Heart Rhythm Community
WHAT DOES THIS MEAN
About This Community:

This patient support community is for discussions relating to heart rhythm issues, arrhythmia, irregular heartbeat, implanted defibrillators, pacemakers, and tachycardia.

Font Size:
A
A
A
Background:
Blank
Blank
Blank
Blank Blank

WHAT DOES THIS MEAN

IF YOUVE EVER READ MY OTHER POSTS YOU WOULD KNOW THAT I WAS REALLY FREAKED OUT ABOUT MY HEART A WHILE BACK BECUSE I WAS HAVING PALPILATIONS LL THE TIME AND THEY WERE FREAKING ME OUT BUT HERE LATLEY I HAVENT BEEN SO WORRIED ABOUT IT BECAUSE IVE BEEN TKING VITAMIN B 12 SUPPLEMENTS AND THEY HAVE SEEMED TO STOP . BUT EVERY ONCE IN A WHILE I THINK I HAVE ONE BUT THERE NOWHERE NEAR AS SEVERE I CNT EVEN TELL IF ITS EVEN A PALPITATION WHAT DOES THIS MEN IF THE PALPITATIONS EASY UP LIKE THAT
17 Comments Post a Comment
Blank
257552_tn?1404606154
Hopefully, you have seen a doctor and been told your palpitations are benign.

That said, palpitations may consist of a variety of premature beats, originating in the atrium (top of the heart), or the ventricles (bottom of your heart).

The kind that originate on the top are PACs, on the bottom are PVCs. PACs are usually not felt very strongly, just king of extra beats. Some PVCs can be the same way, they are known as interpolated PVCs, again, just rather like an extra beat. The other types of PVCs, which are very common, produce a pause in your heart rhythm, known as a compensatory pause. Since during this slight pause, the heart fills with more blood than usual, when the heart beats again, you feel a thud as the extra blood is pushed out.

If you've been examined by a doctor, told that you have a healthy heart, none of these extra beats is harmful, i.e., they are benign. You may be used to the heart beat with the pause and thud, and may now be experiencing a PAC or Interpolated PVC, I get all three kinds at different times, sometimes PACs and PVCs mixed together.

The links below show you what these different premature beats look like on an EKG. Hope this helps.

http://www.equimedcorp.com/rhythms/topic/40/

http://www.equimedcorp.com/rhythms/topic/39/
Blank
86819_tn?1378951092
OK, so one of the things I see here is how the complexity of a problem can make it more difficult to deal with.  Its one thing if you're the sort of person that can accept a doctors explanation, based on the fact that he's the doc and nothing else. But if you are the type of person that has to analyze until you understand it, like me, then it takes time. When I find people like me that are struggling, I try to tell them to be less like me. ( It takes me forever to get comfortable with things. I simply dont know enough, and it takes that long to find out enough information until I get comfortable).

Then I go about my own business as usual and analyze everything to death, basically ignoring the advice I just gave to someone else.

OK, so when I analyze something, I dont get too excited about it until I am finished, at least now.  But when I first started on finding out about all of this cardiac stuff, I was totally weirded out about it all. Every time I didn't understand something I got excited about it because it seemed like I would never understand it. I think that the reason I am able to relax about it now, even when I get bad news, is that I have been through the information gathering phase, and at least have a reasonable perspective on some of the more difficult technical matters that underlie some of this stuff. Having a good understanding of the subject matter, in my opinion, results naturally in a more realistic, more healthy perspective and attitude, which allows me to relax.

OK so its not that hard. As I see it, the reasons some beats feel stonger than others has to do with the force placed on the heart and some of the surrounding structures when the heart beats badly. Why would two beats feel differently? Well, first, there is the question of how much of the heart muscle is involved in the rogue beat. If the circuit is a small loop at the bottom of the heart and only involves the fascicullar system, and other things are held constant, the beat might feel relatively light as compared with the situation that the entire left ventricle contracts in response to a backward flowing electrical current for instance. Surely, if an ectopic beats originate in different places on the heart (you have more than one point on the heart the creates a simple PVC), those are going to feel different for this reason.

