Hi Billycat
Just wanted to tell / remind you about my ectopic experience. I have had all tests - stress, heart scan, 24 hour and 7 day monitors. I do have ectopics - very frequent, isolated, runs of them, ones that don't stop for hours, ones you can feel in your chest and ones that you can't. I probably have thousands of them per day if I averaged them out. I also get tachycardias.

You don't need to worry (easier said that done, because I do still worry!) You are now entering into the classic state of being offered more tests by well meaning doctors that you don't need. This increases your worry over your symptoms when all you really need to know is - not dangerous, not life-threatening, just not very nice.

I also can see, because I have been through just what you have, that you are getting bombarded with hearsay medical information from people who work in the profession. Your cardiologist should know best.

You are being offered more tests by well meaning medical professionals - but I have learnt the hard way that ongoing tests do not necessarily offer reassurance. Because if one test comes up clear and then you are offered another one just in case they have missed something, you just start worrying about the next test / procedure.

And now for you you have had the prospect of a 7 day monitor and this remote possibility of an operation. No wonder you are getting more ectopics and they are not going away....

As for the operation - I believe you are talking about catheter ablation therapy. Well, don't worry about getting that, because it's unlikely that any UK doctor in their right mind is going to burn away part of a healthy heart for something that is non-life threatening - not on the NHS, and not in private practice either. The surgery itself carries risks of damage to the heart (slim, but would you risk a pace-maker just to get rid of something that is NOT DANGEROUS.) My cardiologist told me that no doctor would operate on my heart despite the ectopics being frequent, complex and multifocal. I guess this is because the ectopics are not caused by some malignant pathway in the heart but because too much adrenaline is agitating my heart rate and ryhthm.

Please don't assume I know what I am talking about, but  because I put up with these horrid ectopics every day I just want you to try to get ectopics in perspective like I am trying to. You have got a little baby on the way amd mustn't let the thoughts of ectopics get in the way. You know the anxiety cycle (even if you don't realise it) - negative thoughts of any sort lead to more anxiety and more symptoms (of which ectopics happen to be one of them.)

I bet RLR will be along later and I'll be interested in what he has to say.

Wishing you all the best
bead

Okay, I think we're on a runaway train here. Let's back up and look at the issue at hand.

First of all, you're experiencing benign palpitations that are the result of vagus nerve stimulation via some GI difficulty. Think of this happening as similar to a party line where several people can join in a conversation all using the same connection. The vagus nerve is like a telephone cable in that it permits transmission of signals that under normal circumstances, provide signals to organs of the body using neurotransmitters like acetylcholine. If you are experiencing a disturbance at a terminal end of the vagus nerve, most commonly the GI tract (also described as the gastric nerve), then there is a great potential for the nerve to be stimulated and cause signals to be sent along the vagus nerve tract. When it reaches the heart, it acts as it normally does as part of the parasympathetic nervous system to slow the heart rate. This imposed signal acts upon the normal sinus ryhthm and you sense it as a flutter or skip, often followed by brief pounding heart which is simply the body adjusting to the slight change in blood pressure created by the palpitation. The signals can be many or few, but typically vary depending upon level of stress, anxiety and conditions necessary for them to occur.

Now that is all that is happening. You do not have a defective heart, there are no structural abnormalities and nothing is being overlooked. Patients with anxiety feel compelled to have their doctor look and re-evaluate and evaluate the re-evaluation because they need to be relieved of the anxiety that in reality, is the source of the problem. I have actually had experiences myself where after performing a full evaluation on a patient, they will actually grab hold of my arm to alert me that a palpitation just occurred and request that I re-evaluate them as though the prospect of detecting illness had changed right before my very eyes. Anxiety patients are compelled to try and prod their physician to look further because nothing is being done to alleviate their symptoms. As I spoke of many times before, physical symptoms are not a direct 1:1 relationship with physical disease. It also must be remembered that in the case of underlying disease which is causing symptoms, diagnostic tests are designed very accurately to detect these various diseases. If the test is negative, it doesn't mean that something has been overlooked. It means there is no disease causing the symptoms. Furthermore, patients with anxiety create the circumstances to feel confused by primarily worrying about the prospect of serious disease while simultaneously throttling their doctor for not finding it. Subjective feelings that something is seriously wrong can become an extremely powerful influence and so convincing that some people continue throughout life relying upon their instincts, which have been misrepresenting the actual circumstances all along. Lastly on this topic is that when doctors really don't want you to be there, it's simply because there's nothing in the way of disease that they can treat and although the visit can provide some needed reassurance, there are more suitable avenues for you to obtain such support.  

