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Many Types of Heart Palpitations
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Many Types of Heart Palpitations

Hello,

I am a 44 year old male.  I am not overweight and am in good shape and exercise regularly.  I have a 3+ year history of increasing palpitations with no known cause.  Other health conditions include raynauds.

I am currently finishing wearing an event monitor and it is catching all sorts of different kinds of palpitations.  So far, this is what the monitor reports say:  sinus bradycardia, PAC's, atrial couplets, atrial triplets, atrial runs, wide complex tachycardia, PVC's, accelerated junctional rhythm PAC's, ventricular bigeminy, ventricular couplet, accelerated ventricular rhythm.  I am on Toprol due to prior diagnosis of sinus and supraventricular tachycardia so the Toprol may well account for the bradycardia but I am sure it is not responsible for these other arrythmias because they started before I ever began Toprol.

My doctor is concerned because the monitor showed I had sinus bradycardia in the 30's which skipped to an atrial couplet and a run of triplets.  He has scheduled a stress test for me.  Questions I have:

1.  Why is my doctor concerned about the bradycardia skipping to the atrial couplet and run of triplets?  Am I going to drop over dead?
2.  How is it possible that I could have all these different types of palpitations going on in the same heart?  What types of disorders could cause such a thing?
3.  I have no problem exercising vigorously and so I think the stress test will come out fine.  Assuming it is okay, what other tests should I consider?
4.  Can anxiety cause all these types of palpitations?

Thank you so much...


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239757_tn?1213813182
Pete,

thanks for the post.

1. Why is my doctor concerned about the bradycardia skipping to the atrial couplet and run of triplets? Am I going to drop over dead?

No. He is concerned because you have various arrythmias and wants to rule out coronary blockages as a cause. Sinus bradycardia in itself is not something to be concerned about unless it were causing symptoms.


2. How is it possible that I could have all these different types of palpitations going on in the same heart? What types of disorders could cause such a thing?

It is extremely common. Odds are the rest of your work up will be normal.

3. I have no problem exercising vigorously and so I think the stress test will come out fine. Assuming it is okay, what other tests should I consider?

Other than an echo, none.

4. Can anxiety cause all these types of palpitations?

They can be a factor, and in some the most significant symptom. If your anxiety is driving your life, or you have a hard time keeping focused on important stuff, you should seek help in dealing with it.

good luck
26 Comments
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Avatar_n_tn
Can I ask (this is important as I'm trying to compile information which may help me move closer to the possible cause of these annoying, harmless beats): if you breathe mostly through your mouth, can you post 'MOUTH', or if through the nose, post 'NOSE'. If you are always struggling for air (as an annoying habit), post 'AIR HUNGER'.

Thanks.

I'll get back to you.
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Avatar_f_tn
Hello, I too have several different arrythmias as well. You said that you have wide complex tachycardia do you me ventricular tachycardia? I have Pac, pvcs, supraventricular tachycardia and ventricular tachycardia as well as accelerated idioventricular rhythm. So I can totally relate to your problem. I have had several monitors in fact I just had my loop recorder taken out two weeks ago. I have had a ep study in January. They gave me a 90% chance of being fixed but lucky me they didnt fix me. (hahha) They couldnt induce my vt. I was pretty bummed but they say its not life threating, but try to convince me of that when it happens.I am not on any meds, when I did try the toprol xl I started out with very small doses and did them for three days and thats when I had the worse run of vt yet so that is why they did the ep study. They say I have good strong healthy heart with a ef of 70 so that is why they are not worried. I wish you luck.
wmac
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Avatar_n_tn
Pete,
I have multiple arrhythmias as well, and as in your case no one knows why.  I have had them for 5 years and have been told by numerous doc's that while they are no fun to live with they should not kill me.  They just came out of nowhere. Before that I had never felt one in my whole life. I am 54 now.   I know it is hard to believe that one heart with no known disease can do all this.  I have figured out some of my triggers: bending over,indigestion, and definitely stress. I get them every day at different levels. I sometimes get short of breath and sometimes not. I think it has to do with the type of arrhythmia at the time. Also for me Pepsi is a a thing of the past. No caffeine at all. Even when I do everything right I can still get some really uncomfortable days or nights. The point in telling you all this is that some times it makes me feel better knowing other people that have the same thing are still here and it hasn't progressed into something worse. I hope knowing that I have had all these different arrthythmias and am still here helps you.
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Avatar_n_tn
Thanks Doc.  And thanks Wmac and Bama Jane.

