Question: I've had heart palpitations the last couple months, with no spikes in high heart rate. It all started with a throat and nasal virus (or at least that was the only health reason) and after I stopped caffeine cold XXXXXXX I've seen two cardiologists, done EKGs, Echo Cardiograms, blood enzymes, glucose, and thyroid testing, etc. All negative to date and told they are common PVCs. My back and chest get tight and know when they are coming on because I feel it in my throat. I recently had cortisol and adrenal testing and am awaiting results. I'm rarely tired. When I sleep well, the palpitations and sensations are not as great the next day. The palps are usually non-existent in the morning and build throughout the day with the witching hour being 3 in the afternoon till about 9 pm. I seem to get more palps with certain foods (carbohydrates) and almost always get palps 20 minutes after food unless I eat only protein. I have not recorded a palp during exercise and I actually seem to feel better after exercise but then get palps almost always about 20 minutes after when I'm resting or stretching. The first bout of palps in December were eliminated for a month after I spiked by heart rate over 180 during a workout. (Almost like it shocked my heart into normalcy again.) I have low chlosterol and took the treadmill test beyond level 7. I have mild sleep apnea and hold my breath at times at night. I've cut back on caffeine and alcohol but ironically when I have had caffeine when having a bout of palpitations it actually helps or eliminates the symptoms. I began the usual homeopathics including drops of liquid potassium, magnesium and licorice. Like anyone with PVCs, it's no fun when they come with episodes and wonder if there's anything else I can do? Or if there are any other insights that can be provided. I am 49, a runner/cyclist have a fairly high metabolism and been diagnosed with anxiety disorder in the past. Finally, I've read up on vagus nerve dysfunction and many of those symptoms seem to mimic my symptoms.

Dr. ANANTHaramakrishnan, thank you for your insights so far. It's appreciated. Can you explain why caffeine or exercise may help the symptoms, if only for a time before I crash back into palpitations again? Is it possible to shock my heart into natural rythmn again, as it seemed after they went away for a month the first time?

Dr. Haramakrishnan, thank you for your timely insights. It's greatly appreciated. Final questions as part of this program to wrap up this session:

1. You are recommending revisiting my cardiologist if palpitations continue. And possibly look at EPS but only if it's severe (or diagnosed as acute)?

2. In these circumstances where the electrical system of the heart is irregular, do you recommend less exercise or more? Is there a danger in either? Is rest the best panacea near term?

3. Finally, why do certain foods or stress trigger palpitations? Tied to hormone levels? And what are best foods?

I've talked to several people who have had these sensations suddenly stop or cease after a couple months. Why?

Many, many thanks again.