annoying, SCARY arrhythmia

[arc718]

Alright, so here's the deal. Back in 2006 I was driving home late at night from visiting a friend. It'd been a long day between work and school, then the long drive to visit my friend and the long drive back home. When I got back into the city and was no more than 15 minutes or so from home, my heart took off in the fastest race I think it'd ever been in before. It was beating SO FAST, it terrified me. I felt shaky, dizzy, scared - I thought I was about to die. I was later informed, after various testing, that the hypothesis was a panic attack. And while I now tend to believe that's what happened, I still wonder why I didn't feel panicky UNTIL my heart started racing out of nowhere. I was in a good mood, singing to the radio, just enjoying the drive. Then BOOM - this racing heart that was so fast it seemed like it was seriously dangerous. Just out of nowhere. I had a few more episodes like this in the next few weeks, which gradually led to me shutting down for the most part, quitting my job, withdrawing from school, and becoming a hermit for almost a year. I'll admit that panic and anxiety did factor in at a point, but to me it seemed like they were a result of the initial incidence of racing heart.

After that strange, scary, and seemingly out of the blue episode, I started experiencing skipped heartbeats. I've been told that everyone gets these at some point, and some more than others - and that some notice them while others don't. Ok, fine, I can deal with that. And, after a myriad of tests during this, the bleakest year of my life (2006), I finally started to come around after almost a year of this. My life started to get back to normal, I stopped fearing all the time that I was at death's door from whatever mysterious ailment this was. I got a job again, started looking at re-enrolling in school, and started driving again (I'd completely stopped driving myself anywhere).

BUT, the skipped beats never totally went away. Sometimes I'll go for weeks, or seemingly even months, without noticing a single one. But yet, other times I'll notice a few a day. Then, there are particularly bad days when I get what seems to be worse than just a skipped beat, or two, or three. It feels like a squeezing sensation, with the beat jumping around all over in what seems like a random order. It terrifies the crap out of me. the only thing I can describe it as being is a flip-flopping, squeezing feeling. And it almost feels like it's trying to stop altogether. After it starts behaving again, it leaves me with a pulsing head. WTF?! I had numerous tests done - 2 different kinds of monitors, HUNDREDS of EKGs, 2 echos, 1 stress echo, blood work, you name it. The only thing the doctors said is that the EKG shows as "abnormal" but that it's still "normal" - some worded it as being an "abnormal normal" or a variant of normal. Clear as mud. But they said the structure is fine, the ejection fraction is good (whatever that is), pressure is good, yada-yada. Nothing wrong at all, according to them. If nothing's wrong, then why has it suddenly started with this new, flip-flop squeezing, almost-stopping arrhythmia? I work part-time, I have no insurance, can't afford even the cost of an office visit (much less any tests that are requested), and don't even have a family doctor anyway. I recently moved out of state to live with family so I can try to get through school again, which I'm enrolled in now. I don't know what to do. Has anyone else experienced this squeezing flip-flopping, heart almost stopping feeling? And if so, have you been given a diagnosis of it? I was diagnosed with PVCs, PACs, occasional couplets, and very rare triplets (I think they said they saw one or two of those throughout the whole ordeal). If anyone has any ideas or suggestions, you have my full attention.

[is_something_wrong]

Your reaction towards this phenomenon is concerning but I completely understand it.

I'm going to tell you a little secret:
No acute dangerous arrhythmia will present with irregular heart rhythm.

In other words, what's the most scary and dangerous thing this can be? A short run of atrial fibrillation. Several % of the world are living with permanent atrial fibrillation, and for old people, doctors want to prevent blood clots, but this is only if the runs are long-lasting or permanent.

Atrial fibrillation is extremely uncommon in young people.

What's the most likely explaination? A normal rhythm with frequent premature beats (PACs or PVCs). This isn't dangerous but it feels terrible.

How is your pulse when this happens? Rapid? completely irregular or just some irregularities in between?

I agree you should try to capture this on EKG, because if it is atrial fibrillation or SVT, treatment is available.

