Short runs of PAC's?

Dear Doctor:

I am 35 year old healthy male with long history of PVC's and PAC's and one episode of A-Fib two and a half years ago. I take Toprol 50mg QD and Cardizem 180mg QD. I tolerate the Premature beats with no problem and have learned to cope with them after having them for 18 years. But just the past two days I have what feels like short consecutive runs of PAC's(6 or 7 beats at a time) no other symptoms are present. The episodes were on and off for only about half an hour each day.Exercising on my treadmill does not induce these episodes. It comes on usually  while at rest sitting down. My concern is I don't think I've ever had these kinds of episodes before. It definitely doesn't feel like the A-Fib. I plan to call my Cardiologist if it continues. My question for you is: What do you think this could be based on what I described to you and do you think it sounds like something serious? Any comments would be greatly appreciated. I know that you would need to see a tracing of my heart during an episode to see what is going on. Thank you in advance for your help and this great service you provide!

Erik

[CCF-M.D.-RCJ]

Erik,

Q:"What do you think this could be based on what I described to you and do you think it sounds like something serious?"

I think you have a pretty good idea yourself!  PACs and/or PVCs are the most common reasons for palpitations, but the only way to know for sure is with a cardiac rhythm analysis.

It is very uncommon for 35 yo, otherwise healthy persons with palpitations to have something serious, but I have never seen you before.  Talk to your doctor.

Best of luck.

[bigmick]

Eric,

You sound a bit like myself my friend: here is a brief history.

43 yrs old, 6'4", 230lbs, generally fit and healthy, moderate excerciser, no health issues other than anxiety (diagnosed and treated over recent years - violent and traumatic childhood).

PVCs diagnosed further to me visiting doc feeling anxious about my heart missing beats at age 27. Had 'em on and off ever since. First Holters in late 80s and mid-90s showed monomorphic PVCs. More recent Holters have shown mainly PACs (last Holter Nov 2003 32 PACs and no PVCs. 5 episodes of AF in last 5 yrs - all occurring early AM/nocturnally and self-converting after 3-4 hrs - I am not on any meds and nor do I want to be unless I ABSOLUTELY have to.

Here is a typical week for me. 20-60 ectopics per day - mainly PACs. A good day will have 10 or so noticable ectopics and a bad day will have a couple of hundred noticable ectopics. A few times per week I also get EXACTLY (I think) what you are posting to the Doc here about. My heart will suddenly for no reason (at rest - sitting down in car or at desk) start beating at say 150-180 bpm for a few seconds (as short as 2 or 3 beats and as long (to date) as say 10 seconds or so. I've NEVER caught these little runs on a Holter - annoying. The runs feel too regular to be short runs of AF. I actually have a 24hr Holter on today as I sit and write in an atempt to capture one of these runs. Even tho I admit I am a little cardiophobic, these short runs often feel uncomfortable and panicky - occasionally being uncomfortable to the point where I start to feel a little lightheaded/dizzy. After such a run lasting more than a couple or three seconds I will typically jump out of my chair and jump up and down around the room in a panic to try and sort myself out - it sounds a little mad but it strangely enough does the trick! I sometimes fear that if they went on for any longer than they do that I would have to lie down and might even pass out.

So far as I am aware, the runs are more than likely runs of PACs or some form of SVT. Only way is to capture one of the darned things on a Holter and find out.

Let me know if you can identify with what I am talking about - it always makes one feel better to know that one is not alone with these things (-: Maybe between us (and others here like us) we can suss it out.

Cheers,

BM

[Dr. Erik]

You and I have the same exact symptoms and we describe them in the same exact way.  I react the same way as you when my heart goes into an irregular pattern. I jump up or start to run for a moment to try to jar myself out of the episode and it has always seemed to work. I too have anxiety for which I take Paxil. I also take Toprol and cardizem which prevents my A-Fib from occurring.

Your short runs of a rapid heartbeat sounds like either a non-sustained A-Tach or V-tach which are both harmless in an otherwise healthy heart. This isn't very reassuring when you have to deal with these episodes. It's scary and I've been there and done that. When I'm getting constant skipped beats it seems to put a dark cloud over my head.  I try to deal with it the best I can.