Second, there is timing and the affect on cardiac output. Lets say that you have only one point of ectopy, but the rogue beat decides to occur at different times within the cardiac cycle. One case might be more likely to drive the flow of blood backward, which you would surely feel, whereas another timing might not have much of an effect at all.

Third, there is the affect of drugs, stress hormones, the state of your nervous system, the affect of your brain on your nervous system, the amount of caffeine you've had, and a whole pile of other stuff, that can affect whether you have more or less rogue beats, how strong they feel, and so on.

Now, when I was still young enough to brave surfing in the ocean, I at times went surfing alone. When I was alone, not knowing what was in the water beneath me, I imagined all sorts of creepy creatures down in there nibbling on my feet and chasing after me. If I had been with someone i would never have bought this ridiculous point of view. True what's in deep water underneath you is a scarey thought, but it is just water and fish after all.....

Likewise, with the topic of heart rhythms being as complicated as it is, it is surely understandable how as arrhythmia patients, we can freek out, and it been my experience that many many people do. There is also a certain aspect of feeling alone with this. Just keep in mind that you are definitely in good company here.
Blank
86819_tn?1378951092
One other thing I didn't quite connect the dots on. In the area of heart rhythms, unlike some other areas of medicine, medical treatments have advanced pretty well in the last 20 years. In fact there are darn few things that can not be detected and addressed through some reasonable strategy that has a favorable end  point. The issues addressed range in complexity from simple PVC's to full blown polymorphic VT's.

My point is you really dont have anything to worry about.  See your doctor and get the testing.  Medicine will pretty much take care of the rest.
Blank
257552_tn?1404606154
Have you ever heard of Occam's Razor.
https://en.m.wikipedia.org/wiki/Occam%27s_razor

"It states that among competing hypotheses, the one with the fewest assumptions should be selected."

Bottom line, after the exegesis on various aspects, that it could be the difference between compensated PVCs and Interpolated PVCs or PACs.

Best regards.
Blank
86819_tn?1378951092
Ok artaud, thank you for the helpful criticism. In my simple way of thinking, when I troubleshoot I propose numerous hypothesis, and then eliminate them until I have one that fits. As a part of building up the tree though, I first collect ideas until I have my initial tree. I then use the idea of choosing the "most likely" to delve into (or test) first, and as a rule, I tend to rule out multiple contributing problems for initial investigation. For instance, a failure in which two separate systems failed at the same time. This is something I learned while working in aviation, and I assume that whoever taught me the concept must have had the advantage of knowing Occam's razor.

I dont know that I considered interpolation specifically, but in my way of thinking, this would be added to the tree at this point under timing. I did read about interpolation, and entrainment, and find both concepts helpful if reading literature in the electrophysiology realm. Specifically, I read about fascicular VT, and the idea of entrainment helped me to understand. This was scarey at first too.

I suppose this all makes sense, somehow. That is, it is only just that a person who surfs should think like this. If you worked in southern california, and were in aerospace when it was king, you might have adopted this approach.

But sometime before i was as old as I am, I also mentally compared windshear and waves too. These two aspects of nature are very scarey, especially if you are without equipment that "looks ahead" and steers clear of trouble (experienced surfers look out over the ocean before they get in, a tip I learned the hard way).


Blank
257552_tn?1404606154
My views are much simpler, largely limiting my comments to my experience, and in all cases urging people that have not already done so to consult with a doctor. Having experienced benign premature beats for nearly 40 years, I have indeed agonized with concerns and received many tests. My main dysfunction is PVCs with pauses, 40 years of pause thump, etc. PACs threw me for a loop, as they do not create the thump. There is no pause. I was surprised to learn one day of interpolated PVCs, they too occur without the pause.

Subjectively, PACs and Interpolated PVCs are less disturbing, when coming in limited numbers, isolated, if you will. Yet to someone accustomed to experiencing pause thump, they represented a departure from norm that concerns me.