I would try to trust the doctor. This isn't dangerous but it can really ruin your life quality and that's serious enough.

[Mom2four85]

just an added thought - have you gotten your medical records to see what all has been found? I know I had to get mine to force me to believe that something was seriously wrong; sometimes it's the unknown that's worse to deal with than what's really going on (speaking from personal experience)

[Mom2four85]

My son is almost 26, he's been in the AF for 3 1/2 years and has had pvc's and just in the past few months during PT fainted; they did full testing and said - yup just run of the mill pvc's and sent him on his way with the same old warning...stop drinking caffeine, energy drinks, drink more water, exercise daily yada yada...

I haven't read all of the posts sorry if I missed this - have you had a full cardiac workup and found everything "normal"? If so, I don't know how they could say anything about what you have - you could have symptoms but if nothing is ever found or deemed "normal" then they'll probably just say what they did to my son...get off your butt and workout more.

Had he told them hey my mom has malignant arrhythmia's and HOCM etc etc they might have paid more attention to what's going on with him...most of the time he said they want you in and out of their doctor's office and back out doing your job more than anything and to go off base to a doctor would be really expensive.

I've lived with MA's for awhile; lived through constant bigeminy from April 2007 - August 2009 and had over 50,000 pvc's daily; and fainted quite often.  I didn't know what I had was dangerous at the time, but never let what I was feeling stop me - I walked, ran, lifted weights, push mowed the yard, built fences and a ton of other stuff that doctor's were surprised I could do being severely symptomatic and didn't camp out at the dr's office or ER...our minds are a powerful tool.

[kyomagi]

Oh man i feel ya there! I JUST one a episode!  Im 29 and my last holter recorded 6600, but since i have been on verapamil 240mg they have gone down to nothing or random pvc's

My episode just now was a sinking feeling, small thud with a sinking feeling and a slightly panic endused fast heart beat (not too fast, about 100) thats normal now.  No dizzyness or other symptoms.  Its annoying yes, scary yes, but you have to learn to live through it

[arc718]

What I'm most irritated about, more than anything, is that I was - or I should say I still am - considering trying to enlist in the national guard. I've thought about some sort of military service on and off since I was a kid. When this BS started back in 2006, military service became the furthest thing from my mind. However, in the last year or so, I've started thinking about it again. I even went and took the ASVAB, and scored very well on it. But, they do a medical questionnaire, as well as a physical, and then when you're sent to boot camp - well, I don't need to really say much more about that. The gist of it though is that they put you through intensive physical training, and from what I understand, you don't get the luxury of being able to sleep very much. Or at least, not anywhere near as much as what most of the general population has access to.

Thing is, the less sleep I get, the more "skips" and "flip-flops" I get. And the more likely I am to have them. I am ok to do exercising, and in fact before it started getting unbearably hot everywhere in the country lately, I was starting to run more again. I also ran almost every day last summer. I can do push-ups, pull-ups, sit-ups, etc. And to spite the heat, I've (as ridiculous as it may sound) been jogging in the house. But, if the military knew I have these stupid things, and especially if they knew I've actually been DIAGNOSED with them, they'd most likely DQ me without a second thought. So, on the questionnaire, I didn't say ANYTHING about the beats. However, if I get to the physical, they'll ask me those questions again. I want to be honest with them because I don't want to be dishonorably discharged later on (if I get in) and I don't particularly want to drop from potentially serious problems during a day at boot camp.

So to get to my point, is there anyone here who has done military service WHILE having these stupid things? Either by going into military with these things pre-existing, or developing them while you're there, and still being able to successfully complete boot camp? I just turned 34 this past Monday, and the cut-off age for enlistment is 35, so I don't have much longer to even apply for this. And the older I get, the less functional everything becomes (compared to how it all used to work, anyway). Bottom line is I WANT to do this because I want that sense of pride and accomplishment, and to prove to myself that I can do it. I just am curious to know if this is safe to do and if anybody else in a similar situation has done it.