I very much appreciate your response doc!  You helped ease my mind some but what concerns me is that these palpitations are gradually getting more frequent over time.  Two years ago I could go two days without feeling anything - now I am doing good if I go four hours without something flopping around in there!  People who don't have these palpitations don't know how lucky they have it.  Once you have them you feel like you are living on the "edge" of life.  I guess we are all always only a heartbeat away from death but when you have palpitations you just realize this more than anyone else.

I saw a cardiologist today and he said that the one palpitation that my regular doctor is most concerned about could even be a short run of V-tac but he cannot tell for sure.  Eeeeeeks!  I always thought v-tac was BAD BAD BAD.  But he did not seem too concerned about it.  So, yes Wmac - I MAY have had v-tac also!

A question for Wmac, Bama Jane, and anyone else who wants to answer:

Have your palpitations gotten more frequent with passing time?

Thanks Everyone.  Take Care...      :^)
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Avatar_f_tn
I just dont get any of if. Just when I think I have it all figured out boom here they are again. I do not drink caffine at all or eat chocolate, No msg. Tonight out of the blue they are here with everything I do I bend boom, I sit boom, I relax boom I just dont get it. They are the booms that hurt. Im afraid to move at times. And yes it seems that they have gotten worse over time. I have had palpitations since I was 19 but up untill six years ago not much then the last three years have been the worst. I sometimes cant function I get depressed and all I want to do is cry at times. I am 41 now I have gone to counselors to and that really hasnt helped much either. I feel very crippled at times. Help
wmac
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Avatar_n_tn
i think all of us at one time or another have felt the same way about our pvc's. I myself will go long periods of time and feeel nothing and them they hit... I have found that hormones play a big role, so I just expect to feel bad around those times of the month. I try my hardest not to eat certain things.. including MSG. I went to Applebees last night and asked about MSG in thier food and found out that EVERYTHING they cook (according to manager of this particular restaurant) is cooked with some type of MSG with the exception of the salads!! I am blown away because I should have put that together with why I always feel bad when I eat out at places like that. I thought MSG was pretty much oin chinese food and I aske for it to be cooked without it. I did get my food prepared last night without MSG. EVEn the veggies had to be special prepared with no seasongings. AMAZING!!!
I hope that things get better for you Pete.. just remember, before you had this bad spot things were ok.. know that that time will come again.. It feels like that the skips will never end.. but.. they usually do,,
good luck
cam
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Avatar_f_tn
Yes I agree with you that hormones play a big role! But its funny none of the docs will admitt that. I find that about a week before my monthly my heart will go nuts. I have been talking with a gyno about this and we are considering a hysterectomy not only because of that but due to other problems, but im just concerned either A it will help with the heart or B it will make it worse. I can live with the monthly thing forever but I can cope with the heart thing on a daily basis. So im kinda stuck and I have to decide by tomorrow what im going to do. In the medical book however it does say one of the symptoms of pms is cardiac palpitations and when you read under premenoupause it also say palpitations and tacycardia. So go figure. Im just really getting to the point I cant deal with any of these heart palps or tachy.
wmac
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Avatar_n_tn
Hi,

Thanks everyone for your input.  Here is another question for any of you who get various types of palpitations.

NOT counting individual PVC's or PAC's, how many events do you get in a day?  By an "event", I mean something that is an abnormal heart beat or string of beats separated by a relatively longer time of no symptoms.  So an event could be a couple seconds of SVT or an event could be 5 minutes of bigeminy or 45 minutes of SVT.  I know this is hard to answer but please take a stab at it.  On a typical day I will get probably 3 to 6 of these "events."  

Thanks....
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21064_tn?1309312333
Wmac,

Although I value and respect the opinions and treatment options presented by male doctors, I have found that a female cardio is really helpful.  She really, really gets the whole hormone thing!!  Hope you are have a great day!

Pete,

Can't say how many events I had prior to my ablations, but I can tell you that I had NSVT a LOT, to the tune of 24% of my daily heartbeats.  Holter recorded 22,000 ectopics, lots of peculiar stuff.  Good luck to you!  I know frustating those extra beats are, boy do I!!
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Avatar_n_tn
I tried Toprol once. It was so bad. Probably 8 hours after the first tablet (probably around the time the blood levels peaked I guess) my heart abruptly broke into ectopic after ectopic for hours. I had to try and go to sleep with it happening. Called the doctor and he just said drink lots of water and stop taking them. The doctors told me that a beta blocker cannot make your ectopics worse! It made me reluctant to ever try another beta blocker, let alone something with known pro-arrythmic side-effects! Fortunately I have tried a few others without anywhere near the problems, although whenever I stop taking a beta blocker after I have been on it for a while there is a period where my heart gets much worse with tachys and other things.
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Avatar_f_tn
Hello, well needless to say my cardio is a women
wmac
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Avatar_f_tn
So what meds are you taking now and dot they work well for you? Have nsvt also right?
wmac
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Avatar_n_tn
I suspect NSVT, but never been captured.
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21064_tn?1309312333
OUCH!!  Have you considered a 2nd opinion?  Near Cleveland?
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Avatar_n_tn
Hey everyone.

