Suggest Treatment For Ectopic Beats And Palpitations

Posted on Wed, 15 Jul 2015

Question: Hi doctor i have been having Etopic beats and palpitations over the past year. I had all cardiac testing done and my echocardiogram showed a structurally normal heart with some trace regurgitation in 3 areas. I passed both stress tests i had and i also had 2 48 hour holters. The first last year showed 925 PACS in 48 hours including 2 bigemy cycles and 3 couplets. The most recent holter showed 400 single PACS over 48 hours and 15 pvcs. I saw 2 separate cardiologists and both insist my heart is very healthy and that anxiety is at the root of the problem. However why do i get these symptoms when i am calm before bed and in the morning when i wake up. Also if my heart is healthy whey am i getting these symptoms. My doctor says my heart is healthy and these etopics have a different etiology that is not originating from my heart. I dont understand what this means.

Also this morning i noticed a few etopics and then i had tacycardia. Can PACS trigger this or this from anxiety about feeling the etopics?

Answered by Dr. Ilir Sharka (1 hour later)

Brief Answer:
Your symptoms are caused by anxiety.

Detailed Answer:
Hello!

Thank you for asking on HCM!

Regarding your concern, I would like to explain that all your symptoms seem to be related to anxiety.

Anxiety can cause similar symptoms during all the day long, due to an increase of the catecholamines levels in the blood. The catecholamines induce the heart to work faster, causing tachycardia and ectopic beats.

You may notice these symptoms more during the night before sleep, because of an increased awareness of your nervous system during this period, when your body is relaxing and your mind keeps thinking and paying attention to your heart rhythm.

In the morning it is normal to have some ectopic beats because the levels of catecholamines and cortisol (normal stress hormones) are higher in this period of the day in all healthy persons.

All your cardiac tests are reassuring that there is nothing wrong with your heart.
The results of your previous cardiac tests are compatible with a normal and healthy heart.

So just relax!

I would advise you to continue with psychotherapy to manage better your anxiety and try not to pay attention to your heart rhythm. It is just working like every healthy person's heart. Everything is OK!

Hope to have been helpful!

Feel free to ask any other questions whenever you need!

Greetings! Dr. Iliri

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar