Thanks for your time! I suffered with GERD for a number of years and finally had the LAP Nissan procedure in April of this past year. It has helped with the reflux, but I now have a great deal of bloating/gas etc. It varies but doesn't seem to matter if I eat a little bit or a lot. As I mentioned earlier I'm losing weight on a modified "low-carb" diet. I have mentioned this last year to my cardio but he didn't think there was much of a relation, but, I have an increased number of ectopic beats when I'm having stomach discomfort. Many times I feel hard flip-flop in my throat that is immediately followed up by a long gurgle or stomach churning that will sometimes last a few seconds. I do have some anxiety and I'm taking 150 mg of Norpace CR once daily for LAF. I've only had one episode thankfully, and that was in Sept of 2000. I had heart tests run then that were all normal. I got a really weird feeling back in January and kept feeling bad so I finally gave in an went to the ER. They did ekg and blood work-all normal. ER doc said it was probably gastritus. I know I have a tendency to obsess about my heart. For several years before the GERD was discovered I was certain I had some sort of heart problems and let my imagination run away with me numerous times. Do you see or believe there is any connection between digestive problems and ectopic beats up to an including afib? I had hoped the LAP proecdure would decrease my ectopics but it hasn't. And finally, should I be taking an antiarrhythmic after only one episode of LAF? God bless and thanks for your time.
Just a reminder to only post 2 questions in a 6 month period.
Yes, the same nerves that innervate the gastrointestinal tract have some fibers that also innervate the heart. Sometimes there is cross talk between the 2 and it is not uncommon for people to experience PVCs associated with meals.
I generally would not treat an isolated episode of fibrillation with an antiarrythmic. But I always evaluate patients for anticoagulation options if they have a history of fibrillation.
My LAF was treated by rf ablation of a focus located at the pulmonary vein entrance to the back of the left atrium. Before the procedure, I had numerous PACs (premature atrial contractions) and about six LAF (or PAF, paroxysmal atrial fibrillation) bouts over a one year period, each lasting about 10-20 hours. These were generally kicked up by adrenaline surges during physical activity, which for someone who is actively engaged in sports is a hugely depressive finding. Mix that with anxiety over the whole thing, and wham, I was a wreck for about a year. It took that long to find the right EP, get the right information, and get my mind around the facts to the extent that I fully understood what caused what and why.
This was a couple of years ago. Now I get very few PACs, and had only one LAF event which was probably due to a combination of heat exhaustion during a soccer match combined with stupidity.
I don't check my pulse every hour, I don't fret over a sudden bump in my chest due to a "skip", and I eat up every opportunity to be physically active. My life's back, and I think you can do that too.
Good for you. I visit another web forum that deals strictly with LAF and many people have had ablations such as yours. Some are completely cured, and some have small hiccups from time to time as you describe. It is interesting that you were able to get the ablation after only fighting the fib for a year. Most ep's won't mess with you until you've had severe problems for an extended period. I'm glad you were able to get yours done. I don't blame you for seeking that solution because I don't want to be faced with a life-time of heart medications!
Subj: (no subject)
Date: 2/14/2005 9:22:28 PM Central Standard Time
RE: Those concerned with Heart palpitations
Well, it appears only my supplemental message made onto your network, so I will take the time hear to try and repost it.
okaaaaay. This effort is placed on your support group website courtesy of my spouse, who is seated next to me with threats of bodily harm if I do not take time from my schedule to provide a professional response and take appropriate interest and concern. To this extent, I summarily aplogize that my occupational schedule generally prohibits the latitude necessary to search out your groups and assist with providing information where it might be sought or needed.
Under the circumstances and to avoid physical reprisal by my well-intended wife, I hereby consent to the necessary time expenditure without further delay. And with particular reply to the young lady who so keenly observed that no men visit or participate in your support network, allow me to make a footprint in the sand and be the first to join you.
Well ladies, down to business. Firstly, let's see if we can collect your concerns and provide a general and hopefully beneficial response. We need to start with a little and very brief general anatomy course, so let's take our seats.
