Atrial tachycardia?

[ann88]

I'm 26 years old and have suffered with panic attacks and agoraphobia for about 6 or 7 years. I get a lot of PVCs and have had lots of ECGs, an echo, 48 hour monitor, blood tests etc. all ok, benign PVCs.

Twice in the last month or so, I've had these episodes where my heart rate jumps REALLY high for no reason. I'm talking 180-200bpm. It has happened a couple of other times in the last couple of years but have always persuaded myself it was just a bad panic attack. But now I don't think it was. Last time, I was hoovering when I got that familiar feeling of heart going too fast. Stopped what I was doing, went to get a glass of water and it kept getting faster and faster. It lasted about 45mins to an hour. I took a couple of propranolol and waited for it to pass. I know it wasn't SVT because it came and went gradually. And it wasn't A Fib because it felt regular throughout. But now someone has mentioned atrial tachycardia and now I'm terrified that's what it was. It was hard enough trying to beat these panic attacks, but now I feel it's almost impossible with this worry that my heart could flip into a crazy rhythm at any minute. The scariest thing is, when it happens, if I try and do the smallest exertion, even just walking upstairs, it will make it shoot up even more. So what if I'm out in the middle of nowhere walking the dogs, how would I get home if I can't even walk?!

I am just so scared that this is what I have, I know most arrhythmias are not dangerous in healthy hearts and I should just forget about it but it's so difficult. I'm literally spending every day just waiting for it to happen again. I am going to book an appointment with my cardiologist again for some reassurance but I know there are no other tests I can have. It happens so infrequently that it would never be caught on a monitor. I guess I'm just looking for some reassurance from anyone that's been through something similar :weep:

---------- Post added at 21:49 ---------- Previous post was at 21:47 ----------

Also, I thought about calling an ambulance last time it happened, but I couldn't do it. I was so anxious that I don't think I could have sat still long enough for them to do an ECG on me while it was happening!!

[Aaahhfreakout]

There are portable monitors which are meant to catch rare arrhythmias. You can wear them for weeks or just keep them with you in a bag, ready to use. You need one of those.

I'd innocently ask if they have something like that, not tell them you know they do as they do like to suspect we're hypochondriacs. ;)

In my experience, I need to be having a serious panic attack to be getting 180+ bpm and it won't stay that high for very long so you may well be right about it being atrial tachycardia. However, recently I was fairly certain that my heart rate had shot up far quicker than panic can make it. Third time it happened I caught it on a sports heart monitor and the graph showed it was actually a relatively slow climb and nothing special at all. It didn't feel like that but it was.

[ann88]

Thanks so much for replying, I agree that over 180 sounds excessive for a panic attack and some people rarely get above 150 no matter how scared they are. But the heart racing has always been the worst symptom for me, I guess it's the thing that terrifies me the most.

I've thought about that monitor, in fact I'm seeing he cardiologist on Friday, but I'm hoping he will say that even if it is atrial tachycardia it's nothing to worry about as my heart is structurally normal. I don't want to go on any stronger drugs (currently on 10mg propranolol) and definitely don't want to go down the surgical route.

I think I'm still trying to convince myself they are panic attacks and nothing more - I do seem to be very sensitive to the slightest bit of adrenaline and especially in the mornings, exercise or eating breakfast too soon after waking makes my heart rate increase much higher than it would any other time of day. Wishful thinking perhaps, but the idea of having to live with an actual arrhythmia is just terrifying to me. I'm now scared to try and beat my agoraphobia because I'm so worried that my heart could flip out again.

[Aaahhfreakout]

I read a medical professional say that atrial tachycardia is basically just a lot of ectopic PACs in a row, so just really a lot of early heartbeats really.

There are actually various tricks doctors know for stopping atrial tachycardias such as cold water to the face, rubbing a certain spot in the neck, etc.

If it does turn out to be that, remember to ask your cardiologist to teach you the tricks. :)

[ann88]

I'll definitely do that, thanks! I guess I just need to keep reminding myself that even if it is atrial tachycardia, it's not dangerous and won't kill me, and there are plenty of people much worse off than me. Easy to forget that sometimes isn't it.

Anyway thanks so much for taking the time to reply to me. :)

[Aaahhfreakout]

No problem, I've been having similar concerns with PACs and PVCs, agoraphobia and possible atrial tachycardia so I've been reading a lot about it all. :)

[hanshan]

Hi Ann,

I don't want to worry you, but there is an atrial arrhythmia which is related to atrial fibrillation, but is regular. It's called atrial flutter.

I have had it on several occasions. The good news is that it is absolutely non-life threatening in the short term.

Also, it isn't associated with anxiety or panic attacks. In fact, the first time I had it, I wasn't even aware I had a rapid heart rate, even though it was going about 150 beats per minute (hard to believe, but true).

There is a danger in the slightly longer term, however, that blood will pool in the heart and form clots which could cause a stroke. For this reason, anticoagulant medication such as Warfarin should be commenced immediately, under medical supervision.

Atrial flutter tends to persist. Two methods of reversion are cardioversion using paddles, and medication. Long term treatment may involve catheter ablation. That may all sound scary, but I've been living with it for around five years now, and I'm fine.

[Aaahhfreakout]

Yup, the blood clot risk is also true of atrial fibrillation, although ann88 talked of gradual onset of the tachycardia and I think fibrillation and flutter are both sudden. Not sure, though.

Anyway, portable monitoring should catch whatever it is, sooner or later. That's the next step.

[hanshan]

The monitor will give a good diagnosis of the tachycardia. Unfortunately, the tachycardia never seems to appear when the person is wearing the monitor.

The good (or bad) news is that episodes of atrial fibrillation or atrial flutter are less transient - there is enough time to get to a hospital and have an electrocardiogram. The last electrocardiogram that I was hooked up to even analysed the signal and gave a diagnosis (it kept changing!).

As some reassurance, brief episodes of rapid heartbeat that do not persist are most likely to be the harmless (but distressing) variety, particularly if the doctor can find no heart abnormality.

[iwantpeace]

i even got 215 bpm while i was on a very bad panic attack because of the addrenaline rush.
it was sinus though which is normal...