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Avatar universal

ectopic beats and afib help

My brother 35 / father 63 have afib - brother all his life two conversions - father two episodes 58/63 both converted.

I'm 38. Christmas 2000 suffered  run of ectopic beats (scary) -then developed upper abdominal pain. I've since had ECG/24 Holter x2/excercise stress test. Ectopic beats  shown including bi-tri geminy everything else OK.

Since had two longer episodes of ectopic beats - during a fever -day after wisdom tooth removal - non-adrenaline local, no sedative. Plus occasional skipped beats. Presume PVCs as they're an obvious pause followed by hard beat.

I've a couple of other symptoms 1.Following excercise,  in some postures (eg bending over), heart rate will drop temporarily. eg after excercise it might be 130 but will suddenly drop to 60 ish for 5-10 seconds. Appears to be some kind of vagal response. Might have a skipped beat when this happens. 2. On getting up from sitting sometimes get feeling of pressure in upper abdomen plus slow strong beats/feel dizzy

I've had an endoscopy for the abdominal pain - take Losec - Gavascon - I have reflux/GERD. Get skipped beats when I reflux ocasionally too.

My questions are:

1) Given the family history is it likely that my ectopic beats will eventually become afib?

2) Is there a relationship between increased vagal  tone and skipped beats? (There appears to be an association in my case) If so given that "afib can beget afib" can heightened vagal activity due to stomach problems alter the heart to increase the tendency of skipped bets?

3)What's with the other symptoms?

Remaining calm (Not)- Ringo
14 Responses
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Avatar universal
Pheochromocytomas are tumors originating from the adrenal gland.  These tumors can produce a large amount of adrenaline sporadically...so the symptoms end up being something like racing heart, the sweats, palpitations, high blood pressure...on and off.  Most cases are treatable, most tumors caught early enough are benign.  There is a urine test (24hr) that is generally done which looks for abnormal amounts of catecholamines.  There is a more accurate blood test as well.  Both tests suffer from the fact that recent exercise will produce interference, and the additional fact that the tumor(s) may not be producing adrenaline at the time of the test.  Further diagnosis involves abdominal sonograms and/or CAT scan to look for a funny looking adrenal gland.

Even though they are considered rare, they happen often enough that doctors are generally aware of them. If there is a suggestion that you may have one of these, check it out.
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Avatar universal
I have recently had my 1st episode of ectopics(scary!!)in conjunction with a hypertensive period when my bp hit 245/135.
ecg done at local er they said it was ok apart from the "big bits".Gave me atenolol 25mg 2x daily I'm normally healthy no meds at all but a little heavy.....reducing daily! I've had lots of blood chemistry done (full count,elecolyts,liver/kidny fnctn etc etc)for the weight loss progrm---- all OK.
Ireally don't want to stay on atenolol for any time at all.
Do I have to? what will be the result if i'm on them for any length of time? I an now intending to retire(49) so my stress levels will fall.Presently work in primary healthcare!!!!!!!!!!!!

