ectopic beats with exercise and daily patterns

[CGI]

This is my first post and I'd like to say this site is a great way to share these scary experiences. I've read many of the older posts and felt I had to post to share my experience and ask for some advice...

I'm 28 years old and have had ectopic beats (ventricular) for 6 years. It runs in my family. I've had 24/48 hour ecgs, treadmill test, bloodtest, cbt sessions, and am currently on a small daily dose of propranolol which can help - like most people on here I've been reassured by GP and NHS/private cardiologists that they are entirely benign. I suffer health anxiety though, so I still think stressful times with it.

The ectopics have always frightened me, though they come and go. I've had 3-6 month periods without experiencing the emptiness, then dizzy flutter, then thud, then panic cycle. But recently I've been getting them regularly everyday.

My worst culprits seem to be: Exercise, day after alcohol and daily patterns.

I had 4 big thuds while swimming - which freaked me out as it's bad enough imagining collapsing on land let alone in water! I need to exeercise more for my fitness, but I can't because I always get the beats. Especially as I'm slowing down. Does anyone know the cause of this? I hear it's adrenaline, but I don't quite get the science behind it.

After alcohol I'm prone to them - especially if I have things to do the following day. I'll get anxious and this will bring on the beats.

Currently I'm experiencing ectopics around 10 big thuds during my 10 minute walk from the train station to my work! Every day. I'll not get them when I'm at work, or walking home. I'm not currently in a new job, or particularly stressed at work. And I've done the walk for 2 years and never before had this pattern. I can predict and would put substantial money on having these beats 5 times tomorrow morning walking to work. Wierd! Makes me think it's definitely in the head - yet it's still really unnerving.

One outstanding issue that does worry me - and I wonder if anyone's had this answered by a health professional. But I've read studies on the internet on doctor sites and on medical journal research that do suggest that ectopic's are not deadly in themselves (in fact the thud you feel is the sign of a heart doing what it should - if had the premature beat at not the compensatory pause and thud, then you'd need to worry) but that people who have them are slightly more susceptable to ventricular tachycardia in the future. This does worry me a bit. So when a diagnosis is "benign ectopic beats" is that benign at the moment but not necessarily in the future?

Anyway, one cardiologist told me that they don't even consider medication in healthy hearts regarding ectopics unless there's more than 1,000 extra beats per day.

Anyway, really sorry to go on, thanks to those that have read this far, any feedback would be much appreciated.

Plus, be positive everyone and don't be afraid to keep going back to the doctor - CBT didn't work for me unfortunately. I take comfort in knowing my mum had these, as well as prolapse valve, and she's still doing well. So I'll be alright.

[suzyq54]

gosh when i read this i thought i was reading my own posting it is exactly like my symptoms. i get them after excercise 9 and during), after alcohol and just trying to go about my usual routine. i have had an ecg but no other tests and my uncle has just found out he has something wrong with a valve in his heart. i am really worried but hey what can i do. i have heard the adrenaline gland can become over active which can effect the heart rythm and can cause these symptoms when your cooling down after excercise. i cant answer any of your questions but just thought id assure you that your not alone. XXXX

[CGI]

Many thanks for the reply - it can be scary. Sure enough this morning I had 4 episodes just walking to work again. Always on the same bit of road.

The power of the mind amazes me - it must be anxiety through association. I remember after the tube bombings in London, I used to get the extra beats when I was waiting on the tube platforms. I'm convinced it's in the head. But it still stresses me out loads - especially panic during the exercise.

Hope it doesn't impact too much on your daily life. I think about it everyday. But sometimes without thinking I'll have gone a week without one and then I realise, get really chuffed about it - and then they come back again!

All the best...

[kawasaki kid]

hi there.....a little reply to your post.....................first off regarding the ventricular tachacardia....................from what i understand theres two class types......sustained ventricular tach and non sustained........you can only have sustained tach if theres a defect found in the structure of your heart......this is ruled out by the echo test......any abnormality would show up......................non sustained i believe is just a fast heart rate which takes a little time to settle down and can be treated by meds......as can the other,although svt is a more serious condition...........your cardio would ave noticed any problems by all the tests youve had sooooooo i'd rule that one out and relax about it..................DONT GOOGLE......... trust the experts, they wouldnt tell you lies...............regards to your ectopics i totally agree with you about your thoughts on them being mental.....i find that if i get a few i become aware of them....therefore i get more and then worry and think OH NO THERE BACK and get loads......lol.......i think if you assosiate them with something your waiting for them to happen and thinking about it makes you aware.........there is alot of speculation about ectopics and the connection to the vagus nerve......this is the biggest nerve in the body that runs from the brain to the lungs, gut and heart..........i understand that stimulation of this nerve ie wind/gastric trouble......stress depression and anxiety can agravate this nerve and in turn trigger ectopics.......soooo my thinking is......if the nerve runs from the brain....the brain is the mind and the mind triggers ectopics.......i rest my case....ha.......hope i may of been some help to you......chris..

