How ectopics feel and echo result - can anyone help?

[Honeyskye]

Hi all

I won't list my complete history here as it's long....I do have other posts on here though that describes it all in detail. By way of background, I have suffered from PACs/PVCs for around 3 years. Came on during pregnancy and never really left...

I posted a few weeks ago about a scary episode I had where my heart just went all fluttery and when I felt my pulse it was bounding away pretty fast. I jumped up and coughed and it stopped. I'd say it lasted less than 5 seconds. I have had similar episodes and was referred to cardiology again in Summer 2019 as my GP knows I get very anxious and she said it could have been SVT. More holter monitors but nothing significant caught. My last monitor was a 7 day one in February of last year and again, nothing found.

I'm used to the skips and thuds, the little flutters, the double beats and all of those but I'd always thought these horribly fluttery episodes where my heart races was SVT but one day I stupidly googled and came across VT and I read a comment on a site from someone saying that if your heart feels fluttery, it's definitely VT. That really frightened me and put me back on my slippery slope of anxiety again. I have read a lot of things about heart rhythm disturbances from cardiologists and watched Dr Gupta's videos from York Cardiology and they have all stated that you would not be able to tell from how they feel as to whether they are atrial or ventricular. Also, you cannot necessarily tell by feeling your pulse as to whether it's SVT or NSVT. I feel in a right mess because I have all this information flying around in my head. I guess i'm just after some perspective from someone who knows a bit about ectopics or has suffered with them for a while - can they feel different sometimes but be the same thing? I.e. can a PAC feel fluttery one time but a heavy thud the next? I'm terrified that I had NSVT or a run of VT because of the quick succession of fast beats before it righted itself. I listened to how Dr Gupta tapped out a VT and it scared me but it also is similar to how a SVT is tapped out....I will state that I don't feel anything other than anxious when these happen - no dizziness, pain or anything, just sheer terror that makes me need the toilet...

Also - I had a echo done March 2019 after the height of my ectopics and it came back that I had a structurally normal and functioning heart. Would these results still stand even though it was done 2 years ago considering there have not been any significant heart events such as a heart attack since?

I acknowledge my anxiety and stress (I am still having EMDR therapy where I was documented by my therapist as a 'severe case') so I know this won't help but they happen at times when I don't feel particularly stressed too. Sometimes I can go weeks without noticing anything and then weeks where I'm bothered by all manner of sensations. I have been discharged from cardiology twice and have asked to be referred again and am awaiting my appointment.

Thanks for reading, hopefully someone can relate.

[Careful1]

If you had an echo two years ago and your heart was structurally normal at that time, I doubt anything has changed. PACS are benign, PVCS are benign in a structurally normal heart free of any heart disease. SVT (Supra ventricular tachycardia) is a fast arrhythmia that comes from the atrium which is located at the top part of your heart. SVT while annoying and at times scary is benign. If your heart rate shoots above 150 beats per minute and the episode starts and stops suddenly, you may very well be having brief episodes of SVT. The only way to know would be to catch it on a monitor which is an extremely hard thing to do especially if episodes happen rarely.
If your not anxiety prone I would suggest the getting a Kardia. They aren’t that expensive and cardiologists actually recommend them. If you suffer with anxiety however it probably isn’t a good idea.
Are you having any other symptoms with these episodes? You could possibly ask your doctor about a loop recorder if you are. This is a monitor that they implant in a pocket made in the muscle of your chest that monitors your heart and is left until the battery dies around 3 to 5 years, once the battery dies it’s removed. I have one going on a two and a half years now. Maybe it’s an option?

Don’t go looking up arrhythmia’s on Google. That’s definitely not a good idea as all it will do is freak you out.
You said the episode you had was 5 seconds long and so even if it was VT which I highly doubt it was, that’s less then 30 seconds and would be considered non sustained ventricular tachycardia. I had an episode of NSVT on April 15th, my rate was over 200 beats per minute, it went on for 24 beats and lasted for 8 seconds. The doctors are not rushing to throw me on an operating table to implant an ICD. I had never experienced it before and it was definitely obvious that something was happening different then all my usual stuff. I also get brief episodes of SVT. They happen rarely, are very brief and it just feels like all of a sudden my heart is racing. The NSVT felt very different. It felt like a never ending PVC.

