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Irregular Heartbeat
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Irregular Heartbeat

I have a very long history of tachycardia and PVC's (30 years; I am now 49) and have had a lot of medical attention.  The many ER docs, cardiologists and PCP's have always concluded that I have nothing structurally wrong with my heart.  They treat my condition as a benign sinus arrythmia, and many have said it is related to anxiety.  For several weeks now I have had a very irregular heartbeat --- much worse than in the past --- that seems to be unrelated to lying down, standing, walking etc., although the worst episodes have come on after lying in bed with a regular beat and then rising.  My heartbeat gets very erratic, skipping every other beat, sometimes with couplets, and it feels like my heart is breaking through my ribs.  This may last for hours and even days, with occasional periods of calming.  Should I continue to trust what I have been told so mnay times over or is it a possibility that something has been overlooked?  Can this be related to perimenopause and if so what can be done about it?  One doc recently said "I think this is going to get worse before it gets better," but he did not explain what he meant.  I appreciate any help you can give me.
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watertown,

thanks for the post.

Should I continue to trust what I have been told so mnay times over or is it a possibility that something has been overlooked?

Probably not. However, if your symptoms have markedly changed its not unreasonable to seek medical attention for some reassurance.

Can this be related to perimenopause and if so what can be done about it?

Hormonal fluctuation can change peoples PVCs. Without knowing your full history its hard to say why things have changed recently.

One doc recently said "I think this is going to get worse before it gets better," but he did not explain what he meant. I appreciate any help you can give me.

Its somewhat of a nonrassuring response.  I can tell you A LOT of people are in your boat and suffer from palpitations. Hopefully its reassuring to know that with a normal cardiac evaluation they are benign.  A better approach may be to deal with your feelings of anxiety and concern over the palpitations. Talk to your heath provider, and you might look back through the forum to see how others have dealt with their symptoms.

good luck
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Watertown, good luck in dealing with these symptoms. I hope the doctor can help. I am fighting the same symptoms, with GERD's thrown in as well. There are good days, and bad. This past weekend was horrible. Hang in there. I feel like I have no real medical alternative but to trust what I'm being told. I've had an angiogram, so I am certain there is no significant cardio problem.

But still the palps come....

Art S.
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I am in the same boat as you are I am now 47 and have had pvc's for over 13 years. They seem to get worse as we age.But my doctor says there is nothing to worry about like Art said you have to trust your Doctors. I do not let them bother me any more at night I just roll with them and say prayers. Like they say if it was going to kill us it would of happened by now.

Take care
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I had the same problem.  Mine were PAC's which led to AFIB.  For many years nothing was done until I developed AFIB.  Then the treatment got more sincere.  Finally meds didn't work and I had ablation.  Since ablation for AFIB the AFIB & PAC's are basically gone.  Actually the EP got a few spots causing PAC's not related to AFIB.

I don't know if your arrythmia is related to PVC's or PAC's.  I do know that ablations work.  Although there is some question as to the success of PVC ablation.  However my EP was very thorough and went looked for areas to ablate for PVC's as well. Have you gone to an EP to determine a course of action? meds?  ablation?

I'd hate to think that your problem would have to progress before something could be done.

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Just wanted to let you know you are not alone. I have a 24 year history of PVCs, with increasing frequency to the point of almost regular bigeminy.

I have been told anxiety does not contribute to them, but is a separate issue. I don't know if I believe that, it may be a matter of which came first. I think they go hand in hand. And as a female at age 42, I definitely think that hormonal changes triggered my latest frequency increase. It may not be the only reason, but it's got to be considered.

I do know that .12mg of xanax helps me not to care about the pvcs. If you've been told your heart is structually fine, then you should believe it. You've lived this long with them and you are still around right?

I'm getting a stress echocardiogram in two weeks to check the structure of my heart. I do know of at least two other people who post in this forum who have high frequency PVCs and also developed a cardiomyopathy. Coincidence? Their doctors do not seem to think so anymore. And from the research I've done I believe that cardiologists are debating whether or not high frequency PVCs are still considered benign. They may not be life threatening, but they might mean change to your heart tissue over time.

