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Reeeally long skipped beats
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Reeeally long skipped beats

One day last week and then again today, I experienced some of the longest skipped heartbeats of my life. I don't know exactly how long they were, but I felt a pause in my pulse during which I had time to think 'this is going on for a long time-is my heart stopping-please, heart, don't stop.' When I finally felt my tired old heart resume its rhythm, I was too afraid to be relieved. I am getting better at dealing with PACs that feel like flutters in my chest, but when I feel my heart pause altogether, it just freaks me out. It makes me I feel like I am hovering on the brink of death. Maybe I am. After all, if my heart pauses for a long enough time, surely I will not remain conscious, or alive. These events can't be harmless! I know that people deal with constant skipped beats all day and night, so my relatively infrequent ones should be easy to manage, but I feel like one of mine is worth twenty of other people's. Like my heart is saving itself to execute an especially dramatic skipped beat. What do you think? Do skipped heartbeats become more dangerous the longer they go on? I sure wish that I could catch some of these extra-long skips on a Holter monitor: that might be the only way to know if they're dangerous or not. If they persist or get worse, and if I'm still alive, I'll ask my doctor. In the meantime, what are my chances?
17 Comments Post a Comment
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Avatar_m_tn
if i were you,i would ask for a 30 day event monitor and record the rhythm during those long pauses. to me,it sounds like you are having pvc's. there is a compensatory pause after a pvc. it feels scary,but if your heart is fine,then it is a benign arrhythmia.
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1124887_tn?1313758491
PACs are a little strange, where a PVC often have a fixed pause (equal to exact 2x the normal pause between the heart beats if you don't feel the PVC itself), the pause after PACs can be variable, depending on the "sinus node recovery time" and in what setting the PAC did occur. See this picture for an example (forget the text, it's Norwegian or Danish)

http://laegehaandbogen.dk/hjerte-kar/illustrationer/supraventrikuler-ekstrasystole-6398.html

Most often, PACs are like this:

http://www.cableguy.net/ECG/pac.gif

Your heart has backup "pacemakers" if the normal rhythm should fail. Don't worry about that. I assume that you've had Holter tests confirming that your sinus node works normal.

