NIGHTTIME!

[Ihatepalps2]

Ive had PVC's/PACs for 18 years, had all the tests...been told what most of you have been told..they are stress related, try to ignore them etc.
I thought I had been thru all there is to go thru with these darn things. But last night, was new for me! I had been totally palpitation free on Saturday. Great day!!! But..on our way home from up north yesterday, suddenly out of absolutly nowhere ( like it usually happens) I could feel a few palps "popping" in there. By the time we got home 2 hours later, I was having some BIG palpitations, many a minute (5-10)...I was miserble. And I was wracking my brain trying to figure out what on earth couldve brought them on THIS time. ( I should know better....)
Well, usually I take a Xanax and that relaxes me, and they dont "get to me". Or, I distract myself with reading, or tv, ( I tried both last night) but nothing worked.
Usually, as a very last resort, I take another xanax, and I go to bed. Sleeping will usually get rid of them--the xanax relaxes me enough to put me to sleep, and when I wake up, they may come back, but i usually have no trouble through the night.
Last night, was a night from hell. Ive never had it like this before. I couldnt sleep--my heart was really skipping beats and thumping around in there--it was awful! Not every beat--I had minutes where there may not have been any, but the ones I had were so...strong...and distracting. I never had a chance to relax enough to sleep. I would say, I dozed. off and on. I was awake every hour at some point. I even thought about getting up, and going to the emergency room..but Ive done that...only twice last year...but...i dont know if they have my record or something, but last time, they didnt even hook me up to a monitor. I laid there last night, ALL night, near tears, and so scared. It was the worst night ever!
They just didnt let up, no matter what I did.
Anyone else have nights like this? Even this morning, they are still bad, but not as bad. Im going to call my Cardio...even tho last time, he seemed frustrated with me--that hes told me time and time again they are benign. But..I havent had a holter monitor now since June of last year.
Im wondering, can these things change in that length of time? (10 months).... although..I didnt die last night..so...they cant be all that deadly...
im exhausted..depressed...tired....feel sick...these things totally have me beat.
They win.

[Linsy0637]

Wow, I just stumbled across this looking for differences in zoloft and celexa and it made me want to cry! I have been having PVC's PAC's whatever since I was 20 years old. My cardiologist told me the same exact things you have said and I was so certain he was wrong. I would be kept up all night freaking out with my heart doing all kinds of crazy stuff. It finally got to the point where I just stopped saying anything about it  because I know everyone was sick of hearing about it,and was just freaking out in my head thinking I am eventually going to die from these. The cardiologist put me on citalopram/tartrate and it didn't help. I got pregnant shortly after and had to stop taking it , after I had my son I decided I didn't want to go back on it and instead went and saw a doctor for anxiety disorder. He put me on celexa and since I rarley have PAC's or PVC's. My point is, that I suffered with this same thing for years and it was destroying my life! I wish I would have seen that there was others going through the same thing and that alone I know would have helped but I do recommend celexa or some type of ssri. It doesn't mean you have to take it forever but if you take it and it helps then you know alot of the heart problems were mental and that alone even off the medication is a huge relief. I had no idea that some SSRI's could mess with your heart rythm and I'm glad I didn't because I probably would have been to scared to take it and never had experienced the life changing relief that I got from it.

[DeltaDawn23]

I think from my 8 years of experience with Afib, pac's, pvcs., that the anxiety comes after the heart issues, not the other way around.  I was told I was having panic attacks, I was depressed, no one actually addressing the heart issues.  After reading on this message board, I think the dizziness and irregular beats are part of the heart issues.  I too, was offered anti-depressants and when I went for counseling, was told I was not depressed, I was anxious. Xanax (shrink says it is not addictive in small doses), and Atenolol in divided (1/4 doses) has gotten me through so far.  Now Afib episodes are coming closer together.

