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Postural arrhythmias
My electrophysiologist does not believe that people have worse PACs, etc. when they lie down. He believes people just don’t notice them during their busy day. I’m someone who feels my heart whenever I’m quiet and I have always had increased PACs when lying down. Right now, two months post ablation, my heart is not happy when I’m trying to go to sleep. It pounds or races or I have relentless PACs. I have Atenolol prescribed to take as needed and that helps. But it’s also causing hair loss. Help! I’m very frustrated and discouraged that all this is happening after my double ablation. And I really don’t want to lose my hair. It doesn’t help when my doctor doesn’t believe in postural ectopic beats. Or hair loss.
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My pvc’s are always worse in the evening and at night. I have a Kardia mobile card and I can prove it with ecgs.
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1 ReactionHello,
I am new to the community and have seen a cardiologist at the Mayo Clinic in Jacksonville, FL. I have a loop recorder implanted due to NSVT, so I know when my PVCs are triggered (I feel everything anyway) and can vouch that at night PVCs/PACs can be worse. I wish this were studied more, especially regarding whether it occurs more at night or simply due to body position. I can be fine, but as soon as I lie down, they become very bothersome. There is data on my loop recorder, so at least for some people, this can be true. I also go through phases where I can barely feel any PVCs, and then for months at a time, they are relentless. Nothing I do in my lifestyle has changed to make them flare up or go down, and this is the part that is most frustrating to me. I do not drink caffeine, have been a lifelong athlete and work out every day, eat as healthy as possible, and even my professional life is in health promotion and disease prevention. I take 12.5 mg of metoprolol daily (sometimes 25 mg if they are really flared up, per my doctor), and I am not sure this really helps me any. I take magnesium, C, D, and iron (since I can be anemic) and hydrate well, etc.
I wish there were an answer or solution for those of us who are so bothered by these things. My burden is still around 1 percent on average, so the doctors have not thought an ablation is necessary. When they are in a flare-up, it is higher than that, but it evens out to 1 percent over time.
It is nice to find this page.
@nichammond1978 This gentleman's information might help:
I have had paroxysmal atrial fibrillation since 2003, pill-in-pocket (flecainide) since 2018, average 2.5 episodes a year. In March an episode started that was characterized by posture hypersensitivity, could not recline at all without triggering. I was also hypersensitive to just biting into food sometimes resulting in presyncope. I also started getting IST around 100bpm. I quickly ran out of flecainide and was put on amiodarone until I could be retested (echo, perfusion, no change since 2018). I suspect Roemheld syndrome, or some kind of viral infection, or vagus nerve damage?
You might consider wearable devices to support your concerns . For example the Health app for Apple Watch has a Heart Rate Variability tracking feature which can show data hourly. (I'm not familiar with other wearables but assume they have something similar.) I can review that data in chart form to identify spikes in HRV that are consistent with episodes of ectopics – whether AF or benign – and it has confirmed that for me, lying prone is associated with a high burden of palpitations. Like others have suggested I believe it's related to the Vagus nerve, It must be really frustrating to have your doctor dismiss your very reasonable concerns out of hand. All the best in. getting it resolved. .