You may also have had a short run of supraventricular tachycardia (several PACs after each other) that didn't produce any noticeable pulse in the beginning, but I assume this would have caused fluttering in the chest.
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1807132_tn?1318747197
A pvc pause is essentially equal to one beat so I don't know that you would feel as though your heart is not going to start back up.  It would start back up before you could finish that thought.  The scenarios that I see are a possible bigeminy situation.  For me when I get bigeminy if feels like a longer pause but there are beats in between you just don't feel them.  Other than that you could have some sort of avnode block or sinus pause going on.  Finally, I personally have trouble finding my pulse sometimes so a weak beat may even feel like a missing beat to us.  This all said, if you are not getting light headed, short of breath or passing out then what you are feeling is likely of no real consequence.  But you are right, the only way to really know what is going on for sure is to get it caught on a monitor.  If you notice this is happening at least once a month then ask your doctor for an event monitor to catch it.  Then you will know what you are dealing.  If this can help you deal with any anxiety that is arising from this then just ask for a monitor.  Hang in there.  I am sure you will be around for quite some time to come.  Stay strong.
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1298588_tn?1330322581
Thank you, you explained that so well! I feel alot better now. Of course, the true test of my mental state will come the next time I feel something like this happening to me. If I can prevent myself from freaking out, I'll know that progress has been made!
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1298588_tn?1330322581
Thanks michelle! I would love to catch this on a monitor, but I'm not sure because it doesn't happen that often. Could be bigeminy, although I'm pretty sure there weren't any beats at all during the pause. Who knows? If it happens more frequently, I'll definitely look into the monitor. Take care :)
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1298588_tn?1330322581
I'm sorry to report that it's gotten worse: today I was standing at a bus stop feeling perfectly all right-I have felt especially energetic and healthy all week, in fact-when all of a sudden, my heartbeat pauses. This is nothing out of the ordinary for me, so as usual, I (sort of) calmly waited for the heavy thump that would indicate my return to normal rhythm. And waited. It didn't come. Just when I thought I would pass out for sure, my heart jumped back to life. However, I barely had time to breathe a sigh of relief before my heart paused again. Again I awaited its return to life, and I swear I waited even longer than before. Again I breathed a sigh of relief when I finally felt my heart kicks tart itself into belated action, and again my relief was mitigated by repeated fear as the next pause came. This went on for at least five minutes, with each pause longer than the last and each instant of panic more intense. Towards the end of the pauses, when my heart had been stopped for awhile, I started to feel dizzy and shaky. Quite frankly, I don't know how I remained on my feet. I got on the bus, and I sat down, and gradually my heart resumed a consistent beat. My mind, however, has failed to return to consistent calm. My heartbeat has never paused for so long before. It felt as if my heart was on the verge of quitting its job, like a kitchen appliance that works less and less consistently and then one day doesn't work at all. How can I feel so good one minute and then be dead the next? Can my heart simply put itself on pause for eternity? My instinct and everything I have read on this website tell me no, but my experience today tells me yes. I sure wish I had been able to catch this incident on a monitor of some kind, as I realize that is the only way to know for certain what hanever came.
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1298588_tn?1330322581
Sorry, I was in the middle of typing when I accidentally posted my unfinished message. I should have done this on the computer instead of my phone! I sure wish we could edit our posts on here. Anyway, as I was saying, I know that a heart monitor is the only way of knowing what happened for sure. I will probably call my cardiologist on Monday and ask him if he can set me up with an event monitor in case it happens again. In the meantime, I guess I'm just looking for some reassurance. Do you think I'm going to be OK?
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1464004_tn?1384139333
Hi, long time no see!  It's so funny ( not funny ha ha)  but I was just getting ready to post about the same thing!  I've been going great guns for awhile, less PVCsPACs  and SVT, when they all decided to reappear with a vengeance... and those extra extra long pauses between beats.  Nothing scares me more!  Exactly how you feel, like your heart will just stop and NEVER start again.  Fortunately I work for a cardiologist and recently had a work up done including a thirty day monitor, which looked good. I also talked to my boss today and he reassured me if the heart is structurally fine these beats are benign.  Maybe you should do the thirty day, it may give you some piece of mind.
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177337_tn?1310063499
I have had this at times.  For me, with my typically pvcs or pacs I don't usually feel the thud after. I always feel the early beat, then the pause then the next beat.  But the pause you are describing I do get from time to time.  I don't feel the early beat first so I am assuming that it just comes so early I don't feel it and that is why the pause is longer.  I start running to the door thinking it isn't going to start back.  I have had all the tests including a 30 day holter  (didn't have any of that type on there but plenty of pvcs and sinus tachy) but my doctor wasn't concerned when I described it to her because my heart is healthy and structurally sound.  So....it is a good idea to call your doctor for some reassurance but as you know, if you keep worrying about It, your cortisol level will continue to rise and will trigger more of those beats.  It is a vicious cycle but try not to allow yourself to even think about what it could be.  Even thoughts will raise your cortisol level at this point.  
Most likely it is just in the timing of the early beats you are getting that creates the longer pause.  
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1569985_tn?1328251082
I seem to recall that the pause needs to be 5 seconds before they get concerned.  I had a couple picked up on a holter that were not quite 3 seconds and the NP said they don't worry until they're longer.  I had a 9 second pause during my first afib episode when I converted back to nsr and it scared me half to death.  I later learned that when you're heart is going back to normal rhythm that is normal.
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Avatar_f_tn
I am having the same problem at the moment! I have had PVCs, PACs, short runs of PSVT and probably NSVT for almost 20 years, but just recently the pauses feel longer and I get dizzy and pre-syncopal. So I am going back to the cardiologist too, although I could be waiting a while to get an appointment. I was wondering if they were sinus pauses too as I didn't get the normal thump  that I am all too used to. However I was taking my pulse when one happened and I felt the tiniest, faintest premature beat followed by a very long pause, so I am thinking they are extra long compensatory pauses and the ectopic beat is just very early. Not sure though so will be asking for a monitor. I hope you are ok and they settle down soon. I also find it hard to function normally when this is going on - especially at work - trying to have a conversation with the boss when it feels like my heart is stopping is a challenge I don't appreciate.
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Avatar_f_tn
Goth, from your previous posts, it is clear that you worry about your heart either beating itself to death and stopping--or just stopping, period, as you mention here:

