Irregular heart beat

You need to purchase a Kardia Mobile, a slim card-like pad that you put fingers on when you know or suspect that you are having an arrhythmia...which is what you are experiencing.

Patients report 'palpitation's to their doctors, or their doctors ask if you are having 'palpitations.' Palpitations are the sensation when a heart's rhythm is off, not a formal diagnosis. So, the doctors want to know what it feels like, and then they'll usually order a Holter monitor to be worn by you for 16-100 hours or so, sometimes more if the arrhythmia happens seldom.

You might have what is known as an SVT, or supra-ventricular tachycardia. This means 'above the ventricle extraordinarily high heart rate.' The two smaller pumps high on the heart, the two 'atria', are beating at two or three times the the rate, or faster, than the large ventricles below them. This is abnormal.

SVTs are common as we age. In fact, the current best guess in the research suggests that up to 40% of all living humans today will develop a cardiac arrhythmia in the future. Wow!! And the trends at hospitals are certainly supporting this contention.

There are other arrhythmias, and you should have a formal assessment to eliminate them as what is actually going on. A particularly dangerous one is VT, or ventricular tachycardia. Chances are very low that you have that because you have been experiencing your arrhythmia for several years now. We can all but rule that out.

You should consult a good, and I do mean a GOOD, cardiologist and ask for a formal assessment for cardiac arrhythmia, and I bet what you have is either PACs or AF, premature atrial complexes or atrial fibrillation. But they can be treated, and they SHOULD be treated early if possible. You will need an echocardiogram, possibly a stress test to determine if you have ischemia (poor oxygen supply to the heart and organs), and possibly an angiogram where they put you on your back, maybe sedate you, and slide a very thin fiber/tube up your arm and into your heart to be used like a tiny camera. I had that done...no big deal, honestly.

We can offer more information as we develop the conversation, but I don't want to load you up too much at first. Maybe you have other information you'd be willing to share, or you have other questions?

I appreciate your reply, and the detail. Once it does go back to a normal rhythm, I've had an ECG and from what I gather, it all looks normal when it's beating in time. I think I had an echo sound, if that's correct and that showed nothing abnormal. I've been put on bisoprolol, a small dose.

So far, so good! However, we still don't know which of the arrhythmias it is, and if it is atrial fibrillation or atrial flutter, you really 'should be' on a DOAC (Direct Oral Anti-Coagulant) such as rivaroxaban or apixaban. If you do have intermittent AF, also formally known as 'paroxysmal' AF, the greatest risk early in the development of it is a risk of stroke. The problem is that a fibrillating left atrium has a small 'grotto-like' lump on its extreme upper left that is called the left atrial appendage. The LAA doesn't flush itself out of stale blood quickly enough when its host atrium is fibrillating, and if a clot forms there and gets dislodged, which can happen at any time, including weeks later (!!!!), the clot can travel to coronary arteries, the lungs, or, egads!...to the brain. A most unwanted event.

Metoprolol is a 'rate control' medication that works to slow the heart and also to make its beat strokes less forceful. It happens to be also useful for people with incipient hypertension (high blood pressure) as a result of its action.

Finally, yes, as far as I know (I'm far from a cardiologist, or even a doctor), an otherwise healthy heart, no cardiomyopathy, no valve disease, no ischemia, is going to show a normal ECG when it is in sinus rhythm. It is when the electrical disorder happens that an ECG running concurrently will definitely show unusual waveforms.

If you take a look at Kardia, and decide you'd like to try one (they are good and have sold millions....and no, I am not 'involved, and only use a Galaxy watch), you can get a 'readout' downloaded from the device to you tablet or PC and take a look. If it's AF, there will be no P-wave and the distance between the R-waves, also called the 'R-to-R interval', will be quite clearly varied, some long, some short. AF is characterized as 'irregularly irregular' heartbeats.