[DeltaDawn23]

I have had a very similar history to you.  Diagnosed with panic, nothing wrong with my heart.  Then I landed in Afib and the panic was worse.  I take Atenolol a beta blocker to slow things down, also Xanax.  Some people are afraid of the Xanax being addictive but my docs say I am on such a low dose it is not a concern (25 mg.).  I take up to 4 25 mg. tablets a day of the Xanax, breaking them in half.  I later found a lot of my symptoms are symptoms of Afib.  The panic comes AFTER the heart issues.  Between the beta blocker and the Xanax, I have been able to function, but have pretty much stopped driving -- something I want to get back to.

i put on 30 pounds thinking it was low blood sugar.  It literally came out of the blue.  I found out later  tend to have PAC'S, and PVC's as well as runs of tachycardia.  BTW, ejection fraction is how well your heart is pumping the blood around your body -- may not be the technical definition, but that is how I understand it.

Another good book is "The Sky is Falling."  Don't recall the author, but it is about panic and is excellent.  It is probably out of print, but I am sure available at the library or online.  Also, "You Can't Afford the Luxury of a Negative Thought."  This book helped me a lot as did meditation, and seeing a shrink.

If you can distract yourself from the condition, it can ward off the panic.  I have breathing exercises I do that helps.

All that said, I think talking to your ex-cardio is a good idea.  You should have some medical input.  A sliding scale or low cost or free clinic is an excellent idea.  Check out your options, take control and that alone should make you feel better emotionally.

Good luck

[achillea]

"What is getting to me now is the concern over this scary thing that's happened about 2 or 3 times in the last 2 to 3 weeks....the squeezing, flip-flopping feeling that lasts for a minute or so. It's not just a skipped beat sensation, or a hard skipped beat sensation, like before. This is totally new. Which is what's got me concerned."

Yeah.  As I said, given your history of tests, the details of what you perceive are--amazingly enough--not important:  'Squeeze' vs 'skip' vs 'flipflop' is very subjective and it does not give you useful info.  You need to understand what actually happens during PVCs, and it isn't that difficult.  Type this into a google search:

John Kenyon, CNA pvcs

The first site that will come up will be a description by an cardiac EMT specialist who writes for lay people about ectopic beats.  His info is solid, simplified a bit for non-medical people, but it will give you material that you really need to read and understand.  You write in an intelligent way, and I think if your panic does not intrude, you are capable of understanding your heart's contractions.  The nature of this process is not rocket science, but you will have to read thoughtfully.  The info that you--an essentially healthy person--need is right there in this short explanation.

You mention that  SSRIs were tried on you and that these "nasty meds" made things worse.  Few medications are inherently 'nasty,' and every med in this class--and there are many--work differently for different individuals.  If the ones you tried made things worse, then your docs were not thoughtful or selective enough or did not sift through the right ones for you to try.  Every patient is different, and not one of the meds in this class is either right or wrong for every patient who comes down the pike.

I hope you can get settled enough to read and to understand what goes on in the heart during benign PVCs, no matter how strange they feel.

If so, you will comprehend why it is that you can live a perfectly capable life, walking, performing everyday tasks, and even running up stairs, without puking, fainting or dying, even in the presence of, let's say, as many as 10,000 PVCs per day.

[arc718]

Well, the thing is, it's not the plain old, average, run-of-the-mill PVCs that really get me. If I get a skipped beat, or two, or three....or if I get a real strong thumper once or twice...no big deal. Even those used to scare the daylights out of me. Those don't bother me anymore. What is getting to me now is the concern over this scary thing that's happened about 2 or 3 times in the last 2 to 3 weeks....the squeezing, flip-flopping feeling that lasts for a minute or so. It's not just a skipped beat sensation, or a hard skipped beat sensation, like before. This is totally new. Which is what's got me concerned. As for the panic thing, yep the counselors I saw about that side of it ultimately diagnosed me with that, and I had no problem with believing it once I finally allowed myself to. I admit fully that I'm prone to anxiety, and even to panic. And as my first "panic attack" happened when I was driving, the counselors attributed it to the two very bad car wrecks I'd been in years before the panic onset. Apparently, it was "latent onset panic" that I was experiencing, due to repressed memories of the wrecks, according to them. Funny little side note - they tried some SSRIs with me, and those actually made my skipped beats worse. I ultimately decided that for my psychological well-being, it was best to avoid those nasty meds. They may work great for some, but for others - not so much. I was one of the ones that they didn't do so well for.