Now, catheter ablation in your case would be analagous to undergoing gastric resection surgery because you are experiencing hiccups. Not only do I not recommend it, I also would shutter to think that there was a surgeon available who would even give it a passing thought in your case. I can certianly tell you that the more you worry that you're correct in assuming something serious is wrong with you, the more you will experience GI upset and increased frequency of palpitations. You have to realize what a vicious cycle this can become because as symptoms become worse due to increased anxiety, patients become further convinced that they are right about their suspicions and the disease is progressing to ever-worsening proportions while doctors continue to merely look the other way. During more than 40 years of practice, I've had many a patient challenge my evaluation and diagnosis in this regard and after sufficient passage of time, they come to realize that indeed, nothing physical was actually wrong. This does, however, come at the expense of realizing that these patients created life-altering restrictions on themselves for many months or years that was entirely unnecessary and unwarranted.

As for alternatively relying upon the advice of "relatives" who work in a medical practice environment, you get what you pay for in the way of advice, if you see what I mean here. No disrespect intended, but your relative is entirely off base with their comments and from a medical standpoint, unsubstantiated by any medical facts known. The fact that patients can feel benign palpitations is what causes the initial worry and the fact that the syndrome has been known for more than a century to be harmless would, in of itself, represent clear evidence that your relative's perspective is way off course. Furthermore, the frequency of benign palpitations does not suggest "greater" pathology of any sort whatsoever.

The actual truth in this regard is that it is the source of the ectopics which determines the nature and course of such events. It takes years of medical training to separate the difference between presumption of medical fact and actual working knowledge of those facts.

You'll be fine.

Best regards and Good Health

Thanks so much as always guys!! The reassurance is always welcome. All of the information and advice that RLR has given on this site makes so much sense, so I'm taking that to "heart" and not let my vivid imagination run away with itself - got more important things to worry about!!!  

Thanks beadbabe also - it really sound like you have similar experiences to me - which is also a comfort!

Regarding the "only a problem if there are less than 15 a minute" thing - there is another US web site I look at which has a heart forum. There are many people who post on there who have thousands of ectopics a day and have had so for many years. They have had all the checks and been told they are benign and have to live with it - now, it is always a comfort to me that they are told this because in such a litigious culture as the US I am sure a doctor would be doing an operation or prescribing drugs if there was any chance at all that they could be sued for failing to treat a serious condition.

I have also read several times that there is no significance to whether you feel the ectopics or not - it's simply bad luck that you feel them. It only matters in that they may be more ready to treat the symptoms if they cause you distress. Remember, they are not treating a heart defect, they are trying to alleviate the symptoms for the sake of your mental health.

The fact that the doctor was so disinterested is a good sign. Have the 24 hour test if it will help to put your mind at rest. You have had a lot more tests than I have and my GP was so worried when she took my pulse that she sent me straight to A and E - my tests were fine despite loads of ectopics.

Thanks again Saab and beadbabe!! You two have obviously done your research!!

I'm feeling loads more rational about the blighters now and I get what you're saying about America and litigation Saab - thats a good point.  

I haven't really looked into information other than from this site - I can often scare myself silly with information overload (which I'm currently doing with regard to pregnancy info and stories!! when will I ever learn!?).


Best Wishes to you both...