I am getting incerasingly frustrarted by the PACS and PVCs which have dominated my life now for 6 months. It just seems like one thing after the other, and no one could possibly understand what I'm going through (except you guys!) It's so hard to try and relax when you're heart is beating so irregularly. I cant relax, I'm scared of exercise, I even took today off work beacuse of how much the little monsters are getting to me. I know how important it is to get on with your life, but I'm finding it so hard. I dont feel so bad sometimes and think "hey, I can get through this!" but then like always, the BUMP comes back and scares me so much that I end up just wanting to cry. I just wish I could live in harmony with these little things, but each time I get one, it still takes my breath away. I don't think you could ever get used to them.
Just my thoughts at the moment...thanks for everyone's helpful comments on this forum.

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Avatar_n_tn
I was happy to see this thread about the hormones possibly being a cause.  I have never suffered with heart palpitations before this month.  At one point they were so bad, I thought I would die.  I wondered if these palpitations could somehow be related to my cycle, because my body goes absolutely nuts when Im PMSing, but i dont really know.  I am still having a few palpitations even though my cycle is done, but it is no where as bad as it was last week.
Im crossing my fingers hoping thats all this is.  I also hope I can find a time that they accept questions here haha, Im always out of luck on that!
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Avatar_n_tn
I think it was you that asked how often people have these in a day.  I have them on a good day maybe ten to 20 times on a bad maybe a hundred or more (that I feel) and having different arrhythmia problems it feels different with each little episode. Some make me short of breath, some times my heart will race for ten or 20 beats. Sometimes it will race for longer times with palpitations thrown in.  This has been daily for 5 years to various degrees. Some make me feel pressure in my chest. Having different arrhythmias make it a little difficult to always brush them aside because it doesn't always feel the same. Some are easier to ignore than others. Either way I certainly understand your concern. Hope you find some relief and I hope some day science will find better ways to treat arrhythmias. I think anyhting involving the heart can give people a sense of loss of control over their lives.  Especially when you have no warning when one of these episode will occur, how long it will last, and if it will get worse over time.
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Avatar_n_tn
Thanks for answering my question regarding how many "events" you get in a day.

Momto3, so you actually get non sustained ventricular tachycardia on a regular basis?  Do they tell you this is anything to worry about?  I may have had short run of NSVT but the cardiologist I saw did not seem overly concerned.

Bama Jane, the way you describe the variations in palpiations is much the way I feel although it sounds like you get more than I do.  Over time have your palpitations gotten worse in terms how often they occur?  

Two years ago (the last time I wore a monitor) they found only PAC's, PVC's, inappropriate sinus tachycardia, and SVT and I was getting the IST and SVT once every other day or so.  Now, two years later I am having several palpitations a day (not counting single PAC's or PVC's) and my monitor has found just about every type of arrythmia possible it seems.  So things are definitely getting worse.  I think sometimes that in a few more years all my heart will be doing is just flopping around chaotically all day with maybe one or two normal beats here and there....a scary thought.

Thanks.  This is great to be able to talk to others and learn that you are not alone!
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Avatar_n_tn
In the beginning I wasn't even aware that palpitations were what was causing my symptoms. I just knew that I would have episodes of weakness and feel very tired and some chest preessure which could have been from arrhyththmia or indigestion, but I did have an increase in misbeats over the years and the more they monitored my heart over the years the more thngs that showed up.  As I said earlier some days are much worse than others.   I am not sure if they increased or were there all along and picked up as time went on.  I was hospitalized and monitored a lot in the beginning, but I haven't been to the emergency room in a few years.  Unless I get tach ogoing on for 30 minutes or more at 160 or above I don't go. I take a small dose of atenenol, it keeps the episodes shorter and the rate lower when it does happen. All the other heart meds I tried made it worse or had intolerable side effects. Exercise has helped to blunt the tach as well. 50 minutes on the treadmill 7 days a week, but I get misbeats still and also during exercise.  I try to keep exercising unless they become too frequent. It is a difficult situation to get your head around for sure, but I try not to let it stop me.  I still ride horses and do all of the things I use to I just have to change things around a bit. The hardest part is the uncertainty of when it will happen and how long it will last. I got caught once out on the trail with my horse with a major episode of tach and had to get off and walk him back in case I got light headed I didn' want to fall off.I ended up in the emergency room for a while until it slowed down but I got back, put the horse away, and drove to the hospital. Fortunately my heart rate has never been fast enough to make me pass out. Haven't had anyhting like that happen again in a few years. Like I said the hardest part is not letting the arrhythmia make me what one of my doc's referred to as a cardiac cripple.  I didn't like what he said at the time, but in the beginning I can see how the fear of it was starting to control my life. Let us know how your tests turn out.  I hope it gets better for you.
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Avatar_n_tn
Thanks so much for your information.  So, do you ever get V-tac that you know of?  I am concerned because one of my arrythmias was called a "wide complex tachycardia" which I understand is usually v-tac.