Everything will be okay, stress and anxiety makes arrhythmia’s worse and so try not to overly worry and get yourself all worked up. I know this is much easier said then done as I have been an anxious mess since I had my episode but I’m trying and you gotta try too (((hugs)))

[Carys]

Following this thread, as I had what I believe 2 brief SVT episodes this year (I've replied on your threads before Honeyskye). Careful, I am also a life-time sufferer of PAC and PVC, and the SVT (I believe it to be, but 'it' has only happened twice in 3 or 4 months) came after a large ectopic beat and raced incredibly fast. I heard somewhere that SVT is the usual arrythmia after a large ectopic, have you heard that fact also ? I am presuming SVT and not VT as both mine were after a run of ectopics and then a particularly large ectopic. I've taken no further action on it as it lasted seconds (8 maybe) and stopped as quickly as it started after a vagal manouveur. I am wondering if this might help Honeyskye too, to know this fact about the ectopics as it makes it benign ?

[Careful1]

Technically 3 or more PACS in a row without a normal heart beat in between is technically considered SVT and the same goes for PVCS, 3 consecutive PVCS in a row with no normal beats in between is technically considered NSVT and what I mean by normal beats is that there are no beats coming from the sinus node in between the ectopic beats.

[Careful1]

Following this thread, as I had what I believe 2 brief SVT episodes this year (I've replied on your threads before Honeyskye). Careful, I am also a life-time sufferer of PAC and PVC, and the SVT (I believe it to be, but 'it' has only happened twice in 3 or 4 months) came after a large ectopic beat and raced incredibly fast. I heard somewhere that SVT is the usual arrythmia after a large ectopic, have you heard that fact also ? I am presuming SVT and not VT as both mine were after a run of ectopics and then a particularly large ectopic. I've taken no further action on it as it lasted seconds (8 maybe) and stopped as quickly as it started after a vagal manouveur. I am wondering if this might help Honeyskye too, to know this fact about the ectopics as it makes it benign ?

And I would say if you were able to get back into normal sinus rhythm by coughing or other vagal maneuvers then it likely was SVT because those don’t work for other arrhythmia’s.

[Honeyskye]

When I had the episode I immediately jumped up in a panic and did a big cough and it immediately stopped and returned to normal. I believe this constitutes a vagal maneuver? When i've had little runs of ectopics i've done the same and the episodes have terminated from me doing a big cough. That is why I initially thought SVT, however, because my heart felt like one big continual flutter and I read that someone had said that VT feels like a big flutter, I have convinced myself that's what it was....

I can get ectopics and funny runs of them just by lying down quickly or in certain positions and at which point, I have to sit up quickly and cough to stop it. It really gets me down as previous to my last pregnancy I was so active. I'm an ex competitive gymnast - like, elite level so was always in the gym. I carried on being active until my last pregnancy three years ago, running, doing obstacle and mud runs, running 5ks each lunchtime and boxing....never once had a problem with my heart. So sick of it.

[Careful1]

When I had the episode I immediately jumped up in a panic and did a big cough and it immediately stopped and returned to normal. I believe this constitutes a vagal maneuver? When i've had little runs of ectopics i've done the same and the episodes have terminated from me doing a big cough. That is why I initially thought SVT, however, because my heart felt like one big continual flutter and I read that someone had said that VT feels like a big flutter, I have convinced myself that's what it was....

I can get ectopics and funny runs of them just by lying down quickly or in certain positions and at which point, I have to sit up quickly and cough to stop it. It really gets me down as previous to my last pregnancy I was so active. I'm an ex competitive gymnast - like, elite level so was always in the gym. I carried on being active until my last pregnancy three years ago, running, doing obstacle and mud runs, running 5ks each lunchtime and boxing....never once had a problem with my heart. So sick of it.

VT probably feels different person to person, some people don’t feel it all. My husband has AFIB and he says he feels like his heart is fluttering. I know a girl who has both atrial tachycardia and runs of NSVT and she said sometimes it’s hard for her to tell which is which. Do you feel you’re PVCS? If so what do they feel like? My NSVT felt exactly the way my PVCS feel only instead of a quick flutter and gone and it was never ending flutter that took my breath away.
I don’t believe vagal maneuvers work in stopping VT in fact I think I read somewhere that it was dangerous to do them during an episode.

If this episode was different then all your other episodes, new to you then it’s probably a good idea to see the cardiologist for his/her opinion and if possible maybe even see an EP because electrical problems are their expertise. You can have an ECG strip showing an arrhythmia and even some of the best EPs can’t tell for sure if it’s atrial or ventricular so me personally I go with an EP for my rhythm issues.