[No Imagination]

Hi mate,

Sorry to hear of your troubles. As regards your morning ectopics have you thought of changing your routine slightly? Maybe leaving earlier and making the walk more of a stroll or stopping to buy a newspaper, maybe even taking a different route if it's possible. You might find if your journey changes you don't have the same problems especially if it really is in your head? The other thing to remember is that walking is exercise and you get them with exercise. Although you might not realise it I would guess you are in more of a hurry on your way to work than on your way home - I know I am - and as such you will be under more stress even if it's not what you'd actually label stress.

When you exercise you experience much greater changes in heart rhythm depending on what you're doing and so I think it's easier for it to get slightly out of step. Plus with those things firing more often to contract your heart maybe it just easier for them to get out of sync. If you are that concerned I'd switch to another form of exercise as I'd imagine your only problem is if you get overly anxious whilst swimming and tense up rather than anything to do with your ectopics. Mind you I'm a hopeless swimmer!

In terms of how dangerous they are, as Chris said, if you've had an echo and your heart is structually sound then there is no danger at all apparently. My specialist actually said that he knew of a patient that got them every other beat and he wasn't concerned about him at all - poor bugger though eh! Certainly put my problems in perspective.

Anyway, like I said it may be worth trying different things to see if they reduce the number you get. It could be that some small changes make a big difference or they may make no difference at all. Either way it's worth a go.

Good luck.

N.I.

[CGI]

Many thanks for your posts; really, really appreciated. The VT explanation and the idea of changing routine were very useful. And I know - I shouldn't Google.

I'm in a bit of a bad place at the moment as the awareness is heightened. I can go weeks (sometimes months) without noticing them. But when they come - they come in abundance (despite the beta blockers).

This morning I took a slightly different route, but was conscious that I was doing it because of the beats. Plus had a significant number on the train. In fact, I was feeling my pulse and it does pause and then come back in after the thud. My word, I'm obsessed by the fear of these things.

The weekend is near, and routines will change - so I'm hoping I'll get 2 days off the beats.

Thanks again for taking the time to respond. When I'm through this phase of episodes I hope to come back to the site and give some advice to others...

[No Imagination]

I don't think there is anything wrong with googling as such but it really depends on the individual. For me being able to search the internet has made me feel much better about them. But then I've always been the kind of person that would rather know something than not know - it's the unknown that really bothers me when it comes down to it.

The problem is there are people who would read say 50 articles about this stuff, 49 would say they're harmless and 1 would say there could 'possibly' be a problem if this, this and this happens and you know they'd lend more credence to that one article than the other 49 put together.

Sitting there feeling your pulse is not a good idea mate. I know because I've been there doing the same thing and it means your attention is completely focused on what's happening, which will in turn lead to greater anxiety. Have you not got an ipod/radio or something you can listen to whilst your travelling into work perhaps - maybe try and take your mind off the journey completely? If the journey is the trigger then to me you've got to find ways to change it. I know that stuff isn't guaranteed success but don't give up cos you had a bad day mate. I think with some persistence you might find you can break the cycle you're on and once you've done that you'll feel so much better. After that anything will seem possible.

The only other thing is this: My specialist said that at times they will be more frequent that's just how it goes. There doesn't need to be a specific reason for it, there will just be times you get them frequently just as there will be times you don't get them at all. I think half the battle is realising this so that when you get them you don't get as freaked out by them - "today is a bad day" or "this week is a bad week" but remember that "tomorrow or next week will be better". The thing is this has the added benefit of being true.

N.I.

[Cip]

About 5 years ago, I had a sudden onset of PVC's and went to ER. After that date, I continued to have them at a whopping rate of 1,000 per hour. Yes. Holter monitor counted them. It lasted 6 frightening weeks. I saw every specialist including an electrophysiologist who specializes in heart rates. Guess what? They were not dangerous!! I was not convinced, and on Thanksgiving day after 6 weeks of fear, they went away as quickly as they came.

During that 6 week period I started taking my first antidepressant and I have been on them ever since. I have had some period of extended pvc's, but none lasting that long. They always scare me. If they come once or twice in a row, I can handle it. The ones that come and stay are more difficult for me to deal with.

My problem is that I have developed a fear of exercising now, because like many of you they can happen during that time.

I used to walk 5 mi/day. Now it is hard for me to think about walking at all. I am trying to get in shape after having 9 children. I have conquered this anxiety before, but why can't I now?

It's tough.

Cindy

[Mikke]

In a healthy heart, ectopic beats are never of any concern.
There is actually NO medical research that suggests otherwise. You wouldn't be able to find research that would support the idea that ectopic beats are dangerous to healthy hearts even if you tried.

