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Wondering what these arrhythmias are....thoughts?

Hello all! New to this community. Short (sort of) history. 48YO overweight female. I've had ectopic beats (not sure PVC vs PAC) for over 20 years. They come and go in cycles. They can be gone for months (even over a year), then come back as suddenly as they disappear. 15 years ago, after 2 visits to the ER (of course they stopped before I got there), an Echo, an EKG, a holtor monitor (negative as they had stopped by then), I was told what I was describing were ectopic beats, they were normal and learn to live with the cycles. Which I have. Normal cycles will usually include 5-10 beats an hour during a bad episode. They are definitely triggered by caffeine and adrenaline.

Fast forward to this current episode (which has been ongoing for 4 weeks now). We are currently in the most stressful time of our lives (moving across country, transferring jobs, building a new house and renovating our current house to sell, dealing with loans, etc.), so when they started back up with a vengeance (up to 8 a minute) I chalked it up to the stress (and the caffeine I had been cheating with). I began taking a supplement cocktail of Potassium, Magnesium, CoQ10 and B-Complex (which has helped in the past). Their severity and frequency started to really freak me out, so I also dipped into my Xanax on many nights (diagnosed health related anxiety). The only meds I am on is 5mg Amlodopine and 40mg Benicar for high BP (which is very controlled on the meds) and the Xanax as needed.

Now for the question on the arrhythmias. Over the years, I have had the occassional wacky run of beats (happens 3-4 times a year) where it will seem like a pinball is bouncing around in my heart. It only lasts a few seconds (maybe 5-8). If I had to describe it more, it would be that instead of my heart going "Lub-Dub, Lub-Dub, Lub-Dub", it went "Dip-Dop-Dippity-Dippity-Dop-Dip-Dippity".  I would always cough and it would go away.

With my current flare up of ectopics, I have noticed this same weird rhythm a few times over the last month, but this time instead of it going back to normal, it would start racing afterwards. All three times, it was between 140-155 bpm while racing. It wasn't erractic, skippy, or quivery. It felt like a normal beat, just fast, except for one thing... it felt shallow. Almost as if my heart were only pumping half as hard as usual. Every time it happened, I was able to stop it by blowing into my thumb. I let it go on its own one time to see what would happen and it stopped after about 4 minutes. It also happened the other night when I got into an extremely hot bath immediately after eating. 10 minutes into my bath, I noticed my heart slow down for a few beats, then speed up for a few, then slowed down for a few, then speed up for a few, then it skipped a few times, then it took off racing (only about 120 bmp this time). Again was able to stop it immediately by blowing into my thumb.

I went to my GP and he did an EKG that came back completely normal, blood work all came back spot on. My cholesterol was only 135 (HDL 52, LDL 70, TRI 64). I declined a holtor only because the ectopics had stopped by the time I got to the GP. They have started back up, so I'm waiting on orders to have a holtor put on. He's referring me to a cardiologist to check for AFib and other arrhythmias, but they still haven't called me for an appt.

Has anyone ever experienced anything like this weird rhythm I'm describing? What are your thoughts? Just to add on, I did have what I think was a run of PACs yesterday (which is new). I've had Quadremy before, but never a run. I was feeling my pulse on my wrist to time how far apart my ectopics were when suddenly my pulse stopped in my wrist for a moment and while it was stopped, I felt my heart "tap" in my chest 4 times in a row very rhythmically, then my pulse started back up in my wrist normally again. No hard thud like a PVC usually does, that's why I'm assuming it was a run of PACs. Agree?

Thanks all! I'm trying to not freak out about all these new blips and bleeps and frequent ectopics, but it's hard. I'm not sure the Holtor will pick up anything other than the ectopics as the other things are so far spread apart (7-10 days), so I'd really appreciate your feedback.
1 Responses
20748650 tn?1521032211
You need either a 2 week holter or a 1 month event monitor.

If coughing successfully stops what you are experiencing then,that indicates reentry.

In short you may actually have something going on other then ectopics and anxiety. Its very suspicious.

If you go back in to the doctor, preferably a cardiac electrophysiologist and inform them youve been having episodes of tachycardia that stop when you cough.. Particuarly of these episodes come after ectopy.. Theyll listen.

In terms of severity, no im not saying what you are experiencing is serious. In fact it likely isn't..

What I AM saying however is that your history has some buzzwords that point to a handful of conditions that can be treated.
Telling them your history of quadrigeminy is helpful as well (in addition to the bit about coughing and ectopy).

Patterns of pvc's are always of interest. Bigeminy of course is the big enemy, but quadrigeminy can be an early warning sign for things to come.
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