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Heart Palpitations Forum >> Symptoms and other concerns >> Does EVERYONE get ectopic beats?
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Message started by aurora75 on Mar 24^th, 2008, 4:24am

Title: Does EVERYONE get ectopic beats?
Post by aurora75 on Mar 24^th, 2008, 4:24am

Hello (I'm new here :)),

I have, what my doctor calls stress-related anxiety, which primarily shows through extrasystoli.

When it's worst I feel about 60 "extra" beats a day, when it's better I have long periods without them (days to months or even years).

I am curious to know whether it is true that ALL people get those extra beats every day?
Is it true that I just notice mine, because of my heart-focused health anxiety (and maybe have a few extra because of the anxiety)?

The days when I don't feel them, do I not have any then? Or am I just not aware of them?

My husband have no idea what an extra beat feels like.
Is it because he doesn't get them, or is it just because he is less aware of his body? (He is a real down-to-earth type, that doesn't worry much about anything.)

I've had two EKGs that both showed "non-specific ST-changes". And because I made so much fuss about this I also had a 24-hour Holter recording. I just had a letter three weeks later from the hospital saying: "The 24-hour recording of your heart rythm is completely normal".

I didn't have any extra beats during neither EKGs or the 24-hour recording.... :-/

Thank you for reading this (I know my English is not perfect). :-)

Any comments?

aurora75

Title: Re: Does EVERYONE get ectopic beats?
Post by Kathryn on Mar 24^th, 2008, 5:21am

Hi

I'm not sure if everybody gets them, but a large percentage do, I've had bad anxiety and have had extra beats for years, not as much as some on here, it's good that your heart tests have come back fine, if you had a problem with the heart itself then they extra beats would not stay absent during the time you were wearing a monitor.

Try and read the Palpitations 1 - 6.

Kath x

Title: Re: Does EVERYONE get ectopic beats?
Post by beadbabe on Mar 24^th, 2008, 5:28am

Hi Aurora
Welcome to the forum - we all know what it is like to have ectopics here. Read lots of the postings and you will know you are in good company! I hope you can find some help here.

I get thousands of ectopics a day, although there are some days when I don't get so many (in the hundreds instead - for me this is fantastic). And I have a theory about this... when I don't have so many (whatever the reason) I don't feel them and therefore I am less likely to have more because I am not so worried about my heart going funny. So whatever the reason for ectopics, anxiety only makes them worse. Guaranteed. I have been able to prove this to myself. I had none before getting anxiety and panic attacks.

Anyway, I can try to answer a few of your questions even though I am not a doctor. I think I have read that most people will have the odd ectopic on a daily basis, but let's face it, if you only have one per day you are so unlikely to feel it. If you have lots you will feel them, particularly if they are every minute or even closer together, as they are unmissable. Having said that, there are people who have lots and have never noticed until it has been picked up by a doctor.

It is difficult to explain to someone who doesn't have ectopics how noticeable and uncomfortable they are - for me if I am resting they are particularly bad, so it's very annoying because with anxiety they tell you to take time out and relax, but then come the ectopics and I just start to fidget. They are also worst for me when I warm up for exercise, but fine when I run. My cardiologist told me the best thing I could do for palpitations was to take up exercise, which I am doing. 5 months in, I am starting to feel a little better mentally.

If you have regular ectopics the chances are these were picked up on the ecg, but you may not have noticed you had them particularly if you were up and about, getting on with things.

Even if you have thousands on your ecg over a 24 hour period, as I did, they will still tell you your heartbeat is 'normal', as ectopics are considered a variation of normal, as long as there is nothing structurally wrong with your heart.

Oh and if your husband is a laid-back type he is much less likely to have lots of ectopics, as he is less likely to be stressed or have anxiety.

There is a great doctor here, RLR, who comments on postings and I am sure he will be along to say 'hi' too and help you out.

Take care, bead x

Title: Re: Does EVERYONE get ectopic beats?
Post by RLR on Mar 24^th, 2008, 3:21pm

Hello and welcome to the forum.