As for the arrhythmias themselves, I'm perfectly OK now with getting PVCs and PACs. What I'm not OK with is this seemingly brand new type of arrhythmia. I don't even know if what I experienced today, and a week ago, and a week before that, is still a PVC or PAC variant - or something else. And potentially something worse. This has got me concerned, pretty concerned actually. So now I'm mulling over how to go about figuring this out. I've considered calling my old cardiologist, who's out of state (I moved to another state back in March), to briefly explain this and get his opinion as to whether I should see someone here or not.

So, with regard to the new arrhythmia (not just plain old PVCs and PACs) - what is your take?

[achillea]

Many--as in MANY--of us here have experienced what you are describing.  In fact, when I experience PVCs (which is what my tests have shown they mostly are), they tend to come on as yours do:  Out of the blue and always, always accompanied by  absolutely instantaneous symptoms of panic.  I could never, not even after more than twenty years' exxperience with these things, be absolutely sure which is the chicken and which is the egg, so to speak (although my sense is that the funny heartbeat very slightly precedes the symptoms of panic).

In my case, since repeated heart tests showed a pretty normal ticker, I was ultimately diagnosed with panic disorder without any external triggering event or trauma.  The fact that your symptoms come on without warning and cause you to withdraw socially--a real biggie in psychological terms--points most strongly to panic disorder, by the way.

In my case, my earlier attacks came on at wide intervals of many years, for example, but with the passage of time, I've noticed they're a bit more frequent.  

At first, I tried to deal with them by means of self help books like Dr. Claire Weekes' nice little "Hope and Help for Your Nerves," which I always recommend to anyone who experiences symptoms like mine and yours.  It's a sensible book that helps ordinary people understand just what is going on, and supplies some mental exercises that may actually help in dealing with it all.

However, since neither I nor my doc have been able to isolate any 'trigger' that might set off this reaction and for which I could therefore prepare, he decided I had a kind of 'intrinsic' condition, probably part of my genetic makeup, and suggested the approach that works reliably for me:

Since the assumption is that my internal car alarm, so to speak, is set to go off when the wind blows funny or the phase of the moon is wrong--in other words for no da*n good reason--the thing to do is to let the system cool off and then re-set it.

To accomplish this, my doc tried me on various kinds of antidepressants of the SSRI class.  I believe I tried four, and the one that works best for me is Zoloft.  When a bout of this kind of nonsense descends on me, I take a low dose of this drug for two to four months, enough to let things cool off, and then slowly (very slowly) taper off the drug.  Some people have to stay on it longer, but in those for whom it works, it is magic.  Personally, in very short order, I no longer am able to 'hear' the funny heartbeats, and at the same time, they actually decrease in frequency.  The panicky feeling absolutely gone.

SSRIs (and indeed most effective medications for this sort of thing) are prescriptions of course, and unless the self-help books work unusually for you, you will have to find some way to get a doctor's care for efficient treatment.  In the meantime, do please buy the Weekes' book; it is cheap and actually very informative.  You can also read up big time on PVCs.  You will learn that no matter how chaotic or varied your heartbeats feel, their assorted differences and where and how you feel them (flip-flops, stops, squeezing, aching head, etc) are of no significance.  The most important symptoms you feel are, not surprisingly, the result of hypersensitivity to the erratic beats and the resultant scare they give you.

Given that your heart has been shown to be healthy, the most serious problem to be dealt with is fright.  You say you have no income and cannot afford a doctor,  but you are living with family and returning to school. There are programs and clinics (many associated with schools) that cater to low income clients, and in any case, all you have to do is scrounge up the bucks for one sit down and talk with a good doctor to get you started with effective treatment.