"Towards the end of the pauses, when my heart had been stopped for awhile, I started to feel dizzy and shaky"

Rest assured, your heart did not stop. The heart is intrinsically rhythmic, and will continue to beat even when removed from the body surgically.  You've probably seen this in films showing heart transplants.

The situation when the heart really stops beating is called 'cardiac arrest,' and the victim absolutely does **not** have time to stop, think about stuff, or count the seconds between beats--for the simple reason that he or she is almost instantly unconscious, and very shortly quite dead (if CPR is not applied).  Clearly, this is not you.

The faintness you describe in the quote above is probably due to a combo of fear and vasovagal stimulation, which causes the heart to beat even more slowly (with a good shot of vagal stimulation, you can induce a pretty long pause).  But even if you get a pause long enough to truly reduce oxygen to the brain, what happens is that you just faint, and as soon as you're out cold and horizontal, the vagal/fear thing is no longer operative, and your normal pacemaker is in control again, and you wake up in a few seconds.  

You're young and you've had a lot of checkups, and your ticker has always been found to be normal, but considering this recent increase in symptoms and worry, I suggest two things:

1.  Take yourself to a doc and get a monitor to see if there are any signs of 'Sick Sinus Syndrome' (rare and most usually a condition associated with old age).

2.  When that comes up negative--as it almost certainly will--get in contact with your therapist or shrink again.  You may need to have your antidepressant dose readjusted a bit (unless you recently cut back on the meds on your own, which patients love to do).

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1298588_tn?1330322581
As always, you guys are the best: thank you so much for your info and support. My heart was skipping again today with a couple of longer pauses, and I remembered what you all said and I felt hardly any anxiety at all. I'm alive! If this sort of thing starts happening more frequently, I might check in with my cardiologist just to let him know what's going on, but in the meantime, I'm going to have faith in my heart and enjoy life!!!
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1569985_tn?1328251082
I think this is a very good attitude.  When we can all calm down about our symptoms (after we've been medically evaluated and know we're not in  danger) we are much better off.  So glad you are feeling better about this and in general.  Keep up the good work!  Keeping you in my thoughts and prayers.
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1298588_tn?1330322581
It constantly amazes me how intimately connected our physical health is to our mental attitude. It's not always easy to uphold the latter; in fact, it's sometimes practically a full-time job to keep my thoughts positive. However, it is most absolutely worth it. I continue to think about and pray for you too, DeltaDawn ... How are you doing?
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1569985_tn?1328251082
I am doing well, thanks.  My afib is pretty stable, altho I have the occasional lightheadedness (is that a word?), irregular beats as well as short runs of tachycardia now and then.  Today I had a couple of dizzy spells, which I attribute mostly to my meds, and it was a also a busy day.  But, thankfully. I am staying out of the hospital and feel pretty well most days.  I am exercising and I think it has made a big difference and resulted in a general feeling of well being.  I have an appt. at the Cleveland Clinic later this month for a second opinion, actually third, on the PVI ablation.  My meds are working for now, but I want to get my ducks in a row before I encounter another crisis situation.  I figure more input can't hurt.  I'm trying to keep calm about holiday plans and not overtax myself.  I get in trouble when I try to do too much or get too stressed out and tired.   Thank you for your good wishes, it means a lot.
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1298588_tn?1330322581
So glad you're doing well, and that you're taking time to gather all the facts before taking any kind of definitive action such as an ablation. In the meantime, exercise does indeed make a huge difference, as does following a healthy diet. We just have to believe that if we take care of our bodies, they will take care of us. Stay healthy :)
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