Arrhythmia

[zk]

What would cause arrhythmia(pac or pvc) laying in bed at night and trying to sleep and also what causes either pac or pvc when adult male person wakes up during sleep,but not during exercise and (less) during daytime,when the same person had a normal stress echo and does not have high blood pressure?The temperature at night is between 96.5 to 97.5.Thyroid function tests results are: tsh 0.87, t4 9.7 t3u 33.7.Would the above thyroid function tests results cause arrhythmia?If no at what level would thyroid tests cause arrhythmia? At what level do thyroid function tests (tsh,t3,t4) cause heart disease and are tests accurate?Thank you

[CCF-M.D.-RCJ]

zk,

Thanks for the post.

Q1:"What would cause arrhythmia(pac or pvc) laying in bed at night and trying to sleep ...?"

Some people have vagally-mediated PAC/PVC.  During periods of rest, and especially at night, most people have a high vagal tone (also called high parasympathetic activity).  For whatever reason, a high vagal tone can lead to arrhythmias in some people.

Q2:"Would the above thyroid function tests results cause arrhythmia?"

I don't think so, but you didn't provide the lab references.

Q3:"At what level do thyroid function tests (tsh,t3,t4) cause heart disease and are tests accurate?"?

Abnormal thyroid function does not cause cardiac manifestations in all people, nor do all people respond the same.  If a person is experiencing tachycardia or atrial fibrillation, and they have abnormal thyroid tests, then fixing the thyroid is a reasonable thing to do.  But it is not A+B=C, by that I mean that you cannot say that abnormal thyroid function reliably leads to abnormal hearft function or heart disease.

Hope that helps.

[DottyCece]

I have been kept hyperthyroid for years in order to prevent further thyroid malignancy.  Years ago, I had five occurances of thyroid cancer in about five years so this was one of the ways they were suppressing it.  So, recently when I did have atrial fibrillation, they reduced my thyroid medication by 1/2 so that now I am euthyroid or normal.  However, it has not prevented re-occurrences of atrial flutter.  This has occurred four times which has required cardioversions while my thyroid has been normal.  So, I don't think there is a correlation in all individuals as the MD said. Having been hyperthyroid for so many years, this has been a huge adjustment.  I am tired all the time, go to bed very early.  I have been trying to get them to increase my thyroid a bit..but we will see.  

I have noticed very rapid and irregular heart rhythms when I lay down at night, expecially on my left side.  It usually goes away after about 20 minutes or so or I fall asleep and don't know what happened.

[Joe P.]

Hi, I could not post but Ill Ask Here... I seem to have some what the same thing.... I'm 27, this started when I was 26... I used to smoke and drink heavily and not to active life style, I started getting chest pains, and once in great while at night, some time I would get woke up and my heart felt like it was fluttering. They didn’t happen much at first, but keep getting worst. So I told my GP about what was going on... I Got so bad that I started having what I guess was anxiety attacks. They would not last long, but I thought I was Going to die… My thyroid was normal and he said my cholesterol was a border line, So I was put on Zoloft for depression And anxiety After some time nothing seemed to be getting better, my GP sent me to a cardiologist, I told him what was going on and I had a stress test done. Near the end of the test my heart rate was about 165 – 175, and they said my peak should be about 190. I got so Out of breath and dizzy I thought I was going to fall. My heart didn’t want to slow down, they laid me on the table and my heart continued to race, I was covered in sweat, after I laid there for about 15min it started to slow back down. They sent me home and called me in a few days later, they told me I had a mild tachycardia, but they wanted to do a holter test. After returning the test the next morning I got a call to come in. I seen the doctor and he said that their were few PAC’s. But he was concerned because my heart rate dropped unusually low (20-30) beats. So right away he wanted me to take the test were, a camera is inserted to check for blockage. When I was done he stated the I had 30% blockage on my LAD. He then sent my holter test to an electro cardiologist, that looked at the test results and he stated the (20-30)bpm near the end of the test was due to the device slowing down to extend tape time. I said ok, but I’m still feeling pains in my chest, arms & shoulder, and once in while a little light headed Like heart attack signs. He said he didn’t know why I was having the pains maybe anxiety, I told him over time going to all the doctors that every now in then my blood pressure would be a little high, he said that some people get nervous and that could me it, but he would give me a tilt table test, about 8 min in the test my heart rate got up to about (125)bpm and I stated that my feet started feeling funny, than it went my hands, next thing I know is I sort of blacked out, I couldn’t move, but I could hear them yelling that blood pressure was falling and that I’ve lost color. As they lowered me back down I could hear them saying blood pressure was & color was returning. I opened my eyes and I felt weak and covered I sweat, after back in my room I was told that my heart rate went from 125 down to 40. And they put me on a beta blocker toparol 50mg. Going back for my follow up the report stated that that I had super cardiovascular ventricular tachycardia??? And a heart arrhythmia, not to worry a lot of people my age has this… I said ok, after developing a non stopping cough my GP decided it was the toparol, and took me off it, the cough went away. I m still on Zoloft, and as of today the pains aren’t as often or as bad as they were, BUT my fluttering seems to be worse, I have a hard time sleeping at night, It wakes me up about 3 times a night almost every other night, about once a week I’ll sleep almost all night and not be woke up from this, When It happens I check my pulse and it seems farley normal, but at the same time my heart is gong crazy. I don’t seem to have any chest pain during this, but it seems like when I wake up or move around some it stops. I don’t know how long it last before I wake up, but after I’m up, I move around or sit up, It seems to last about 30 to 60 sec. after that than goes away. Some times I get a weird feeling like its trying to start when I first lay down. I don’t know what to do at this point I’ve tried to just live with it for the past several months, but nothing seems to help. Is there any Idea if this may be serious, or is this normal for some people? Any Ideas Would Help Set Me At Ease…

[Joe P.]

Hi hankstar, Thanks for the reply, Yes, thats what he said I had.. ( neurocardiogenic syncope ). And he did put me on betablockers. I have been off of them for a few months, however. as I Don't seem to get light headed any more. But one thing I did notice is before I started getting light headed, Is that I hurt my neck, I Went to the University Of Chicago, I Had a enclosed mri, ct and mra, and they said they couldn't see anything wrong with my neck except some disk sparing of the C6 and C7 Region, but nothing that would cause my symptons, also the lightheadedness got better the less my neck hurt, And my neck hurt for several months, I told this all to doctor after doctor, but they suggested my neck had nothing to do with it and it was most likely my heart.. But as of 2 about to months ago, my neck stoped hurting and low and behold no light headedness. Thats also why I agreed with my GP and stoped taking my betablocker, But now with the weird fluttering at night, I wonder if I should Have Stoped It.. But It makes me feel at ease that It also dosent sound serious.. Thanks for your thoughts hank..