Ongoing Palpitations

[Dracee322]

I have a few questions about ongoing palpitations and trying to understand the etiology of them. In particular, PAC's. I delevoped these PAC's this past fall. They come and go and can get quite frequent at times. I have seen a cardiologist (an EP doc) and had an event monitor, bloodwork, and an echo stress test. The PAC's were determined basically benign. But I feel anything but "benign" when they pop up. I'll admit that there is  some anxiety involved when they do occur but otherwise I do not have any issues with anxiety.
Could the palpitations be at all related to Epstein Barr virus?
I tested positive with "recent primary infection" after looking into a possible case of Mono and ongoing fatigue last May.
How and why are PAC's hormonally related to women? The EP doc indicated that he sees a lot of menopausal women with PAC's. I am not menopausal but I am 34 and just recently completely stopped breastfeeding. The PAC's seem to be related to my monthly cycle. But I have never experienced anything like this in the 20 years of having menstrual cycles so why now?
Also, I am told over and over that people have these all the time and I probably have too and I am just more aware of them now. There is NO WAY that I just "became aware" of these PAC's. I am not doubting that I ever have had them but I guarentee that I have never had them like now.
When I get the flare ups of PAC's, it is not just the "skipped beat" feeling that concerns me. I also feel very fatigued, dizzy, and discomfort in my chest area. I get sort of an "aura" and can tell they're coming. What is this?

[arthur]

The "aura" sounds intriguing...it sounds like you are feeling the weak beat (the "skip") before the strong beat (the make up beat).  I feel this too, but never referred to it as an "aura".

The "skip" is simply the premature atrial beat, which most of us can't feel very well, since it occurs early and therefore is rather weak and unproductive (since the ventricles did not fire).  This is followed by a normal atrial beat, which now triggers the ventricle into action, and is felt a bit more strongly since now the atria were more full than normal.  Contrary to popular opinion, there is no extra beat.

-Arthur

[Dracee322]

Wow! A lot of awesome advice/comments as usual. Is it not funny how sometimes you can feel almost "silly" because of the symptoms you experience? But to hear others have the same exact thing is refreshing. I thought I must really be reaching if I am experiencing an "aura" before the PAC's start. Also to hear other women having the same problem with hormones/breastfeeding is comforting. I cannot imagine the complete train wreck I will be during menopause if I am having the problems I do now!!! You think they could figure out how to help women balance their hormones better. and to USAR....as I described I also get a chest discomfort and sometimes pain as well as a feeling of shortness of breath, very fatigued, and a sort of lump in my throat during flare ups. I also get tachycardic or my heart will "pound" and I can even feel it in my hands at times as well. So, like you, it is not just the PAC's. It is the entire group of symptoms that occur that is frightening and frustrating. The nurse practitioner that I saw at the cardiology office recommended a calcium channel blocker (30 mg) for flare ups. I have not yet tried it and am just hoping this craziness goes away on its own. Fortunately, it seems to have slowed down(knock on wood). I know that all of these heart meds come with side-effects and it is basically the lesser of two evils so I am hoping and praying that my body balances itself back out! I too try to get regular aerobic excercise but I always have. Even right before this all started I walked several miles per day and work with weights. And I don't do caffiene nor do I smoke. I do suffer a type of insomnia (frequent waking, sometimes trouble falling asleep)so that could be a part of it. Thanks to all for the great input!

[sampants]

"How and why are PAC's hormonally related to women? The EP doc indicated that he sees a lot of menopausal women with PAC's. I am not menopausal but I am 34 and just recently completely stopped breastfeeding."

I also started having palps after ceasing nursing with my third child.  I had basically been pregnant or nursing for over 4 years.  I think the sudden change in hormones were definitely the cause of my PACs and PVCs.  I also had them just before my period would come.

Thankfully, I think my hormones have really evened out.  I am off a beta blocker and have had not noticeable palps for almost two months.  *knocks wood*

I am off caffeine, though I do indulge in chocolate sometimes.  I don't drink or smoke.  I started a regluar exercise program, which I think has also made a difference.

Good luck.

[dquenzer]

It is difficult to know if it eliminated the AFIB completely.  It has greatly reduced the number of PAC's I used to have.  I used to get about 2 or 3 a minute, and at night when I woke up my heart would be very erratic from PAC's.  It made it very hard to sleep.  Now I don't have really any at night, and I have them from time to time during the day (2 or 3 an hour). I could have them more but really don't notice them much.

Since the ablation the first week I had 3 episodes of AFIB which were in short duration (1 a few seconds to 2 a few hours), the second week I had 2 episodes ( 1 seconds and 1 a few hours), and then a few episodes of seconds since then.  Compared this to half a day to day and half every 2 to 3 weeks that's definitely an improvement.  These episodes could be from a foci not ablated or from the irritation caused by the ablation.  If it's the latter then eventually it will dissipate.

I'm on 50mg of atenolol to basically keep the irritation of the heart down.  I use to be on an tikosyn and 25 mg of atenolol. I'm also on coumadin and small amount of klonopin (atenolol gives me insomnia and the klonopin helps with that).  They did want me to stay in the hospital a few more days to go on flecanide (sp?), but I needed to get back to work so they just increased the atenolol.  Besides if I was on an antiarrythmic I wouldn't know exactly if the procedure worked or the antiarrythmic was working.

But the jury is still out.  The real test is at about 8 to 12 weeks.  By then the nerves are healed.  If I am still having episodes of AFIB then I may need a 2nd ablation.

The wierd thing right now is that my normal heart rate has been elevated by about 15 beats per minute since the ablation.  Normally if I was on 50 mg of atenolol my resting rate would be in the low 50's.  Not it is about the mid 60's.  The lit. states that this may occur for several weeks after the ablation.  Not sure what "several" means.  I'm hoping this will end, because I am hoping to get off the atenolol as well.  My goal is to be med free in 3 to 6 months.

Thanks for asking.  

[usar13b]

I too am a 34 year old female and started having PVC's about 7 months ago.  They definitely increase during my cycle.  Stress also seems to have an effect on them.  Did I mention that I have six kids ages 5 to 13 and my husband is away on military duty.  Just a little stress... Anyway I too experience the auora you mentioned.  I also have begun to experience some other symptoms that I wonder if any of you share. From time to time I also experience shortness of breath and my chest is sometimes sore.  The one that bothers me the most is this.  I can't lay on my left side because of the discomfort it causes.  It is not painful but I can't quite describe it.  I can just tell it is affecting my heart in some way.  I had a complete work-up during a hospital stay in November (echo, treadmill stress test, etc) and their exact words were "It would take the hand of God to stop your heart."  I just feel like I have gotten worse since then.  I wish now that the only thing I was dealing with was the PVC's.  I actually was able to come to terms with that but these new symptoms really seem to be getting to me.

[NHS]

It was nice to read about your positive outcome from the catheterization. Did it eliminate the arrhythmias completely, so that you don't need to take meds anymore?

NHS