Heart "flutter" that lasts <5 seconds

[Gamgra]

Hello all,

I have a quick question for you, I'll try to be brief. My backstory is as follows: Diagnosed with mild LVH and mild HBP which is under control with Irbesartan 75mg. I'm 23 years old, and I exercise and I'm losing weight currently. I try to follow a low sodium diet. My BP is controlled now. I also have stage 1 diastolic dysfunction due to the HBP and my aortic root is dilated mildly. Event monitor patch, stress test and ekgs normal.

So in the past and recently I get this feeling where my heart will suddenly start feeling as if it's quivering or fluttering. This lasts less than 5 seconds and I panic as a result. I've tried to feel my pulse and I feel heartbeats but I don't remember if it was regular or not. My watch picked up the dramatic increase in heart rate (I think due to panic).

So, do you guys feel these butterflies? I honestly don't know if it's afib or a run of PVCs, but from all the research I've gathered most people say a run of PVCs feels strongly palpable (I guess depending on the rate, how much the ventricles can fill?) but this just felt totally irregular so more run of pacs or afib?

Thanks

[Theherbalist_now]

If you don’t mind me asking. What does her B12, D, and magnesium levels look like. The only reason why I asked is because I experience trauma in a car accident and was having burning and aching sensation in chest, shoulder, neck, and lower back that wouldn’t go away and it made me fatigue and weak. After doing test after test to find nothing I got some blood work done to look for vitamin and level deficiency and those levels were low. After supplement the condition got better.

The B12 helps
With nerve function and restoration

Vitamin D help with many things

Magnesium helps with muscle recovery and eliminate fatigue.

Hopes this help and she gets well soon.

[Gamgra]

It's for me, and my b12 and magnesium (serum) was normal. D was low and I take a supplement. I take magnesium daily at around 300mg..I would imagine the burning and aching were a result from the accident, and some residual weakness due to injury of the muscle. Many people in USA and around the world are deficient in D and magnesium..we're all recommended to increase both in our diet.

[cardiophobiac]

I recently posted about a similar situation ive had. Feels somewhat like a pvc or pac ( i dont think i could establish the difference without a holter ) that happens, but then happens again and again and again in the space of about 5 or 6 seconds. Not quite a run so to speak, but something like PVC..NORMAL..PVC...PVC..NORMAL..PVC..NORMAL NORMAL. I dont have any abnormalities on my ecg except a very slight early repol on v2.  This episode has happened maybe 5 or 6 times in 2 years. Usually in the morning.

[Gamgra]

Could be Bigeminy or Trigeminy, depending on how many normal beats are in between. If you feel a normal beat. What are your experiences with PACs, I showed just one on my event patch and barely any PVCs, I've had PVCs in the past and I know how those feel, but I'm wondering how a PAC or a run of PACs feel. Maybe that was the heart fluttering and weirdness feeling I had...just nothing like a single PVC...but I also don't know what multiple PVCs feel like and how to discern. You just need a monitor but I never ever catch anything on monitors and I've had many over the years..ER visits, bloodwork, etc. Nothing. But out of the blue my heart will go out of it and it's so frustrating!

[Careful35]

I dont know what it is but I have had episodes like you describe. It feels like my heart is quivering for a few seconds and it scares me.
I do suffer from both PVCS and PACS. I also get episodes of SVT and if I remember correctly NSVT was once caught on a holter monitor many years ago when I was around your age. I am 37 now.

I had an EP study when I was 26 years old but they weren't able to provoke arrhythmia long enough for mapping so I didn't get to have ablation. I have suffered with rare episodes of lightheadness for about 10 years now that have become frequent in the last 2 years and also waking in the middle of the night choking and gasping. I just had genetic testing done due to these episodes and history of sudden death on my fathers side. I was found to have a mutation in the gene responsible for the genetic form of WPW but we dont know yet what it means. I have to see a new cardiologist and have an MRI of my heart which surprisingly is the only test I have not yet had. There were some changes on my last echo.. like you I have diastolic dysfunction and mild thickening was also seen on my last echo. My EF went from 50/55% to 70/75% in a little less then a year and I have been told by others it's due to the diastolic dysfunction.. I do not know why I have this as my blood pressure doesn't normally run high. I have noticed a serious increase in ectopics in the last several months and I sometimes feel my heart beating out of sync. Its not beating to fast or to slow but in my chest when I'm laying down I can feel it and it feels like its not in rhythm. This is new though and has only been going on for a couple months. I had a loop recorder implanted back in September and so perhaps I will gain some knowledge at my 6 month follow up..
My last event monitor done in July of this year showed some episodes of AV heart block but my cardiologist didn't really touch on it when she gave me my results and I only found out when i went through my copies of the strips from cardio net. I then made an appt to see the EP that performed my study and got the loop recorder..

Forgive my long response.. We seem to have a couple things in common. I am sorry that your having to deal with all this at such a young age.. I wish I had an answer for you.. I know how it feels to have things like this going on and have no answers and so I suppose I just wanted to let you know that you weren't alone.

Have you wore an event monitor? If not it might be a good idea to speak with your dr about ordering one. The only way to know what this quivering is would be to catch it on a monitor.

[Gamgra]

I understand your frustrations and your situation and I hope you find answers soon. It's hard to tell what these are without a monitor, but we can go on experience. I have had an event patch (ZioXT) and it showed only a few PVCs and one PAC, no runs of anything...I also didn't feel the same sensations while I had the monitor on. These things are so elusive, and it costs a fortune to keep having to get all these tests done just to be told there's nothing we can do. I hope your ILR comes back with some good results so you can plan treatment. I was debating whether to get one myself, but they cost another fortune on top of all the costs I've incurred. I haven't had issues in the recent past so when I had this episode it kind of came out of the blue.