Sorry P.S,--1st time on this forum..One ER Dr said its possible that I have a Phaeochromacytoma!!! --Can't find anything to do with this on the web,- any ideas?
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Avatar universal
I have recently had my 1st episode of ectopics(scary!!)in conjunction with a hypertensive period when my bp hit 245/135.
ecg done at local er they said it was ok apart from the "big bits".Gave me atenolol 25mg 2x daily I'm normally healthy no meds at all but a little heavy.....reducing daily! I've had lots of blood chemistry done (full count,elecolyts,liver/kidny fnctn etc etc)for the weight loss progrm---- all OK.
Ireally don't want to stay on atenolol for any time at all.
Do I have to? what will be the result if i'm on them for any length of time? I an now intending to retire(49) so my stress levels will fall.Presently work in primary healthcare!!!!!!!!!!!!
Helpful - 0
Avatar universal
Hi everybody,this is my first time visiting this site and u can imagine how am i surprised to read things that happens to me too.Also they appear the same way too bending,deep inspiration and etc..But a few told about the relation with exercise my pvc 's get worse after the exercise (but only 2-3\min worse).i only have 20-30 /day when they get worse and i can see now that its nothing according to yours.I'm 36 and suffering about for one year  i was depressed when i first catch the skipped beat ,i went to a cardiologist and do all the tests he said nothing important but i was not concerned.I'm much better now but  i still feel very bad when i feel tose gaps between my heart beats and afraid of having an af .I play tennis at least 2 hours a day and i also play tournements and mostly i feel the pvc's ,what should i do give up playing or do some aerobic exercises instead,or  go on with the same way if anybody can help me i'll be thankfull.I hope god help you all..
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Avatar universal
I had PAF (due to PV foci) which was ablated 1.5 years ago...I now have PACs which occur 0-5 /min, more while exercising, less afterwards.  I play competitive soccer and workout 3xweek about one hour of intense exercise (everything from jogging through sprints, total about 3-5 mi).  I have gotten used to the PACs and hope that someday they will give up before I do.

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Avatar universal
Thanks Arthur for your helpful comments.  I'm glad I found this forum, and look forward to learning more from everyone.  I forgot to mention that my doctor did run an EKG on me in the office, and it was normal.  Thanks again!  Kel
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Avatar universal
Feeling some skips now and then could be normal, especially if you are under a lot of stress.  If you are really concerned, go see a cardiologist...he/she may recommend wearing a Holter monitor for 24 hrs to try and catch those annoying skips...in this way your "condition" could be diagnosed with more certainty.
Many of us "skippers" have quite healthy hearts, it's just that our wiring picks up "noise" generated by all sorts of things...you may find that your condition is not life-threatening, and that finding may actually calm you and your skips down.  Good luck.
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Avatar universal
Q.  I have irregular beats.  My doctor hasn't diagnosed it as of yet.  But my question to you all is, that I have noticed when these pausing beats happen to you, but with me, I could just be sitting very still watching T.V., and it will almost hesitate for a second, and then start beating a few times quickly, and then regular.  I can be at work typing on the computer, and feel it skip.  Just the other day, I was watching T.V., and it felt like it did a cartwheel inside my chest.  Really scared me, but when I have told my doctor, she asks if I have any other symptoms, and I don't.  No pain in my chest, dizziness, etc...  Although the other day my palms got a little sweaty, and I got a cold chill.  Don't know if that was the fear in me when it happened or what?  My mother has "the pulminary valve condition", so I'm wondering does it sound as if I do too?  I'm 34 years old.  My triglyceride levels are high, I'm on a low fat diet now, and the doctor has put me on a low dosage beta blocker, which has brought my pulse rate to normal (70's). She's also got me on Zoloft until the winter months are over.  (Recently lost my grandfather, and Sept. 11th attacks have gotten me very upset.)  (I've always had problems even taking an aspirin, so taking these two medications are depressing to me in itself.)  Any thoughts?  Thanks!  Kel
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Avatar universal
JR
I too seem to be suffering from some kind of form of vagally mediated AF, just like my father has on and off for years. i belive that there must be something to it
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Avatar universal
Dear doctor thanks for your reply. You expressed an interest re familial link for afib and asked a question about the onset of afib in my father.

My father (age 62) first noticed ectopic beats in his 30s - post-prandial, postural - seemingly related to vagal activity. He had his first afib episode at 57 - cold ice cream induced- second at 62 - nighttime/ lying on left side/ wind induced - only two episodes both converted -  seems to be vagally mediated.

My  brother (age 35) has suffered from adrenalin/vagally mediated afib since childhood. First needed to be converted in his 30s.

