ISOLATED PACs with low resting heart rate

Keeping in mind that virtually nobody replying to you here is a medical expert or a physician of some description, your number of PACs is relatively low, but it's nearing the point where the literature says you might be playing with morphology of the heart's substrate and further deterioration or a move toward atrial fibrillation (AF). The typical hear runs between 55 and 75 BPM for most adults, with quite a surprising variation. The is at rest, and calm. So, if we take your figure, 68, multiply it by 60 minutes to get the hour-count, and then multiply that product with the 24 hours of a day, we get a total of approximately 98K beats each day. Your recorded result for PACs was 1930...if I understand your statement above. That represents approximately 2% of your daily beats. If this is truly representative of your day.....these days......you have a relatively modest number of PACs for those who are known to have more than the typical 20-50 each day. So, as I said at the outset, you are getting 'up there', nearing the point where the literature I have seen suggests that cardiologists would want to begin talking about a strategy to at least monitor you more often if not talk about an ablation. Many electrophysiologists won't look at you until you are quite beside yourself with how they make you feel, meaning you're quite adversely symptomatic, and averse to continuing as you are doing. Also, that your percentage represents a 'burden' near 3%, but even that varies from EP to EP. Please read this:
https://www.ahajournals.org/doi/10.1161/JAHA.115.002192

@gloaming i read your link and frankly, its scaring the crap out of me 😔
I do have a doc appointment this Friday and im going to ask if he can send me for a cardiologist referral.
I believe my anxiety started this entire fiasco. My anxiety is 80% better and im feeling a lot better.
I just hoping and praying that everything will be ok.

Over the past couple of days...im hardly feeling any pacs at all. What does this mean?
The cause of my anxiety is gone and im feeling a lot better. Can pacs be brought on totally by anxiety and get better or disappear when anxiety is gone? Im still confused by all of this...

@muppet7777
You mentioned to another poster going to cardiologist. May I suggest going to a Electrophysiologist (EP). They are cardiologist specializing in electrical functions of heart. They are the experts in medications, ablations, etc.

I have far more PVCs and VTAC than AFIB and PACs.

This comes from cardiologist and EPs. The primary danger from PACs is strokes. If you are on sustained episodes most will (my experience) prescribed medications like Eliquis (I am on it) which is a blood thinner to help prevent blood clots. They will more closely where your PACs are coming from and if ablation is justified.

@muppet7777
Hay again muppet777. I did not ready this before posting a previous comment. PACs come and go for most but some stay in it (more dangerous for blood clots). Almost everyone will have them. Some feel them some don't. It is the ones who don't feel them and never see a doctor are the most in danger for blood clots and strokes.

You mentioned caused by anxiety? YES! Every single EP, Cardiologist and even my heart failure doctors says YES stress and anxiety can definitely cause PACs, PVCS, AFIB, etc.

The electrical functions of heart is very complex and why I mentioned in another post suggesting seeing a Electrophysiologist.

To combat stress and anxiety my doctors and psychiatric medication specialist all recommend trying to prevent or lesson this episodes through exercise and hobbies. With doctors approval find an exercise you like. It will greatly help reduce adrenaline (fight or fight hormone) which can build up into PACs and PVCs.

If exercise is not something you like to do (and it needs to be something you like doing) consider a hobby. Anything that brings a smile or enjoyment to you will greatly help withe mental side of PACs, PVCs, etc.

Summer is coming which for me means camping and lots of hiking...with the occasional beer. I dont want to be hiking a long trail and my heart go all wonkey on me 😔. Thats why im hoping for a doctor referral to a specialist to get this sorted out for me. In Canada all specialist have to be referred by family doctor, i cant just make an appointment by myself.

@muppet7777 The EP and cardiologist will be most interested in how you feel when you suspect or know you have PACs going on. If you can tolerate them when their numbers are relatively few, then that eliminates any risk inherent in surgery, including catheter ablations. If you can tolerate them, very low anxiety, and you can sleep okay, they may not even try to put you an any drugs. This would be ideal. But if you begin to complain about how awful they are, they will be sympathetic and offer to intervene one way or another. So, while your numbers may be low-to-moderate for the 'burden', if you shrug and say that you're good, they are more likely to just ask to see you again in a year. But..................maybe by June you're advancing and now your burden has doubled, and you KNOW IT! Will either of those two people advance your yearly interview/assessment? Probably not...unless you are on a cancellation list.

I am in BC, so I know about our vaunted Canadian health care spasm.....I mean, system. It is excellent, among the best in the world....if you can get it. Across Canada, an 18 month wait to see an ortho for hip or knee. People working get priority, so the more aged/retirees are told they'll call you, not to call them. I'll say one thing for BC, though...they're cancer and cardiac services are top drawer and quite responsive.

@muppet7777 I don't intent for people to be afraid of what I offer them in the way of information, but......it's hard to argue with research papers if for no other reason that they suggest society and the medical community need to treat the topic more assiduously. Keep in mind that individual cases vary widely, and that this is just a sample of people they followed, some of whom may have had other comorbidities that 'dragged' their results downward.

If I were in your shoes, I would generate, on paper, two or three key questions for your cardiologist with the intention of either allaying your fears or getting him/her to propose a treatment plan that seems reasonable, responsible, and reactive. If, for example, you are deeply anxious about this, and you are already building sleep loss and an increasingly lower quality of life, ask him/her what they can suggest. Ask the person at what burden of PACs/AF they would begin to recommend surgical intervention, or at least a referral to an electrophysiologist (EP). You want to leave the consultation more buoyant, more optimistic, and with some dates or numbers that will allow YOU to compute and to plot your progression through this disorder and any proposed treatment.

Thanks! My health anxiety and overall anxiety drives me crazy. Its been like that my entire life. What i think started this whole Pac fiasco is when my partner planned a month long trip overseas. With our crazy maritime weather, and me living in the "sticks" i worried about storms, loss of power, shoveling the big driveway and of course...partner half way across the world and im here...alone. i was scared something would happen to me, so pacs happened more often. Partner back home now and im not noticing any, or very few. Did i bring this all on myself? Ugh. Im looking forward to my dr appointment friday to see if he can point me in the right direction of having someone to talk to. He's really good that way. Even though 24 hour monitor says BENIGN...i still need to know what i should expect going forward.
Thanks for your reply.

I just had my first beer in over a month...i feel normal again. My anxiety has deterred me from doing something even as meaningless as this. Im tired of letting my anxiety win