I’ll get on this later tonight!
Hey, sorry I took so long!
I was researching your case a bit more! It’s interesting because of your cough, which is likely a vagal response to the ectopy!
It’s hard to say when they will go away on their own! I think these are a unique case given how noticeable they are and how symptomatic you are. Thankfully, this doesn’t make them any more dangerous.
I would say however that you might benefit from an additional visit to wear a longer term 2 week or 1 month monitor as opposed to a 24 hour or a 48 hour, just to be certain that they’re not missing a more sustained superventricular tacharrhythmia.
I think your doctor would be interested in knowing that a cough “sets things right”. Because this brings up a key question; are the PACs causing the cough or is there another arrhythmia that’s being terminated by the cough.
As for your key questions, the summary is:
1. Will they go away on their own?
No one can really predict that, sometimes they do and sometimes they don’t. There’s many causes of superventricular ectopy but one of the more common sources (potentially implicated here) is related to the nervous system. Unfortunately not much can be done. At 1% burden most medications would do more harm than good.
Some patients are able to identify triggers and successfully get rid of ectopy at home. However, literally every persons trigger is going to be different. There really is no “smoking gun” that can work with everyone. Therefore there is really no guarantee whatever remedies you find will work.
I’ve had patients triggered by cold weather, dust, menstral cycles, daylight savings time sleep disturbances, food preservatives, bacterial infections, dehydration etc etc. No kidding, you name it, it can potentially trigger ectopy. Finding a trigger is like finding a 4 leaf clover, you just gotta be lucky in all honesty.
2. Should you be worried?
No, everyone gets ectopics. There are certain situations in which ectopics can be a “clue” that something else is going on but in and of themselves they tend to be pretty benign.
The more important question is WILL you be worried? The answer here is probably yes! Unfortunately you don’t have much control over the anxiety that comes with having a palpitation.
You can go back and request longer monitoring on the basis that the palpitations affiliation with your cough makes you anxious that there may be something missing. Most of the time a provider will oblige if it puts your mind at ease.
However nothing they find, even in this scenario, is likely to be particularly “dangerous”. It just may open up additional treatment options for you if this is uncovered.
Apart from this you can also seek behavioral health services which can perhaps assist in calming you down or give you a medication which can help you get through the day if your symptoms are PARTICULARLY bad.
This isn’t available to everyone with insurance companies and such limiting folks financially. However if feasible I recommend pretty much every heart patient at least have 1 session with that department to determine if there’s anything they can do to assist in a multidisciplinary fashion.
There’s also dieticians which can help identify food triggers (if any) and generally advise for a heart healthy diet in many cases.