Very irregular runs of PACs

[Jansell84]

Hey everyone. I went through a 30 day holter study due to what I thought were skipped heart beats. Luckily I had a couple of episodes caught on the holter and they were determined to be PACs. I've lived with them for a year and always just dealt with them. No biggie. But I fainted and had a seizure back in September so it prompted me to have everything checked out... anyway what I want to ask is does anyone else have severe runs of PACs? I'll get them for several minutes at times, and they'll come in irregular intervals... Like I'll get one on top of another, and then it'll switch to every 3rd beat, then every 4th beat, then back to every other beat... This usually only happens when my heart rate increases to above 120 and it stops when my pulse settles back down. I especially get them in a hot shower, or sometimes after a big meal. And I get them when I exercise and really bad during exercise recovery. I'm concerned about Afib. Thanks all!

[MichelleP_3811]

Odds of it being afib are probably rare if your holter caught the episode and the doctors ruled it out.  But you can take your holter results for a second opinion which is never a bad idea.  Do the runs stop and start in what feels like one beat?  Was it suggested to you to try and ablation to correct the tachycardia?  It could be that you are bouncing in and out of and svt that is fixable and having pacs as a result of the irritation.  The next time you have an episode I would try and cough and see if that helps stop them sooner.  As well you can try holding your breath and bearing down like straining to go to the bathroom.  The sooner you can get the episode to stop the less stress on the heart.  And make sure you are drinking enough water.  It will help the heart function better.  As for the unpredictable nature of the episodes and their duration that is pretty common.  None of this follows a strict pattern so the randomness is not of significance.  

[Jansell84]

With all I've read about ablations and the relatively mediocre success rate I'll just try and deal with the episodes. They're unsettling is all. Even if they are benign it's tough to train my mind not to worry about it... but I don't know that I'd want to risk making the problem worse with the ablation procedure. I've browsed the forum and have read about folks who have the issue all day every day... a resting heart rate in the 100s without medication, and thousands of PACs or PVCs daily. I can't even imagine having to cope with that. I'll just count my lucky stars my episodes are mild in comparison.

[researcher09]

I don't know if you have AF or not but your cardiologists dismissive attitude just because of your age is a concern since AF can affect young people too.  The incidence is just about proportional to age.  The good news is that the younger the patient, the higher success rate when it comes to getting a cure via ablation - high 90s at experienced centers.

[Jansell84]

Thank you, and yes, I agree. I've been battling both my cardiologist and my GP where age is concerned. I wish they'd treat me the same as a 50 y/o who came in exhibiting the same symptoms. This is one of the top doctors in my region, though.

[MichelleP_3811]

Without them being caught on a monitor it is hard to say if it is afib.  You say you caught a couple of episodes while having the monitor on.  Were they the same as the ones that feel on top of each other?  If so then it is likely just runs of pacs.  Some sort of atrial tachycardia as opposed to afib.  If you are having issues in the shower and after exercise I would suggest making sure you are drinking plenty of water.  How is your sodium?  Low bp can cause issues in the show and raise the heart rate.  When exercising make sure you to a proper ramp up and slow down and maybe try and not push quite as hard and see if the pacs ease up.  Also stomach issues are a big trigger for ectopics so if you are getting them after a big meal your vagus nerve may be part of the problem.  Try to eat smaller meals, consider an antacid if you get gerd or indigestion and watch caffeine, sugary foods and carbohydrates.  As well spicy foods can do it for me too.  If you think that your symptoms are worse than go back to your doctor and ask for a new monitor, maybe a 30 day version to try and catch the runs.  But just because you have a run of pacs does not mean you are having afib just to put your mind at ease.  The less stress you put out about this the less they will bother you.  Take care and feel better soon.

[Jansell84]

Thanks for the response. I actually had one of my worst runs when I was wearing the monitor. It was determined to be sinus tachycardia with PACs. I've had a couple of runs that really threw mw for  loop since the monitor though. One night I got them after a meal... I was waking around shopping and it started and didn't stop until I sat down in the car for a minute. Lasted maybe 20 minutes. I usually only get them for a minute or so and once my heart settles down they stop. I rarely get them when I'm just relaxing. I was just concerned about the interchanging intervals. They're irregularly irregular if that makes since haha. I'm only 31 so my cardio told me he isn't even concerned about Afib. My uncle was diagnosed with Afib when he was my age though. But he's also a really big dude, and also has congestive heart failure. He's lived with both for 18 years.