Sinus arrhythmia with PAC's & PVC's

[BlueCheetah55]

Hi everyone,

I am a 31 year old female with Lyme disease and Babesia since April of 2008. Tachycardia has been one of my main symptoms since the onset of my illness. My fiancé also has Lyme as well and has on and off heart issues himself.

Since the end of April of this year, I have been feeling thuds on the bottom of my heart every now and then and I am assumining these are PVC's. I went to my cardiologist in early May who again had me wear a 24 hour monitor and an echo. My monitor showed periods of tachycardia getting up to 144 and I had a normal echo. No PAC's or PVC's where shown on the monitor.

Since that time, the PAC's and PVC's have been getting worse and worse. About a week before my period they would start and continue into a few days into my period. At this point they are constant. Some days I will have a few PVC's a minute and other days I will have 3-5 PAC's a minute. Lyme disease and Babesia is known to cause these issues but I am not sure if that is the case or if it could be something else.

My fiancé is also experiencing the same thing. We have been in and out of the ER for weeks now over this because it is so scary. My fiancé wore a 24 hour monitor that showed severe sinus arrhythmia. No ectopic beats where seen. His EKG's have all been abnormal showing arrhythmia.

All of my EKG's have been normal except for one that showed sinus arrhythmia and one that had a PAC. I have had 3 echos, three 24 hour monitors, and a stress test. The most recent testing was in May. My heart seems to be getting worse and worse since then with PAC's and PVC's and now this sinus arrhythmia.

We cannot get in to see our cardiologist until the 17th of this month so I am sitting on pins and needles. The anxiety and worry of this is insane. I am a thin person so I can feel my heart beating in my chest most times and these strange beats. My heart rate will vary from 54 while active to up to tachycardic ranges. If you feel my pulse for a minute, you will feel it slow up and then speed up over and over and either you will feel pauses in my pulse or what feels like double beats. I have up to 5 a minute at times of the double beats.

I was prescribed Toprol XL 25 mg for this but I cannot take it due to having a 60 or 50 range pulse at times and low blood pressure of 100/60. So each day is a living nightmare for me and my fiance. I am afraid I am going to die and am afraid to go to sleep. I have been to the ER more times than I can count and they do not do a thing.

I am very scared. Is this dangerous?? I have always had normal sinus rhythm with periods of sinus tachycardia but never sinus arrhythmia or tons of PVC's and PAC's a minute. I am afraid to live a normal life and I am obsessed with worry over my heart. Any help on this would be greatly appreciated!

[Wisconsin2007]

Unless I'm missing something, that's a whole lot of tests for what seems to be a pretty minor condition.  

Check your heart rate and compare it to your respiration.  Does your heart rate go up when you inhale?  Slow down when you exhale?  That's showing vagal tone, and that's not a bad thing.  Some say it's a good thing.  Nobody says it's bad.

As for the PVCs and PACs - with the number of tests and ER trips you've had, I'm guessing you're freaking out pretty hard about these, which is almost certainly making them worse.  

I'd be interested to get some further details about the sinus arrhythmia diagnosis.  For the other findings on the Holter, that's about as clean as you can get - there really shouldn't be a need for worry.

Instead of pursuing heart meds and heart tests, you might ask your family doctor about some anti-anxiety meds.  It sounds like that might be something you would benefit from, because the results from your tests don't seem to indicate much of any problem.

For your reference, 3-5 PACs a minute is not something most doctors would treat.  Anything less than 6 PVCs a minute and most doctors will pat you on the head and tell you to quit worrying so much.  They do this because, absent any structural problems with your heart (which would have been discovered in your tests), there is no need for medical intervention, and some interventions actually carry greater risk than doing nothing at all.  Also for your reference - I spent about 10 months in 2006 with 15,000+ PVCs a day - all day, every day.  Every 5-6 beats.  I'm not on any heart meds, didn't have any surgeries.  Just figured out how to reduce my stress level.  I would recommend you look into the same.

You're going to be fine.  

[ott70]

I with you on the Lyme symptoms. I also have PAC's and PVC's and it didn't all kick up until I started feeling ill. I also deal with chest pain, sometimes centered right over where my heart is, back pain on the left side of my spine, and shortness of breath. It all comes and goes, good days and bad days.

I don't have an "official" Lyme diagnosis, but I have enough positive markers to suggest Lyme and co-infections. At the very least, I have positive markers for EBV and inflammation.

I also fall in the minor PAC/PVC range. On a bad day, maybe I have a 100 that I sense. On a good day, none. They are creepy feeling and there are times that doom-n-gloom is the sensation. As Wisconsin states, we fall in a minor category compared to others on the amount of "skipped" beats. My heart has been tested as structurally fine, so the cardiologists won't take it any further and probably rightfully so.

Lyme and the co-infections associated with it affects nerves and the heart is full of nerves. They say about 10% of chronic Lyme patients have cardiac-related symptoms. It is reasonable to think that the bacteria is affecting the nerve impulses to the heart causing the PAC's/PVC's. The bacteria could also be messing with the vagus nerve. If you search some of the Lyme forums on the Net, such as LymeNet, you will find comments about people having heart symptoms, getting treatment, and having the heart symptoms resolve.

I have taken a natural course with my treatment and seem to be getting better, but I still have off days. This morning was an example as I thought I felt a squeezing in my chest when I woke up for 15 seconds or so and then tachycardia for 5 minutes. Could have been a panic attack. Could have been a spasm. Could have been some hormonal release. Tough to say. Still walking around, so I have to assume it wasn't a major heart issue.

I get tired of the ER too. I had more trips last year and each time nothing was found. Some low potassium at times and my platelets and lymphocytes are generally just below minimum. I try not to stress about it, although easier said than done.

Hang in there and try to kick the Lyme in the butt!