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Avatar universal

are ventricular ectopic heartbeats always followed by a compensatory pause?

This is what I read on a few sources, but I'm not sure if it is always true.  I get some ectopic beats that are followed by a long pause and a forceful thud, but most of my ectopic beats blend in quite well to the underlying rhythm.  There is usually no pause, I just feel an uncomfortable beat in my chest and my heart just resumes beating normally.  I also noticed that preceding some of my ectopic beats I feel a tickling sensation in my chest, like an air bubble expanding in my chest.  Sometimes this tickle doesn't produce anything, but sometimes it leads to a single premature beat or a burst of 2-4 premature beats.  Again, there is almost never a pause after this event.  My heart just continues on as if uninterrupted.  Does the tickling and the fact that there is no exaggerated pause after the ectopics have any value in discerning where in my heart these ectopics might be originating?
5 Responses
Avatar universal
Maybe you dont always feel it in your chest but if you check your pulse you will feel it there. Don't worry about the pause, it's just the sinus node resetting and preparing to fire the next beat.
Avatar universal
Maybe you don't feel it in your chest but check your pulse and you will feel it there. Don't worry about the pause though, it's just the sinus node resetting and preparing to fire.
Avatar universal
I thought my first comment didnt post so I did another one. I'm not sure how to delete the 2nd one... sorry...
Avatar universal
Yes a pvc without a pause is called a interpolated pvc. Usually happens early in the cycle and don’t reset itself
6 Comments
I have had them on holiter monitors and from what I understand they are no more dangerous from what my cardiologist says.
The only way to know if your pvcs don’t have a pause is to catch it on a holiter or ecg. You could also be having some pacs and they usually don’t have a full compensatory pause. However I have been fooled by both.
Interesting, so I'm guessing that NSVT (if it is even felt) can feel like an exaggerated sinus arrhythmia, or like a normal heartbeat if the NSVT happens to be close to the rate of your baseline heartrate.  Of course, I am aware that most of the time PVCs and NSVT is not even felt.  
Nsvt should be faster then your baseline heartrate
Of course, but say you're working out and your heartrate is 140-160 BPM and the NSVT happens to be around the same rate you will probably experience the beats as normal heartbeats.  That's what I meant.  
I guess it is possible but if it in not significant it is probably better if you don’t know. The doctor would just tell you nothing to worry about. Easier said then done.
Avatar universal
I think there is some confusion as to what a compensatory pause and a non compensatory pause is.
3 Comments
Compensatory pause is the sinus node resetting itself the r to r interval with be double the preceding beat. Non compensatory pause the sinus node is not reset and the pvc is sandwiched in between to normal beats. The r to r interval will be the same. This is called a interpolated pvc
Full compensatory pause does not reset the sinus node, a non compensatory pause does.

Also, most ectopics are followed by a pause regardless. Compensatory and non compensatory are just the length and weather or not the sinus node is reset or not (with the exception of interpolated PVCS).

A person isnt gonna know what sort of pause it is by feeling in their chest etc, these things are only known through EKG. Technically PVCS and PACS aren't even felt, its the next normal heart beat that is.
I have enough experience of watching ECGs while having PVCs to know it's not the pause and next normal heart beat I feel, it's the missed beat itself. Sometimes I feel both, but mostly just the PVC itself and not the next beat. I can tell this quite easily. I can also distinctly feel the difference between a PVC with a pause, an interpolated PVC, etc.
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