Heart has a delayed beat upon exhalation

[potatolover]

Hi, I've been having this issue where when I exhale (especially laying down to go to sleep) I get this delayed beat. I have been diagnosed with PVCs and know what those feel like (a long pause with a hard thump). These are different. I've read about respiratory sinus arrhythmia and know that this happens, but it seems to be more than that. I feel my heart slow down and when I get to the end of the exhale, the beat becomes even more delayed followed by a smaller thump (like I said, it FEELS different from PVCs that I know).  There's no way to avoid it happening.

It happens quite often but with no pain whatsoever, more of a nuisance than anything. It's just I have major anxiety over my heart and this isn't exactly helping. I'm a 26 year old male that doesn't smoke.

My question is: Does anyone actually know what the hell is going on? Is it a PVC after all or something different? I saw a cardiologist over it last month and he said it was different from a PVC but didn't tell me what it was. Any help would be much appreciated.

[is_something_wrong]

Sounds to me like sinus arrhythmia. When vagal activity is strong, the sinus heart rate can easily change 100% when going from inhaling to exhaling. I've experienced this a lot of times and it really feels weird.

Still, if this happens often, why don't you get it registered so you can know for sure? If you have a blood pressure monitor, you can use that as well. If it is a PAC, the monitor will usually produce a double beep, and if it is a short sinus pause/sinus arrhythmia it will not. But the easiest and safest way is EKG.

(just wanted to mention blood pressure monitor in case you already have one of those..)

[MontyFL]

Can you afford $75 to end the worrying?

Get an Alivecor device like Hefner above and capture an ecg of the beat. You can easily email it straight to your doc;  then you and your doc will know for sure.

They're super easy to use.

[hefner33]

Hey sorry. Just seeing this reply.

Also sorry for not being clear. I'm not the smartest on the subject but from what I read and being told from docs, is that your parasympathetic nervous system (think of it as the breaks on your heart beat) kicks in and can dramatically decrease your HR from your normal rythym. They actually call this sinus arrhythmia http://www.cardiachealth.org/sinus-arrhythmia. Some studies have shown it to be a sign of good health if its more pronounced. For eg. I can go from walking around and then sit or lay down and my heart beat will dramtically slow very quickly which will feel like a drawn out heart beat. Again this is just an assumption on whats going on.

PAC is just a extra beat that occurs that you dont have to feel. Since your heart rate is slowing, the actual extra beat may feel like is the normal beat that was suppose to come next but it instead is a atrial beat since your heart rate was starting to slow down and then the draw out is a compensatory pause with the thump you mention.

I have a alivecor ecg monitor that I was using to record tracings and I use to think I was exeriencing sinus pauses. But I showed to EP and thats what he told me

[potatolover]

Nice explanation!! Thank you Elli!

It doesn't really feel like an extra heartbeat so much as it feels like the heart is having to wait to fill with blood before pumping it out. But instead it waits a little too long and pumps more through than usual.. Kind of like when you accidentally take too big of a bite of food and end up swallowing it all at once. I don't know if that makes sense.

I know I shouldn't substitute this for a real doctor but If that still sounds like a PAC, then this will allow my anxiety to calm down until I can get it checked out.

[Elli126]

What he's talking about is a PAC, same as a PVC but starts in the atrium rather than the ventrical. The compensatory pause is the pause while the atrium is refilling with blood after the early beat. The parasympathetic system kicking in is the "system" that rums your heartbeat, breathing etc. the "involuntary" bodily actions. Hope that helps. (Yay, I remember some things from being a nurse in the olden days. Lol )

[potatolover]

Actually, I'm reading what you wrote again. I get the gist of what you're saying but would you mind clarifying what you mean by the parasympathetic system kicking in to "cause what seems like a pause"?

Also, what you mean by the extra atrial beat and compensatory pause? That was most confusing.

Thank you.

[potatolover]

hefner33, that was a mouthful.

Not taking what you said as a definite answer, but if that is what is going on; I have to know. Is it dangerous? That's my biggest concern as it happens EVERY night and is fuel for anxiety.

[hefner33]

I also had this happen. I showed a electrophysiologists this on  recording I did and he said it was where your parasympathetic system kicks in which can be drawn out causing what seems to be a pause. Also......was told that it can be a extra beat(atrial) that kicks in around the normal rhythym but causes a compensatory pause

[itdood]

Has to be caught on a EKG to know.