Palpitations and mortality

[LAflipflop]

I am 47y.o. female with a hx of arrhythmia beginning at age 17.  In my teens and 20’s I had sustained  SVT’s (rates over 200)-treated not too successfully with Dig & Beta Blockers.  In my 30’s I had about 8 episodes of documented a-fib, and no more SVT’s. In my 40’s, no more A-fib or SVT’s, but PVC’s.  I feel each and every one, and some days I have 150+, and other days just a few.  Also, 2-3x per yr., I feel a 4-7 beat run of something, never documented. (COULD THIS BE VT? SVT? WILL IT PROGRESS TO SOMETHING WORSE?) I am in otherwise good health.  All labs, echo, stress test, cardiac MRI, stress echo, always OK.  Non-arrhythmia EKG normal. When I feel the “flip-flops,” I am still petrified. WHAT WILL HAPPEN TO ME IN MY 50’s AND 60’s AND BEYOND.? WHAT TYPE OF PATTERN IS THIS? I have been on beta blockers for years, to no avail. Interesting to note, my brother (who is a physician), feels “palpitations,” but has never been evaluated, nor has he tried to document.  IS THERE A FAMILIAL LINK? HELP!

[Cleveland Clinic]

LAflipflop,

There is another flip on this board too.

With a structurally normal heart and normal resting ECG, there really isnt a significant negative prognosis for your rhythm no matter what it may be. However, it would be good to figure out exactly what the rhythm is, as some rhythms are completely treatable through various medications and procedures.  There is no way to guess what the rhythm is without a monitored strip while having the symptoms.

Some people note a familial link with palpitations. Other cardiac rhythms have a familial link, so it wouldnt be surprising.

good luck  

[Heart3]

Great post, I can't wait to see the reply.  I think that is on all of our minds

[mom4cem]

Like your name.

I just have to say that in my twenties I went through the pvc and pac stage. In my early thirties they died down a bit and in my late thirties I started having the annoying svt(though not sure what type)...geesh,,I'm hoping that my forties does not bring forth the a-fib!!!...

I always wonder if, specifically women, how much of a correlation there is between hormonal and these arrhythmias.

I seem to notice the svt over the past two years when perhaps many women would start cycle changes going towards menopause.

I'm interested in what he says also.

My mom said she has noticed some rapid rates at times plus the flips but she has never pursued it either and she is in her late 60s now.

[tickertock]

Very interesting post & questions. I myself a 41 year old male. Besides a connective tissue disease in fairly good health.

As a young child tachycardia almost constantly, occasionally attacks of what doctors called PAT, rarely PVCs until 27 years of age, then PVCs came in episodes in 1000s daily for weeks to months, appearing in epidoes every 3-4 years in this pattern, luckily nearly 5 years without any significant episode of PVCs.

No documeted a-fib. 5 beat run of NSVT recorded in 87, never felt it, told not to worry about it, heart otherwise perfect. I wonder why person with PAT or PSVT often go on to develop PVCs, or persons with PVCs develop PSVT. 2 different arrhythmias, yet same to go together at times.

[Lecah]

I totally agree with mom4cem question about the relationship of hormone issues with PVC's or any irregular rhythms....The Drs posted that there is no viable connection but I believe there is some connection. For men, I don't know what to say :-) I wonder with the hormonal changes during pre and post menapause will that cause my benign PVC's to worsen? I've asked my cardiologist several times as i get older will the PVC's get worse and he always said not likely but I am just not sure. Can't wait to see what is posted by the Dr.

[dmbe70]

While we are waiting for the doctor, can anyone explain what they feel (as best and specific as possible) when you get PVC, PAC or SVT??  I would love to know.  This is a great post, by the way.  Anxious to hear the doctors response.

[momto3girls]

For me, my pac's feel like a flutter and my breath goes out.  When I get a pvc, it's a very distinct pause and then a big THUMP and my breath goes out and sometimes they're a teeny pit painful.  As far as svt goes, I'm currently on another event monitor to try to catch the darned thing.  Whenever I feel a "supposed" stretch of svt, I feel very jittery (like too much caffeine)  like I jumped on a treadmill at the same time.  It usually only lasts for 10-20 beats or so and then back to normal.  My cardio has heard it and said my heart went from 68 bpm up to 120 in 1 beat and stayed there for about 5 beats.  Who knows why! (:  Best wishes!

