Arrythmia

[Herve]

Approximately 1 1/2 years ago I had an episode of heart flip flopping and fluttering which scared me enough to send me the emergency room. They did an EKG and found irregularities and told me to follow up with my physician.  At the same time I started to experience a full feeling in my stomach, almost like a bloated feeling.  He put me on Zantac for my stomach and 25 mil. of toporol for the fluttering.  Needless to say I went like this visit after visit and the fluttering got worse and more consistent.  I had nights when I could not fall asleep at all because of the feeling.  With the fluttering getting increasingly worse I made an appointment to see a cardiologist to put my mind at ease.  He scheduled an Echocardiogram, Stress test, blood work and an event recorder. Everything checked out O.K..  I do have irregular beats & premature beats.  He increased the toporol to 50 mil. twice a day.  It still is not getting better.  He has scheduled me an appt. at an arrythmia center in 2 weeks.  This feeling really kicks in sometime in the late afternoon, early evening.  It also can start with something so simple as leaning forward or reclining on the couch.  Sometimes it will flutter for hours to the point where it actually tires you out from the irregularity of the beat.  Remember, this whole time my stomach does not seem right.  I feel full alot of the time and I burp a lot more than normal.  I have this heart fluttering at least everyday and unless someone understands what it feels like they do not understand.  My question is can there by some correlation between the stomach fullness/bloating/burping and the heart flipping and flopping feeling?  Can I make any special adjustment in my lifestyle that would help me with this.  I do not smoke or drink alcohol.  I am not overweight and I am pretty active.  I am 45 years of age.  Is there something in my daily diet that is triggering this?  I have been reading alot about reflux and wonder is that an avenue that maybe my doctor should be going down.  During the day I can feel the fluttering but not to the magnitude that I do in the early evening.  What will an arrythmia center determine for me?  Can they tell me what is causing this irregular beat, flip-flop, fluttering feeling?

[Kevin Pho, MD]

Hello - thanks for asking your question.

You note palpitations and a bloating feeling in your stomach.  Echocardiogram, stress test, blood work, event recorder all non-revealing.  

I assume they tested thyroid levels in the blood work.  

An arrhthmia center is a wise next move, considering the negative tests so far.  You will likely be considered for an EP test (electrophysiology) to make sure you don't have a serious arrhythmia causing your symptoms.  If an arrythmia is found, it can be ablated at an arrythmia center.  

I am unaware of a GI disorder that can directly cause palpitations.  Some suggest that the chest discomfort caused by GERD or dyspepsia may trigger palpitations.  In any case, the upper GI discomfort can be further evaluated with an upper endoscopy.  This would also look for inflammation or ulcers that may be causing your symptoms.  I would also consider an ultrasound to rule out gall bladder disease.  If those tests are negative, a 24-hr pH test can be performed to give a definitive diagnosis of GERD.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.

[nadia]

I have also developed a condition known a paroxysmal tachycardia at the same time that my abdominal pain appeared.  I am convinced there is a correlation between the two. I get severe palpitations early in the morning and take tenormin to regulate this. The vagus nerve, I believe, has something to do with this. Inflammation has an effect on this nerve.  I am investigating this theory further with my surgeon.

[Snap]

I too have heart flutter directly associated with gas in the stomach. I think there is a big link between afib and stomach problems. Burping usually releaves this. It might be pressure on the Vagus nerve as you mentioned. Many afib forums are full of people saying this very same thing, but the Doc's don't seem to want to check into it much. Odd.