If I have learned anything about my studies into benign rhythm issues, there are physicians that say one thing about them, and physicians that say something else, the loss of reassurance is but a hyperlink click away.

Perhaps you can offer me suggestions on the selection of a Beta Blocker, I was surprised when the E.P. said that Atenolol was a weak Beta Blocker. Eliminating Sotaolol, as for my situation it would not be warranted, which others are considered stronger? Adrenaline is and has always been an easy trigger for my PVCs, there has to be something that more thoroughly blocks the effects of adrenaline. I can remember meetings at work, over the years, where my heart was plagued with PVCs, and even presently, news stories that cause me strife will send it into frequent PVCs. This makes my problem worse from the vantage that once my ability to ignore the PVCs on a day to day basis has been worn down, the adrenaline starts to flow and the problem becomes self feeding.
Blank
Avatar_m_tn
I WAS KINDA HOPING ONE OF YOU COULD TELL ME IF THIS COULD BE SOMETHING SERIOUSE IM DEALING WITH HERE OR NOT GIVE ME YOUR PERSONAL OPINION ON WHAT YOU THINK IT COULD BE INSTEAD OF GETTING UPSET WITH EACH OTHER IM GOING TO THE DOCTOR IN A COUPLE OF DAYS TO HAVE IT CHECKED OUT HAS JUST A LITTLE FREAKED ABOUT IT SO I THOUGH MAYBE SOMEONE ON HERE COULD GIVE ME A GOOD IDEA ABOUT WHAT IT IS IM DEALING WITH
Blank
257552_tn?1404606154
Sorry Jake, I thought I did. In my experience there are different types of premature beats, none more serious than the other in a healthy heart, but they feel different. The ones I get with the thuds after the pause are horrible, but I'm used to them. When I started getting the ones without the thud and pause, it scared me because it was different. But, lying in the E.R. twice now, and all these different kinds of beats going on, the E.R. Doctor was bored, nothing significant there, despite how they felt. When you said you can't even tell if it's a palpitation, I figured it might be PACs, they are just extra beats inserted between regular beats, there is no pause or thud. Your stomach and intestines can produce churning that may be perceived as coming from your heart. If they are so infrequent, and cause no problems like dizziness or lightheadedness, then no need to worry. And you can call your doctor and ask for advice as well. So I gave you my opinion from the start. Your concern was first and foremost in my reply. Just relax, be sure to write down your concerns so that when you visit the Dr., you can be sure to remember every item.

Best Regards.
Blank
Avatar_n_tn
Hi Jake. I have PVCs - currently going through a good spell where I am not getting many, or feeling them anyway. No idea why they have reduced. All I can say is that I have read lots about palpitations and everything I read says that they are benign in a structurally normal heart - even when frequent. Apparently, research shows that up to 40% of people will have them in a random EKG test. PVCs are easy to identify on an EKG and don't necessarily lead to other serious arrhythmias. If you heart is otherwise OK, doctors don't seem concerned unless you are having 10k a day, everyday. The main thing with palps is to have the tests to identify what causes them and to rule out other things. I get lots of pvcs at times and they can be terrifying, but please don't be like me and spend years waiting for a catastrophe that never happened. I have struggled to accept that my pvcs will not harm me and wasted a lot of time worrying.Read the All Experts Cardiology forum for more reassurance - Dr David Richardson's replies are very comforting.
Blank
Avatar_n_tn
Just to give a more direct answer to your question - it is very common for palpitations to come and go, especially if they are stress related. Mine come and go. Also,most people will have a few PACs or pvcs during any day, they just don't feel them. Your heart beats 100,000 times a day so it would be near impossible for every beat to be perfectly spaced, given that at some point each day we move about, get scared, get out of breath etc. A few palpitations out of 100k beats is unlikely to be a problem. I am glad your palps have subsided - start working on the stress and anxiety with relaxation exercises, I have found it helps.
Blank
1464004_tn?1384139333
Hey jake! Long time no see! Glad your palps have eased up some. If you remember we all discussed the way they come and go awhile back and that's still true. Not gonna get all scientifical like our very smart friends above
Blank
1464004_tn?1384139333
Don't know what happened to the rest of my post by I went on to say: but we know you had all the cardiac tests you needed and they were all fine, so try to relax and glad to see you're back!
Blank
257552_tn?1404606154
Always a comfort to read your comments. I saw one of your other posts about event monitoring (someone is concerned whether the 2 minute window starts before or after event button push), you mentioned your 20,000 PVCs during an outbreak. It's hard to believe that many, I had 6000 and I was going nuts.