[Erik36]

There is definitely a familial connection with these heartbeats. Everyone on my mother's side has had all the arrhythmias you've had and more. I have them too. The bad news is you'll probably only live into your 90's. The good news is you'll probably live into your 90's. Stress less! These things won't hurt you or alter your life expectancy. That is what my Cardiologist has told me. Good luck!


Erik

[tickertock]

I agree completely with Erik , the majority of my famaily on both sides have complained of these things and both sides are fairly long lived, late 80s to mid 90s. My Dad is 78 has PVCs in the 1000s daily for years and going just as strong as a 50 year old man, luckily he is not aware of a single one., on the other hand I feel nearly every blip.

[LAflipflop]

Thank you everyone for your understanding and support! Your comments and experiences are most helpful.  Those who have never felt(the terror of) repeated palpitations could never understand.

[steveki]

Sorry to post this on someone elses thread

Hi everyone, i keep trying to  post a question, but you know how hard it is!
I am 33 history of palps...longtime weightlifter, since i was 18.

I went to the cardio with complaints of shooting chest pain and pvcs and pacs...especially at night.
...got me all the tests....my resting bp is 130/90 and the doc said my bp was too high on my stress test...echo was abnormal....slighty enlarged aorta... high normal is 3.7 i was dilated to 4.0.
The doc put mr on toprol, and said never to lift again.

My question to anyone who might know is
1. Does toprol work? I heard it can aggravate worse rythmns.

2. Will or can the aorta go back to normal or does it stay enlarged permanently?

I am really lost right now, I dont know what to do. I always lifted to deal with my stress and anxiety. I dont know where to go from here.

Any responses would be greatly appreciated.

[upbeat63]

only my personal opinion, as someone who has tried toperol xl, 12.5mg to 25mg/day for high frequency PVCs. It did bring down my blood pressure (which was usually in the 120 to 130/75 to 85 range and my pulse rate to about 60bpm on average. Sadly, it didn't bring down the PVC frequency much at all. But it did lessen the sensation of PVCs so much that sometimes I thought they stopped!

However, it did make me tired, that was the only drawback. But it was sufficient enough for me to ask for a different BB. I'm trying inderal now and feel less tired, but sometimes a little spacey (on only 5mg/day.

A great stress reducer IS exercise. If you can't lift, can you do any cycling or running or even just walking??

I don't know if the aorta will return to normal size or not, but the heart is very pliable and responsive to proper care and nutrition and I've read other poster who have reversed an enlarged heart, so anything is possible (?). Good luck.

[sunluv]

i have kind of an extensive multifaceted question here.  7 yrs ago i was dx'd w/ postpartum cardiomyopathy after a long 9 mo.
dx period.  the cardiologists said they had a hard time dxing me because i was a female in what on the outside seemed to be in optimal health.  i first started complaining to my gyn 6 wks postpartum w/ my third pregnancy.(unable to regain energy, increased fatigue)  long story short finally got a dx-pp cardiomyopathy w/ ef of 45%.  started on dig and captopril only to find out i was pregnant w/ baby #4 when dx was made.  i was used as a case study due to the subsequent pregnancy and my refusal to abort.  everything wound up going wonderful-and when i was postpartum #4 i became a md's worst(but respectful) nightmare-NONCOMPLIANT!  maybe a little bit in denial.  by the way i am also a nurse.  my cardio's wife was also my children's pediatrician so not completely out of the loop over the years.  fastforward 7 yrs pp i run 3 miles a day once again am the picture of health on the outside, but had a frank syncopal episode 6 wks ago.  was up medicating my sick 7 yr old and when down in the kitchen.  went to see the cardio the next day scared senseless-have now completed echo, st, holter, event monitor and am on the way to see the ep doc next wk, just saw the cardio today.  the echo showed mild decline, ef is back to 45 when i had been at 65 6 wks pp.  st was wnl- i did have pvcs while post test while hr was returning to norm.  my main complaints have been arrythmias and side affects.  cardio said i have multi events with sustained bigeminy and tri.  kind of curious as what they will do since i am kind of a wierd case.  have been sent to 2nd, 3rd and 4th opinions over the course of orig dx-couldn't have asked for a better primary cardio, but he has reiterated i am at high risk for "sudden death syn" due to the syncopal epi-i'm kind of at a loss because i truly am trying to be compliant this time around because it seems all that was said 7 yrs ago is becoming reality and am a little scared-would just like a little input if possible. also got started on altace as of today-having lots of palpitations-i really think i have been having them for a long period of time, but have just adjusted myself to them-please give me some input or just a little reinforcement!thanks

