Does anyone know what this is??

I hate to keep asking questions...I am sorry but I have a new thing that is happening for the last week or so. If anyone has read my older posts they know that I have been having rate issues. Well now I have this crazy thing kind of like a pvc except that I will have three or four fast beats then a pause then a hard beat(not two in a row like a pvc) then three or four slow beats. This goes on for hours at a time. Does anyone have a clue what this is and why my pacemaker wouldn't step in during the pause?? I am beyond frustrated at this point and don't go back to the doctor for three more weeks!

12 Comments

??

by wenditt - 2010-01-29 07:01:51

I don't know but if you find out let me know! I have the same thing and no one seems to tell me what it is!

Good luck-
W

I get those!!!!

by FirstDuely - 2010-01-29 07:01:54

Mine beats normally, then pauses and then a hard beat, then repeats after a few more beats, then sometimes continues on for awhile and the does it again.
I am taking extra magnesium in the form of magnesium citrate (because it dissolves with higher % of Mg) along with some (it varies) added potassium.
This, I believe, helps reduce these "episodes" but I cannot swear to it. Reason to do this? Both elements (I'm a retired chemistry teacher) help the electrical system of the heart by improving conduction, or at least this is what I read in the literature I've read.
This is only my opinion and you will have to evaluate whether this is an option for you or not. I am only offering my own ideas based on what I have done to "fix" this problem. It is annoying to say the least.
Your doctor can make adjustments. Mine will be doing the same the next time I see him (March)
Hope this helps....and get some exercise. While exercising there are no "pre-beats" thankfully.

Same here

by sln - 2010-01-29 08:01:53

I get the same pattern as FirstDuely (sorry, don't know your actual name!) with the pause then hard beat every 4-5 beats, but it appears to happen only when the PM is working (based on my heartrate always being exactly 80 when I experience this.) The device rep explained to me that it is due to some irritability of the heart during pacing, and is harmless, but I'll be asking my EP more about it at the next visit, also. It is pretty uncomfortable at times.

Get this checked

by tsimbrow - 2010-01-29 11:01:29

Hi,
My post is going to be very short. I get the exact same thing as you and my doctor has finally caught it on both the monitor and on an EKG. I have been told that it is bigeminy. Basically it means that your heart is throwing in an extra beat. I don't know why, but if it is going on for hours, you need to get this checked out sooner rather than later because the other thing it could be is a-fib and that can be dangerous. I have both bigeminy and what they call slow a-fib. I have just been diagnosed with the a-fib. I actually am on an event recorder now to try to figure out why and where this is coming from. You need to speak with your doctor ASAP and see if they can do a Holter or something to try to catch the rhythm so that they know what you are dealing with. If you get this again over the weekend, get into an ER and get an EKG ASAP. This could end up being harmless, but until you and they know for sure it's better to be safe than sorry. Read the last part of the comment from Cabg Patch. There is a lot of truth to what they say about a premature beat triggering a longer lasting arrhythmia. This is more common in people with pre existing heart conditions and it happened to me. I ignored the symptoms for a while until it got so bad that I started fainting. Get it checked OK?

Arrhythmia

by Nim Rod - 2010-01-30 02:01:00

A heart beat of this type is called arrhythmia. An arrhythmia is a change in the rhythm of your heartbeat. When the heart beats too fast, it's called tachycardia. When it beats too slow, it's called bradycardia. An arrhythmia can also mean that your heart beats irregularly (skips a beat or has an extra beat). At some time or another, most people have felt their heart race or skip a beat. They usually are not a cause for alarm. Arrhythmias that occur more often or cause symptoms may be more serious and need to be discussed with your doctor.

Need to talk to an M.D

by tsimbrow - 2010-01-30 05:01:15

Hey,
After all of that, I agree that you need to find a way to relax, but I do understand what you are feeling. I get the same and my doctor has said that sometimes it's bigeminy trigeminy and relaxing can help, but not always. a-fib can be another problem this is why I am now going to say to you that eventhough everyone's advise is great, seeing your own doctor is even better so that you know what is really going on and if it is a problem they can treat it.
I'm going to say again, as a nurse if this is something different and unlike anything else you have experienced, like you said, you need to see your M.D. Playing with your meds is not the best idea. It can in some cases make things worse. Atenolol is not a drug that you should be taking more than prescribed.
As a nurse and I have using this card, you need to see an M.D soon. Try relaxing if you can, but if this is different from your usual and unlike anything you have experienced you need to go to the ER especially if it is going on for hours. One question which is what helped me figure this out, does the rhythm change with movement, better or worse?

to tsimbrow

by nat36 - 2010-01-30 06:01:40

You asked if it gets better when I move around. The answer is that most of the time no it does not help. I usually notice it when I am doing something and start to feel funny, so I sit down for a minute. Then when that does not work I try getting up and walking around. Most of the time nothing stops it until it wants to stop. I have noticed that walking alot or any form of mild exercise seems to bring it on.
When I was not able to get in with my EP early I called and made an appt with my gp but it is not until next Friday. I may see if my regular cardio doc can see me sooner or may end up in the ER like you said. So far today I had not had it again. Thank you!

