Heart stoppage

[David-F]

  15 years ago I began having episodes once every 6 months of lightheadedness
  due to my heart slowing down or stopping.  10 years ago while on a vacation
  I had a pronounced one, went to emergency, and it cut my vacation short.  
  After back in town I wore a holter monitor, ran tread mills, etc. and they
  found nothing.  Since then I have lived it and the frequency has varied to
  once or twice a month to once every 6 months.  Two years ago I had a serious
  one that caused me to go to emergency.  EKG showed nothing.  Another
  treadmill showed nothing, perfectly normal.  In the past six months I have
  had about a dozen of these attacks, two today that scared me.  I am
  normally relaxing or talking and suddenly start passing out and almost
  black out, but not quite.  I have felt my heart during these episodes and
  it seems that it stops beating.  Also when it kicks in it seems irregular,
  a real strong beat, then soft ones, then a strong one or skips, with no
  regular pattern.  Every time I have gone in nothing is found.  Today was
  one of the most serious ones but I slept it off and now feel fine.  I am
  healthy, fit, and don't have caffiene in my diet.  I don't know when I'll
  have another attack, could be months. What do I do next.  Thanks alot.  
  It is very kind of you to have this web site and help people like myself.

[Cleveland Clinic, MD]

Dear  David F.,
The medical term for what you are describing is syncope (or near syncope if you don’t actually pass out).  This is a common but complex condition that has many causes.  The most common cause is the common faint (neurocardiogenic or vasovagal syncope).  This is the typical faint caused by strong emotional factors (i.e. the sight of blood) and is usually brief in duration.  The person almost never harms themselves and the precipitating factor can usually be identified.  More serious forms of syncope are due to cardiac and neurologic causes.  
Syncope due to bradyarrhythmias (slow heart rate) or tachyarrhythmias (fast heart rates) are often hard to document.  Holter monitors will only reveal the source if they are being worn during an event.  "Event monitors" are devices that can be worn for months at a time and when an event occurs a button is pressed that saves the heart rhythm for the last 5 minutes.  This can then be sent to the doctor over the telephone for a diagnosis.  Other less common cardiac causes are carotid sinus irritability which is due to an abnormal structure in the neck that results in syncope when pressed upon.
Neurologic forms of syncope include autonomic nervous system diseases and seizure disorders.  These are diagnosed with tilt table testing and seizures with an EEG.
As you can see the diagnosis is somewhat complex. Therefore,  I would recommend that you see a specialist in the area of syncope.  Two doctors that specialize in this area here are Dr. Fred Jaeger and Dr. Fetnat Fouad.  You can make an appointment with either of them by calling the number below.  Good luck.
Information provided here is for general educational purposes only. Only your doctor can provide specific diagnoses and treatments. If you would like to be seen at the Cleveland Clinic, please Call 1 - 800 - CCF - CARE for an appointment at Desk F15 with a cardiologist.