Can you help?

[Julie C]

I'm a 36 y/o female. 6 months ago I started experiencing PVC's, bigeminy, and trigeminy. I noticed these to be somewhat stress related. They then subsided for a couple of months.For the past 3 months I have again been experiencing them. They again seem to be stress related and can last for minutes or off and on for days.They are uncomfortable and often leave an ache in my chest. Last month on my way to work I experienced an episode of blacking out.It came on very quickly and lasted only moments. I saw a cardiologist/physiologist at this time. An ECG was done and found to be normal. An echocardiogram was also done and no heart disease was found. He stated that he felt the PVCs were nothing to worry about and he did'nt feel an EP study was warrented at this time. He also stated that he felt this could have been a vagal response. I was doing nothing or experiencing nothing at the time that would have caused a vagal response. 3 evenings ago I was relaxing at home when I started blacking out. As soon as I was able I took my pulse and found it to be 38-40 and quickly rising back up to my normal 60-65 resting rate.It came out of nowhere. I was not experiencing any of the sensations I normally have with my arrythmias. Could these arrythmias and syncope episodes be related, or two seperate problems occuring? Would it be benificial to have an EP study? The idea that I can pass out like this with no warning scares me.

[CCF CARDIO MD JMF]

Generally, PVC's are nothing to worry about.  An EPS study is not warranted.  You may consider medication.

[Hi]

Hi Julie,

YES they can be related.  You can have sinus bradycardia, this is when the pulse goes slow and or stops.  This is called a sinus pause or if long enough, sinus arrest.  You need to ask for a 48 hr holter and or a loop recorder.  This holter will record 48 hrs of your heart beating and if the slow rates happen while on it, you can be sure that the doctor will see it !  Also then, a loop recorder is a 30 day recording that when you feel the funny rates, you press a button and then send the ekg across the phone lines and the place it is sent to prints it out and sends it back to the cardiologist. An EP study is not all that great for use when someone has a slow heart rate, it is mostly used, I think, for finding fast heart rates.  BUT you need to see a good EP doctor.  Cardiologist's are great but an EP doctor will pick up on any funny heart arrhythmia.  There are many other heart rhythm disorders that can cause this slow rate, BUT you need to DEMAND a holter or a loop recorder until the doctors listen.  You may very well at some point pass out, and depending on where and what you are doing...it can be tragic.
Hope you find out soon what is wrong.  Good Luck

[Hi]

Julie,

By the way, I would ask these good doctors on this forum their opinion.  They seem to really want to help people.  I am NOT a doctor, but just wanted to try to help you.

Take care

[CCF CARDIO MD JMF]

thank you for your comments.