long pause after pvc

Why does there seem to be a longer pause after a PVC than it would normally feel if you just counted the beats? I had a PVC and it seemed like my heart paused for a good 2 seconds then started again

i wore a holter 2 years ago and recorded 6600 pvcs in a day, im on meds now and they are almost all gone, when i do have a pvc, i just feel a long pause and nothing else, although the one i felt today was about 2 seconds, maybe it was just me cause i was standing up and could not count. My BP rose sharply cause it bothered me

[itdood]

It's called a compensatory pause.  The length of the compensatory pause varies based on when the PVC occurs.  Sometimes there's no pause at all, it depends on the timing of the PVC during the QRS complex.

The pause occurs because the sinus rhythm does not change when PVCs occur, it stays the same, meaning the spark plug is still firing at a normal interval but the ventricles misfired.    During the PVC one of the sinus beats is not able to reach the ventricles and causes the pause.  it's of little concern and does not change the volume of blood heading out in a structurally normal heart.

PVCs can occur early in the cylce (R on T waves), after the T wave (meaning right after a normal beat) or late in the cycle, almost on top of the next P wave.  If  a late cycle PVC occurs late enough, it will fuse with the current QRS complex and it's called a fusion beat, meaning it fused with the P wave.

This variable timing (R on T, post T, or late) affects the sensations of the PVC, symptoms, and pause length.  This variability does not have any implications in a structurally normal heart.  For someone with ischemia or other structural problems, R on T are the most concerning.

[TatiSD]

How would you explain the one I felt last night?  I felt a slight irregularity in my chest, I immediately took my pulse and in the middle of the extended pause that I was having after the pvc, I felt a slight shudder or weak vibration, very quick, then finally it went back into rhythm. Immediately after that weird pvc, my heart started pounding and BP shot up to 183/88 all within a minute.  Freaked me out!  Thanks itdood.  You are a special asset to this site!!!

[kyomagi]

Tatisd, seems like you had a double pvc, those are normally ok too.  And the BP spike is normal cause your starting to freak out

[kyomagi]

sry for the dbl, so what your saying, since i felt no symptoms besides the flip flop in my chest, the pause is normal?  I was litteraly just standing in subway, felt the flop, took my pulse and went like, beat, light beat, pause......beat.  Now what struck me as odd was the fact that my heart was beating really slow for a couple seconds, i cant remember if i had dome something to cause my heart to beat real slow, but its something that i have felt before and had it caught on a heart monitor a few years back, no issues arose to my EP.  He said i had 6600 and he was not concerned with it.

No other symptoms, no dizzyness, lightheaded ness or pains anywhere

[Mom2four85]

search for couplets, triplets, salvo, biegeminy & trigeminy, sustained and nonsustained VTach or ventricular tachycardia and you'll get alot of useful information on here

6600 pvc's with no known heart problems is probably nothing to be concerned about, but keep a watchful eye on your symptoms and try to find and eliminate your triggers if you can - keeping a journal of symptoms, dates, times etc can be very helpful

normally with 6000-8000 pvc's they treat with meds and make sure all else is in good strucutral health, if you start getting about 15-20% of your 24hr HR total, they may look into what else is going on and recommend surgery

also, you may feel pvc's more when the heart is beating at a slower rate; and if you had a couplet at a slower rate it hurts! even if the dr says it shouldn't :P hehehe

[Nurse2b1982]

Good info guys! I was getting at this when I posted my question last week, kyomagi just put into words what I was trying to say!

[kyomagi]

heres my biggest issue, i have a lot of muscle twitches, and most of them happen around where you can feel your heart thud.  I know this because i have caught a string of thuds that turned out to be spasms cause it did not match with my pulse, so i may be thinking i have a pvc but its a twitch, just like what happened 1 minute ago lol

[itdood]

I'm not really sure what could a cause the vibration during the pause.  If you could feel it as a pulse at an atrial source, I would think it's something ventricular.  If you're just feeling this in your chest, like a muscle twitch, it's anyone's guess.  Have to catch that bugger on a holter monitor.  :-)  I don't think it's anything to worry about.

[TatiSD]

I felt it in my pulse in the neck, as if the heart was trying to catch back its rhythm.  Maybe it was a week contraction since it was still in that long pause period after the big pvc.  Or maybe I'm analyzing it too much.  Thanks.