Another Question - Skipped Heart Beats (PVC's § PAC's)

[ardx74]

Dear Doctor,

I just had a few more quesitoins regarding the heart and arrythmia's. (Male:28, 195LBS-Large Build, Caucasian, Good Health - No diagnosed heart abnormalities)

1. Is sinus arrythmia a factor for increased PVC's/PAC's? (I get 1-10 a day)

2. What could be a cause of getting a skipped beat when bending over forward - as in picking up an object - this doesn't happen most times, just occasionally?

3. When I inhale my pulse increases slightly and decreases when I exhale, at the last phase of exhalation when my pulse is the slowest, the timming between the next beat is obviously longer, like a 1.5sec pause (estimate), however this doesn't feel like a skipped beat, just a longer duration between the next beat.  So what's the difference in a skipped beat that one feels - that fluttering sensation that most individuals describe as opposed to pauses as in sinus arrythmia.

4. My blood pressure during the day is generally 130/80  -140/90 and at rest lying down around 110/70 however my pulse is generally 46-50BPM at rest, would a slower heart beat require an increased blood pressure to maintain normal blood volume as in my case - In your opinion do I require BP medication?

Thanks and have a great day.

Alex in Toronto, Canada.

[CCF-M.D.-KE]

Dear Ardx74,


Sinus arrythmia is not a major factor in the occurrence of PVCs and PACs.  PVCs and PACs are very common in people with normal hearts and are not necessarily related to a history of a sinus arrhythmia. Sinus arrhythmia is where the rate of the SA node, the heart's natural pacemaker,  varies. The PAC is a premature atrial contraction originating from a different atrial location than the SA node.

The findings of an increased pulse during inspiration and a decreased pulse during expiration are typical responses in the respiratory type of sinus arrhythmia. This occurs as a result of changes in vagal tone.

Without electrocardiographic (ECG) monitoring it is difficult to tell the difference between the fluttering sensation you feel compared to pauses. A holter monitor study would be a good test to distinguish the 2 sensations. The holter monitor is worn for 24 to 48 hours and records the electrical activity of the heart.

Hypertension is defined as a blood pressure greater than 140/90 on 2 separate occassions. Initial recommendations for the treatment of hypertension include dietary changes and exercise.  Lowering your sodium intake and starting an exercise regimen would be a good start. I would further discuss your blood pressure readings with your doctor before recommending treatment.

Thanks for your question,


CCF-MD-KE

[TSC]

I also have sinus arrhythmia.  I have been told by my cardiologist that this is completely normal, however, I have often wondered myself if this can contribute to pac's and pvc's.

[alexa's mom]

Hello, I have ALL the same symptoms as you describe. I was wondering if you've had all the tests done for a proper diagnosis. Were you told that it was PVC's/PAC's/MVP?
I was just wondering because I have to go for a stress test tuesday and am preparing myself for the worst. Also, did you find out why it happens when you bend over........happens to me too and I think it is very strange!

Michelle from Saskatchewan

[ardx74]

Hi Michelle, I believe I had all the necessary tests.  24HR Holter Monitor (3 times), numerouse EKG's, 3 Tread Mill Tests, and 1 Echocardiogram - 3 different cardiologists.  All said that there was nothing unusual, one holter found 1 skipped heart beat in 24HR.  The last test was done about 6 months ago, the doctor said the holter study was normal and that my heart sounded "the best heart he heard all day"... The bending forward thing is a new development but seems to happen when I'm stressed and worrying about it, only occasionally.  MVP (Mitral Valve Prolapse) I don't have which could be mild or series - apparantly people with MVP have PVC's as a cause but not always.  ***@****

Good luck with your tests and don't worry...

Alex in Toronto
***@****

[pookysoo]

Hello - This is my first posting and I know I am not posting it in the correct spot but all the PVC "threads" were full.  It's a real relief to me to see that there are many others who go through all this confusion regarding arrythmias, to know that I'm not alone.  I have a lot of strange rhythms (just hundreds though, not thousands like some of you) and have full sympathy for how frightening they can sometimes be.  My recent holter showed mostly PVC's and some V-tach, but it was a very light day for my rhythms.  I keep reading that your doctors tell you it is nothing and then they put you on more medication and tell you don't worry as long as you have no structural problems.  MY QUESTION IS:  I have these crazy rhythms and my doctor told me the same (as above) but I have congenital calcific aortic stenosis (from a bicuspid aortic valve)and the echo showed a 50-55 mm gradient (with marked concentric lvh and hyperdynamic systolic function and mild mitral regurgitation).  I had a coaractation of the aorta repaired nearly 25 years ago and I am a 41 year old hypertensive woman.  So, I DO HAVE structural problems and from what I read these rhythms may indicate I need more tests.  My cardiologist told me the rhythms are completely benign and he put me on a beta blocker and told me to come back in a year.  My dad died with IHSS at age 66 a couple of years ago and I remember vividly how some of the doctors just blew him off because they didn't know what to do with him.  I feel like my cardiologist blew me off.  I really don't know whether to wait around another year or seek a second opinion now.  Thanks to anyone who might have a suggestion.

[sheryl1945]

Please help me, I am terrified.  I've had this condition for 8 years but it still frightens me.  When I bend over, my heart goes into an irregular beat, specifically when I inhale.  It will skip beats, go fast then slow down, and it stays in the mode until I straighten up.  In the bending position, when I exhale it resumes normal beating.  I get no other symptoms; no pain, no lightheadedness, just this annoying irregular heart rhythm.  I've had heart tests and everything comes back fine.  Have you ever heard of this?  I am so frightened!  Please help me!

[sheryl1945]

I wanted to add some things to my above comment.  I've had every heart test in the book and they all come back normal.  I even asked a heart doctor what this was and he just shrugged his shoulders.  Common sense tells me that since I've had this for 8 years and it hasn't done anything to me it must be benign...but I have panic attacks and then I focus on it.  Please help, I am so nervous!  My email is ***@****.

[katin]

hi every one i have had skipped heart beats since i was 30  does any one ele have this as well? i also get dizzy with them at times