What Did I Feel?

[nicia88]

I'm a 27-year-old female. In 2010, I was diagnosed with benign ectopic heartbeats. I wore a 48-hour holter monitor in order to be diagnosed. I have been doing okay with them, however, there are rare events (maybe once every few months) where I feel about 3 forceful beats in a row. They happen quickly, maybe 3 beats within a second or two. They scare the crap out of me, frankly. However, I don't feel faint or dizzy or anything. This happened again last night as I was laying in bed watching TV. (It was a really boring show on HGTV... I'm not sure why my heart was so excited. ;))

My dad had mitral valve prolapse; but as far as I know, I don't have it. I have also had an EKG and an echocardiogram with normal results.

Does anyone know what these 3 rapid, forceful beats are that I am feeling?

Thank you in advance!

[Bromley]

Hi.  sounds like you were diagnosed with benign beats. Having 3 in a row is probably consistent with your existing diagnosis: no cause for alarm.  If you have questions or need reassurance, you could call your doctor.

[Artaud]

I agree, except when I go into bigeminy, it feels like back-to-back PVCs. I asked the E.P. about it, he said it's bigeminy. The premature beat is not felt, the pause occurs, a normal beat, a thump, then a premature beat that's not felt, pause, normal, thump. I've gotten these for a few beats to twelve perceived beats or longer. Due to the pause, it's a slow rhythm.

I'm trying to differentiate it from runs. They would be 3 rapid ventricular beats without pauses, such as a couplet, two fast ventricular beats. Three or more, and if more than 3 lasting less than 30 seconds, is NSVT.

The geminy patterns seem to be a PVC after a number of normal beats, one, two, three, etc. normal. NSVT is sequential PVCs with no normal beats separating them.

Good points about the trigeminy though.

[is_something_wrong]

If you felt three forceful rapid beats, it was likely a brief run of atrial or nodal arrhythmia. Sudden "forceful" beats are likely not caused by hard heart beats (high cardiac output) as blood inflow to the heart doesn't change that rapid. More likely you felt atrial beats firing towards closed AV valves.

Whatever it was, it doesn't sound dangerous. Not at all :-)

[Pooyan01]

When you feel three I think it's called ventricular trigeminy. I get ventricular bigeminy a lot, especially in bed. I think it's just easier to notice them when you're laying still and relaxed. If doc says All is ok then don't worry (as that will mAke it all worse) I take propranalol for this and also for the anxiety it sometimes causes.

[Artaud]

It would be impossible to say for sure.

I get Bigeminy, which is one premature beat and one normal beat. You don't feel the premature beat. Many Premature Ventricular Contractions have a Compensatory Pause after them, allowing the heart to fill with a little more blood than usual, during the pause, and is followed by a normal beat that feels like a thump as the extra blood is ejected. Some forms of Premature Ventricular Contractions, known as Interpolated PVCs, don't have a pause. If you're having Compensatory Pause PVCs in brief Bigeminy patterns like mine, it would feel like forceful beats in a row. I get 12 or more of these beats at a time. Depending on your resting heart rate, they could feel fairly quick. My resting heart rate is slow, so during a series of these PVCs, I actually feel quite odd, the heart rate effectively slowed to nearly half.

Some people get Supra Ventricular Tachycardia, very rapid acceleration of the heart rate, even at rest. I used to get episodes of PSVT, I had to wear an event monitor to capture it, but they were self limiting in duration and the doctors were unconcerned. You could be experiencing a brief but self limiting episode of this.

A "run" of premature ventricular beats can cause the same. A couplet is two fast PVCs, 3 or more fast PVCs (and if more than 3, with the episode lasting less than 30 seconds) is know as Non-Sustained Ventricular Tachycardia.

If it concerns you, you can speak with your doctor. An event monitor can be used to catch rare events. I'm not a doctor, but these things, happening in the absence of heart disease, are usually of no concern.

More sleep, no caffeine or alcohol, can lessen the likelihood that they'd occur.