It is so sad that they don't have a better handle on this.  All of this suffering and it seems that that they are not taking it seriously.  It is SO incapacitating!  I have been on Norpace for 3 days -- a half dose -- and I had so many irregular beats this morning it scared me.  It has settled down now, but I will talk to the nurse practitioner in the morning.  (I'm supposed to go to work).  Seems like mornings and after eating are my worst times.

[rilesnic]

I am not menopausal. I just turned 39 this week and everything is still regular. I have had palps since I was 21, but started to get hot flashes and dizziness about 3 years ago. These hot flashes feel like I'm going to pass out and I literally see dark spots. My heart races and the pac's and pvc's begin too. I've never had a seizure, but I bet that is what the aura feeling is like, I almost feel out of body. My body temperature does rise and I begin sweating profusely within seconds.  The flash lasts for about a minute..tops, but the exhaustion lasts for hours.They blamed it on gallbladder at first, which did need to come out, but the symptoms continued. That was a lot of fun seeing a crash cart outside my door b/c of palps and tachy. I do, however, believe my symptoms are hormonal related. They wanted to put me on birth control pills to see, but I only took those in between the births of my two girls and that was 18 years ago, so I refused the meds. I hope you can find some answers or at least some relief. Best to you!

[mare505]

Just wondering after reading all these posts and especially yours, are you by chance menopausal?  Asking b/c I have the same symptoms as you stated:  palpitations, dizziness, hot flashes and am 55 and post-menopause.  I keep wondering if this most recent bout of palps I've been having are due to menopause.  I asked my gyn who said I shouldn't be having any symptoms of menopause b/c i am three years post.  I can't believe that is true b/c i've been on so many forums trying to find out if other women are experiencing palpitations and dizziness like i've been and see that alot of women have these same symptoms and are post-menopause.  I've had all the tests (heart, brain, ENT) trying to find a cause for these symptoms and all the tests came back fine but still can't find a reason for them.  It's very exhausting and makes me very anxious.  Thanks for any comments you can provide.

[rilesnic]

Well, sadly, it sounds all too familiar. At my last visit I was told these were not going to hurt me and I had to live my life. Just a few years ago he told me if I passed out I would come to...and if I was driving to pull over b/c I knew when they were coming on...very reassuring (not!). Most of my PVC's and PAC's begin about 2 hours after I eat lunch and continue throughtout the evening. Most of my most violent episodes have happened in my sleep and woke me up...and I can tell you, they were NOT PAC's or PVC's...more like afib or vtach! They have caught my heart rate at it's highest at 160+ at 3:00 in the morning when I was sound asleep...I never knew it until they told me...can you imagine what that crazy thing has to do to actually wake me up??? I used to think I was a hypochondriac, but now I am just upset that no one will listen and no one will fix it. It is not anxiety...it is my heart...if I didn't have this problem, I wouldn't have anxiety. I am upset that my quality of life has diminished so much. I honestly don't think they know what to do with patients like us so they put it in our heads that we are anxious and high-strung...that's bull b/c I've always been high-strung, but didn't always feel heart palpitations, dizziness, hot flashes, nausea, and whatever other symptoms want to manifest during any given episode. I'm sorry you're going through this too...but know you are not alone...your fellow sufferers are out there. It does give me some peace to know I'm not alone. Hang in there!

[Ihatepalps2]

Well, I started this post...and I will end it. Got my holter results back. Had 5,600 PACs in the 24 hr period. That (felt like) and sounds like a lot to me. What do you all think? My cardio left me a message on the ans mach. Said he saw NO PVCs ( ive had them in the past) and what he saw is totally, completly absolutly 100 BENIGN..not worrisome in the least..not even worth medicating for, but..he forgot--he IS medicating me..im on Metoprolol and Enalapril..but mostly for blood pressure. So..he said, (and I quote) " try to go about your life-some people feel these PACs...and you are one of them. Try to keep busy (yea, right) and try to not let them bother you (yea, right). "  Sooooooo. I know..that what he got on the monitor was NOT what I experienced on Sunday night, the night they were so bad that they kept me from sleeping. SO...whats a girl to do?? Ive had my regular Dr at my physical tell me he was not concerned, and now, my cardiologist. WHy am I still concerned???? Am I a hypochondriac?? I am already dreading my next episode!! Cause I know its lurking out there!
That is SO wrong!!!
I shouldnt be doing that, or I will bring them on. I am so confused.....
I should be relieved, but...why am I not?
Any thoughts fellow sufferers?