This is a horribly long URL, but it's an example of what an ECG looks like for AF:
https://www.bing.com/images/search?view=detailV2&ccid=dOPF%2FGF5&id=F50BDF95F0407EF68AE1E22358CC3D32BC6BBDF7&thid=OIP.dOPF_GF5LOVkZ1qGhkvUVwHaCx&mediaurl=https%3A%2F%2Fwww.aclsmedicaltraining.com%2Fwp-content%2Fuploads%2F2021%2F09%2FACLS-Figure-30.jpg&cdnurl=https%3A%2F%2Fth.bing.com%2Fth%2Fid%2FR.74e3c5fc61792ce564675a86864bd457%3Frik%3D971rvDI9zFgj4g%26pid%3DImgRaw%26r%3D0&exph=560&expw=1495&q=what+does+an+af+ecg+look+like&simid=607992676649951713&FORM=IRPRST&ck=E161CC42AA92820B0C42730ACA137F9B&selectedIndex=6&itb=0&cw=2297&ch=1183&ajaxhist=0&ajaxserp=0

@woody5
When you have had these episodes do they check your electrolytes? That can be key to heart arrymythmias.

MY EP asked me to take magnesium to help with PVCs and arrythmias.

How is your stress and axniety levels? The old flight or fight hormone adrenaline can have a big impact on heart rates. If the adrenaline builds up can affect heart.

If you are under stress or anxiety talk to your PCP and cardiologist about things to do to lower stress and anxiety. I always suggest exercise (with doctor approval) and hobbies. And there are some great medications out there that really helped with stress and anxiety. I do both and really helped me.

Hi, I'm not sure what they check when they take my blood, but I really should enquire! They do say all tests are OK!. My stress levels are OK, unless I go into hospital and I'm sure it goes up. My main concern is what starts it initially. I'm reasonably active but am hesitant to do anything to excess for fear of setting it off.

DOAC was mentioned but was determined I didn't require it. I do believe it is AF but the doctors offer no advice as to how it starts...its a case of it just does! How to prevent it is my biggest issue, and what measures I can take to get it back in rhythm. I estimate it can last for 10 hours and then all of a sudden decide to go back to normal, most perplexing!

That's the very nature of AF....'irregularly irregular', and also the descriptor 'paroxysmal'. It comes and goes. Some find that supplementing with magnesium helps, or reducing calcium intake, or upping their potassium a little. Avoiding alcohol, caffeine, taking cold showers helps some, or sticking their head in a bucket of cold tap water...truthfully, it works for some to convert their AF to NSR. Not eating too much at a meal so that stomach distension is not overdone. Not sleeping on their left side, or they try sleeping semi-recumbent on a sitter or with two pillows behind them.

Some do Vagus nerve tone increment exercising like stroking the earlobe, or placing the tip of a finger into the ear canal and rubbing, or tugging repeatedly on the tragus. The Valsalva maneuver helps for some. Some find relief walking....just pacing around until they feel better.

Lastly, if it is AF, and I would take great pains, personally, to rule it out, you MUST Be on a DOAC. That's the first protocol for someone deemed to have AF, even paroxysmal and rare AF.

You say your heart goes out of rhythm for no reason. In my opinion, there is always a reason. For me, even when under 20 years old, the culprit was caffeine. Some people are extremely sensitive to it, which includes me. I also had episodes which lasted several hours and sometimes all night.

Even 1/4 cup a day will set me off within a few days. Or maybe getting older, your heart cannot handle what it did before because of years of unhealthy habits??

If you are consuming ANY caffeine from coffee, tea, colas, Mountain Dew which has more than colas, chocolate, energy drinks, try abstaining for one month minimum and watch improvement. High sugar diet, which revs you up including your heart. Over exercising. I walk up and down hills to town every day, but do not jump around like a nut in a spa which the music alone could make your heart go too fast.

That is very common to have short period of an arrhythmia and then you see the doc and you are back in rhythm. The Kardia will record the event in real time. I am assuming you can feel it with it happens. Then you can send the pdf to the doc and they can see read the pdf that you send them. That way you are not playing wack a mole with running to urgent care or the ER and it is already back in rhythm. What kind of doctor are you seeing that is "at a loss" for what causes it? It is caused my any number of issues within the the heart. Some people have "triggers" that they feel starts the event but others do not necessarily notice any triggers.
A good cardiologist who specializes in electrophysiology of the heart is trained to find and understand the underlining mechanisms of what actually is causing the particular arrhythmia you have. There may be triggers that make people feel make it easier to identify but they as still prone to having Afib whether they can identify a trigger or not. Normal hearts do not go into Afib.

Thanks, I'm sure there is something that sets it off, it's just finding it. On each occasion there doesn't seem to be a common factor, or something I've done similar on each occasion. I drink very little alcohol and no coffee, only tea. I would be lovely to actually pin point the actually culprit!