By the way, I really appreciate talking to you folks with palpitations.  If this thread gets cut off because we reach the limits of number of posts then please look for messages attached to other newer posts where there is still room to talk.

Thanks.
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Avatar_n_tn
Pete,
I don't think I have ever had v tach.  My tach is narrow complex tach. I think most of my rhythm problems are from the top of the heart .  I do get some PVC's, but I don't think at this point they have ever documentd any v tach. I think that the one that is most concerning is v fib.  I do know other people have v tach, and their doc's didn't seem too concerned.  Look through the archives here and you will see some other posts about v tach. I can understand your concern, any of this is worrisome. I hope your doc can give you some assurance and that everything will get better.
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Avatar_n_tn
Thanks for your response bama-jane.  I appreciated hearing back from you.  I wish you nothing but the best and hope to talk to you again.

-Pete-Man.
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Avatar_n_tn
Hi there fellow people in hell.  I have had PVC's, PAC's, paroxysmal tachycardia and various other disrhythmias since I am 19 years old.  I will be 48 this month.  No, they haven't killed me, but like my cardiologist said, they feel like they will.  It is so nice to know that there are others out there, but hearing stories scares me a bit.  I have had about 5 good years where my heart only "acted up" a few times a day.  I just finished my first year of nursing school and it was very stressful.  My heart is now on a roll!  I find leaning over, standing, sitting laying on either my left side or my back...well, any number of things can provoke it.  I have been studying cardiac for a looong time.  Best subject in nursing school. Well, now I am so depressed because I am afraid I will never be able to be a nurse.  When these things happen, I get distracted and feel terrible.  You guys understand.  What if I am taking care of a patient?  I do not smoke.  I eat pretty well.  I'm about 10 pounds overweight, if that.  I do Yoga.  I always kind of can FEEL when my heart is excitable, too.  I take atenelol so at least my heart rate is good.  I have tried EVERYTHING but won't try most antiarrhythmic meds because the side effects can be worse.  I though of ablation, but they say mine start at the wrong place.  Together we should be able to figure SOMETHING out.  I do NOT want to lose this thread!  Is there any way of exchanging emails????
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Avatar_n_tn
Hello fellow insomniacs!! I am wondering if anyone out there can relate to the crazy 2 yrs I've had!! Had minor PVC's at first, went to doc and told him about them. He said it could be my thyroid. It was low and he put me on 25mcg of Synthroid. Everything was fine. My thyroid was still too low so he put me on 50mcg and my PVC's went nuts. I was having them like every other heartbeat. Went to emergency room one night they were so bad. He told my that thyroid meds could make them worse and he put me on Beta Blockers, I think Toprol. I started feeling better. Went to regular doc for follow up and he changed my beta blockers and had sent me for echo and holter moniter..I have Mitral Valve Prolapse. All they told me was "take antibiotics before dental work or surgeries"..that was IT! My PVC's were like this everyday and night...no sleep, cried a lot, depressed, anxieties, felt as you do even afraid to do aerobics , thought i was gonna have a heart attack. I finally just threw out my thyroid meds and I started feeling better. Started taking CoQ10's and my PVC's were very little, the only time I noticed them more was right before my period...so it's not in our heads girls as the doc says!! Continued........
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Avatar_n_tn
OK....started to notice lump in throat a few months ago and went to doc, had ultrasound done on my thyroid..i have thyroid nodules/goiter and he put me on 150mcg of Synthroid. I was on 50 until we found the nodules. I cannot stop taking synthroid or the nodules will grow and may become cancerous. My Pvc's are coming back!! So far they aren't as bad as before but I am scared they still will. These PVC's have ruined my life. I think of death a lot. I can't go to bed without these nasty things. Along with them the beat can be so hard that I feel it through my entire body. I will go to doc soon and ask to be put on beta blockers again...which one does anybody suggest has worked good for them?? I feel like my heart and thyroid are battling and to make one ok the other suffers but i cannot deal with these things and at my wits end. It's not fair that you can't even enjoy a cup of caffeinated coffee in the morning or a glass of wine, god knows i could use one to relax but it'd make it worse. How do you guys get through the day with them??? Sorry this is sooo long.
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