Do you worry about palpitations?

[debera]

Thank you so much for posting. I feel a lot calmer now about my palpitations.

[Bittersweet05]

Thank you so much for all your post. When i lay in bed in am and try to go back to sleep. I get them. They are scary. I know it my anxiety because i have been going thru a rough bout of anxiety lately. It's a nasty thing. Thanks again.

[username5927]

I know it was a while ago, but thank you for this post.
My dance with panic seems to cycle every four years or so and this time it's presenting with all these heart palpitations.
Terrifying.
Your post helps me say to giving in to the cycle and giving the panic attacks power again.

[Belge du sud]

Hi everybody ! I recently came across this forum where I've found lots of informations and good advices, for which I want to thank you sincerely.


Reading many threads, I discovered I've been lucky: I only met heart rhythm disorders two years ago, and I'm nearly 60! Nevertheless, I met them the hard way, one night at 2:00 am, when our home alarm system awoke us brutally. Nothing serious, happily, but I got back to bed with palpitations. My heart was beating irregularly and way faster than I was used to (50 bpm at rest – I'm a road biker). Of course, I thought this was stress induced, and I spent the next couple of hours waiting this crazy thing to stop (and urinating every 20 min or so). My average HR then got back around 85 bpm, but still irregularly. I went to work and, in the evening, went to see my GP. And guess what? The crazy thing stopped as I was sitting in the waiting room. The ECG, of course, was perfect.

I thought it was all over, but ten days later, at 10:00 pm, while I was in bed reading a book, those crazy palpitations came back. I swear I had nearly forgot about them, but they were back with the same symptoms. My BP was low (around 8/5), I was sweating and had to urinate frequently. My wife drove me to the ER, and I was diagnosed atrial fibrillation and atrial flutter. It was around midnight. They did inject me some blood thinner in the belly and amiodarone on a drip. Lots of exams followed: radiography, ultrasound-scan (externally and then by swallowing an horrible pipe)... and in the afternoon I received an electric shock to bring my heart in SR. The cardiologist sent me back home in the evening with propafenone (a rhythm drug), dabigatran (a blood thinner to take for a while) and the reassuring information that I was a healthy young man (medically speaking) with a healthy heart.


Since then, I went through some good and bad days, but most were so-so. No drugs I tried could cure me, but all of them made me weak. Propafenone was unefficient at low dose and toxic (QRS enlargement) at higher dose. Sotalol (a betablocker being a rhythm drug too) was slightly better, but I couldn't exercice normally. I was feeling so old and tired... and I had A-fib nearly two times a month (average), during 15-20H, with those horrible symptoms in the first couple of hours.


I got two ablations: the first one for right atrial flutter (then, no more flutter but still A-fib), the second one for A-fib (cryoablation of pulmonary veins).


Since then, I've weekly A-fib attacks (but they only last about 1 hour, without the horrible symptoms I suffered from before but still the need to urinate) and I'm frequently feeling PVCs and PACs I'm sure I hadn't before (at least the PVCs, which are unmistakable). I've been monitored a couple of times, with various results (from 0 to 15000 PB/24h!)


I got a 3rd intervention (by catheter), but leading to nothing. They didn't succeed setting my heart in A-fib. Just some ectopic beats here and there... My heart is an anarchy freak.
I tried some other drugs: bisoprolol (a betablocker) and flecainide (rhythm drug), but as soon as I got better for a couple of weeks, A-fib was coming back unexpectedly.


Now, I'm just taking some flecainide when I'm feeling bad. I've thrown away betablockers, they're too bad for me, as my HR is usually slow (60 bpm) and my BP below average for a 60 year man.
There's no cure. Palpitations are just a symptom. There's no cure for a symptom. Just some relief.




Here's what I noticed (most are « classic » things):


- Nothing is simple with palpitations.
- A-fib is likely triggered by premature beats.
- Premature beats are vagal tone related.
- The vagus nerve can be irritated by emotional things as well than by functional things.
- Vagal disorders are hard to cope with, because they not only affect (and are affected by) the throat, the lungs, the heart, the stomach, the bowels... but our stress, anxiety and emotions too.
- It's hard being sure (apart for the obvious like alcohol and big meals) what triggers palpitations, because we are all different and, from what I've noticed, something we one day believe being a trigger may not trigger anything the other day. I guess when we're « receptive » (tired, anxious, nervous, weak or diseased), the culprit may be nearly anything. Conversely, when we're feeling good, we may eat or drink some « banned » stuff without damage.
- Understanding what happens and how our body works may help a lot. Knowledge is crucial for our peace of mind.


Other (more personal) things I noticed... and some questions:


- Palpitations usually appear after meal or while laying in bed. In the same time, I'm bloated; but I can't tell if I'm bloated because of heart rhythm problems or conversely. Burping helps. Drinking some water and gently moving helps burping. When I'm bloated, It's as if my stomach was pushing towards my lungs. I've to breathe out deeply just to force the whole thing going down. Palpitations coming after meal are PVCs. Sitting involves more PVCs, and it's worse if I bend my head to read or write. Undoubtedly, all of this involves the vagus nerve. After meal, I've better standing up for a while or, still better, going out for a quiet walk (30 to 60min).
Hypothesis: there's some gas trapped in the upper part of the stomach. The latter is then pushed up against the diaphragm (hence some shortness of breath), pinching the vagus nerve and, possibly, the descending aorta. Consequently, the left ventricle might have to fight against some counterpressure, hence the PVCs. Any thoughts about that?


- Lying down on the left side doesn't relieve the pressure, so turning on the right side may seem better. But IMO, it's only marginally better, because it can't help burping (see our anatomy). The fact is premature beats are often unbearable when lying on our left side or on our back. PVCs are horrible. Ventricular bigeminism is hard on me. I'm feeling some sort of bradycardia, my heart loudly bumping at 35-40bpm. An ECG showed it's actually 70-80bpm, but the ectopic beats are so loud I don't feel anything else in between.


- I wrote having more PVCs when sitting, but it's getting worse when I'm driving my car or riding my bike on a bad road (bad roads are the rule, here in Belgium). This reinforces me in thinking that PVCs are mostly mechanically or functionally induced.


- I often wake up suddenly during the 2nd part of the night (2:00 to 3:00 am), my heart heavily bumping, but its rhythm is quiet, around 60 bpm. It's likely emotional, because it's always while dreaming. I've no nightmares, and I'm still wondering what awakes me and why. Maybe some PACs? It seems PACs are more stress-induced than PVCs.
When woke up this way, I've to keep calm and move slowly. Turning instantaneously on the other side to go back to sleep is a natural reaction I've to avoid. If I don't, If I move quickly, chances are great I trigger some A-fib attack. Any thoughts about this?


- I'm trying some FODMAP diet. It helps, undoubtedly: better digestion, less bloating. I've still to indentify the offending stuff, but wheat flour, yeast, food additives like sodium glutamate and other industrial poisons are among the main suspects. Did some of you try a FODMAP diet?


- Yoga is my friend, even if I sometimes feel some PVCs while leaning forward, laying on the ground or holding strange postures. At the end of the session, I always feel really quiet, just sitting on the rug and don't wanting to move.


- Someone here wrote that, considering palpitations are harmless on a healthy heart, the most important is to keep our heart healthy (good food, good sleep, some sport, no stress...) and stop worrying about premature beats. Wise person! I'll try to follow this really good advice, even if it's easier said than done.


Thanks to the all of you for sharing your own experience and good advices, and I wish you a really healthy new year.


(Sorry for my mistakes, I'm usually french speaking.)