[jkfrench]

That happened to me the last time too.  Back in February when I had the first monitor on, it was skipping like crazy all morning.  I was so glad that it caught everything.  Then around 2pm that day, they just stopped or slowed way down.  I took the monitor back and they called me and told me it wasn't working properly and I had to go back.  Crap...it missed all that good stuff in the morning.   So of course, I go back and got hooked up again but they had remained settlted down.  The doctor called me the next day and told me I had 14 pvcs and 4 pacs.!  Now he knows I can get more because 2 years ago they were also at their worst and it recorded hundreds.  I am sure that what they aren't seeing is exactly what they are seeing.  You know what I mean?   You are just having more than you did prior to taking the holter off but they are all still benign pvcs and pacs.    They just can be scary because there are so many sensations linked to this specific arrythmia.  Hang in there.  Yes it can be a mind game, but hopefully you will get the reassurance you need to help settle them down a bit.  That is the case with me.  If they start acting out of the "norm" I see the doctor, get the holter and then get reassurance.
Oh, I decided to not take the Lexapro.  I just don't think I need it.  Cardio agreed.  

Jodie

[Ihatepalps2]

Well, the monitor is off. And would you believe ( im sure most of you would) that from about 3:00 yesterday till 9am this morning, I would have to say I had a perfectly NORMAL rhythm?? I could about scream!! It automatically shut off today around 8:30am...and I took it off..and as I was walking back to my desk--the palpitations started up! Are they mental then? I have the monitor off, and they come back? Since then, ( its now 1pm) Ive had some..less than yesterday, but more than last night. I just cant believe it. What they arent seeing, is what Im having right now! Grrrrr!!! I take it back tonight after work, so I would hope I would get the results this week yet. I will let you know.

[yarrow]

Interesting.

[jkfrench]

I also have a perscription for Xanax.  I've used it a few times.  It is only .025mg and I break them in half.  I am just so sensitive to medicine that I'm always afraid to try something.  I'm very small to begin with and usually I take pediatric doses of things.  Perfect example is the 1/4 of the atenolol I take.  That usually does the trick.  If I notice my heart acting up, then I just take another 1/4.  Regardless my doctor says it is a homopathic dose.
I think Celexa is the same as Lexapro as far as side effects.  When I google Lexapro and Atril fibrillation the same page comes up as when I google Celexa or Citalopram and A-fib
http://doublecheckmd.com/EffectsDetail.do?dname=Celexa&sid=11806&eid=4417
I don't have Afib either and I don't want to add it to the list.  
So I have a call in to my cardiologist and I'll let you know.  I just bet, he will say no to taking it.
Ask your doctor too when they call you with your holter results.

[Ihatepalps2]

Hmmm..I dont really know if Celexa is in that same family. I havent really researched it much, and I usually do that. Just havent had time. I would be REALLLLLY interested to know what your Dr says about the drug and Afib. I dont have Afib, but I do have rhythm issues for sure, so I sure dont want to be taking anything like that  if it can disturb the very few normal rhythm days I have! Please let me know what your cardio says....
I take Xanax now, thats not a long term med tho. But it does nothing to my heart, so Im safe for short term anxiety....I still have the Celexa on my dresser...I know some would say thats dumb...but...I have to check things out further first.