So like the dr. here answered, get your heart checked out when you notice changes in rhythym and symptoms. And if everything checks out, maybe just do a yearly follow-up for peace of mind. Otherwise, try and enjoy life as best you can, the PVCs will take over if you let them.
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Thanks to all of you for your comments.  Although I don't wish these symptoms on anyone, I am glad there are others out there who know what this condition feels like.  Just when I sort of get used to living with them, something in the pattern of the palps changes or they become much more frequent.  My mind keeps telling me there has got to be a specific cause for PVCs/PACs -- diet, hormones, GERD, allergies, etc. -- yet no one really seems to have much of a clue.  Maybe the cause actually IS anxiety and I should just accept it and deal with it in that way.  Meditation?  SSRIs?  I am grateful for the treatment possibilities, like medications, ablation, etc.  Wouldn't it be nice if it would all just go away, though??  Art S. -- I also recently began treatment for GERD, although I think my stomach is so messed up because of the awful concern over these palps.  Which came first: the chicken or the egg?  Who knows?  Dquenzer -- Not sure if mine are mostly PVCs or PACs.  A holter moniter a year ago showed "thousands" of PACs in a 24-hour period and "some PVCs."  During recent visits to the ER, the docs referred to them only as PVCs.  Upbeat63 -- Can you explain what bigeminy is?  Charlie S. -- I hope to be able to roll with them again soon.  I do believe in prayer, but sometimes it's hard to dig yourself out from under the worry over the situation.  Has anyone ever had this experience?  Last year during a particularly awful bout of palps, the doctor sent me for an echo.  My heart, which had been skipping constantly, did not skip once during the entire test.  Once the exam was over, the palps resumed. Perhaps they can market a mini soundwave device that can be attached to the chest during an attack of palpitations???  Hey, you never know??!!  Thanks again to the doc and all of you.
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When you get the skipped beats or the different heart beats do you every get a pressure feeling in your upper stomach? Like a knot sitting there. It is sorta hard to explain.
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It is interesting to read the varying threads about this problem.  I am a 36 year old male, and had a pretty severe panic attack where my heart went to about 120-130 bps.  My doc gave me an ekg (which was normal) put me on 50 mg of Atenolol and .5mg of ativan, and referred me to a psychologist.  Eventually the 50 mg of atenolol became 25 mg because of the side effects.  I was sent to the cardiologist who performed two more ekg's, an echocardiogram, nuclear stress test, and I wore a holter monitor.  It all came back normal.  I even went to an endocrinologist, and he said everything was normal.  Since then I am off the beta blocker because it appears I am allergic to it.  My heart rate is normally between 70 to 96 during the day.  It can go higher than 100 on occasion, but tops out at 106 and that can last for a few hours.  I have been told I am fine and there is nothing wrong with me.  The heart rate, combined with some other symptoms, have led my doctor and psyhologist to tell me that I have anxiety disorder.  It is a powerful disorder to have, and there may be some truth to issues of anxiety and stress....
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Always!  I understand exactly what you are talking about.  Several times I have told my doctor that I am sure they would be able to discover what is going on if they could just peek inside and look at the top of my stomach.  There is no doubt in my mind that at least SOME of what I experience with my heart is related to my stomach:  tomatoe sauce, tea, and whole milk are almost sure to set something off.  Obviously I avoid these foods as much as possible.  My sister has noticed the same reaction to tea and tomatoe sauce. For several years she was complaining that she felt a tickle in her throat after eating certain foods.  I felt her pulse once and, sure enough, the tickle she was experiencing was in synch with ectopic beats. As I mentioned in my earlier post, I am now being treated for GERD for the first time in my life and my palps have never been worse.  Coincidence? Maybe. Maybe not.   There is some research on the Internet that connects atrial stimulation with irritation of the esophagus.  If I can locate it, I will post the URL's here.
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Thanks for sharing your story. For many years my heart symptoms were primarily tachycardia only (1975-2000).  My heart would get up to a snapping 180-190 b.p.m. and stay there for 15-20 minutes, but there was no irregularity to the rhythm.  That went hand in hand with many of the scary symptoms of hyperventilation. The diagnosis was anxiety disorder, and I pretty easily accepted that since my mother and a couple of other relatives had experienced similar episodes. As I mentioned earlier, certain foods like whole milk would bring on an irregular rhythm, but if I avoided the food products I pretty much controlled the ectopic beats.  

This was all prior to starting Lopressor (beta blocker) around 2000-2001.  In the past 5 years, I have seen a big change in the symptoms.  While I still occasionally get the very rapid beat -- had a full blown panic attack during the plane crash scene in "The Aviator" -- the primary symptom has switched from a very rapid beat to a slower but more disturbing irregular rhythm.  The Lopressor seems to control the rate pretty well but not the rhythm, at least that's been my experience of the last 5 years.  

I have had periods of up to 5 or 6 months where I was off everything (hate taking any kind of medication) and experienced almost no symptoms.  Then the craziness would start up again, so back on the Lopressor.