[bigmick]

Hey Pluto, thanks for the input - very helpful and thanks for taking the time to post.

Erik, good news. I've got one of the flutters I described caught on my Holter mid-day today. It will be interesting to see what it was - I'll make sure that you know via this board - one way or another - shortly after I do. Thanks for the additional input.

Best of health to both youz guys and to anyone else reading,

BM

[Dr. Erik]

Yes, please let us know

[GPO]

I am so glad to have searched for PAC and found this site!
I thought something was wrong with me because I was concerned about this shaking of my chest that has been termed PACs.

I wore a Holter monitor for 48 hours and only two very slight "tremors" were recorded and identified as PACS. Most nights I have them all night long and hard enough to wake me up. When hardly anything showed on the monitor I thought maybe this was all in my mind and I was a hypochonriac.  Neither my family physician or my rheumatologist seemed concerned at all, and both felt they had the problem taken care of.

Thanks for sharing your stories so I know I need to press doctors for answers and speak up for control in determining what this might be....
No one bothered to check and look at my records to know that I also have MVP and these two together could be significant.

With all the money spent on health care, a patient often has to be assertive and aggressive in order to get answers. It is hard for me to be that way, easpecially when I am not feeling well.

This is a wonderful site and I am hoping I can get my question up there for a second opinion.

[BigBoy2u]

I am a 41 male with a one time caught on tape episode of exercised induced NSVT and I am on 75mg Atenolol 1x daily. I had a battery of tests all ok, Cath, sonogram, cardiac MIR all A-OK.  I never noticed the PVC, PAC's before my heart condition was diagnosed and I suspect the Atenolol causes more than what I ever had before.  What are some of the tricks people have learned to deal with the PVC's, PAC's?  Often I do ok when they hit and I am lucky that often I don

[BigBoy2u]

I really appreciate your comments Thank You!

[shima]

Hello, just reading everyone's comments makes me feel so much more comfortable with my problems, they are so much like so many of you have described,  my pvc's (i believe) started when i was about 17 y.o. i had taken midol for cramps and that is when it all started. I had the typical palp's until about 5 years ago, i had my gallbladder removed and a day later is i started getting really bad palpations,(maybe the anesthesia? and what some of you have desribed as possible runs of a-fib or svt, i also have bigeminy off and on several times a day. the bigeminy was caught on the monitor because i freaked out thinking i was going into some lethal arrhythimia and went to e.r. the doc actually sat there and said "i never know what to do about this!) comforting! i had already been taking antenol 50 mg. a day for the palps, he told me to take another 25 mg, and magniesium 250 mg. a day, i am not hypertensive so sometimes all that antenol makes my bp low, and im tired alot. but anyway, it doesnt help i still have all that i had before, maybe it would be much worse if i took nothing at all but im too scared to stop and find out. but when i do have the bigemny or runs of whatever they are i can make them go away instantly by coughing, if that helps anyone. i also can not drink caffiene, it makes it ten times worse!  i often am amazed that this subject (pvc's etc,,) isnt talked about more other then places like this, as i find several people have them. doctors seemed stumped by this. i went to a cardiologist and he did not seemed concerned, saying it is not life threatening. but i agree, it does scare the daylights out of you sometimes. i see that cozaar has helped some of you along with the meds i take, maybe i should ask my doc about it?  thanks for being here, it really helps!

[scaredy-cat]

Okay, after a few weeks of a fast heart rate that comes and goes for no reason plus an irregular rythym that often goes along with the high heart rate, I went to the doctor and had a battery of tests performed.  Got an EKG, echo, blood work, and holter monitor.  The doc says that my heart is healthy, cholesterol is great (HDL of 87!) and that the holter picked up some "premature heart beats" that are nothing to worry about and will never cause a heart attack.  In fact, he has told me if I don't embark on a regular exercise program before the next time I see him in six weeks, he'll "kick my butt."  Problem is, when I get these I feel like I'm gonna keel over.  It never happens during exercise or after.  It usually occurs when I am upset, stressed or when I get up from crouching or laying down.  I think it scares me most because often it is not a single flip-flop, but a string of paused beats with fast ones in between.  Any body else experience or no anything about this????