PAC's

Hey everyone,

My situation is very complex, but I'm desperate for some feedback about what has been happening the last few days. Two days ago, I started having an influx of what I knew were PAC's. I've had them many times, as well as PVC's, but this is all new. I didn't think anyone could survive PAC storms like this. It is bizarre. First came a couple, then a few. Now, I have been having what I can only describe as "clusters." It feels like my heart is convulsing inside my chest for minutes straight. When I feel my pulse at the carotid, there are huge pauses, over and over and over. It doesn't seem like my heart is retaining any kind of sinus rhythm. It's just a bunch of disorganized fluttering. For literally minutes straight. I did not think my pacer could let things get this spaced and erratic. There are huge pauses. I thought it's job was keeping things organized and not allowing these kinds of gaps. The other night, there were so many, so close together, with so much fluttering without a break, that I went into the ER. I was terrified. The EKG read many PAC's. They also interrogated me and called my EP. Even right now as I'm typing, I'm getting a constant quivering in my chest. How long can this go on? At the ER, the nurse tried to tell me I was having runs of PVC's along with PAC's. The doc came in and told me I was just feeling my pacemaker pacing. He also admitted that he was not knowledgeable enough about it and immediately paged my EP. I didn't end up seeing him until later in the morning at his office. They did nothing for me at the ER. So my EP did the interrogation and also watched in real time, since the activity was still going on. He said immediately that he saw the PAC's and that I was probably having thousands over the last couple of days. Just PAC's. He said my interrogation showed no significant arrhythmias. He also said a lot of them were "non-conducted." I have noticed that when I'm feeling my pulse, even when I'm getting the fluttering and flip flopping of the heart, not all of them actually cause a skip that I can feel. What I'm feeling in my chest doesn't always reflect what I'm getting from my pulse. The best way I can describe it is that it feels like there are "half PAC's" over and over and over. Are these the "non-conducted" ones? Is it possible that this can disappear as quickly as it came? It actually went away for 12 hours and then came back with a vengeance and I almost called 911. My EP put me on Multaq, but acted like this was acceptable. Should I expect to eventually pass out? Why does it feel like my heart is being squeezed in fast motion from the inside? It feels like PAC's coming in double time. I would greatly appreciate any input. I have never been so scared in my life.


1 Comments

PAC ? AF

by Selwyn - 2014-12-20 12:12:10

This is very upsetting. Having had atrial flutter a number of times, I can see how a fast heart rate causes anxiety.

In general, if you are otherwise fit and well, and I note you are on the younger side for a PM, then PACs are harmless, often stopping as if someone has thrown a switch. I was on the way to being driven to hospital by my wife in the middle of the night, when after 200 yards in the car, I noticed the palpitations had stopped- 'turn the car around', and back home we went. All was back to normal. To some extent it is reassuring that your coronary arteries can cope with such a fast heart beat - otherwise you would have chest pain ( angina)

It is important to distinguish between regular fast beats, and irregular fast beats, and very irregular fast beats ( so called irregularly irregular!). The latter are typical of atrial fibrillation - paroxysmal AF ( that is, it comes and goes) is prevented by Multaq. Other extra beats only need treatment if they are causing distress or not settling after a reasonable period. The regular PACs are not associated with anything other than the awareness of your fast heart beat in a fit person. Anxiety worsens the situation.

You should try a Valsalva Manoeuver- there are excellent demos on U Tube. This slows down all fast atrial arrhythmias to some degree ( though not flutter). It can stop paroxysmal atrial fibrillation and PACs.( atrial ectopics and atrial tachycardia). I find it stops my paroxysmal AF. Give it a go.

Avoid stress/tiredness, alcohol, caffeine, stimulant drugs. Heavy exercise can cause PACs as well. Make sure your thyroid function is normal.

Hopefully, with the above advice you will get rid of the problem.

Wishing you well,

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