To answer your question, which likely arose from a comment by your physician, is that ectopic beats are observed in virtually all people but that fact tends to be glossed over when associating it to persons who experience benign palpitations as a consequence of anxiety. There is a difference. While ectopics do appear in virtually all ECGs if monitored long enough, they are not necessarily in the form of Vagus nerve stimulation. Such stimulation imposes a rather abrupt signal upon the normal sinus rhythm of the heart and it's felt by the patient as a thump, a flutter, a erractic stumbling sensation, sometimes even the perceived absence of a beat or two. Realize that what you are experiencing is not associated with the normal pacemakers in your heart whatsoever. In fact, the origin comes from outside the heart itself. What you're experiencing is a superimposed signal upon the regular beat of the heart. This is why sometimes you feel it mildly and other times quite forcefully. Depending upon the entry of the impulse, the heart can be at various points in the cycle. So, for instance, if the signal occurs during atrial depolarization, the sensation is typically mild but if it occurs during ventricular depolarization, then it can be sensed a lot more forcefully because the ventricles are the power-house of the heart and responsible for pumping blood out to your body. The ventricular chambers are much larger and more reactive than the atrial chambers, thus an extra beat can cause subtle changes in blood pressure, often responded to by the heart with very forceful beats until you're stable again.

Also, sensitivity in this case is more appropriately characterized as awareness. Once the anxious person becomes aware of the anomolous beat, they are compelled to be highly vigilient for any future occurrences. Thus, a cycle is established wherein the affected individual begins checking their pulse and watching for signs of change. When a subsequent encounter is experienced, it reinforces the need to check it even more continuously and because it is frightening, patients begin to notice other physiological processes occuring that were formally taking place without awareness.

It tends to establish a premise for health anxiety and vigilence to seek reassurance on a constant basis. Many persons have taken the same path in seeking cardiology tests and other diagnostic evaluations because they become concerned that if they don't locate the cause, it will result in a catastrophic incident.

My suggestion is to read my postings entitled HEART PALPITATIONS 101 PARTS 1 through 6 and more importantly, visit and talk with members on this forum. They have very similar circumstances to your own and you'll find that your situation is not harmful. In fact, as I've told many others here, in more than 40 years of practice I've never even once heard of a person suffering any type of cardiac event or latent heart damage as a consequence of benign palpitations.

You're going to be just fine. Visit with the folks here and feel free to ask questions. I'll be around if you need help with medical concerns, but the folks here provide wonderful support.

Best regards and Good Health

Title: Re: Does EVERYONE get ectopic beats?
Post by aurora75 on Mar 25^th, 2008, 4:40am

Thank you all for taking time replying, it is very comforting!

I will read the suggested posts on palpitations.

Beadbabe: Do you feel those thousands of extra beats? How are you
able to concentrate on work etc.?

RLR: I will read the "HEART PALPITATIONS 101 PARTS 1 through 6", before asking more questions. :-)

Thanks again!

aurora75

Title: Re: Does EVERYONE get ectopic beats?
Post by beadbabe on Mar 25^th, 2008, 6:30am

Hi there
If I sat and concentrated on it I would feel them all, but these days I don't. I feel them all the time when I am still - sitting watching telly or lying in bed. I find them most disconcerting when I am on the exercise bike at the gym - this actually worries me the most. Up and about I don't always feel them, but I averaged it once by taking an average pulse for a minute and counting the ectopics at different times, and I average 3-4 ectopics per minute. so you can work that out for yourself - 3 x 60 x 24 at the lowest amount in 24 hours. It has gone up to eight per min in the past which is very hard to deal with because there is a lot of pounding going on too with that.

I try not to focus on it these days but they are hard to NOT feel.

Bead x

Title: Re: Does EVERYONE get ectopic beats?
Post by saab on Mar 31^st, 2008, 1:42pm

I just wanted to say welcome to the forum too. When I first had extra beats (after an operation), I would get a missed beat every second or third beat for hours at a time - this adds up to thousands a day. I didn't feel them really. At the moment I just get a few a minute for short periods - but I feel these as a 'flip' sensation in my chest.

My tests were done when my missed beats were very bad - but I was given the all-clear, so I am sure if you were told you had a normal result then that is exactly what it is and you are fine. they would do further tests if it was anything at all to be worried about.

I have read that when a large scale research test was done many of those tested had ectopic beats which they were not aware of - all were harmless. Also, I have also read that it is not significant whether you feel them or not - some people are more 'tuned in' to their heart than others. We can all sympathise with you because these things cause an incredible amount of stress and anxiety. Best wishes.