[jkfrench]

Is Lexapro in the same family as citalopram  (Celexa)?
I just keep reading things about these drugs causing A-fib.  I'm trying to figure it all out.
Don't yell at me Yarrow and don't copy and paste some of what I say prior to responding.  I know you are just trying to help but I am not stupid and I realize all of what you are saying.  
Everyone is different, however I know myself better than anoyone and I am not depressed.  So whether this is the drug for me or not, I don't know.  I'm going to call my cardiologist and run it by him.  You make some valid points.  But, I will not take the chance of going into A-fib so I need to research this a little more.  Maybe there are other anti anxiety meds that are safer.  
Jodie

[Ihatepalps2]

Wellll...I have the holter on. And..I AM having some palps...but nothing like the other night. (of course). And Im trying....to get some to happen! Cleaned the house...up & down basement steps, but...theres just no way to know what set off my rough night the other night. So, I will see what this thing shows when I take it back tomorrow. Its just a 24 hour monitor...and unless they see something serious, I probably wont hear from them till...maybe Friday, or next week.
To IMFletcher..that sounds like a horrible night!! I have them too, that feel as if they are in my throat---how weird is that?
After reading some of the posts, Im thinking seriously of starting the Citalopram that the Dr prescribed---like yarrow suggested, I think I will start maybe by cutting it in half...starting slow.
I will wait to see what this monitor says though.

[Madge270]

I used to take Zoloft (for two years), which is a PPI like Lexapro. But it never stopped the adrenalin rushes that caused my anxiety. It did, however, make me less tired, so I continued to take it so I had more energy at work. But  continued to get adrenalin rushes (internal shaky feelings that for me means anxiety) and eventually hand tremors.  When the tremors begain, the doc had me slowly taper off the Zoloft.

In an effort to control the anxiety (internal shakiness and "adrenalin rushes" that I sometimes get, I went to a different doctor (neurologist) who said he felt that PPIs (proton pump inhibitors like Zoloft, Paxil, Effexor and Lexapro)  can help people with depression. But he said they didn't do all that much for anxiety. So he had me try Xanax (valium family). But it didn't last long enough. Then he had me try clonazepam, just at bedtime. That lasts longer. I found it helped me sleep well. I still have some anxiety during the day, but not every day, and the anxiety is better controlled.  I still take clonazepam at bedtime.
The bad thing is that xanax and clonazepam are addictive. But I feel better taking it.

But that's just me, and everyone's different. You might follow yarrow's suggestion of trying just a smaller dose of the Lexapro and seeing whether it makes a difference. (I think you need to take it for several weeks before it starts to work well, though.  Check with your doctor on that, and how to do this.)

[IMFletcher]

Last night - 3am - woke up after "dreaming" I was having a bad run of pvcs...that's right - I was aware of them before I woke up!! Sure enough I was in fact having an episode...brutal. I counted close to 20 a minute, they were coming almost every 2nd or 3rd beat.. I had to get up, get some water, and pace around...miraculously, they subsided after about 30 minutes, and I was able to calm myself to fall asleep by 6am, only to be woken at 7am by my alarm!!...So I am now unrested, and will expect another episode is looming in the near future. I was given metroprolol to take "when needed", but I tried once, and there was no success in breaking an episode of PVCs...I am really hesitant to take any medications, but like you guys, the anxiety consumes me at times, and I am confident my own mind is exacerbating the pvc problem. I am not sure if my pvcs last night were the result of hyper focus in my subconscious, or perhaps they just woke me because an episode started due to my low resting heart rate. Either way, I can't understand why I was "pvc free" for weeks, and have now had 3 episodes in the last 48 hours!! This really is terrible!