I worry about my LVH and it's predisposition to arrhythmia, but I've been told mild LVH does not affect my risk. My Irbesartan should be reversing any fibrosis...I take magnesium daily to help with irritability and have for years and years.

From the research I've done DD is usually due to blood pressure, so make sure yours is strictly controlled. My cardiologist actually told me he likes to see BP under 120/80, with new recommendations as low as comfortable...I have to agree with him especially for us that are predisposed to changes in heart tone and structure via stress.  

[Careful35]

Yeah none of the times I have wore a monitor have I ever caught my quivering episodes but luckily those are few and far between. I can't really tell the difference between PVCS and PACS when I am having them but monitors show I get more PVCS then I do PACS. The quivering feeling I get does not feel like the PVCS or PACS even when i get a couplet it doesnt feel like the quivering. I get two types of feelings with my ectopics... 1 is a fluttering which I hate and the other is just hard thumps which are aggervating but much more tolerable then the flutters.

I haven't researched diastolic dysfunction but I have been told by others it's mostly caused by high blood pressure.. A lot of times when mine is taken its low but I guess that doesn't mean it's never above normal. Its all very frustrating esp because both my father and his father died suddenly at the age of 50 and 51. The gene that I have the mutation in is associated with wolf Parkinson's white syndrome and people with the genetic form also tend to have or develop cardiomyopathy. I have been getting episodes of SVT for many years. It doesn't much bother me, I just deal with it but it makes sense as SVT is the most common arrythmia among people with WPW.
Anyways, I want to live longer then my father did and so I am changing over to a different cardiologist and will do whatever they tell me I must. I use to be on beta blockers and Flecainide for the arrythmia's but I took myself off of everything years ago.. I felt I was in a place where I no longer was afraid of all the funky things my heart did and since I was told they weren't life threatening and the medication was for my comfort I stopped taking them..

Does heart disease run in your family? I mean your so young to be dealing with all this...

[Gamgra]

I see. I understand your sensations, the fluttering definitely feels different from a single PVC. I don't know if I've ever had a "run" of PVCs before, so I wouldn't know what they feel like. My monitors have only ever showed single isolated ectopics and very very few <1% of all heartbeats. This last monitor only showed like 10 PVCs and 1 PAC, no runs. I would imagine a run of PVCs or NSVT would feel like just a quick flutter because you don't have any blood in the ventricles, they are beating way too fast to fill. Whereas a single PVC has a compensatory pause. A PAC is even less so because the atria are small compared to the ventricles.

I've only had this stage 1 DD on my most recent echo and the mild LVH. Really, my walls are normal its my septum that's 1.3cm. I was concerned about hypertrophic cardiomyopathy as well, but I've been told this is not that but hypertensive related. I was overweight (over 300lbs) so I dramatically started losing weight and have lost over 30 pounds so far. My blood pressure is normal as well. I would recommend to all with or without heart disease in the family to follow as much of a sodium restricted diet as possible, watch the weight, and exercise 5 days a week no matter what kind it is. I personally do cardio 5 days a week.

Have you considered ablation for the SVT? I've heard this has the most successful curative rate for ablation. I would imagine they could try to map out your WPW pathways and possibly ablate those and you could be well on your way.

In regards to the fluttering, my best guess without a monitor is a run of PACs, or a small bit of afib. It was irregular. Felt jumbling all over the place. I can't prove that though.

[Careful35]

I did have an EP study with the goal being ablation when I was 26 years old but the dr was not able to provoke arrhythmia long enough for mapping but in truth I'm used to it and so it really doesn't bother me much anymore... The increase I have been having in ectopics does.

I also had grade 1 DD on my echo, I don't know if its changed though. I do not know where the thickening is as they didnt tell me. She just say there is mild thickening. I am waiting for her to send the copy to my genetic dr though so she can forward it to the cardio she wants me to see.

Some of my single PVCS feel like a quick flutter but the episodes I get similar to your feels like a fluttering and quivering for several seconds. I have never caught that on a monitor though cause thankfully it doesn't happen often (knock on wood). The run of NSVT that was caught caught years ago I dont remember feeling. I dont feel all my PVCS. I feel A LOT of them but have been hooked up to a monitor in the ER and it was showing them frequently but I was only feeling some. Things are getting bad now though. I have never gotten them as bad as I have been lately..

[Gamgra]

I see. I'm sorry I forgot you mentioned the EP study you had at 26. There are some risks with an EP study and it's usually the last resort, but I'm glad you are dealing with a geneticist and a good cardiologist because of your WPW genetic ties.

Are you on any medications to control the ectopics i.e. beta blockers? I hate those drugs but I've heard they work to reduce the sensations enough to be able to ignore them.

My echo showed mild LVH so that may be what you have, but there are multiple types of LVH and of course many causes so it's good to find out why. If your blood pressure is even mildly elevated this can cause issues like I said before for those cardio sensitive. You can add a low dose sartan (arb) or ace inhibitor drug (i.e. 75 mg Irbesartan) once daily and this has been proven to promote regression of hypertrophy and improve DD. Coq10 has as well, along with both reducing ventricular arrythmia risks. Something to think about when you see your doctor. Arb drugs have no side effects for the vast majority of patients <95%.

Good to know at least we can share a similar experience. We're not alone and we can support each other!