Hopefully, you have seen a doctor and been told your palpitations are benign.
That said, palpitations may consist of a variety of premature beats, originating in the atrium (top of the heart), or the ventricles (bottom of your heart).
The kind that originate on the top are PACs, on the bottom are PVCs. PACs are usually not felt very strongly, just king of extra beats. Some PVCs can be the same way, they are known as interpolated PVCs, again, just rather like an extra beat. The other types of PVCs, which are very common, produce a pause in your heart rhythm, known as a compensatory pause. Since during this slight pause, the heart fills with more blood than usual, when the heart beats again, you feel a thud as the extra blood is pushed out.
If you've been examined by a doctor, told that you have a healthy heart, none of these extra beats is harmful, i.e., they are benign. You may be used to the heart beat with the pause and thud, and may now be experiencing a PAC or Interpolated PVC, I get all three kinds at different times, sometimes PACs and PVCs mixed together.
The links below show you what these different premature beats look like on an EKG. Hope this helps.
OK, so one of the things I see here is how the complexity of a problem can make it more difficult to deal with. Its one thing if you're the sort of person that can accept a doctors explanation, based on the fact that he's the doc and nothing else. But if you are the type of person that has to analyze until you understand it, like me, then it takes time. When I find people like me that are struggling, I try to tell them to be less like me. ( It takes me forever to get comfortable with things. I simply dont know enough, and it takes that long to find out enough information until I get comfortable).
Then I go about my own business as usual and analyze everything to death, basically ignoring the advice I just gave to someone else.
OK, so when I analyze something, I dont get too excited about it until I am finished, at least now. But when I first started on finding out about all of this cardiac stuff, I was totally weirded out about it all. Every time I didn't understand something I got excited about it because it seemed like I would never understand it. I think that the reason I am able to relax about it now, even when I get bad news, is that I have been through the information gathering phase, and at least have a reasonable perspective on some of the more difficult technical matters that underlie some of this stuff. Having a good understanding of the subject matter, in my opinion, results naturally in a more realistic, more healthy perspective and attitude, which allows me to relax.
OK so its not that hard. As I see it, the reasons some beats feel stonger than others has to do with the force placed on the heart and some of the surrounding structures when the heart beats badly. Why would two beats feel differently? Well, first, there is the question of how much of the heart muscle is involved in the rogue beat. If the circuit is a small loop at the bottom of the heart and only involves the fascicullar system, and other things are held constant, the beat might feel relatively light as compared with the situation that the entire left ventricle contracts in response to a backward flowing electrical current for instance. Surely, if an ectopic beats originate in different places on the heart (you have more than one point on the heart the creates a simple PVC), those are going to feel different for this reason.
Second, there is timing and the affect on cardiac output. Lets say that you have only one point of ectopy, but the rogue beat decides to occur at different times within the cardiac cycle. One case might be more likely to drive the flow of blood backward, which you would surely feel, whereas another timing might not have much of an effect at all.
Third, there is the affect of drugs, stress hormones, the state of your nervous system, the affect of your brain on your nervous system, the amount of caffeine you've had, and a whole pile of other stuff, that can affect whether you have more or less rogue beats, how strong they feel, and so on.
Now, when I was still young enough to brave surfing in the ocean, I at times went surfing alone. When I was alone, not knowing what was in the water beneath me, I imagined all sorts of creepy creatures down in there nibbling on my feet and chasing after me. If I had been with someone i would never have bought this ridiculous point of view. True what's in deep water underneath you is a scarey thought, but it is just water and fish after all.....
Likewise, with the topic of heart rhythms being as complicated as it is, it is surely understandable how as arrhythmia patients, we can freek out, and it been my experience that many many people do. There is also a certain aspect of feeling alone with this. Just keep in mind that you are definitely in good company here.
One other thing I didn't quite connect the dots on. In the area of heart rhythms, unlike some other areas of medicine, medical treatments have advanced pretty well in the last 20 years. In fact there are darn few things that can not be detected and addressed through some reasonable strategy that has a favorable end point. The issues addressed range in complexity from simple PVC's to full blown polymorphic VT's.
My point is you really dont have anything to worry about. See your doctor and get the testing. Medicine will pretty much take care of the rest.
Have you ever heard of Occam's Razor.
"It states that among competing hypotheses, the one with the fewest assumptions should be selected."
Bottom line, after the exegesis on various aspects, that it could be the difference between compensated PVCs and Interpolated PVCs or PACs.
Ok artaud, thank you for the helpful criticism. In my simple way of thinking, when I troubleshoot I propose numerous hypothesis, and then eliminate them until I have one that fits. As a part of building up the tree though, I first collect ideas until I have my initial tree. I then use the idea of choosing the "most likely" to delve into (or test) first, and as a rule, I tend to rule out multiple contributing problems for initial investigation. For instance, a failure in which two separate systems failed at the same time. This is something I learned while working in aviation, and I assume that whoever taught me the concept must have had the advantage of knowing Occam's razor.
I dont know that I considered interpolation specifically, but in my way of thinking, this would be added to the tree at this point under timing. I did read about interpolation, and entrainment, and find both concepts helpful if reading literature in the electrophysiology realm. Specifically, I read about fascicular VT, and the idea of entrainment helped me to understand. This was scarey at first too.
I suppose this all makes sense, somehow. That is, it is only just that a person who surfs should think like this. If you worked in southern california, and were in aerospace when it was king, you might have adopted this approach.
But sometime before i was as old as I am, I also mentally compared windshear and waves too. These two aspects of nature are very scarey, especially if you are without equipment that "looks ahead" and steers clear of trouble (experienced surfers look out over the ocean before they get in, a tip I learned the hard way).
My views are much simpler, largely limiting my comments to my experience, and in all cases urging people that have not already done so to consult with a doctor. Having experienced benign premature beats for nearly 40 years, I have indeed agonized with concerns and received many tests. My main dysfunction is PVCs with pauses, 40 years of pause thump, etc. PACs threw me for a loop, as they do not create the thump. There is no pause. I was surprised to learn one day of interpolated PVCs, they too occur without the pause.
Subjectively, PACs and Interpolated PVCs are less disturbing, when coming in limited numbers, isolated, if you will. Yet to someone accustomed to experiencing pause thump, they represented a departure from norm that concerns me.
If I have learned anything about my studies into benign rhythm issues, there are physicians that say one thing about them, and physicians that say something else, the loss of reassurance is but a hyperlink click away.
Perhaps you can offer me suggestions on the selection of a Beta Blocker, I was surprised when the E.P. said that Atenolol was a weak Beta Blocker. Eliminating Sotaolol, as for my situation it would not be warranted, which others are considered stronger? Adrenaline is and has always been an easy trigger for my PVCs, there has to be something that more thoroughly blocks the effects of adrenaline. I can remember meetings at work, over the years, where my heart was plagued with PVCs, and even presently, news stories that cause me strife will send it into frequent PVCs. This makes my problem worse from the vantage that once my ability to ignore the PVCs on a day to day basis has been worn down, the adrenaline starts to flow and the problem becomes self feeding.