PACs vs. Afib

[kevtt]

One of the MD responses stated that "Premature atrial contractions (PACs) ..., but there is no way to distinguish PACs from atrial fibrillation without an electrocardiogram. A definition of afib is awareness of a strong, fast, irregular or "galloping" heartbeat. But what about the other sensations that I (and others based on their comments from this board) have that include fluttering or flopping with a "hollow" feeling, "air bubbles bursting," etc.? I was under the assumption that these were sensations of PACs and not afib. Are you suggesting that these feelings could be afibs? Because if these are or could be afib, then maybe I have a bigger problem than I thought I did because I get alot of these other types of sensations throughout the day. Are event monitors sensitive enough to pick up these other sensations?

Assuming for the moment that these are PACs, is clotting still a potential problem? It was mentioned from another response that for those under 65 that an aspirin is usually sufficient but the question was is a 81 mg. low dosage aspirin sufficient?

My first post here and think this is great. Thanks.

[arthur]

I am 54 and had lone AFib three years ago; it was rf ablated and I am now free of AFib.  The ablation targeted pulmonary vein foci.  Some of these buggers were left behind intentionally in order to minimize the risk of the procedure by avoiding unecessary burns.  The outcome is that since that time (and before) I am stuck with numerous PACs (0-5/min) which come and go day to day.  I, too, was on a beta blocker and tambocor.  I play competitive sports (all my life) and I found these drugs to interfere (slightly, but enough).  They did lower the incidence of PACs about 50%, while making the remaining ones tough to notice.

There are all sorts of doctor-recommended remedies for PACs as well as folklore stuff which includes all the homeopathic vitamin supplements, hormones, minerals, and the like.  If you read about these bits very carefully, you'll find that most are actually good for the general health of the heart, but have basically no effect on the palps.  As long as the skips are diagnosed as benign (like mine are), then my advice is to forget about them.  You really have to ignore them completely in order to regain your life and lifestyle.  You're mature enough to understand what I am saying...it's a question of paying attention to them and letting them run you down, or ignoring them, and living life normally.  It's not easy to do this...it took me two years to regain the calm that's needed.  Good luck.  - Arthur

[Kahla]

The symptoms that you describe are what I experience and are occuring at the moment.
I am a 57 year old male , 6ft tall 85 kg very fit ( walk up to 50km per week) 70% up hill, I do not suffer from shortness of breath, I have been a very active sportsperson for the last 35 years.
About 8 years ago while out training ( Road Cycling) I got a dose of A/F and it really frightened me, my close friend was my doctor and he gave me an ECG and then sent me to a cardioligist who also dicovered that I have a Bicuspid Aortic Valve with mild regurgitation.
She has had me on 200mg Tambocor twice daily and 50mg Atenolol twice daily and I have been pretty good since then and the medication has not seemed to have affected my exersize
Just recently I started getting these PVC's and Palpitations and they are very disturbing to say the least.
I have had stress tests , nuclear tests , etc, and she says that my heart is normal size but that one day I may have to have my aortic valve raplaced, she always askes me if I get short of breath but I do not .
I avoid all alcahol, tea, coffee (De Caff ) only , I do not have sugar or salt we are very fussy eaters and avoid most dairy foods and only eat fish , chicken and very lean beef or veal  in fact some tines you wonder if you should just stand still in one spot and not move at all ?
What frustrates me is the fact that the specialist does not seem to be interested in the xtra beats and the Palpitations that I get now and then.
All of my blood tests are spot on and the Tambocor level is spot on.
Cholesterol level is 4.85 which is good
Can any one tell me is there any thing else that I can do to help? should I be taking Magnesium ?
I look forward to your reply.....

[dande4]

I'm stating my own opinion, but I think on the most part you would know the difference between the two. I have pac and pvc at times, sometimes several times a day, but at the most they last only for a beat or two or for a few beats. I believe, but anyone please correct me, that A-fib would last for a while, I don't know exactly how long it could continue though. My pac or pvc feel differently depending on which it is, pac or pvc. The pvc feels like my heart flip flops, like a drop and the pac usually feels like a little fluttery feeling and I usually feel them in seperate areas. I wore an event monitor for a long time, and it is a great way to verify what you are feeling and let you know right then and there what it is. Ask your dr. about it. I was considering taking the low dose aspirin regimen myself for prevention.

[debra21784]

In terms of event monitors they are the best way to capture events of arrythmias and will pick them up,record and transmit to doc as long as you remember to push the button when you are having symptoms.EKG may not capture all occurrences of arrythmias because they may be "occassional or periodic,episodic " and not occurring at time of EKG.The camps are still divided on ASA 81mgs vs. 325 mgs per day for anticougulant effects,but if you are indeed having a-fib then anticougulant is recommended,even if you are under 65(Dr.S Kittner UMMS study on young stroke survivors Balto Washington cooperative study) (see article by Dr.Halperin on under use of anticougulants in a-fib) An EP study is the gold standard and  will be able to differenate between a-fib ,PAC,Atrial flutter  or any other arrythmia you are experiencing.Discuss with your cardio doc as an option and will help design a treatment plan right for you.PACs and most other arrythmias  do not require anticougulants.(whether it be ASA or coumadin)

[CCF-M.D.-KE]

Dear Kevett,

What has been described are palpitations, which is a general term for the sensation of feeling one's own heart beat. It is impossible to distinguish different rhythm disturbances with a reasonable degree of certainty based on symptoms. One needs to have an electrocardiogram  or holter monitor to obtain a definitive diagnosis.

PACs do not pose the same clotting risk as atrial fibrillation. 81 mg of aspirin should be sufficient to treat lone atrial fibrillation if prescribed by your doctor.  

Thanks for your question,


CCF-MD-KE