I agree

by ElectricFrank - 2010-01-30 08:01:15

Your sense of something being different is very important especially after an ablation. The ablation destroys heart tissue with the idea of eliminating the offending area that is causing the problem. Even if done well by a skilled EP there is no way of being 100% sure that it won't alter the intricate conduction paths in a way that will cause a new problem.

I had an experience a couple of years ago where I was skipping beats, but it didn't feel the same as pvc's. I hooked my self up on my ECG and found that the pacer was losing capture for as many as 4 beats at a time. I could see the pacer sending ventricle spikes, but my heart wasn't responding. My sense of it was right..it was different and seriously so. I didn't even try to drive to ER and called 911 for a ride. Fortunately it only required turning up the pacing voltage a bit to correct the problem.

By the way I have experienced the 10,000/day routine and they sure keep your attention.

best of luck with it,

frank

ER

by tsimbrow - 2010-01-30 08:01:41

OK, I know you just left a comment on my post and you are not going to like what I say, but if it gets worse with exercise or doesn't make it go away or resting doesn't either you need to have this looked at right away. It's good that you haven't had it today, but it does need to be checked out. Try keeping a diary for the next few days and write down time of when it starts and time of when it stops and what you feel. I know the ER is the "fastest" way to get this checked out, but if you can wait and call the doctor on Monday and see if they can see you sooner you should try that. Did you have an ablation recently?
Your doctor knows you best and if you do need to be in the hospital they will tell you. I'm trying to help you avoid the ER, but if it gets worse and typically I tell patients if it lasts more than and hour you need to go to the ER, but even I can't take my own advise so how can I expect someone else to. If you need to talk more send me a personal message and we can stay in touch.
Taryn

Thank you guys

by nat36 - 2010-01-30 12:01:28

First of all I want to say how grateful that I am to have all of you!! It means so much to know that I have somewhere to go to get answers!! I don't know what I would do without the support.
I am so glad that I am not the only one feeling this!! At least that means I am not just imagining this and that I have not gone totally crazy yet! lol
This could be some form of a pvc like bigeminy or trigeminy however at one point I was having around 10,000 pvc's a day(before the ablation and pacemaker) and some of them in bigeminy and trigeminy pattern. This feels very different and unlike anything I have ever felt. That's why I am at such a loss and why it is so unsettling. You are right Frank that if I get upset I am sure it just makes it worse. I am trying to just relax when this starts but that is difficult. I have tried the magnesium but not with potassium so maybe that will help. I took three atenolol today which I know is more than I should be taking.
Again thank you all for the wonderful support and for making me feel not so alone in this!!

PVC Runs

by ElectricFrank - 2010-01-30 12:01:33

This is a very common type of PVC. On the interrogation report from a pacer checkup they are in a section called PVC Runs. There are labels for the various types. I picked this up off Wikipedia:

"There are four different patterns of premature ventricular contractions. Bigeminy is where one PVC occurs after every normal beat, in an alternating pattern. Trigeminy is where one PVC occurs after every two normal beats. Quadrigeminy is where one PVC occurs after every 3 normal beats of the heart."

Of course there is the dreaded Deadgiminy LOL.

Actually, while they can be uncomfortable, PVC's aren't necessarily an indication of some deeper underlying condition. They are common even in young athletes.

My concern is that some are starting to recommend aggressive treatment of them with Beta Blockers or even worse, ablation. I'm trying to locate the recent study I ran across that found treatment to increase the risk of sudden cardiac arrest.

Emotional upset can cause an increase in their frequency so getting upset about them creates a self fulfilling diagnosis.

best,

frank

extrasystole

by kidd - 2010-01-31 01:01:57

maybe that's a compensantory pause due to ventricular extrasystole. a type of arrythmia. why don't u ask ur doctor?

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At age 20, I will be getting a pacemaker in few weeks along with an SA node ablation. This opportunity may change a five year prognosis into a normal life span! I look forward to being a little old lady with a wicked cane!