This is by far the most comforting words about skipped beats I've ever read (and it's coming from an retired doctor):

------------------------------------------------
Well my goodness! I think you've let your fears run away with you and it's not an uncommon situation for folks with anxiety.

Your problem is not your heart, but rather your fear that something terrible is going to happen to you as a consequence of benign palpitations. The other primary concern is that you remain convinced that in order for the palpitations to be present and becoming more frequent, there must be an underlying physical cause. You have no medical data to support your contention, but it's certainly convincing enough for you to return to your doctor in search of a cause.

It's critical for you to realize what sort of patterns become established for people with health anxiety. You feel compelled to seek reassurance from your doctor and begin pressing for tests and answers. Some physicians then feel obliged to continue looking, despite the fact that they know the problem to be harmless in nature. They may respond by saying "well, maybe it's some sort of variant of an arrhythmia so let's get you hooked up to the monitor because some arrhythmias are deadly. A statement like that is all a person with anxiety needs in order to accentuate their fears and hoplessness.

Your posting says a great deal about how you rationalize the problem and it's important for you to understand how the mind works relative to the circumstances. You've simply reasoned that the change in character of the palpitations represents something wrong and this presumption is based purely upon your understanding of the problem.

You do not have heart disease of any type and the tests will turn out negative. It is important, however, for you to continue with them in order to gain the reassurance you now need as a consequence of establishing a false belief. You are now forced to undergo testing to quell the fears that are now pending. You're saying to yourself "there's no way this can be happening without a problem with my heart of some type and they're going to find it too late.

You're not going to suffer any type of arrhythmia, most especially not a fatal one, as a consequence of vagus nerve induced palpitations of the type being experienced. The signal which stimulates the heart in this manner cannot interfere with, or otherwise disrupt, the normal sinus pacemaker of the heart. It is medically impossible for such a thing to happen. And simply because your physician has not observed a case wherein palpitations of this type are more frequent, does not suggest that you are the standard by which the circumstances are judged.

I have observed patients with as many as 1400 palpitations per hour or greater and none of these patients suffered any physical compromise as a result. Again, these palpitations do not interfere with the ability for the heart to do its job properly and the sensation is far worse than the actual impact at the level of the heart.

Now, I have to reiterate once again what I've said countless times on the forum; I've been a practicing physician and specialist for more than 40 years now and not once in all of those years have I even heard of one person sustaining any type of cardiac event or damage to their heart as a consequence of palpitations of the type you are now experiencing. Not even once. There is no literature to support such an instance as well. Surely you can't believe that somehow your case is different, that you have a unique problem that must be due to something physically wrong with your heart. You'd stand a better chance of winning the lottery before you would actually experience a physical problem as a consequence of benign palpitations.

My suggestion is to continue with your tests and then seek out a professional who is well established in dealing with anxiety disorders and begin working toward the discovery of thinking patterns which are causing your outlook to become severely diminished and also altering your lifestyle in a detrimental fashion. It is your fears that is driving the palpitations to greater frequency and intensity, not an actual underlying physical condition. You are misinterpreting what is actually taking place and perceiving it as a sign of imminent danger which is absolutely not the case.

Incidentally, blood pressure readings of 134/84 do not constitute hypertension in any manner whatsoever, regardless of what your normal readings otherwise indicate. Again, this is a misconception on your part.

I think you need to take a really deep breath and calm down. Your heart is fine. Look, we don't just send folks home and say we'll see you next month if we had any inclination that some type of problem actually existed that could pose a health risk. Surely you don't believe we're that incompetent as a profession.

You'll be just fine. Take it easy and feel free to go skiing with your family. Absolutely nothing bad is going to happen to you.

Best regards and Good Health

http://palps.chemicalforums.com/cgi-...num=1227599501

[Mikke]

Let med add; I have seen a total of 8 doctors. One american, one british, and six norwegian ones, so I can definately say I have been seeking medical advice on both your question - and so many others regarding the topic that I don't even remember half of them.
I even lied and told some of the docs I had a lot more ectopics than I really had.

Not one, not a single one of these doctors even suggested I get the holter monitor. One of the doctors even had ectopics himself, and couldn't understand why I was so upset about them - he had hundreds every day. "They are just plain normal" he said.

I get them while i excercise too. It's scary, cause the bloodpressure is high, so you feel them a lot more distinct. At first I was terrified, now I don't really care about them anymore. I might even get one while bench pressing, but I just don't care anymore. Life is to short anyways, to let these buggers destroy what I like to do. I have had ectopics while running, swimming, climbing, and lifitng weights - so I figure if my heart was ever going to stop from all of this it would have happened already.

Dont drink alcohol, and try to stay away from caffeine. One of my workout buddies, who has no history of nervous disorders at all, told me a few weeks ago he had experienced some strange things with his heart after drinking, like spasms in the heart he said He clearly had some ectopics - but I didnæt say anything about them. The more you worry, the worse they get.