her upper limit is 225 bpm (same as the one before this one). As I said upthread, she got her first ICD in the 90s and as you would expect, it was not as 'smart' as the one she has now, but she did half a dozen triathlons a year, and trained nearly everyday even with the old one. Again, her case may have almost nothing in common with Sonny, but racing with an ICD is possible (losts of disclaimers obviously).
 
Aug 13, 2011
7,883
12,035
23,180
Update: one of the people who I know (my sister in-law's friend) who has an ICD said that her upper limit is 225 bpm (same as the one before this one). As I said upthread, she got her first ICD in the 90s and as you would expect, it was not as 'smart' as the one she has now, but she did half a dozen triathlons a year, and trained nearly everyday even with the old one. Again, her case may have almost nothing in common with Sonny, but racing with an ICD is possible (losts of disclaimers obviously).
I’m sure there is a high end, expensive, and high tech one that can do a better job at detecting what rhythm and go from there with a lot more fine tuning. Thinking about the ICD, it is like cardioversion which is used for tachycardia but caused by the atrium instead of ventricles and starts at 50 joules. But we didn’t really go over ICD in school besides basics and it’s not part of the ACLS certification course. For more and better information and from the gold standard for all resuscitation and emergency situations is by American Heart Association if anyone wants to read more.