I want to start by talking about a very special part of the human anatomy that does not seem to appear in the collective messages I've reviewed; The VAGUS nerve. The vagus nerve, also referred to as the 10th cranial nerve, is appropriately termed a "mixed" nerve. It provides a sort of two-way communication of nerve impulses back and forth between the brain and the pharnyx,larynx, esophagus, stomach and associated abdominal viscera(basically, your throat, windpipe, your tummy and guts), the heart, lungs and several more complex but irrelevant body organs or functions. The vagus nerve is the longest and most complex of the cranial nerves in the body.
The key point here is to make note that this nerve involves the "heart," the "lungs" and basically the whole digestive system of your tummy and intestines. Now let's pair that with some real specific and limited physiology about the heart and its rhythm.
We also need to bring clarity to some of the medical jargon being taked about by many of you in your messages. The term PVC, or Premature Ventricular Contraction, is just one of many arrythmias and not necessarily isolated to what many term as "palpatations." When we speak of palpatations, what we really mean is the presence of "ectopic" beats(hearbeats where there should not normally be)and the precise induction of these beats is felt by us as dancing of our heart or a flutter sensation in our chest, the prominence or intensity of which is determined by the precise moment of the extra beats in proximity to the most recent beat and the upcoming beat or contraction of the heart ventricles or atria. Think of it in relation to your memory of your worst date, where the guy you're with has no rhythm whatsoever but wants to impress you with all the right moves and clumsily tries to introduce his own dance-step into your otherwise smoothly flowing and natural pace with the music. Depending upon his rather untimely entry, he can cause awkwardness that either simply causes you to quickly pause and regain your rhythm or literally trip you repeatedly until you're forced to leave the dancefloor. Well, the same holds true for the heart in our example. The extra beat, or palpatation might come at a point that's subtle, or it might be at a point where the heart stumbles repeatedly until normal sinus rhythm is regained. Now let's get to "why" palpatations occur.
The heart has a natural pacemaker called the sinoatrial node among several less distinct and similar pacers, which is stimulated by guess which nerve? You guessed it; The VAGUS nerve.
The vagus nerve helps regulate the heart in comparison to other functions taking place with other areas and is doing its job right now in each and every one of us. In fact, the variability of your heart rate during inspiration and expiration of your lungs is an effect of the vagus nerve. We've all noticed that when we take a breath in, our heart tends to beat just a little faster and when we breath out, a little slower. It's an entirely normal bodily function and is connected to the need by the body's system to respond to the environment.
Now that we kind of have a little medical background under our belts, let's take one of the complaints by many of you regarding the proximity or timely appearance of palpatations and indigestion. Remember that we said the vagus nerve is linked to both the tummy, the throat and the heart. Let's assume that we've eaten meal and it's caused us to experience some gastrointestinal discomfort, or in other words, gas. The irregular presence and activity by your tummy and intestines stimulates, more appropriately irritates, the vagus nerve which sends a rather inappropriate signal back along the pathway to guess where? That's right! The heart. Move to the head of the class. The heart is busy pacing away regularly and is relatively unconcerned with all the food you poured into your tummy, when all of a sudden in comes a signal from the vagus nerve because it has been inappropriately stimulated and tells the heart to beat. Well, just like our bad date example, the signal to beat is rather untimely and awkward but the heart has to accept it and respond. The result is extra beats that make the heart feel like it is stumbling. The degree to which it stumbles oftentimes depends upon the extent to which the vagus nerve is irritated and the relative state of indigestion present as the causitive agent.
There is most often no pain assoicated with this occurrence because it is not the result of a lack of blood or oxygen that creates the palpatation, but rather just a simple additional electrical impulse or series of impulses. Pericardial pain, or pain adjacent to the heart, can sometimes accompany palpatations or exist exclusive of any arrythmia, but is not necessarily considered pathologic or harmful to us. Remember that we're dealing with inappropriate electrical impulses and muscle tissue other than the heart that is partially innervated by the vagus nerve and can respond inappropriately, causing a jabbing or shooting pain than many describe as a "catch" in their chest. We'll talk more about chest pain in a bit.