Given my onset of skipped beats in my late 30s and my family history esp. father you can understand my concern at ectopic beats eventually translating into afib. If the odds for getting afib in the general pop. are 5%, the odds for two people in the same family must be high. If I were to subsequently develop afib (I hope I do not) I would think it might suggest a genetic or other common causality.

Cheers,

Ringo
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Avatar universal
Dear ringo,
It is interesting that both your brother and father have afib but may be just coincidence.  How old was your father at the time of his first afib onset?  There is no documented familial link for afib.  Your risk for developing afib should be the same as the general population which is about 5% by age 65.  

There may be a relationship between vagal activity and ectopic beats in that an increased vagal activity leads to slower heart rate which may "unmask" ectopic beats.  This is different from "afib begeting afib" however in that the vagal activity is not causing the ectopic beats but only allowing them where as otherwise a sinus (regular) beat would have occured.

The drop in heart rate is probably related to how your heart is positioned within the chest cavity.  If there is any compression of the heart the normal response is to slow the rate and slightly drop the blood pressure.  Once you change positions this should immediately go away.  Your symptoms may be improved by beta-blockers.  Ask your doctor if this would be a medication that you might try.
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Avatar universal
Hankstar, nice to know you go for long periods without getting skipped beats. If you get them bending over, straining, stooping etc. I wonder if they could be linked with vagal activity. In people who suffer afib - some are triggered vagally by these postures - the vagal reflex slows the heartrate and triggers the afib I believe - in these cases they are usually NOT prescribed beta blockers as it can make it worse. Which leads me to think maybe it's the same for some people with skipped beats.

Question - do you have any stomach problems - reflux, weak diaphragm etc. I'm convinced my skips are related to some weakness in my diaphragm, everytime I aggravate it -like retching during the tooth extraction - bang, reflux gets worse and its skipping time. Gross.
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Avatar universal
Sorry Forgot to mention - my skipped beats almost always come as I breathe in at the point when my lungs are fully extended and I feel a kind of irritation in my upper abdomen. This is usually the point when reflux happens also. cheers.

Ringo
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Avatar universal
Hi all.

       I get these skipped beats off and on and I tend not to worry about them too much, wouldnt be any point anyway cos my doctor (I'm in the UK) doesnt seem to care.  He had me on both Prozac and Ritalin without monitoring me and didnt seem to understand why I ended up in ER with tachy.
Now my heart pounds on at times and at those times taking my shoes off, sat down, will take me to 110 bpm..my doctor finds that acceptable.
Having totally stressed me out by refusing to have any tests done, he then offers me viagra at the same time as I am using Nizoral which is contra-indicated with viagra.
So I'd like any comments people might have, my siuation is as follows:

4 years ago following a dose of prozac and ritalin ended up in er with tachy...was also drinking heavily as a result of an abusive relationship( I was the one being abused)
Relationship fell apart, I fell into depression, couldnt sleep, cried, skipped beats, fast heart.  Went to doctor who offered me Betapace (bit strong dont you think) wouldnt do any tests, though got 24 hour holter with another doctor, which showed nothing.
Gave up drinking totally (had already stopped ritalin and prozac) when I found alcohol made my heart race too.
Now I get fast heart from monosodium glutamate (chinese food) some skippings and missings.  If I exercise my heartrate goes from 80+ at rest to over 160 within 5 minutes (aerobic exercise), yet I am not remotely out of breath, of course I sweat a bit lol. My heartrate then seems to take forever to settle down again afterwards.  like most of you I have both good and bad times, mostly ok, thank god...but I do concern myself that my moving heartrate at 110-120 bpm is just a bit too high for walking around, doing washing up and cleaning the house...I am a 43 year old male and not too overweight (few spare pounds lol) blood pressure low/ normal and cholesterol low...I am however physically aware of my heartbeat and have been so since the incident 4 years ago.
I guess I'm a bit angry at my doctor..do you think I am right to be so and what do you think of my symptoms?

Thanks for any comments and good luck to you all

        
         best wishes

                    Ray
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