I find myself longing for the "tachycardia only" days because the change in my symptoms has brought new fears, new questions, more tests, and more frustration at finding very few answers.  My cardiologist is confident that none of this will hurt me; how I wish that his confidence were contagious.  He thinks it does not pay to search too deeply for a "cause" -- hormones, etc, -- because "the treatment would be the same."  

I have Lexepro sitting on my kitchen counter, given to me by my PCP.  Other friends and relatives who are on SSRI's encourage me to take it, believing that all my heart symptoms will vanish if I get my anxiety under control.  I wish I had their faith.  What I have is a concern that a new medication will bring on new symptoms (I say this because of bad reactions I have had to verapamil, Inderal, novacaine, demerol, percocet, and even the eye drops the optometrist uses).
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When I was in my early 20's I suffered from what is now known as panic attacks, very rapid heart rate and a feeling of doom. They didn't have a name for it then, just nerves. After several years of letting this rule my life, I dicided if it was going to kill me then just do it and get it over with, so I moved on with my life with much success. However, when I reached my late 30' and up to now in my late 50's I have had spells of irregular heart rate. Like many of you say, it comes and go's without apparent cause. I don't take medication unless absolutly necessary,but I did take a few days of a beta blocker last Dec. when the PVC's were especially bad. When they stopped I quite takeng the meds and haven't had a problem since. Anyway, I am always puzzled by this problem and it is scary, but I refuse to let it get the best of me. ( easy to say) I know there are a lot of you out there that have a lot harder time with this than me and my sympothy is with you.  One thing that bother's me is, given the fact that both men and women are bothered by this, is why the first thing doctors say to women is it may be harmonal. I get real tired of hearing that.  When my husband had some chest pain one night and went to the ER they got him right in, admitted him overnight and really gave him the attention he deserved. When I went to the ER with a very irregular heart rate once, I waited for over an hour to even get in to see a doctor.  My husband was o.k. and it wasn't his heart.    I am venting now, sorry.   Take care out there.
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Your story does ring true to me.  I also cannot take verapamil.  They tried that wih me, the side effects were pretty bad.  I have gotten to the point where I am considering the SSRI's, just not sure I want to be drugged like that.  The racing beats normally come at night, sometimes while at work.  I was taught some meditation and that seems to work.  Of course now I get tension headaches, which opens up another whole avenue of neurosis.  But in any event, I have been assured by my cardiologist, the four doctors in his office, my primary car doctor, and my endocrinologist that what I have is harmless, I just have to believe it. Good luck.
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In my case, Watertown, I very definitely had the palps first. There was an evening where I had a combination of too much to drink and green Chinese tea and I woke up at 2 in the morning thinking I was going to have a heart attack. First of several visit to the ER ("...your usual room, sir?...") But for almost a year, the palp symptoms were quite mild as long as I kept off the caffeine and kept the alcohol down.

In feb of this year, during an out of town trip, the GERD attack hit full force. I was in Santa Fe, and felt like I was going to drop dead with the discomfort. This continued unabated for nearly three months. A change in cardio docs brought about the prospect of GERDS being the culprit, and I went to a gastro doc after that. Had an EGD, and several different types of medicine. Nexium seems to be working. Also, I have a bottle of "grasshopper" to shut down the esphagus when it flares up. Great stuff. Maalox, belladonna, lidocaine. Try it. You'll like it. Most days are good days now.

Good luck, watertown!
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I can relate to the irregular heartbeat problems.  I am 22 years old.  I have been a dancer and in etremely good shape since I was 6 years old.  When I was 18 I lost interest and pretty much stopped exercising regularly.  That year I had an attack of tachycardia.  I have been on 25mg of Toprol ever since.  I haven't had anymore cases of tachycardia since.  THANK GOD!!  That medicine that they give you that stops your heart and then another that restarts it is scary enough to send me into an attack.  Ever since I have had alot of problems with palpistations and strange feelings period.  I am afraid to do anything that gets my heart rate up, but after reading alot of posts on this site, I am going to give exercise a shot.  I have had lots of problems with anxiety and have taken 25mg of Zoloft off and on over the past 3 years to deal with it.  It helps TREMENDOUSLY.  My anxiety was related to constantly worrying about my heart and once I got that under control I hardly ever think about it, except when it comes to exercise or doing anything strenuous.  I have palpitations,things that feel like  flutters,and sometimes a really hard beat that kind of catches my breath for a split second.  Does anyone else have these hard beats??
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Definitely have the hard beats. Usually after exercise. My cardio doc was advising continued exercise from the start. I suppose that's how I finally decided that nothing particularly bad was wrong with my heart. If I could exercise aerobically for 50 minutes I should have been ok. If your doc has cleared it, ladybug, please do start exercising. It helped me out a bunch. I've been able to lose weight, and that helped the self esteem, and that helped the anxiety. You are still young. Pick it up back NOW and keep your weight off before the metabolism shuts down when you get a bit older. I'm 48, and losing any one pound was tough work. Don't let yourself get in that position to start with! Keep on dancin!!!!!