[dmacd74]

This is such a good thread.  Yarrow, you are correct and I like your approach.  I have Lexapro sitting in my kitchen waiting for a decision from me.  My doctor prescribed it a couple of weeks ago.  He sat me down and said, "Ok Debra, enough of this anxiety.  You have a recurring anxiety disorder that you medicate with an occasional Klonopin, why don't we treat your anxiety every day so that you don't need a drug that is addicting.  This approach is not working".  I know he is right.  He thinks the Lexapro is safer and keeps the anxiety at bay all the time.  He thinks anxiety is accumulative, layering on itself all day.  I know it contributes to my pvcs.  I think I am going to start it tonight and just watch my weight very closely.  Doctor thinks that if I control the anxiety every day, I will have fewer pvcs.  I can get up to 17K per day.  I have had an anxiety disorder since I was a kid, but it was just discovered because I am a 'trooper" and try to gloss over everything (yes, I am in therapy- have been for years).  Debbie

[rilesnic]

I'm just commenting so I can keep watch on this one....it sounds as if I wrote the main post myself.

[IMFletcher]

I just went through a brutal episode last afternoon/evening...lasted for 4-5 hours, and the sensations kept changing...flip flops, thumps, hard beats...even feeling a series of 10 beats in a row in my throat?!? Were they all PVCs? PACs?...Then the anxiety mounts, and I start wondering if this is THE EPISODE that will never end...Interesting about the recordings from your ECG with your cardiologist today - Sometimes I think our mind can play a few sinister tricks on us, making the sensations worse, more pronounced and more inconsistent. I had to put on my game face for a huge family dinner last night, masking the fact that I was sure I was going down for the count...Past reassurance seems futile when your symptoms are suddenly different. I think our hypersensitivity enhances the problem, and we "feel" things that aren't necessarily abnormal. Not to question the severity of your symptoms, but when PVCs dominate your thoughts, every beat is a new challenge...You sound like you have had all the necessary tests, on several occasions. I am confident that this episode will pass, and you have absolutely noting to be concerned about - except for figuring out new coping techniques!! Trust me, I could use a few myself. I know exactly how you feel! Good luck!!

[yarrow]

"Ugh...I'm so scared to try this.  What if it makes my anxiety worse?  What if I gain weight? "

What if?  How will you know unless you try it?

If you're really frightened of the drug, start out with a quarter of a pill for a week, and then move up to a half.  There's no harm in sneaking up on it, though you might not feel much change if the dose is too low at the outset. If you decide to go that route, let the doc's office know.

In any case, you should be in close contact with any doctor who prescribes a psych drug, just so that if an untoward symptom shows up (like a slight but temporary increase in anxiety or uneasiness--not uncommon), you can call and find out how long it lasts and how to handle it.  A small dose of Ativan is often briefly prescribed to get you over the hump, so to speak.

If, after a month, you're not feeling better, you call again and report that.  The doc can make adjustments to your dosage or try another med (I had to go through four, at least, to find the best one, but I did it over a period of years).  

As to the weight gain possibility, fatness doesn't happen overnight.  Watch the scale, and if after a couple of weeks, you find the fat accumulating, call the doc back and get advice.

There isn't much downside to this approach, and if Lexapro turns out to be right for you, you might just have full nights of pleasant sleep, and a lot more fun during your days.

[Ihatepalps2]

Well, I got my call from the cardiologist. He left a message. He asked if I was having the same palps as last night when I was having the EKG.He said he saw a few PACs...thats it. He asked that I call him back with my answer. I did, right away. A big NO. What I had last night was NOT what I had in the office of course. So, they called me back, and ..its back on the 24 hr Holter monitor first thing tomorrow morning. Thats good. I wanted that. It was only 10 months ago, that I had it on the last time. Oh well. Now, what do you want to bet, that tomorrow I have a very palp free day? Im gonna do everything I can (within reason!) to make them happen.
Jodie... i had the same  thing just happen to me at my yearly physical at my regular Dr. I told him ALL the about the big increase over the past year in the palps..the frequency, the strength...the .. total misery.
He writes me a prescription for Citalopram...antidepressant. Now, I KNOW I am depressed, and Ive had GAD for a very long time. So, I understand where hes coming from, but mine too, is sitting, filled, but untouched on my dresser...some of the same fears. im afraid to take it. I asked the pharmacist ( as I do for every new drug I take) if it has any affect on the heart rhythm, and he says..ahh...well, yes it could. Well, right then and there for me, even tho my own Dr prescribed it...that did me in. Im afraid to take it, afraid it will bring on these nightmarish things.
So...lm with you. What do I do...take it, or leave it. UGH. These darn palpitations are running (and ruining!) my life!!!!

