Dr. McWilliams,
I am a 35-year-old male with a PVC/PAC history. In 2003, I began awakening @ night with a rapid pounding heart rate (180+ bpm). A trip to the ER and ensuing EKG revealed an elevated pulse (and HBP) but no other findings of note. A follow-up echocardiagram showed no structural abnormalities. A holter showed isolated PACs and PVCs. I began attending therapy and, with deep-breathing exercises, contained the tachycardia.
In early 2007, the same symptoms began to occur anew with increasing frequency. I have been under constant stress (new job, home sale, moving, separation from partner), so I have attributed the tachycardia to nocturnal panic attacks. However, on New Year's Eve, I drank and ate to excess. In the early morning hours, I fell asleep but was awakened by what felt like a "skipped" beat followed by the immediate elevation of my heart rate. I immediately panicked (trembling, sweating, more skipped beats) and hopped in my car in an effort to find the closest ER. I was not faint at any time, just scared.
By the time I got to the hospital, I had calmed myself slightly, renewed my breathing exercises, and my pulse gradually declined. I did not go inside the ER and was fine for the rest of the day (save for the emotional trauma and hangover). I am a bit skittish to go to sleep now and have a few questions: (1) Does this episode sound like ventricular tachycardia? (2) Should I see a doctor ASAP? (3) Is it noteworthy that these episodes crop up only @ night?
Thank you for your time and consideration.