Extra beats every time my heart rate is fast

[courtneyazeem]

I will try and make this informative and brief as possible.
I am 24, 6ft1 180lbs.
I have experienced extra/skipped beats and SVT since I was 14.

Had ecg's they did not pick up anything significant so I just ignored the skipped beats when they happened, back then it was extremely infrequent as in once every few months and the SVT was even more infrequent.

As I have gotten older they began to happen more frequently to were I am today were they happen near enough daily but from all my research and additional ecg checks I decided to just put up with them.

However my concerns are whenever my heart rate does become more rapid I always feel fluttering then multiple extra beats as in a steady rapid beat with a couple extra beats chucked in.
The fast heart rate can happen due to Stress,Anger,Exercise,anxiety and panic attacks but I always experience those symptoms which is why I stopped exercising and letting myself get really angry.
The only change in my lifestyle this year was wanting to become more fit and active so i began working out. I never experienced any issues as my heart rate increased until the last few months.

Now one morning I was late for work so i was jogging down the road only for about 1min and noticed my heart was fluttering so i stopped jogging and started walking and even then the fluttering would not stop so I stood still to let my heart calm down and it took about 2mins for it to relax but during this time I was still feeling every flutter. I should of gone A&E which was a 4min walk away but i still decided to go work only because i had experienced this before.

The memory of that morning dominated my thoughts and it began to cause me more random extra beats so i asked for annual leave and on the 1st day googled everything then said let me go up the road for fresh air as i headed up the road my heart rate skyrocketed and i felt the skipped beats again so decided to go A&E and even at this point i knew it was just a panic attack but another problem was slowly getting worse which was oblivious to me as i was so focused on my heart.  my asthma was coming back for the next week I was struggling to walk up stairs and hills it made me out of breath and made my heart race which caused more fluttering.

I waited 3-4 weeks to be seen by a specialist were I had ECG, chest X-ray and a echo-cardiogram. who said structurally and functional normal heart. very infrequent ventricular and supra ventricular ectopic beats  normal sinus,heart sound 1 and 2 were normal, no murmurs  expiatory rhonchi were audible. she told me to get my asthma under control and im still in that process taking my brown inhaler and I can walk up stairs/hills more easily however I still experience the skipped beats as my heart rate becomes rapid.

I was given a 14 day wireless monitor which I have right now, the only way I can replicate the symptoms is by exerting myself hard so i done that yesterday and recorded it. so i am going to do it a few more times. see what they say. I really want a stress test to be honest so i might suggest that. just so i know whats going on.

Before i posted this I looked around people with very similar posts and from the responses to those post people are suggesting they may just have exercise induced extra beats,atrial flutter or heart block.
personally when i experience all of random extra beats,rapid beats etc I never have any other symptoms like shortness of breath,lightheaded, passing out, feeling sick, chest discomfort. its just multiple extra beats,fluttering.
This has stopped me from exercising and I dont like running anymore at all.

[MichelleP_3811]

It is hard to say for sure what is going on but it sounds like you are catching in on the monitor which is good.  It really is the only way to know for sure and glad to hear you are doing your best to trigger the symptoms while you have the monitor on.  That can be a bit scary to do but is what my cardiologist suggested because if they can't see what your heart is doing then they will basically deem you normal.  The one thing I will say is that ectopic beats, even runs of them are different then svt.  They are completely different conditions but they do feed off each other.  

Ectopic beats are extra beats that flare off in the atria/pacs or ventricles/pvcs.  They can be caused by adrenaline from exercise especially if you let yourself get dehydrated or anxiety or from stomach issues and even simply from caffeine. They can come in single extra beats considered isolated or they can come in patterns or runs.  The telltale sign is that they can feel like a fluttering or most people feel a slight pause and/or thud after the heart resets.   In an otherwise healthy heart they are not a threat unless they are persistently in the 10s of thousands of them everyday.  

Svt is a condition that is caused by extra muscle fibers in the heart allowing the heart rate to fall into a reentry circuit causing rates usually well into the 200s.  There usually is shortness of breath but not always.  The telltale sign is that the fast beat feels like it starts and stops in one beat.  You are fine then all of a sudden it is off to the races then it stops just as quickly going back to normal.  Svt can be preceded by an ectopic beat and usually does because the pause is when the accessory pathway has time to complete.  And unfortunately the more svt you have the more ectopic beats you may get because the heart becomes irritated so they two conditions do eventually feed off each other and cause the cycle to become more frequent.  The best bet is to correct the svt with ablation which will help the heart settle down and may lessen the ectopic activity though ectopics are much harder to treat and most people just need to learn to live with them and avoid their triggers like stress/anxiety and stomach issues.

This said, to be clear svt is different then sinus tachycardia. Sinus tachycardia is a fast beat but it is normal in its morphology.  This is usually caused by anxiety or dehydration and sometimes by nervous system issues but the way to tell if it is simply sinus tachycardia usually the rate isn't excessive and it raises and lowers gradually.  It is not a sudden change in rate.

The good news again is that it sounds like you are getting your issues documented so then the doctors can know what course of action to take.  For svt an ablation may be the most prudent choice and for ectopics beta blockers are usually the first line of defense though my cardiologist suggest that I try and learn to deal with them since they are considered harmless in an otherwise healthy heart.  Anyways, finish your testing and let us know what the results say.  Take care and try to not worry.  If you are not passing out or having difficulty breathing you are likely not in any danger so the less you stress the less troublesome the symptoms will be.  Please get back to us with the results.