what the heck is this??!

[dbranden]

Last December I started having weird fast heartbeats if I woke up during the night. I have a very slow pulse after 2 ablations for IST (around 50 bpm). I would wake up in the middle of the night and get about 20 minute episodes of 5 or six rapid beats and then normal beats, repeating over and over. My EP felt it was atrial tach and dismissed it. I had it about 3 months and then it just stopped happening. Until last Friday night. As soon as I layed down in bed, it started up. I'd get 4, 5  or 6 rapid beats, then anywhere between 4 and 30 normal slow beats, then the rapid beats again. I had it Friday night, Sunday night and last night It happened three separate times during the night. This morning I'm even feeling it sporadically after I'm up and about. I'm scared its A-fib. But it doesn't feel "chaotic"--if anything it feels rather regular. And things I've read about Atrial tach don't really sound like it either, as the rapid beats only last usually about 6 beats. The most I've had is 45 rapid beats in a row. Here is how I would describe it: beat beat beat BEATBEATBEATBEAT beat beat beat beat....   I'm trying to get in to see my EP again for a Holter, but until then, any ideas? Does anyone who has atrial tach get something like this? I'm pretty upset about it as it makes it very hard to sleep.

[is_something_wrong]

One thing I've learned about my PACs is that the setting they occur in changes all the time. Sometimes they occur before sleep. Sometimes after work, sometimes in the car on my way home from work. They can even occur during exercise (that's the worst..)

And sometimes they cluster up, just like you describe.

I have no idea why, I've just learned to accept it (almost..). So should you :)

[dbranden]

Thank you for the quick reply. You made me feel better about it. What I find most odd about it is that when I'm not having these episodes at night, my PVC's and PAC's are much worse during the day, but when I am having these fast beats at night, my PVC's and PAc's feel much less frequent during the day. I guess I'll never figure it all out!

[is_something_wrong]

By definition it's named atrial tach (more than three PACs in a row), but I just say PACs. I have this myself all the time, especially if my heart rate is slow, yet I'm stressed. A classical example is in bed, in the morning, when I think about all I need to do at work today. It's just an extra pacemaker taking over for the sinus node for a short while.

Get a Holter to confirm, but my doctor told me to forget it.

Trust your EP doc. Extremely likely he has given the correct diagnosis.