Unless I'm missing something, that's a whole lot of tests for what seems to be a pretty minor condition.
Check your heart rate and compare it to your respiration. Does your heart rate go up when you inhale? Slow down when you exhale? That's showing vagal tone, and that's not a bad thing. Some say it's a good thing. Nobody says it's bad.
As for the PVCs and PACs - with the number of tests and ER trips you've had, I'm guessing you're freaking out pretty hard about these, which is almost certainly making them worse.
I'd be interested to get some further details about the sinus arrhythmia diagnosis. For the other findings on the Holter, that's about as clean as you can get - there really shouldn't be a need for worry.
Instead of pursuing heart meds and heart tests, you might ask your family doctor about some anti-anxiety meds. It sounds like that might be something you would benefit from, because the results from your tests don't seem to indicate much of any problem.
For your reference, 3-5 PACs a minute is not something most doctors would treat. Anything less than 6 PVCs a minute and most doctors will pat you on the head and tell you to quit worrying so much. They do this because, absent any structural problems with your heart (which would have been discovered in your tests), there is no need for medical intervention, and some interventions actually carry greater risk than doing nothing at all. Also for your reference - I spent about 10 months in 2006 with 15,000+ PVCs a day - all day, every day. Every 5-6 beats. I'm not on any heart meds, didn't have any surgeries. Just figured out how to reduce my stress level. I would recommend you look into the same.
You're going to be fine.
I with you on the Lyme symptoms. I also have PAC's and PVC's and it didn't all kick up until I started feeling ill. I also deal with chest pain, sometimes centered right over where my heart is, back pain on the left side of my spine, and shortness of breath. It all comes and goes, good days and bad days.
I don't have an "official" Lyme diagnosis, but I have enough positive markers to suggest Lyme and co-infections. At the very least, I have positive markers for EBV and inflammation.
I also fall in the minor PAC/PVC range. On a bad day, maybe I have a 100 that I sense. On a good day, none. They are creepy feeling and there are times that doom-n-gloom is the sensation. As Wisconsin states, we fall in a minor category compared to others on the amount of "skipped" beats. My heart has been tested as structurally fine, so the cardiologists won't take it any further and probably rightfully so.
Lyme and the co-infections associated with it affects nerves and the heart is full of nerves. They say about 10% of chronic Lyme patients have cardiac-related symptoms. It is reasonable to think that the bacteria is affecting the nerve impulses to the heart causing the PAC's/PVC's. The bacteria could also be messing with the vagus nerve. If you search some of the Lyme forums on the Net, such as LymeNet, you will find comments about people having heart symptoms, getting treatment, and having the heart symptoms resolve.
I have taken a natural course with my treatment and seem to be getting better, but I still have off days. This morning was an example as I thought I felt a squeezing in my chest when I woke up for 15 seconds or so and then tachycardia for 5 minutes. Could have been a panic attack. Could have been a spasm. Could have been some hormonal release. Tough to say. Still walking around, so I have to assume it wasn't a major heart issue.
I get tired of the ER too. I had more trips last year and each time nothing was found. Some low potassium at times and my platelets and lymphocytes are generally just below minimum. I try not to stress about it, although easier said than done.
Hang in there and try to kick the Lyme in the butt!
This will sound like it's coming from left field, but hear me out. I would suggest consulting a sleep doctor. You could have underlying sleep apnea contributing to these cardiac symptoms. A full sleep study is non-invasive and from experience I can say well worth the effort. Make sure to have a consult with a sleep medicine specialist who will do a full sleep evaluation and not just a testing site that will test for apnea.
Yes, I am going through the same thing, it's the LYME disease, I was just in the hospital, i am 30 years old, and the lyme disease has now spread to my heart, severe pvc's , im getting a picc line in this week, and they just let me go home from the hospital??? did not even address the lymes( I am seeing a llmd but still they should have addressed this but everyone wants to ignore it????????? Treat the LYMES and the symptoms that started ever since I was diagnosed with lymes that I never had before will subside if the lymes is treated properly. What is wrong with this world? Yes you need to rule out major heart problems which they did for me suprise suprise. I was told I am a mystery in the hospital???? They mystery is my clear diagnosis of lyme disease? not even debateable by the cdc and I had a rash that covered my entire thigh? And now cause I went so long w/out treatment it has now spread to my heart? This world is disgusting, why do we treat TB and other illnesses agressively with long term antibiotics but no one wants to treat lyme disease.