You provided compassionate advise for Jake.

Be well.
Blank
1464004_tn?1384139333
Hey Artsud! Don't get me wrong, I have PVCs,PACs,PSVT for nearly 30 years and it took me a good many of those years to not freak out over them. I've been converted with Adenosine half a dozen times or more and lost count of how many visits to the ER with out of control rhythm issues. I had panic attacks which led to more issues etc etc. I finally had to believe the docs ( especially since I work for them) and realize if this started at 26 and I'm now 56 and not currently dead, then something else will probably kill me .
Blank
1464004_tn?1384139333
Sorry for the typo on your name on my phone and the letters are soooo tiny lol
Blank
86819_tn?1378951092
Hi. Sorry I missed your post. I've been out. No I dont know much about anti arrythmics, except what I read sometime ago on wikipedia (same article you mentioned in one of your posts).  I did note that you were going to try verapamil. My doctor suggested that I might want to try that as well.  But for the time being, I am going to just tough it out.  The TOPROL XL, as needed,  is working just fine, and these things, including the runs, really dont bug me that much, even if associated with a little vertigo.

My main concern at the time I asked about drugs for VT was a sustained run of VT and a back up plan for dealing with it if  it got out of control.  I no longer believe I am at risk for a sustained run;  however, I need to confirm these findings, if I can. Nevertheless, I have not run into a case for which TOPROL does not suite my needs. Also, I am allergic to sulfa, and a lot of the drugs I can use seem unattractive alternatives to me...
Blank
86819_tn?1378951092
Hi Jake.  Didn't mean to steal you thread. Sorry, wont do it again. I hope your found your answers here....
Blank
Post a Comment
To
Top Arrhythmias Answerers
612551_tn?1247839157
Blank
Jerry_NJ
NJ
1423357_tn?1373023915
Blank
tom_h
Central, MA
1807132_tn?1318747197
Blank
michellepetkus
Chicago, IL
1124887_tn?1313758491
Blank
is_something_wrong
Oslo, Norway
86819_tn?1378951092
Blank
Bromley
257552_tn?1404606154
Blank
Artaud
Pittsburgh, PA
MedHelp Health Answers
Recent Activity
1236893_tn?1394988190
Blank
Food Safety for Both Hot and Cold F...
9 hrs ago by gymdandee
5268376_tn?1406183312
Blank
Navywife21113 Few hours after taking the ... Comment
Jul 28
Avatar_m_tn
Blank
pvctom Chronic PVCs, RCA 100% occl... Comment
Jul 27
Heart Rhythm Community Resources
RSS Expert Activity
233488_tn?1310696703
Blank
New Cannabis Article from NORTH Mag...
Jul 20 by John C Hagan III, MD, FACS, FAAOBlank
242532_tn?1269553979
Blank
3 Reasons Why You are Still Binge E...
Jul 14 by Roger Gould, M.D.Blank
242532_tn?1269553979
Blank
Emotional Eating: What Your Closet ...
Jul 09 by Roger Gould, M.D.Blank
Top Arrhythmias Answerers
612551_tn?1247839157
Blank
Jerry_NJ
NJ
1423357_tn?1373023915
Blank
tom_h
Central, MA
1807132_tn?1318747197
Blank
michellepetkus
Chicago, IL
1124887_tn?1313758491
Blank
is_something_wrong
Oslo, Norway
86819_tn?1378951092
Blank
Bromley
257552_tn?1404606154
Blank
Artaud
Pittsburgh, PA