Title: Re: Does EVERYONE get ectopic beats?
Post by aurora75 on Apr 8^th, 2008, 2:13am

Now I have read the HEART PALPITATIONS 101.

Very interesting with the vagus nerve. I never heard about it before, and can't seem to find any information on the internet in my own language. :( It seems all is related to craniosacral therapy. Nothing wrong with that, I just wonder if it is because the connection between the Nervus Vagus and heart palpitations isn't generally accepted here.

I'll have to ask you: Sometimes when I get skipped beats I can almost bring them on by taking a deep breath, and then when I exhale it brings on a skipped beat. Other times when I bend over, it can bring on a skipped beat. Or when I reach out for something or otherwise turn or move the upper part of my body.
Is that the vagus nerve causing it in all those cases?

Thanks,

aurora75

Title: Re: Does EVERYONE get ectopic beats?
Post by beadbabe on Apr 8^th, 2008, 7:00am

Hello
I would agree with exactly what you say aurora, I find any of the things you mentioned can bring them on - so unless you sit very still not breathing, you're kind of stuck with them ;)

I can remember posting exactly the same question as you probably over a year ago. Bending, a quick sharp breath in or out, moving my head or reaching my arm up - any of these things could set my heart ectopics off - weirdly or perhaps not, I found yoga to be a particularly bad trigger for them, although it is meant to be beneficial for palpitations and stress.

I don't know why there is no explanation given to us in the UK - you are told they are not dangerous, yet there is plenty information on the occasions when they can be a problem, but no information on the benign type. I understand doctors only want to focus on the dangerous sorts of heart problems, but if they understood the kind of trouble ectopics can bring people - the terrible anxiety and worry that can accompany them (and depression too for some people), then perhaps they ought to focus on what it can lead to.
I mean, plenty of time is spent researching other illnesses like ME, which is not fatal either, but debilitating and can be life-ruining.

Battling ectopics all seems to be about positive mental attitude to life - which can get a bit tiring - so anyone that gets them is destined for a hard time unless they can accept them and beat them into remission by ignoring them as best you can!

Best of luck
bead x

Title: Re: Does EVERYONE get ectopic beats?
Post by aurora75 on Apr 8^th, 2008, 7:50am

Bead:

I have wondered about that too!

If someone discovered a way to make the extrabeats go away, or just make you not feel them, they would be RICH!

As it is now, I suppose the only thing you can take to make them go away is arsenic.... ;D

aurora75

Title: Re: Does EVERYONE get ectopic beats?
Post by RLR on Apr 8^th, 2008, 4:15pm

The reason that you can bring about this type of palpitation upon deep inspiration is because the vagus nerve innervates the lungs as well as the heart, GI tract and other areas. It is the largest mixed type nerve in the body.

Under normal circumstances, this activity goes largely unnoticed, but when chronic anxiety is present, the body's fight or flight mechanisms sort of remain turned on all the time. You have to realize that what you're experiencing is exactly the same thing that occurs when you are suddenly started or frightened. Surely you've heard of people say that something scared them so bad that it made their heart skip a beat, or that they nearly passed out, or scared stiff, or that it caused them to suddenly gasp or inhale and a host of other responses.

These experiences occur as a consequence of the sympathetic and parasympathetic nervous system responding to danger or fear by invoking what is commonly referred to as the fight or flight response.

What happens in people with anxiety is that they become anxious or fearful of an unidentifiable source, that causes this system to remain chronically active, albeit to a lesser extent. The parasympathetic nervous system controls the vagus nerve and represents the brakes, so to speak, of the fight or flight response. The sympathetic nervous system is analogous to the gas pedal and activates systems necessary to respond physically by either fighting or fleeing.

So in the case of the vagus nerve, together with the sympathetic and parasympathetic nervous system, anxiety and panic disorder promote a dysregulation that you sense as physical symptoms such as rapid heart rate alternated with slow pounding heart rates, feeling too hot one moment and too cold the next, tingling sensations, changes in vision or voice, weakness or tremulousness, dry mouth or over-salivation, coughing, trouble sleeping, and so on.