Let's discuss the sensation that some of you described as a warm flushing sensation of your face and perhaps other body areas that accompanies the palpatations. Recall our anatomy lesson. The vagus nerve stimulates many areas of the body in response to our environment or internal conditions caused by the outside environment, ie. a meal that produces indigestion. The vagus nerve provides all of us with a stable process called vagal tone. This tone or stability keeps us in a state of balance so to speak with our environment. In response to environmental cues or situations, that tone or stabiity changes to prepare for what may be required. You've probably all seen a guy that makes your heart "skip a beat." Ever wonder why that phrase ever came about? Think for a moment. If you've ever been emotionally overcome, your heart races or feels like it pounds in your chest, we begin sweating, our blood pressure rises, we feel nervous and at some point our face is overcome by a warm flushing sensation that we attribute to nervousness or embarassment. Well, guess what nerve plays a very big role in that entire process? Right Again!!! The VAGUS nerve.
The above scenario would be a case of increased vagal tone. Well, if there's an increase, there's likely to be a case of decreased vagal tone as well. Indeed there is. decreased vagal tone can make us weak, nauseated, tremble, and even faint. It happens in cases of being excessively startled or frightened. Other conditions, such as diabetes can cause decreased vagal tone, but for our purposes we'll stick to conditions that by what I've read from all of you are non-disease provoking conditions, with the exception of one individual with Mitral Valve Prolapse but we'll touch on that in a bit.
Anyway, the point is that our body doesn't always accurately recognize proper environmental cues and the vagus nerve doesn't always know when and how to act. In other words, it misbehaves once in a while as a result of inappropriate stimuation. All sorts of things make the vagus nerve act out, including stress, anxiety, depression, illness and even ideopathic causes(origin or cause is unknown). In fact, there is work going on right now using electrical vagus nerve stimulation to treat depression, anxiety and even seizures.
And here's a little extra for those who cough when experiencing a palpatation. Recall your anatomy lesson again. Remember we said the vagus nerve stimulate the pharnyx, larynx, bronchi and esophagus. Well, what do you know. Those are exactly the processes involved in the cough reflex. So when the vagus nerve inappropriately stimulates the heart and causes a palpitation it also stimulates in some cases the cough reflex. How about that!
So we begin to see that the cause for palpatations and the palpatation itself is not a life-threatening occurence at all. It concerns us for several reasons. First, it has to do with our heart and hey, that's the thing that keeps us alive basically. Big concern! Secondly, we've been bombarded by all the medical revelations and awareness about heart disease. But a case for heart disease does not make for every condition the heart demonstrates, especially palpatations. If you've ever had a cramp in your hand from typing too much, it probably never gave you pause to think you might not make it, so to speak. You reason in your mind that the cramp is caused by repetition fatigue and you need to take a break, massage your hand and rest momentarily. Well, palpatations can be considered sort of a cramp and nothing more. Under stress and other factors we talked about, the vagus nerve gets irritated or fatigued and acts out. Just because the heart is affected, doesn't mean that you've got heart disease or vascular problems that are looming. They're annoying, worrisome and even frightening, but knowing where they come from and why will help go a long way in knowing that they are non-injurous and if we respond appropriately, will subside and we can go about our lives with far less worry.
Let's touch on anxiety for a moment. Anxiety, and depression too, can definitely cause a state of dysfunction in many areas of our body. Many patients who have these disorders are exhausted from constantly presenting themselves to the medical community with real and valid symptoms of pain, fatigue, bowel problems, vision problems, tinnitus or ringing in the ears, difficulty swallowing, excessive saliva, dry mouth, sore or sensitive tongue, and many many more troublesome circumstances only to have repeated tests all return normal. How can that possibly be?!! It's there, we feel it, we experience it, we hate it. Why doesn't the test confirm that it's there? How frustrating is that????
Well, here's some news that should make you feel a bit less frustrated and even comfort you. Most all tests are based upon the algorithmic, or sequential processing, of certain symptoms and signs that are all conclusive of various disease and illness. When someone with anxiety, depression or other condition that has somatic features(felt physically)undergoes these tests, the components that underlie the actual diseases which have similar symptoms simply does not add up and no presence of the actual disease is evident. So it's a case of false identity, sort of like having a biopsy of a mole that turns out to be benign. Looks like cancer, but is not cancer. Well, that same thing can happen to us with regard to all sorts of disorders and diseases. They look similar in presenation, but one reveals true disease and the other a nonpathologic condition or illness. So the next time your doctor tells you he can't find anything wrong, be glad for that much at least. Many people get far worse news!
