Premature Atrial Contractions

[Juniperbear]

Hi,
I guess after 20+ years of having what I have always called palpitations the past six months have been worse.  I started having them every day about six months ago, and having what I would call cluster or many happening at one time.  This needless to say had set me off to worry that something more was wrong.
I carried a haltor monitor for 24 hours, had an Echocardiogram, they also did a stress test on me.  No heart disease was found, arteries were clear.  The stress test show all "normal" activity.  I lasted about 5 minutes of the test and my heart rate reached 171.
I have Asthma and take Advair Disk 250 mg per day, I carry a ventolin inhaler but never really use it.  I take reactince about 9 months out of the year a couple times a week.

I'm so worried that I'm going to have a heart attack.  They just never seem to settle down some days are good some more frequent.  I have completely cut out caffeine, chocolate and all stimulants, I don't drink or smoke.  

Last week when I felt the "Cluster Palpitations" happening I also got very dizzy and thought I would pass out but did not.

So do I need to worry??

Janice B.

[Juniperbear]

Hi,

Thanks very much for your respnse.  I was thinking for sure the Advair would be one of the stimulants, but the doctors were saying they didn't think so....but I believe all the asthma meds do irritate.

I am working hard on ignoring them I think it's because last week it was accompanied by a feeling of a bad dizzy spell that I thought it might be something else.

I also have issues with low blood pressure and did not know if at the time that had dropped.

I appreciate the feedback.

Thanks

[Juniperbear]

Hi,
Thanks for your response.  Yes there are physical issues which are weight related.  I like many need to lose weight and that is probably why they took that in to consideration.  I have been working hard since November to get it downa and I've lost 14 lbs already.  '

This increase in PAC's has helped me realize the urgent need to get in shape.

I agreee I would like to where for monitor for a longer period than 24 hours, although I bet now they would be able to record a lot in that time period.

Again Thanks.

[is_something_wrong]

Hello,

Premature atrial contractions (PACs) are without doubt the most benign cardiac arrhythmia in the book. We all have them, a few of us notice them, and they can greatly flare up with stress, exercise, anxiety, almost everything that affects the heart, and in your case, asthma meds are great triggers for PACs. They are often beta receptor agonists (opposite of beta receptor antagonists, also known as beta blockers, a treatment for PACs). Advair is a beta2 agonist, but don't stop using it!! Just be aware that it may increase the PACs.

They often cluster up (that's what I feel daily, I've suffered from PACs for a couple of years). I know they are related to stress, but it's not always easy to notice the stress levels we have. Often they gather up at night before sleep after a stressful day when your mind is still working overtime.

PACs aren't related to blocked arteries or heart attacks (please read the cardiologist's answer to this question from yesterday at the expert forum). PVCs can in rare cases be related to this, but not PACs. But PACs are definitely more sensitive to adrenaline than PVCs are, so in almost all cases, non-cardiac triggers causes the PACs.

You can relax. PACs are normal and you've been carefully examined by qualified doctors. There really aren't so much more testing you can do. An EP study is really overkill in diagnosing PACs unless you have several ten thousands a day.

The best cure is to not worry. Pay no attention to your PACs and most important, don't be afraid of them. They aren't more dangerous to you than ordinary heart beats.

[Jerry_NJ]

Concern and seeking "the" answer(s), yes, worry, No.

A HR of 171 after 5 minutes on the tread mill, walking on a low slope I assume, indicates either heart or physical condition issues in my mind.  You didn't mention you physical condition:  weight, and level of normal physical active, a.k.a. exercise. I am not asking that you disclose any personal information but offer what I think in general.  

I have permanent Atrial Fibrillation and take both beta and calcium channel blockers to lower my (ventricle) HR.  That being the case I can walk at a good pace, say 3.5+ miles per hour and if the ground is level I think my HR doesn't go past 130.  Hills are speed walking are not in my range any longer, albeit I was still running up to 3 years ago when I went into AFib.  Not to make this about me, just trying to give some basis for my comments and guesses.

From what I understand in your post you wore a monitor, but nothing happened when you were wearing it, thus nothing was found.  You may need to wear a long term monitor, one that is wore for a few weeks....or until something is recorded.  

Back to my first offering, worry, no that makes the problem worse.  If you have not been a regular exercise type, here I mean just some purposeful walking would qualify, you may want to consider trying that.   Start slow, keep you pulse under 0.8(220-age) i.e., if you are 50 the number would be 136 for a maximum exercise HR.  If you have other medical advice, please follow that advice.  I, thankfully, do not have any personal experience with asthma.