Skipped beats - CAD Blockage?

I have had 11 heart caths and 5 stents since 1997 ... told Dr's for years something was not right ..long story short 2ns heart cath found 95% on top and 100% blockage on heart had gone on for so long it had damaged the heart stopped working at 45. Get tested and make sure you make the Dr. aware that you are aware of false positives in the tests .. you have to be your own advocate

Thank you. I will. How do they determine whether you get a stent vs. CABG?

Hello @md5150, I would like to add my welcome along with @artic22. Here is some information from Mayo Clinic that might be helpful:

"Can heart blockage cause irregular heartbeat? Things that can cause an irregular heartbeat (arrhythmia) include: Current heart attack or scarring from a previous heart attack. Blocked arteries in the heart (coronary artery disease) Changes to the heart's structure, such as from cardiomyopathy." --- Heart arrhythmia - Symptoms and causes - Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/heart-arrhythmia/symptoms-causes/syc-20350668.

@thankful may also have some experience to share with you.

I have two bad heart valves discovered about 18 months ago after a bout of COVVID that I am being monitored for. Believe me, I have had a lot of testing and my arteries are "clean." I have had ECHOS, a stress ECHO, a cardiac MRI, a PET SCAN to look at my arteries, two TEE's, lots of blood work etc. I am 69 years old, eat only fish and lots of veggies and have done so for years. About 3 months ago I started having lots of heart palpations (every 5 to 10 m minutes round the clock). My cardiologist had me wear a heart monitor for two weeks and the results show I am not in AFIB which is the important thing. My rhythm is mostly normal sinus rhythm. My cardiologist is at Cedar's Sinai so I know I am getting the best of care and advice. I was told the next step will be to place me on a beta blocker which will cut down the adrenalin that is probably causing my palpations which are VERY concerning to me. I do not have high blood pressure, and in fact, my blood pressure tends to be on the low side. I am worried about taking a beta blocker and the possible side effects but am willing to try it to see if it will help. Your cardiologist needs to have you wear a heart monitor (they have several advanced ones that are much better than the old Holter Monitors) to find out more about your palpations.

Thank you @johnbishop !

@shunt - I'm actually waiting on the results of the holter. I get those on Thursday with the results of the stress test I took today. My stress test seemed to be OK. I had no chest pain or dizziness and I was even having a conversation with the person giving the test the whole time. I wasn't completely out of breath so I could still talk. My BP was rising normally. I wasn't in any distress other than my legs felt like rubber going in which was due to nerves and dehydration. I asked the nurse if he saw anything abnormal and he said nothing jumped out at him and looked fine, "unofficially". We cranked me up to 150bpms. I got off the treadmill and even had the typical "runners high" when I walked out of there but I felt pretty good. (I walk to 110 bpms when I go to the gym)

I did notice that one of the waves on the screen monitoring my heart rate went into a 'V' shape. It was the only one I noticed but I wasn't focusing on it all the time. I didn't feel any palpatations but the V shape looked off to me. So I'm thinking it was abnormal? I won't know again until Thursday. I'm kinda scared though.

not sure I would guess it's where the blockage is some places they can't put stents I understand .. I was tired all the time ...fluttering in my chest ...short of breath .. etc .. they kept fooh ..foohing it ..

Normal sinus rhythm in people without heart disease or disorders have frequent skipped beats, including repolarizations when there shouldn't be any. If you don't have palpitations, and if a capable device can show you a graphic representation of your heart's activity, you will see gaps, sometimes PACs (premature atrial contractions) and PVCs (Premature ventricular contractions). These, again, are normal, and electrophysiologists won't take a serious look at you until your 'burden' of ectopic beats rises to the 8-10% range. It seems odd, especially when one is uneasy knowing now that one has these ectopic beats, but they are not considered dangerous. Instead, it is tachycardia (ventricular and supraventricular) that require attention and management. Under the umbrella of SVT are flutter and fibrillation. They are not worrisome (except to the 'beneficiary') to the medical community right away, and if the heart rate isn't high, say above 100 BPM. Once the burden rises, or the heart seems content to remain steadfastly at a rate of, say, 115-130, the clinician will want to put you on either rate control or anti-arrhythmic. Virtually never both at the same time.

Blockages are from atherosclerotic plaque. Deposits of cholesterol, usually calcified. They are not caused by arrhythmias, but they MAY CAUSE arrhythmias. I had an angiogram a month prior to my first catheter ablation for the singular purpose of determining that I had no ischemia, or not much of it. Turns out I am good....at 70.

Plaque is caused by diet, often by transfats and other lipids in excessive amounts in the blood. It gets worse, and piles up, where there is scarring or inflammation in the lining of blood vessels. Some fats, like poor quality/rancid linoleic acids (plant lipids) will lead to more arachidonic acid, a precursor of inflammation.

A complicated subject. Does any of this help?

Yes, thank you so much. One thing I love about this forum is the people here explain and understand things and are nice enough to share the info with someone like me who is completely terrified.

So the plaque may cause the arrhythmia, which I understand. I don't really know my "burden" yet because I have not gotten the Holter results back. I do know that in the last few days, there have been fewer skipped beats. although still there. In the morning it's pretty quiet and seems to pick up around noon time when I have my first meal. ( I intermittently fast). I know high carb foods make them worse, so I stick to protein and veggies/fruit. I've lost another 10 lbs but I think that was more from the worry and not eating as opposed to the diet.

What was worrisome to me was I saw a "V" shape when I was doing the stress test on one of the leads and then the normal heart rhythm. I didn't feel anything ( I felt quite good actually). So I don't know if this is a problem with blood getting to the heart or just a premature beat. The nurse said "Nothing jumped out at him, unofficially" but it's super annoying I have to wait for these results. Last time I had a stress test I got the results after about 30 minutes of coming down from the run.

Again, don't know if thats a normal thing.

Thank you again.

I had a somewhat similar issue and it was discovered 16 years later I had a Myocardial Bridge which previously was considered a benign condition but new studies have discovered this can cause odd cardiac symptoms. Not all cardiologists are aware of Stanford’s University’s or Cleveland Clinic’s research findings.