Art S.
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Thanks for the response!  I've never (Thank the Lord) had trouble with my weight.  It has fluctuated over the past 8 years between 110 and 120.  But now that I've quit exercising I don't physically LOOK as thin as I always have before, and now that I'm getting a little older I'm afraid of my metabolism slowing down.  I am starting this week (today) with a running program.  It starts VERY slowly for beginners, so I'm excited about it!
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I have been having what I have been told are PVC's since the age of 24.  I am now 40.  I just went 5 years without a single one, and they started up the end of May again.  I had a cardio workup at the age of 24 (holter monitor, stress test, the whole thing) and then again when they cropped up in 2000.  Only benign PVC's ever showed up.  I even had a echo stress test 2 years ago because of jaw pain.  (Can you tell that I'm paranoid that every ache and pain is heart related?)  My dad had bypass at the age of 52, however he smoked heavily, diabetic, etc.  Other than that there isn't really any family history.  I do need to lose 30 pounds, but cholesterol, blood sugar, etc. is good.  I was interested to see the comments about the connection of these PVC's to stomach problems, because when they first started I also was diagnosed with hiatal hernia, and now with this reoccurence I have had the stomach problems again, as well.  They too had gone away for years!  I'm glad to find this site - my husband and family can't relate to this feeling and I'm glad to find someone who can.  I'm back to feeling like I don't want to go anywhere or do anything.  I exercise regularly, but am now scared because sometimes the palps pop up when I do.  Most of the time it's when I'm just at rest, but the exercise ones scare me because I remember a doctor telling me one time that they're harmless unless they pop up during exercise.  Has anyone ever been told that they're harmless during exercise?  I usually just keep going and don't drop, so I feel ok keeping it up.  I"m also wondering about the perimenopause connection, because I'm noticing some other things that would suggest hormonal issues.
Thanks for being in the same boat all of you!
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OH, Watertown! how I relate to your story! My tachycardia is somewhat slower(130-150 b.p.m.), but it is REGULAR now. When I was in the hospital for an angiogram 5 weeks ago,(angiogram-negative)they put me on lopressor. Now I am scared that lopressor will mess my electrical system of the heart. I don't wish an irregular heartbeat as you suggessted might be the result of lopressor.I don't need new fears, either.Thanks for the warning.I am trying to go back to my occasional ativan. I used zanax, for a while , but that made my heart beat irregular. When I mentioned this to the several doctors, they had NO comment. But sure enough, when I looked in the pill book, irregular heart beat was listed as a symptom. It would be nice if doctors would listen to their patients. I am now dealing with periocarditis, which I think is a result of my angiogram.I am sorry I had the angiogram.Now that I look back, it wasn't necessary.

Some mornings I wake up with a tight chest, fast heart,feeling of extreme discomfort, and feeling of passing out and and even death.The last two episodes I could not breath. This morning attack usually occurs if I do aerobic exercise the evening before. I am so fearful of this event. I wonder if this has anything to do with the diabetes dawn effect of insufficient insulin , blod sugar rising, etc? But that is another story.

Watertown, I wish you luck with your concerns for those new medications.Your own research is helpful, I'm sure.
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I went to see a cardiologist locally and then for a second opinion with a cardiologist and a (I can't think of the name, but the doctor that does the ablation procedures).  Both told me to resume exercise that it is absolutely harmless!!!  The specailist was at Emory Medical University in Atlanta, GA and one of the top in his field.  So, I feel good reflecting back on his opinion on eercising with palps, etc.


The feeling that you describe in the mornings is one of many things I was experiencing when I was having anxiety and panic attack problems.  I started taking 25mg of Zoloft and I have to say I LOVE IT!!  It is the only thing that helped with the passing out, feeling of death, fast hear rate, etc. feeling in the mornings as well as lots of other feelings I would have during the day.  Also the Zoloft is safe enough that it doesn't adversely effect my heart rythym, in fact since it decreases my level of anxiety it actually seems to help.  I took it for 10 motnhs and then quit for a year, and am now back on it again.  I chose when to go back on it because I recognized the symptoms coming back again.  My internist is EXTREMELY helpful.  She is very understanding, having had anxiety issues herself.  Finding an understanding doctor can be key to good health, in my opinion.

