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Is there a way to tell if palpitations are PVCs or NSVT from the pulse?

Do ventricular beats produce a weaker or fainter pulse than normal or atrial beats, or not necessarily?

For the past month or so, I have been experiencing severe palpitations during intimate activity.  It's gotten so bad that I am thinking about avoiding intimate activity entirely, because I cannot attain orgasm without my heart firing prematurely or breaking into short runs of tachycardia (3-4 beats).  

I noticed that when my heart fires prematurely or goes into a short run of tachycardia, the pulse is still palpable on my neck and my wrists.  The pulse is not weaker than the normal sinus beats, in fact it is a bit stronger and more forceful.  Does that indicate anything?  I read that NSVT causes dizziness because of reduced cardiac output, so I assume that the pulse would be weak in NSVT.  Does this mean my runs may be supraventricular in nature?  Or is the pulse strong simply because the runs are short?  

Thank you.  

2 Responses
20748650 tn?1521032211
COMMUNITY LEADER
Not necessarily, at least not in the situation you describe.

On one hand, yes, a Run of VT should yield a weaker pulsation than Sinus.

On the other hand, your baseline sinus in this situation is lower than your sinus baseline at rest.

Adrenal stimulation causes the heart to beat more forcefully in general and the pressures to rise.

Lastly, consider that during a PVC or NSVT the pulse only gets (anecdotally speaking) about 20%-50% “weaker”. I’m not entirely sure anyone has the ability to reliably detect a transient 20% loss in pressure with their fingers.
20748650 tn?1521032211
COMMUNITY LEADER
Also bear in mind, in many cases PVC and NSVT are classified together.

By this I mean it’s not uncommon for a patient with PVC to have NSVT from the same location.

It also (thankfully) doesn’t always impact prognosis.

An individual with RVOT PVC and RVOT NSVT have the same “condition” and the same survival rate/prognosis. Whether or not the ectopy is isolated or paired together. The prognosis for these patients is good, they live, even if untreated.

Likewise, someone with PVCs caused by ARVD is going to die without treatment with just the same probability As someone with NSVT caused by ARVD.

In other cases the existence of NSVT vs isolated PVC may be important (Ie prior Myocardial Infarctions with borderline Ejection Fractions) In identifying an ideal course of action.

Bottom line is, you need a Holter, echo and probably a stress test (since this is affiliated with times of increased adrenal stimulation).

Simply figuring out whether what you have is a PVC vs VT based on pulse is gonna mean did diddly squat without further diagnostic work up
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