So with regard to depression and anxiety, these conditions impart disturbance upon body functions. I suppose you're already guessing that the vagus nerve is not exempt from those circumstances and you're exactly right. So when you have an episode of anxiety, rest easy when you have a palpatation or two, or three or even four. The vagus nerve is irritated and needs a break or to reset. No problem whatsoever and you needn't worry any longer that a palpatation is sure indication of worse things to come. Nothing else happens. Just an extra heartbeat or two where there should not normally be. What a relief!!!!!
And the caveat I promised to the one individual with Mitral Valve Prolapse, your heart condition, while not necessarily life-threatening at all, does predispose you to panic disorder which I'm sure you are probably already aware.
Okay, so now we know what these palpatations are and what causes them. What the heck do we do about 'em? Well, there are several techniques that can help. Firstly, let me say that if a run of palpatations makes you feel faint or weak, don't panic and try to make it somewhere less embarassing. Be safe and think smart. Squat to your knees or sit down until the feeling subsides. No sense in cracking open your skull by trying to make a mad dash for privacy. Anyone can feel faint and people in your company will always rally to your aid more often than not. So relax. The conditions will quickly pass and you'll be back to yourself in a jiffy.
Secondly, if you sense indigestion and gas, discomfort and bloating when the palpatations are present, try merely changing positions which often causes the distention to realign from its offending position proximal to the vagus nerve.
If you're pregnant, well indigestion or gestation. It doesn't matter. What's important to realize is that both conditions represent a temporary rearrangement and limited space downstairs. That means proximity or closeness to the nerve receptors of the VAGUS nerve and you're going to get palpations when conditions are right.
As for the palpatations themselves, taking slow, deep breaths repeatedly will typically cause the palpatations to cease. Recall your anatomy lesson. The vagus nerve stimulates the lungs as well as the heart, so this purposeful stimulating of intention-breathing will often interrupt the irritation signal.
If you're experiencing tachycardia(racing heart), then if a fountain or bathroom is nearby, apply cold water from your hands to your face and while holding your hands against your face, press gently, repeat GENTLY, on your eyes. This will invoke what is termed the "dive reflex" and will cause your heart rate to decrease in most cases. Regardless, tachycardia, like palpitations is not harmful in of itself, just a bit unnerving.
The key in all cases is to do your best to remain calm and rational. Know from our little lesson what it actually taking place and that you'll be fine.
Finally, we'll save a lot of space here by simply stating that with regard to any of the conditions either described or that you're experiencing, do not substitute a support group for responsible notification of your symptoms to your personal primary care doctor. We live in an age where medicine is oftentimes scoffed at by many who fail to realize the benefits they expect. Yes, it's true that medicine is not a perfect science, but neither are human beings. It is difficult at best to create perfection from inperfection. But even so, we all must give recognition that many thousands of people are being cured of certain cancers that just a decade ago would have meant their demise. Simple penicillin saves hundreds of thousands in third world countries that would otherwise perish from infection.
So don't become discouraged that medicine doesn't find something wrong with you. Feel blessed that they don't have less encouraging news for you. I exist in an occupational environment where disease and illness is very concentrated. It is of great joy and optimism that I can walk from conditions such as those to the sanctuary of my private life and know that I'll return tomorrow.
You too, all of you, need to be thankful that your condition is benign and that you have the power of influence over its effects.
So kick up your heel, give a shout, grab the keys and your husband's credit cards with the highest limit and PREPARE TO SHOP! Those pesky palpatations are but a mere nusiance and you have the rest of your life to live, so get busy and do the voodoo that you do best!
best regards and good health. Feel free to write if you care to and I'll do my best to answer, but no promises.
and this is for all the attorneys circling overhead who strive for a willing plaintiff, or even an unwilling one.