All of these "symptoms" are actually the very same ones invoked by the nervous system in response to imminent fear. The reason that people don't ordinarily make the connection is that when frightened, your attention is upon the source of the fear rather than how you're body is responding. Only in cases of clinical anxiety and panic disorder does the afflicted person suddenly take note of these physiological changes occuring in the absence of an imminent or unidentifiable threat. Consequently, it is believed that these changes are symptoms of something physically wrong because from an early age, it is both inherent and part of social training to take note of physical symptoms as the anticedent to illness or disease.

Once this perspective is adopted, it becomes extremely difficult to extinguish because the continued presence of the symptoms are reinforcing the false belief that something is physically wrong. And since the belief is that something is physically wrong, medical attention is sought and testing performed in search of the underlying cause. It invaribly results in frustration and even more fear because diagnostic testing fails to detect anything wrong.

All sorts of things begin to take place at this point, most particularly cause & effect thinking. For example, if a person with this disorder experiences symptoms while undertaking a particular task, they conclude that it has a direct link or causal relationship which may not be the case at all. Hence, people begin acting out of character and avoiding certain places or certain types of food, etc. hoping to terminate the underlying cause. They take vitamins, supplements, potions, yoga and many other consumables and activities believed to bring about a cure. The anxiety stricken individual also become panic-stricken rather easily because the symptoms represent a loss of control and a potential source of helplessness if an attack were to occur in a public place.

Do you begin to see how all of this begins to coalesce in the minds and actions of the anxiety-stricken person? The answer is actually found in understanding your disorder from a logical and objective standpoint and taking measures to diminish its effects upon your well-being.

There is no physical disorder associated with this type of physiological symptoms because it is a normal physilogical response by the body to fear, which has become chronic in the presence of anxiety. It can emulate the sensation of extreme illness and yet other than fatigue, it is entirely harmless to the body from a physical standpoint.

Again, the approach to the answer is not to force a direct relationship between the physical symptoms you are experiencing and some type of physical disease. Testing in this manner will always yield a negative result. It is about accepting the fact that anxiety can produce overt physical symptoms that have no basis in disease or illness whatsoever. It is about learning to better understand your body and how it reacts to anxiety and determining ways to alter errors in thinking that almost always make matters worse.

We'll talk more.

Best regards and Good Health

Title: Re: Does EVERYONE get ectopic beats?
Post by aurora75 on Apr 22^nd, 2008, 4:58am

RLR:

What you write about accepting the fact that anxiety can produce overt physical symptoms that have no basis in disease or illness, I find very useful. Thank you.
Actually it is not that my mind didn't know that, but it's hard for my heart to realise it.
I have read of people being paralysed or going blind for months or years, because of anxiety or after traumatic experiences, but when my heart acts up my common sense goes out the window. :( I try to change the way I think though. And as "beadbabe" I didn't feel any funny heartbeats before I got anxiety.

Now that you are here, can I ask you if you know anything about anxiety in a historical perspective?
Do more people have anxiety these days?
I know that 150 years ago women were hysteric and that was it, but I wonder if people went to the doctor with unregular/skipped heartbeats in, let's say the 1920s? And if they did what did the doctors tell them?

I just wondered if you knew something about this as a doctor? I find it quite interesting. :)

Thank you for your time!

Title: Re: Does EVERYONE get ectopic beats?
Post by beadbabe on Apr 22^nd, 2008, 9:11am

hi aurora
What an interesting question - I often have wondered about this too.

Here's what I have read, but this is just from general background not a doctors perspective...

My mum says that in her generation and my grandmother's generation, people talked very hush-hush about a person 'being bad with their nerves'. Presumably this means anxiety and how it makes you go to pieces. In a way I find it a better term as anxiety feels a bit woolly and inappropriate a lot of the time as it's the symptoms that concern me rather than my state of mind! (I think that anxiety and the term panic disorder are relatively recent as psychological tags - when someone developed a grading system for deciding what you kind of anxiety you have - it all seems like variations on the same theme though - same problem just different severity and way it manifests itself).

Perhaps it wasn't so widespread back then as a long term illness because doctors dealt out tranquilisers like nobody's business in those days (which I believe is why they are also nicknamed 'mother's little helpers). And also this is why there are people who have been on tranquilisers for years because they were dealt out for anxiety (and apparently, yes, they do get rid of anxiety like nothing else, but people get stuck on them and find it very hard to go back to normal after being drugged up for years!)

bead

Title: Re: Does EVERYONE get ectopic beats?
Post by aurora75 on Apr 22^nd, 2008, 11:02am

Bead,

I guess I find this interesting, because in a way I find it comforting to know that my ancestors had anxiety too - and that it didn't kill them.