[jkfrench]

Yes, I have had nights like that.  Fortunately the worst night of my life was when I had the monitor on.  I thought I had thousands.  Well, I had 288 so maybe you are like me and just think you feel so many because they come in clusters.  Like several in a minute but then a few minutes without and so on.   I hope the doctor calls you soon because I"m sure you are fine and that will help you once you hear it from him.
I'm starting to believe there is something to what yarrow is trying to tell us.  I saw a wonderful new doctor at a private practice last week.  She is extremely well known and studied at Stanford.   We reviewed all of my records.  She went over everything with me.  Told me I was healthy as a horse.  Dismissed my pvcs.  Yet, I kept wanting to go back and talk about it.  Finally she said, if you feel as if you need reassurance every few minutes about these, then we aren't treating your problem correctly.  She walked out of her office and came in with 6 months worth of Lexapro.   HA....She told me that this could possibly be my solution.  I need to treat the anxiety over these palps.  Doesn't mean they will go away completely, but how I think about them will help decrease them.  Now, I really don't think I have anxiety.  Funny, I started asking my friends, and they said, well you aren't an anxious person but when you are having a problem with your heart, you do panic..  Plus this doctor told me I don't have to have the standard label of GAD but if I'm constantly having to be reassured then there is a small problem.
Anyway, of course the pills are sitting on my dresser.  I'm supposed to break the 10mg in half.
Ugh...I'm so scared to try this.  What if it makes my anxiety worse?  What if I gain weight?
She told me that this particular drug seems to work best for women AND it also has been recently discovered it helps during menopause with night sweats and mood swings.
So....is this the answer???????
Jodie

[itdood]

I was getting nighttime episodes for 8 months straight.  I avereaged about 2-3hours of broken sleep per night.  It was a blast!  

I went to the cardiologist during one of the events and they caught some crazy PVCs.  These QRS waves were so large they barely fit on the chart and made the other normal QRS waves look so tiny they were hard to see.  These things were gigantic and the duration was 4 times llonger than a normal QRS.  Well holy crap!!!  yea I'm going to feel that!!

I remember the nursers walking out without saying a word to me.  I scared the nurses!!  The cardiologist walked right in, no delay.

Anways, long story short that was about 2 years ago and I'm still alive, feel fine, no damage.  I once tried taking some extra strength Maalox based on a suggestion and I swear it would help.  I think perhaps it was the magnesium in the Maalox.

[Ihatepalps2]

I felt uneasy about last night...so I called the cardiologist. They asked if I was still having them this morning...I said yes, but not as strong as last night. She had me come over for an EKG...I did. The technician/nurse said she didnt see anything real bad, but that she would have the Dr take a look and someone would call me. Thats been several hours. I wish I wouldve gotten the ones from last night!! They couldnt mistake those for anything else. Im laying there, with the EKG going..I can feel the palps..I say, well, you are gettin some good ones..she said..I am? I said, you mean you dont see those!?! She said, well, I see a few................... GRRR! I am NOT imagining them! She did say they did get some. Now Im just waiting for a call...who knows when they will call me.

[yarrow]

Sure, I used to have nights like this, in spite of the fact that extensive and repeated testing showed my heart to be healthy.

Finally, I took myself to a good shrink to discuss treating the anxiety about the ectopic beats.  That was the real problem.  The next step was to follow his advice.