THIS COMMUNICATION REPRESENTS OPINION BASED UPON MEDICAL FACTS AND IS IN NO WAY INTENDED TO REPLACE OR SUPPLANT THE NEED FOR PERSONS TO DIRECT THEIR MEDICAL NEEDS AND INQUIRY TO THEIR PERSONAL FAMILY DOCTOR REGARDING THEIR HEALTH.
i think i'mallheart was only posting what he thought might be a good explanation to explain why some experience heart palpitations . the question on this thread , the doctor acknowledged some of the nerves aided in digestion can sometimes cross with nerves that control the heart also and cause PVCs, maybe it was the vagus nerve he was speaking of.
maybe some of the sense of humor could have been left out of the post and just basics explained, but after all you can't please everyone.
Appreciate your entertaining 'fleshing' out of your perspective
of the shadowy vagus-nerve-complex influences, in a relational manner to the body whole and its incorporated pump we're all especially mindful of.
Following minor surgery, I take away from your effort an understandable 'construct' or 'mapping' which may be edited in the form of grangerization via supplemental/enhanced information to sustain its accuracy.
get a life... chill out...oh my gosh... this is suppose to be a forum to share info etc. if i offend you i am sorry.. this is accurate and true info.. and yes i do suffer from bad panic attacks etc.. but came accross this on the net and shared it with my cardio and shrink.. this is just a few of the reasone why we suffer this palps pvc;s... yes there are other reasons also.. but chill out.. and yes i would tell your husband face to face..
be blessed all... just some good info to share with all
You obviously never experienced a REAL panic attack. After reading your theases I can understand why so many therapists and shrinks and doctors don't take us serious. I don't care what your cardiologist said, your article is down right insulting to women i.e. we live in the year of 2005 we do NOT need to be told "to get our husband's credit card and go shopping" we do have jobs and we DO HAVE OUR OWN CREDIT CARDS, and make our OWN PAYMENTS. Some of us did experience palpitations/PVC's while shopping and had to leave the mall/stores because of severe panic attacks before we got help from Specialists who DO UNDERSTAND as it was in my case by reading a book written by a Psychologist who DID UNDERSTAND.
I guess you think all this is real funny, and BTW men TOO get palpitations/PVC's AND panic attacks.
You are a male chauvenist pig in my opinion and you think that you are real funny. I bet you would not tell my husband face to face what you said on this board, you think you're Mr. Big shot behind the keyboard telling us stuff most of us already know. CAN IT!
Even though the article you took the time to post on this board mentioned "depression" but in the end the so called "humor" was directed to the people/women who suffer from the palpitations/pvc's and panic attacks. Would you tell a person who suffers from depression " get your husband's credit card, go to the mall and shop". I don't think a depressed person would take that very well. Whether its panic attacks, depression, hyperchondria etc. all these are mental disorders and unfortunately only depression is understood which it should be and I count my blessings that I do not suffer from depression. But as for panic attacks and worrying about PVC's or other heart related symptoms face it, most every day people and even people in the medical field classify us as "nut cases". So suggesting to me and others like me going to the mall with my husband's credit card to get over my panic attacks or the fear of PVC's does not humor me at all. Mental disorders or physical disorders can be hell to the people who suffer from them. Would you make fun of somebody who came down with cancer or a heart attack or a stroke??
I WAS chilled until I was reminded again what a "joke" this mental disorder is to some people.
I have been diagnosed with anxiety and panic attacks. I did not take any offense in the article. I know how scary panic attacks are but you have to look at this way. People deal with these things different. Barb you have given your opinon about the book that helped you. No one said a word about you doing that. Some people use humor it just takes different things. Im sure imall heart was trying to be insulting but enlightening.
Is it against the rules to "share info" what helped a person i.e. a book? Quite a few times I didn't mention the author of the book until somebody specifically asked me about it.
It just hit a raw nerve with me. That is why so many people who suffer from panic attacks and phobias keep it to themselves out of fear that people will make fun of them. I was being made fun of behind my back more than once by people who had no clue whatsoever about this condition, but if they had a migraine headache oh boy you better understood THEIR misery.
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