My dad has had several heart-related incidents when I grew up. Fast pulse (one time so he had that electric chock thing at the hospital) and I also remember the ambulance coming for him because of chestpain.
The doctors always said his heart was ok except for a minor mis-sound (I don't know the English word), but it meant nothing. They put his troubled heart down to anxiety, and he chose to use alcohol and benzos to treat himself. >:(
I've asked him if he ever felt those skipping beats, and he has said, he knew what I meant but he only had a single one occasionaly.
He just went through a quadriple bypass surgery at age 62 (he has type 2 diabetes, smokes and doesn't excersise at all!). And for the past year he had a lot of PVCs (every second beat all the time). Because some nerves died due to the diabetes he doesn't feel the PVCs, but I suspect that I still "copied" them from him because I've always identified my health with his, beacuse we both have anxiety?
Now I think I just realised that my dad might not make it to much more than 70 years, because of the way he treats his body, and therefore I think I will die early too. And when I think "too early" I think "next week".... :(
Does that make sense (to someone with anxiety)? (I know it might not make much sense to others.)

And there's been other anxiety sufferes in the family:
My dad's mother (my grandmother) I know, used "mothers-little-helper" and beta-blockers for many years, but I don't know what her symptoms were. She died at age 89 from old age (she also had type 2 diabetes).

I recently learned that my other grandmother (mother's mother) had a nervous breakdown in the 1940s and spent some time a nerve-sanatorium. In the 1970s she almost went crazy when my grandfather died, but luckily she re-married and remained sort of sane. ;-) She died at age 83 from leukemia.

So I suppose I don't have my anxiety from strangers then...? :-(

aurora75

Title: Re: Does EVERYONE get ectopic beats?
Post by beadbabe on Apr 23^rd, 2008, 4:25am

Hi there
Well, aurora... I don't think anxiety every killed anyone directly but if you are an anxiety sufferer it makes sense to take some healthy steps to ensure your heart is as healthy as it could be.

I am taking steps myself so you are not alone. I have been going to the gym twice per week since November now (and I have never done this in my whole life - never been sporty or anything, but and I never thought I would say this, it benefits me in lots of ways and I even look forward to it sometimes! :) )

I am sure anxiety does run in families though sometimes it might not at first be obvious. My mum says she has never been anxious, yet... I can think of loads of ways in which she is. She won't drive anywhere, if she goes on holiday she does obsessive checking of plugs and electrical items, she has little self confidence. My dad the same - he has blood phobia (which I inherited), he shows his anxiety in other ways though by going moody and depressed. Is anyone really NORMAL though?

Having said that both my inlaws have had troubled time with panic and depression, but my husband is the most positive thinking person you could meet. so it's not inevitable that you will catch it from your family!

And yes, when you are in deepest anxiety trouble you can spend a lot of time believing that these are your last moments on earth. I know this from experience (I don't think that all the time now - maybe only a few times a week ;) )

If you can find something you really like doing try to find a way to get out there and do it - whatever it takes. I really believe one of the first steps to feeling better is to do that. And then build on it really slowly - it could take a long time but things do improve. It's chore having to work on these things but it IS worth it in the end.

Keep smiling
bead x

Title: Re: Does EVERYONE get ectopic beats?
Post by aurora75 on May 2^nd, 2008, 10:08am

I've been A LOT better the past week. :-)
Every time I get an extra beat I keep telling myself: "It's just anxiety, it's just anxiety, it's just anxiety..." And that seems to do the trick!
Now I just feel 0-3 extra beats a day. :D

I've also begun seeing a psycologist (a good one). It's quite nice to have someone who knows about anxiety, to tell you that it's anxiety (if you know what I mean ;)).

I still would like to know what the "nonspecific ST-changes" on my EKGs meant....but it's not the biggest issue right now.

I can feel the anxiety lurking just beneath the surface, but it seems that as long as I give it a name, it stays downthere.

It's hard work though, maybe I should buy a watchdog? ;D