[Momto3]

Sorry to hear about the recent decline in EF.  I had a similar experience with declining EF, though it was not PP.  After 3 children and years of ectopics my EF dropped from 60 to 40%. I also have MR 2-3+ so at first everyone suspected that the low EF was due to the leaking valve.  Turned out not to be the case. I was treated with RX for several months and then had 2 ablations to try and eliminate the 2 dominant foci causing the trouble. Turns out that persistent pvcs were the cause of the cardiomyopathy!  It has been nearly 3 years since the first ablation, and my EF is now holding at 60%. I do take lisinopril for optimal BP.  I'm wondering if your ectopics could be the problem??  Has that been considered?  It is rare, and rarely documented, but it does happen.

Oh, by the way, the doctor on the forum only answers the first question in a thread.  The best time to post to the MD is between 7 - 9 AM EST(at least that's when I was successful). They only take a max of 2 questions per day, but there are lots of people on the boards that may be able to offer some insight or suggestions (not MD's).  I am NOT a doctor, just a patient : )

Hope you're having a great day!
Connie

[fivespeedsweetie]

I take toprol (50mg) and it works for me.  I have epstein's anamoly.  I was on an event monitor for 30 days (king of hearts)  It did make me tired at first, but once I got through the first week, I got used to it.  It's great because I now have a somewhat normal rhythm.

[anxiousamy]

This is my first time to post on this forum, although I have read many, many articles here. Please forgive me if I have posted on the wrong page.

I am 37 and right now I am suffering with anxiety about my heart. When I was 23 I was diagnosed with sinus tach. with occasional pvc's. I never thought a thing about it before or after my diagnosis. The Dr. told me that it was common and to stay off of caffine. I went on with my life just as before never giving it a 2nd thought. I have never had any symptoms and after about 2 years from the diagnosis the pvc's seemed to have stopped. (I had them since the age of 14.)

I have had 2 children since then. Blood pressure good. Had a benign tumor removed from my thyroid. Levels are good. No one has ever made mention of my high heart rate. Then last year I had an injury to my ribcage that to this day is still causing me pain and spasms.Since this has happened I have been focused more on my heart. One of the spasms scared me so bad that I went to the er. They did all the "heart attack" work-up and said I was fine. My ekg was good. Had an echo done 2 weeks before and it was good except for a tiny leakage in one of the valves. So small the dr. said it wasn't worth mentioning. Just recently I have noticed the pvc's are back.(Due to stress?)

I am obssessed with taking my pulse. I have a high heart rate. Resting it is usually between 76 (coming out of sleep)and 96 as I sit here and type. But when I stand up and move around it goes up. 107 to sometimes 120. I would never know this physically if I wasn't taking my pulse. Does this sound like tachy or ist? When I am nervous it will of course jump up in the 100's, but falls down to the 90's when "the thrill is gone." I do not get dizzy or light headed. I do not even know that my heart is beating so fast unless I take my pulse. Now I am so anxious all the time that my heart rate is going over 100. At Wal-mart pushing a buggy...117. I freak out which I know just makes matters worse.

I do not know anyone else with a high heart rate. I feel so alone in my fears. Do I need to be concerned about this? Is this worth worrying over? Can someone please help me calm down over this? I have read that many of you have tach's at 120 or greater. Are these episodes or your normal heart rate? If I have a rate at 110-120 when I am walking around daily, will this cause heart damage in the future? I try to assure myself by the 2 echos done 12 years apart. Both normal! I am tired of being anxious over this.

[Momto3]

Hi Amy,

Welcome aboard!

You will find lots of helpful people and useful information around here : )

You will probably get more response if your comment is posted up higher on the board.  Try cutting and pasting your comment up higher on the threads.  Sometimes, people don't scroll through older posts.

Try not to be afraid.  There are many others here who share your concern about a high heart rate.  I don't really have tachy episodes (except for right after ablations for chronic pvcs) so I can't really address your concern.  I do, however, understand the anxiety.  Just keep reminding yourself that with a normal cardiac workup, you are likely just fine.  That said, the anxiety can wreak havoc so try and find things to do that help to alleviate the anxiety.  Some find exercise helps; others like yoga or meditation....I'm a reader so that's a real outlet for me.  Good luck and have a great day!

