AFib but normal HR

After a routine ECG I was referred to a cardiologist and after 24 hour holter was diagnosed with extremely high PACs of 36% or 36,000 in a 24 hour period. Usually PACs are not an issue but I have way too many. (maybe I make those of you with only 5000 feel better!) I went on toprol 25mg to start which brings them to 32,000. So still extremely high. I just moved to 50mg maybe that will help. My pulse is only in the 50's and I only get about 50 pacs an hour during sleep so they are non stop during the day but 99% singles

I can't find any info or others with this type of condition. My doctor today called it afib but I thought that was a racing pulse. Does anyone else have this sort of arrhythmia on this board?  I feel sort of alone in this.  All web sites describe the racing kind or say PAC's are benign. If more toprol does not work was told we may try calcium blocker or digoxin. Then ablation if necessary. Doc says this could weaken my heart if not treated but did not mention stroke. Is stroke a problem only for the more classic afib type?

Any insight appreciated.

[is_something_wrong]

Hello.

Your question was a bit confusing.

If you are in normal sinus rhythm, with approx. 1/3 of the beats as PACs, you do not have an increased risk of stroke. I'm a PAC sufferer myself, but my numbers aren't anywhere near yours. You wrote something interesting, though. Your PACs tend to decrease with lowered heart rate, which can be a sign they are provoked by adrenaline, high thyreoids, or other substances that increase your heart rate.

Beta blockers obviously have effect, and I think you should keep in touch with your doctor and measure the effects of gradually increases in dosage. NEVER increase or decrease the dosage without clearing it with your doctor, by the way. Calcium channel blockers can have effect, but they shouldn't be used with beta blockers. You'll have to choose one.

If you are in atrial fibrillation (A-fib), the problem is completely different. I doubt it, unless the condition suddenly changed after your visit to the cardiologist. A cardiologist wouldn't diagnose you with frequent PACs through 24 hours, if you in fact had A-fib. But it's almost impossible to differ loads of PACs from A-fib by checking the pulse or listening to the heart. An EKG is needed, and if you have 36.000 PACs a day, they can degrade to A-fib.

You need to get it completely clear: Are you in sinus rhythm with PACs, or are you in A-fib?

A-fib is actually about 400-600.000 PACs a day (atrias fire at a rate higher than 350 BPM with no sinus rhythm) but luckily not all the beats are conducted further. A-fib can weaken your heart if it's not controlled properly and your average heart rate is above 90-100 BPM (including sleep), and/or you get uncontrolled high heart rate during exercise >200 BPM for a long time.

Again: First thing you need to find out (and ask your cardiologist!) is: Are you in normal sinus rhythm with PACs, or A-fib?

By the way: Sorry if my answer was a bit like I'm a "trying to act like a doctor". I'm not a doctor or a medical professional at all, just a PAC sufferer too.  

[JitterbugNJ]

Thanks for your post. It is confusing and that's the problem!  My doc is the one who increased dosage so no worries I'd do myself. It was my doc who called it afib during my  appt which surprised me. Next time I go I will clarify the sinus vs afib question.  (i have had lots of ekg's and hollters)   He also said he thought they were adrenaline based since I only get a few (for me anyway!) at night.  Thanks again.