230125?1193369457
Michael J. McWilliams, M.D.  
Male, 40
Wilmington, NC

Specialties: atrial fibrillation, Pacemakers


Wilmington Health Associates
910-341-3301
1202 Medical Center Drive
Wilmington, NC
My Posts
Feb 01, 2009 in the Heart Rhythm Expert Forum
How easy is it to get a second opinion with the Canadian health care system?
Jan 29, 2009 in the Heart Rhythm Expert Forum
The first thing I would do is get tested for sleep apnea. That is a common cause of pauses like that during sleep. In general, I am quite conservative about placing pacemakers in people as young as you are. Before having the pacemaker placed, I would consider a second opinion. I am not saying your doctor is wrong or that i disagree that a pacemaker may ...
Jan 29, 2009 in the Heart Rhythm Expert Forum
1. Palpitations (sensation of the heart beating) after standing is common. People tend to feel their heart beat more often when they are stressed, sleep deprived, caffeinated, etc. It does not necessarily point to a problem. Sleep apnea can increase adrenergic tone (adrenaline) and make the heart beat harder and faster and high thryoid hormone levels also ...
Jan 28, 2009 in the Heart Rhythm Expert Forum
As an unsolicited comment, I know Dr. Ellis from Cleveland Clinic days. He is a great person and a balanced physician that has excellent clinical judgment. This is a great opportunity! I may tune in myself. When i was a fellow training in Cleveland, he was a very good sounding board for clinical questions and an excellent teacher in the lab.
Jan 28, 2009 in the Heart Rhythm Expert Forum
I think it sounds like panic attacks/anxiety as well. I know it sounds strange but what sold me was the waking in the middle of the night part. I think you would be surprised how common your symptoms are -- people don't talk about this stuff at work or parties. I agree that no specific treatment is necessary. The hard part will be getting passed the OCD...
Jan 23, 2009 in the Heart Rhythm Expert Forum
1. It is hard to say without seeing it on a monitor -- it could be premature ventricular contractions, bradycardia, you could have had increased vagal tone, it could be the effexor. Unless it happens several times, it is unlikely that you will get an exact answer. 2. More of work up would be necessary. I would start with a Holter monitor. 3. Your do...
Jan 23, 2009 in the Heart Rhythm Expert Forum
1. It is normal for some people to feel lightheaded when they stand up, especially if you are dehydrate. It is also normal for some people to pass out in this setting. It is important to understand that if you are one that is sensitive to these changes, to be ready to sit rapidly if needed to keep yourself from passing out. 2. If I saw a young person li...
Jan 20, 2009 in the Heart Rhythm Expert Forum
That sounds like a very complicated situation. 1. PAC/PVCs are common initiators of arrhythmia's. You doctor should have a decent idea whether the arrhythmia are triggered by pac/pvc if they can capture the arrhythmia on a monitor. 2. Probably not. It is more dependent on what the rhythm is. 3. 12 lead EKGs are a general why to screen the conducti...
Jan 14, 2009 in the Heart Rhythm Expert Forum
I have met very patients that could say i have palpitations when ..... hormonal changes (premenstrual, menstrual, post menopausal) stressful times caffeine There is usually no predictable pattern. I haven't heard anyone say it happens right before sleep before. For now, there is no way to know or test for the mechanism.
Jan 13, 2009 in the Heart Rhythm Expert Forum
Palpitations are almost always benign. In a typical cardiac work up for palpitations, an EKG, Holter, echo +/- a stress test is done. It depends on your risk profile. If you had work up one year ago that was normal and nothing has changed, it is unlikely that there is significant risk. If you have questions, it is appropriate to go to your doctor and as...