Connie

[anxiousamy]

Thanks Connie for the useful info. I am not sure how to cut and paste my comments on the board though. Got any tips. This is all new to me.
I am trying so hard not to be anxious. Just awhile ago, I was decorating for my daughter's surprise birthday party at my church. When I stopped working I obsessively took my pulse and it read 142! I wasn't doing anything other than hanging crepe paper! Now I am so uptight that I am afraid I will not enjoy her day. I know that I have gone for years with this heart of mine and the echos say my heart is sound, but I cannot seem to rid my self of this anxiety. I do not like drugs. I think if I could get some major reassurance that my rate is not destructive, than maybe I can relax. Do you know where I should post to hear from people with the same experience? Were your pvc's debilitating? Is that why you had ablation? Since mine are back, they're not as frequent as they once were. I feel some, others only by pulse. By reading I know that they are harmless. It was listed as benign on my records 12 years ago, so I assume it to be so now.

[Momto3]

Hi Amy!!

Happy Birthday to your daughter : )

I copied your first post and put it higher up on the boards under "HDL Decreasing."  Although your question is entirely different, it should be OK since this thread has lots of room on it still.  Look for YOUR post under my name (momto3).  Hopefully, you'll get some good dialogue going and will get some reassurance.  

As for posting a question directly to the forum doctor:  They only accept 2 questions per day and it is usually best to try between 7:30 and 9:00 am (EST).  In the meantime, maybe some of the other posters can help.

142 seems high for just decorating.  Have you ever worn a holter or event monitor?

Yes, I had over 20000 pvcs daily and eventually they caused a cardiomyopathy.  I went for 2 ablations and am doing much better.  : )

Connie

[Lorace]

Hi Amy and Connie,
     I've been told by my cardio heart doctor that excessive beats can have negative effects on the heart muscle.  Connie, what is your general feeling on ablation.  I've had drugs and cardioversion to no avail.  I'm a candidate for ablation. Was ablations you had productive?   Lorrie

[Momto3]

Hi Lorrie,

I have had GREAT results from the ablations. I was on/off beta blockers for many years, and the extra beats were not causing any problems.  Normal heart function and good cardiac workup.  In late 2002, I had a routine echo (b/c of a leaky mitral valve) and it showed signs of cardiomyopathy.  After lots of research and such, the doctors believed that the CM developed as a result of very frequent pvcs.  Initially, I was prescribed antiarrythmics (flecainide and rhythmol), but I didn't like the side effects and didn't really want to take the antiarrythmics for the rest of my life. About 7 months into taking the RX, my doctor and I discussed ablation(s).  Although I was pretty scared, I decided to give it a try. I knew ahead of time I might need more than one procedure so it was not too surprising that it took 2 procedures.  I was multi-focal, but there were 2 predominant foci and they got 'em!!  Now (2 1/2 yrs later), I get occasional pvcs, but my cardiac function has been back to normal for about 2 years!  It was truly miraculous for me : )
Where are you scheduled to have the ablation?  Although I also have a doctor at CC, I had this procedure done with my EP at another large Cleveland based hospital.

Connie

[Lorace]

Hi Lorrie,

I have had GREAT results from the ablations. I was on/off beta blockers for many years, and the extra beats were not causing any problems. Normal heart function and good cardiac workup. In late 2002, I had a routine echo (b/c of a leaky mitral valve) and it showed signs of cardiomyopathy. After lots of research and such, the doctors believed that the CM developed as a result of very frequent pvcs. Initially, I was prescribed antiarrythmics (flecainide and rhythmol), but I didn't like the side effects and didn't really want to take the antiarrythmics for the rest of my life. About 7 months into taking the RX, my doctor and I discussed ablation(s). Although I was pretty scared, I decided to give it a try. I knew ahead of time I might need more than one procedure so it was not too surprising that it took 2 procedures. I was multi-focal, but there were 2 predominant foci and they got 'em!! Now (2 1/2 yrs later), I get occasional pvcs, but my cardiac function has been back to normal for about 2 years! It was truly miraculous for me : )
Where are you scheduled to have the ablation? Although I also have a doctor at CC, I had this procedure done with my EP at another large Cleveland based hospital.

