Palpitations post Covid

I came down with Covid the second week of February. Looking back, the first symptom was a fast heartrate. It felt so strange, I grabbed my little pulse/ox meter. O2 95, HR 100. I'm pacemaker dependent, so a resting HR of 100 gets my attention. It stayed elevated about a minute then went back to the set minimum of 70. The same thing happened 3-4 times over the next several hours.

I woke the next morning definitely feeling unwell, took a Covid test and was positive. I was given Paxlovid. Overall, my symptoms were minimal, except for a definite increase in palpitations.

After a 5-day quarantine, I resumed my usual schedule, but about 3 days later, came down with Covid again. The triage nurse called it "rebound Covid." Overall symptoms were mild chest congestion with cough, and more frequent palpitations.

By the fourth week of February, I was completly recovered from Covid, but the palpitations persisted. I expected them to go away, but they have not, and in fact are slowly getting worse--occurring more frequently and lasting longer.

I'm not freaked out. I've lived with palpitations for years.

Here's my question. I know rhythm disturbances are pretty common with Covid. How long does it take them to go away?


Palpitations post Covid

by Gemita - 2024-03-13 05:13:41

Dear Gotrhythm, I am so very sorry to hear this is still continuing.  To answer your question, we would need to know what the rhythm disturbance present is, how often it is being triggered, how long it lasts and whether there are indications of a continuing cause, other than the lasting affects of Covid?

You really need a holter monitor to give your doctors a better picture of what is going on, especially if some of your disturbances are not being stored by your pacemaker and this can sometimes happen as we all know, particularly if the rhythm disturbance doesn’t meet the criteria set up for its storage and recording, i.e., the rhythm disturbance has to be of a certain speed and duration for it to be recorded and stored.  My atrial ectopic beat counts for example, are not recorded, even though they can be troublesome and come in fast and trigger Atrial Fibrillation episodes.  A holter monitor would pick these up and give doctors an indication of the total burden of atrial ectopic beats.  Ventricular ectopic beats are however counted by my pacemaker.

The question to be answered perhaps is, has Covid triggered worsening palpitations, or caused lasting damage?  You will need a few checks if your palpitations are significant and do not stop, to look perhaps for any signs of residual bacterial infection or inflammation or for other causes, like electrolyte abnormalities, thyroid problems or another health condition?  

In view of your previous pacemaker induced arrhythmia Gotrhythm, I would also recommend making an appointment to go back to the clinic for some additional checks, perhaps even adjustments to your settings, since an illness like Covid can certainly trigger a change in our heart condition which might then require a change in our medication or pacemaker settings to help settle things down.  A holter monitor to identify the rhythm disturbance present, whether it is a regular or an irregular tachycardia, how it stops and starts would be so helpful here.

As you may know, I had Covid before vaccination and developed multi focal atrial tachycardia coming from different sites in the atria caused by a bacterial chest infection during the long course of my illness.  I received several courses of different antibiotics in an attempt to clear the stubborn infection and had to increase my heart medication too for several months to control my palpitations.  

I hope your palpitations settle my friend but you may need a helping hand and a few additional checks to diagnose the rhythm disturbance present?  Different heart rhythms may require different treatments.  If you are having difficult symptoms this may indicate your palpitations are not under control and need treating.


by Penguin - 2024-03-13 05:37:35

Just in case it's relevant, I enclose a link dated January 2024 from Yale University re: Paxlovid.  It's pretty frank and discloses that they don't know everything about the drug and how it might affect people.

There's a further link in the article to drugs which interact with Paxlovid including drugs for cardiac arrhythmia. 

I can't comment on the drug or the re-bound effects of Covid GotRhythm as I wasn't affected in that way when I had it.  I always check the interactions between drugs though and consider what may not be known. 

In your shoes I'd alert my doctor, and follow Gemita's advice above, but I'd wait a little longer before interfering with altered drug doses / extra drugs if it's safe to do so and follow medical advice.  


