PACs and Nausea

  I have posted here before, and have gotten alot of benefit from your response as well as reading other postings and responses.
  I have been checked out with treadmills, echocardiograms and 24 hour holters, with nothing more than benign PACs.
  Last night out of the clear blue, I experienced a flurry of them along with what seemed to be several fast,
  irregular beats for about 30 seconds.  After 10 years, I have learned to live with PACs, but when this happens,
  I think its the end. I have had this happen before and always seem to feel wiped out, flushed and nauseated afterwards
  like I do today. I'm also getting more PACs than usual today, and feel like I will get alot more.  
  My question is, do you have any explanation for this feeling of tiredness for why I feel this way?  And should I be
  concerned about the "flurry" of irregular beats? Could the tests be missing something that could be dangerous?
  Thank you again

[CCF CARDIO MD APS]

_
Dear Kevin,
The tiredness, etc. sounds like it could be that your body has what is called a vagal reaction to
the PACs.  Vagal reactions are autonomic (they are part of our neuro hormonal response system that
is essentially out of our control.)  It is also possible that you are simply so affected mentally
by the PACs that it wipes you out just to get through it, it is often difficult for patients with
PACs and PVCs to remember as they are having them that their heart is ok and it is NOT the end of the world so to speak AND mentally this
is QUITE stressful.  
It is possible, albeit unlikely, that ANY test is missing something since no holter monitor is 100% sensitive out of its 24 to 48 hour window.
Now as regards to "dangerous", if you were experiencing chest pain/pressure, shortness of breath, and or severe dizziness with the palpitations,
then yes it could be dangerous.  However PACs in a flurry even for 30 seconds will not produce such said symptoms and are certainly of no consequence except to
put fear in the minds of patients like you.
I hope this information is useful. Information provided in the heart forum is for
general purposes only. Only your physician can provided specific diagnoses and therapies.
Feel free to write back with further questions. Good luck!
If you would like to make an appointment at the Cleveland Clinic Heart Center, please
call 1-800-CCF-CARE or inquire online by using the Heart Center website at
www.ccf.org/heartcenter. The Heart Center website contains a directory of the
cardiology staff that can be used to select the physician best suited to address your
cardiac problem.