Connie

Connie,
     I am not scheduled yet.  I was hoping to make an appointment with Dr A Nitale at CC.  I live in Ashtabula County, so I'm relatively close.  I have been going to Hillcrest Hosp, but think CC might be the best suited for the ablation.  I have been taking atenolol and diltiazer and don't like the side effects.  I don't want to continue feeling like I have been feeling for the last five months with the fluttering and weakness. What have you heard about the success rate?     Lorrie

[Momto3]

Hi Lorrie,

Dr. Natale has a wonderfule reputation.  You can check his bio on the CC website.  I think the success rates depend on the location of the foci.  Although Hillcrest is a great facility, I don't think I'd go there for an ablation.  It is a pretty specialized field and I'd rely on the larger hospitals.  

I just moved from Chardon to North Carolina last year!!  We were practically neighbors : )

Feel free to email me at ***@**** if you have any questions, etc.

[P2]

I hate to sound like a newbie, but I am!  I am a 25 year old male in good health.  I would say in October of last year I noticed at certain times my heart would beat harder and faster than normal (at random times).  I let it go for several months - but as many others have alluded to - became worried.  So I went to the doctor.  She listened to my heart and said everything sounded normal (which didn't put me at ease, because I wasn't feeling the abnormal heartbeat at that time).  A month went by and I still felt the same.  They seemed to be completely random - sometimes in the morning, but more often at night when I was laying down.  So I went back a 2nd time.  She told me to remove caffeine from my diet (I used to drink 2-3 cups in the morning, and soda).  This definitely helped but in correlation with the harder beats, I noticed an "extra" beat sometimes.  Sometimes it would be just one extra beat, but other times two or three in a row.  Again, I went back to the doctor.

This time I had an EKG, chest x ray, and some blood work.  Everything came back normal.  She gave me a presciption drug usually used for high blood pressure.  Her dianosis was that it was stress.  I do have a pressures at work, in life, etc, and tend to internalize that stress.  I noticed a definite improvement and the palpitations almost went away completely.  I even started some muscle relaxation exercises (which worked wonders by the way).

However, I have noticed the last 3-4 days I am feeling that extra heartbeat again.  It feels like a quick beat in between a normal rhythm.  I do not have any pain when it happens, but it is scary.  I have another doctor visit scheduled in a couple weeks, and will mention it again to my doctor.

But, being that I am new to this topic, do a lot of you experience these type of palpitations?  When I have them at night, it keeps me awake which is obviously frustrating.  I have supplemented a lot of potassium into my diet (per my doctor's instructions), but that doesn't seem to help much.  Thank you in advance for your help!

[ta69]

being new to this as well i share your frustration. i feel like i can hear my heartbeat at times and it seems to jump out of my chest. i did all the things u did, remove caffeine, lay on a incline, relax, etc and still have palpatations. matter of fact it's 5 a.m. and i have been up since 2:30 a.m. because the palpatations woke me up. i have to see my doctor in the morning because she said one more episode and she wants me to wear a halter. in your ppost it did not specify if you had to waer a halter before. you spoke of muscle relaxtion techniques, could you give me an example to try. because since saturday (3 days now) my palpatation which co-excist with my acid reflux have gotten worse.i know i probably have not been very helpful to you, but i have seen 2 internists and 2 cardiolgists and all stated that just like you my heart looked fine except a little reguritation on the left valve. and that a extra beat here and there is normal. which i know doesn't do one any good when you're being woke up at 2;30 a.m. by palpatations. have you gotten a stress test yet? good luck.

[iamsrae]

I would like to know if anybody has had any experience with toporol (?).  I am currently taking lisinopril with many asthma medications and have tachycardia and some bronchospasms or arrythmias that make me feel like I am going to hit the pavement and then I recoup.  When that happened today scared me to death as I was driving. It came on very quick.  I thought it was heart at first but now I feel it was asthma that made this problem. We have a lot of smoke in air and lots of dust here. After the spasm of whatever, it went away I was okay.  How do people function and get their kids around when this stuff happens?  Would toporol make my blood pressure sink lower?  Lisinopril works very well with me and I can tolerate it.  Normally my problem is tachycardia and high pulse and high BP.  I was at 110/80 late today and I was afraid to take the toporol. Cardiologist wants me to take 25 mg xl and cut in half if too strong.  Pharmacist says no way, do not cut and do not take till I talk to my primary.  Anyone have any suggestions?