Maybe Time Will Help

by SeenBetterDays - 2024-03-14 09:01:08

Hi GotRhythm

I'm really sorry you've had such a rough time, first with Covid and then the worsening palpitations.  I know that whenever my body is fighting a viral infection I seem to experience more fluttering and palpitations in my chest.  I wonder if this is a common experience for those of us with electrical problems of the heart.  It wasn't something I used to feel prior to the development of heart block when I was dealing with a virus.  The problem with Covid is there are so many unknowns.  It clearly has cardiac implications for some people but the extent and duration seem pretty difficult to determine with any certainty. 

I would hope that the palpitations would gradually subside over time but it seems strange that they are getting more persistent.  If you don't see any improvement some medical input is probably advisable though you may just be given medication to deal with the symptoms rather than the root cause.  As long as you feel that the palpitations are tolerable I think I would be tempted to give it a little longer and see if they subside.  I think there is so much we have yet to learn about Covid and it's legacy.  I am sending you love and hoping that you get relief from these troublesome symptoms soon.  Sorry I can't be of more help to you GotRhythm.

Covid ruined my life

by DutchyDawg67 - 2024-03-14 23:57:09

I was very active and healthy prior to 2020.  I had Covid before testing was available (Dr's backed into the diagnosis and I also had Covid after testing was available and it was identical to what I had in 2020).  And I've had several doctors make the diagnosis of Long Covid.  

As a result, I now have a pacemaker, sleep with a APAP machine, and spend a lot of time at various clinics trying to figure out what the heck is wrong.  Drs are now saying Post Exertion Malaise, Mitochondrial Dysfunction, Autonomic Dysfunction, etc...  Some days I feel OK.  In fact, at one point I thought Long Covid was over and I was to where I was pre-covid.  But then it rears its ugly head and I go back to feeling crappy.  

One thing that helped me was having Thumper (my pacemaker) adjusted.  The last bout was that my resting heart rate was dropping into the 50's even though my pacemaker was supposed to keep me at 60.  She adjusted a setting (A blank after V pace) for a second time and it made a difference.  This is the second time she had to do this in the past year and my fear is that maybe this will happen a few more times and she won't be able to adjust anymore.  She actually said she cannot do much more with that setting.  I don't know what next steps will be if I continue to need this adjustment.

I was having palpitations too.  Felt like Thumper was doing his self check but it was happening many times per day.  The adjustment made a difference. 

My recommendation is to push them to make sure your settings are correct. I know you've probably heard this a million times.  I had to push my EP and she kept saying everything was fine and would blame my symptoms on the other Long Covid issues.  But I pushed because I started feeling really crappy when my average resting HR dropped below Thumpers base.  I do feel better now that she made the adjustment and my average resting HR is a cool 60 every day.  

Pacemaker Settings

by Gemita - 2024-03-15 05:44:46


I see you have a Boston Scientific pacemaker but I was interested and pleased to hear that a settings adjustment worked so well for you to provide relief from a ?pacemaker mediated arrhythmia?  I believe this setting change would have been related to the Atrial Refractory period in the Boston Scientific pacemaker.  It would be interesting to know exactly what those changes were?

During any illness our meds and settings may need adjusting more frequently to keep up with any changes in our health condition so we mustn't overlook this important fact and ask for help if we need it.

Update: palpitations

by Gotrhythm - 2024-03-18 11:44:49

Thanks for all the replies. This group can always be counted on.

 In the last 3-4 days the palpitations have subsided somewhat. It's still happening but I no longer feel they are increasing in frequency, though they are accompanied by a sudded sharp chest pain occasionally. 

Gemita, you may be onto something with the possible RNRVAS associated PMT. I have an already scheduled pacemaker check coming up this week. When I have had PMT in the past, the symtom that distinguished the PMT was the sudden pain that lasts less than a second. Over time, the frequency doesn't change much, but the episodes are more and more often accumpanied by pain.

DuchyDawg: My pacemaker team are clued in now that RNRVAS is a wrinkle my heart adds to the whole pacemaker adjustment, so hopefully if that's what's going on, it will be easier for them to identify it. But you are so right. If we don't feel fine, we shouldn't accept the old "Your pacemaker is working fine" brush off.

I'm so sorry you're still struggling with long Covid. It's hard, I know.

You know you're wired when...

Titanium is your favorite metal.

Member Quotes

It may be the first time we've felt a normal heart rhythm in a long time, so of course it seems too fast and too strong.