Hang in there you guys, we all have our days!!
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Hi. I sympathise with everyone on this board! For several months I have been experiencing what appears to be a problem that is developing into MVP; it progressed from a complete inability to sleep (due to my heart rate suddenly jumping for no reason on any attempt to nap or rest, from its normal 55-60 to about 90+).

I have a history of sleep apnea and in April, for some weeks I had been waking up with shaking legs (chills) and felt I had had difficulty breathing. Other events: I woke up in late April with a sharp chest pain, which disappeared; I started hearing/feeling a 'noise'/vibration in my left chest and in my back. It got very bad and I began 'hearing/feeling' flutters and even clicks and other strange 'noises' in my back. These 'noises' have subsided a lot with the Zoloft but the flow murmur has remained (I feel a 'flowing' across my chest, now much of the time whereas at first it only came after a 'long' day etc.).

Due to a heavy work schedule, I did not pay enough attention to this...I have also been sustaining a 4 - year long very stressful relationship (long distance). Finally, my father suddenly passed away in early May; and I was forced to fly from the UK to Canada within 3 days,do the eulogy and etc. I did not realise how ill I was, and for the next twelve days I did not sleep at all, because every time I tried my heart rate would go up.

Eventually, I was so depleted of energy that I finally slept; but it felt like my heart was trying to pound right out of my chest and, worse, it felt like it was wobbling.

That was about 9 weeks ago. Since then I have seen a Cardiologist, had a stress test, 48 hour holter (all normal, I am told); and I was given Lorazepam to control my anxiety. I had used a penis enlarger for several months (keeping it on at night) and this greatly increased my anxiety, as I felt it had contributed to weakening my mitral valve; but all the docs (including ER) I have seen and the cardiologist have said that would not have done any damage.

I felt well enough on the Lorazepam to return to the UK in July; but my symptoms persisted and have morphed into other things. Whilst I continue to have a tingling in my left foot (which fluctuates but appears to be constant), and a numbness in my right thigh on lying down for a long period or sleeping (not always), it's the arrythmia that I get which frightens me a lot (I believe I got the tingling and numbness before taking Lorazepam).

I saw a UK GP, who immediately prescribed me Sertraline/Zoloft and is treating me as a depressive/GERD. He ignores my complaints about my heart 'wobbling' slightly (due I believe to the mitral leak); the irregular 'double, fluttering beats' which I get some mornings (starting about ten days ago); and he does not believe Zoloft is causing me the problem (50 mg now 75 mg at night).

I was very disappointed with my GP's counsel and the hopeless performance of the NHS (months waiting for a holter monitor), so have paid more than
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I've just read the thread of several weeks ago and I hope you all are still around.  I have been dealing with anxiety for several years.  In 1997 I identified my first adult panic attack.  Long story short, I have been off and on medication.  I, too, have a hiatal hernia and GERD and it has complicated the anxiety.  Exercise was very helpful in the early stages, but I have gotten lazy and old and perimenopausal.  The reason I write now is that my PVCs, if they are that, are really frequent now.  Generally they come on strong in the evening when I am sitting down (like now).  Many nights I have had trouble getting to sleep, because lying down is so bad for them.  I went to my primary and we seemed to think maybe they were spasms in my esophagus because the stomach connection seemed so strong.  A few days later I asked my husband to listen to my chest, and he said it was definitely heartbeats that he was hearing.  When I feel my neck pulse it seems to me that it is very much like the description of PVCs.  I feel like I am losing a little consciousness with each one, kind of like when you hold your breath for awhile.  I have had halter monitors and stress tests before, EKGs, etc., and have always passed with flying colors.  This recent episode of the last three weeks has been very disturbing.  I am now wondering whether the severity of it has to do with sugar because I have been doing a bad thing by eating sweets in the evening (more than usual. Some things I have looked up recently - from what I have read and believe the heart responds to extra adrenaline that is kicking around in the system.  I believe that we who are at risk cannot process the adrenaline efficiently, or we overproduce it, such that it there when it is not needed and wreaks havoc on the body.  Many of my panic attacks come about 30 minutes after I fall asleep.  Right now it is the PVCs or whatever these things are that are really bugging me.  I know that I do have anxiety issues, but this is really out of the ordinary but my stress level is about the same as it has been for several months.  I have read these posts and so much identify with many of you feeling helpless.
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