HI everyone,

So glad I have found a forum that seems to be based 100% on scientific fact. Mainly due to the fantastic advice be RLR!

I'm 40 yrs old, male, generally in good health, been having intermittent fast heart rate for a few years, been having missed/skipped heart rate on and off for about a year.

I also have GAD or symptom specific anxiety, not sure which came 1st the anxiety or the palps etc - chicken and egg story I guess.

Over the years I've been to the doc's many times about my heart, and also had a heart trace - normal.

Needless  to say as with everyone else here the palps get me down and obviously I wish they would stop, I really feel they stop me from fully enjoying my life as they feel so uncomfortable.

The palps can go on almost non stop for 2 weeks at a time! then I might not have 1 for a month!

I really dont understand how they can be so sporadic, as my stress levels dont really appear to fluctuate much.

I'd say the worst part about them is the constant thought about will they come back, when wil they stop, why me etc etc etc so the anxiety part really.

Had a real bad night last night when I woke up at 2am with a fast heart rate that stayed all night and I just couldnt get back to sleep, things always seem Soooo much worse in the middle of the night dont they.

I've read a lot of posts where RLR discusses the Vagus Nerve etc and it all makes perfect sense, and if I am reading correctly the palps are mainly caused by anxiety and dread - basically thinking about and fearing them or the return of them etc, which I guess tenses up the nerve? and also any type of stomach problem like indigestion, bloating etc IBS and also possibly just changing body positions etc so now I fear about what I am eating too!

Let me know if I have those facts straight.

It's quite frightening to think that I might have these palps happen whenever I get anxious, or perhaps cross with a situation, say my son does something wrong and I get worked up etc.

I never had them before all this so I wonder why they don't go away now.

Has anyone on the forum ever recovered from them? or is it usually a life long thing?

REALLY appreciate anyone that can spare the time to talk

Hi Jason and welcome to the forum.

It's very important to consider your perspective about the palpitations when taking steps to better understand them, as well as diminishing their presence and effects in your life.

Firstly, everyone becomes frightened if they detect any abnormal rhythm of their heart and it's quite understandable. It's sort of kin to your car's engine acting up on a dark desolate highway. A sense of helplessness is always a concern. But there's another more scientific basis for sensing dread or doom and it would help you to understand that the vagus nerve has influence at the level of the brain in a region known as the Locus Coeruleus, responsible for emotional regulation.

So part of the fear and apprehension arises from brain stimulation and therefore, the affected person can relax knowing that their reactions are not purely overdrawn emotions concerning the presence of benign palpitations.

The greatest facts that you need to draw from this forum have to do with a more keen understanding of precisely what is happening when these palpitations occur, what actually causes them and why it is absolutely impossible for them to actually place you in harm's way or somehow cause you to suffer any type of cardiac event.

Although you may have read it elsewhere on this forum, the origin of the palpitations is based in a rather complex physiological reaction that occurs in the body in response to the perception of fear, whether real or imagined. It's known as the fight-or-flight response and it imposes upon both the sympathetic and parasympathetic nervous system to establish necessary changes in physiology in order to either fend off a threat or escape from it. It occurs in all mammals and more necessary in lower animals due to the more predatory environment in which they live.

The absolute best example of this is for you to recall an event that suddenly frightened or startled you. The effect happens to most anyone who watches a gruesome horror movie. Following a climactic event in the film, you can always hear someone in the audience exclaim afterwards "That made my heart skip a beat!" Well, that person experienced a benign palpitation as a consequence of vagus nerve stimulation. They are not concerned in the least, however, because they have a rational and salient event with which to dismiss it as normal.

What happens in the case of a person with significant stress or anxiety disorder is that the heart is simply responding to vagus nerve stimulation as part of the fight or flight response, but the stimulus or threat cannot be identified. In other words, the people in the movie theatre were exposed to visual and auditory information that produced a fearful circumstance and the brain acts automatically to induce physiological change when sensing fear. In the case of the anxious or stressed individual, the stimulus is largely undefined or alternatively may be intentionally suppressed or avoided because it invokes or increases the stress or anxiety. Thus, the body receives mixed and fluctuating signals regarding the nature or existence of the threat.

This is highly critical because this undulation is what causes the nervous system to express mild dysregulation. When the body induces physiological changes, the affected person universally and erroneously believes them to be symptoms of some type of disorder or disease. It is not uncommon for such persons to state that the only stress or anxiety they have is related to the very issue, ie heart palpitations, and would be fine otherwise. This is an essential among persons with anxiety, because it represents the moving target. In other words, the most worrisome or imminent risk is the object at that time. No other worries or concerns merit the same focus with the same intensity and therefore, become secondary and even non-existent in many cases.

Here's how this entire problem can manifest itself into something entirely unrecognizable and unwanted by the affected individual: A person experiences significant stress or anxiety about a past, present of more often a future event and it establishes prominence to a good extent. People who generally deal less effectively with stress and or anxiety disorder are those who tend to allow most other issues in their lives to lose the wind from their sails, focusing entirely upon a single point of stress until resolved or incorporated in a suitable fashion.

As situational anxiety increases, it can exceed that threshold to constitute a threat or fearful circumstance at some point. The fight-or-flight response is engaged and the individual begins experiencing "symptoms," ie racing or pounding heart, muscle tension or tendonitis, increased sweating, tremulousness, changes in GI function, heart palpitations and a host of other physiological manifestations. The individual is suddenly shifted from the original basis for their anxiety or fear, now centered upon the presence of physical symptoms by their impressions. A state of health anxiety forms and if serious enough, can actually alter the lifestyle of the individual.

The search for answers also mistakenly takes aim at underlying physical disease since they are unable to explain the nature of their "symptoms." They begin undergoing batteries of tests, all of which turn up negative, which on one hand brings temporary relief, soon replaced by more intense fear that the cause is elusive.

(CONTINUED)

Thank you for taking such a long time out o fyour day to type all that wonderful information for me - it is VERY much appreciated.

So basically due to my increased anxiety / stress the Vagus nerve is sending wrong signals to the heart to make an extra beat. When it really shouldnt be sending that signal. Although this can sometimes feel like it's missing beats because they are at the wrong time? Is that kind of correctt? - just trying to get it 100% understood in my head.

So does the vagus nerve also control the quickness of the beat when I experience rapid heart rate, for instance in the middle of the night? or does the Vagus only control the slowing / relaxing part?

So I think I am right in saying that my main cause is the increased anxiety, which can cause a palpitation to come seemingly out of the blue, then the adrenaline from the fright and worry of it perpetuates it to get worse and continue.

So I need to reduce my stress and anxiety to reduce or eliminate them from happening - which is easier said than done

You have obviously come across this very same problem thousands of time, so what would your advice be for stress and anxiety reduction?

Also I used to exercise a lot years ago, but don't do anything at all now, my doc told me to exercise about a year ago (I'm not over weight) and I did some form of aerobic exercise every other day for about 3 weeks, 1stly the Palps stopped, but then after a couple of weeks they came back, frightened me and I stopped exercising again.

It even seemed that the exercising was making them start at the end - I'd love to hear your opinion on exercise and the vagus nerve / heart.

Really appreciate you taking the time with my queries, I need to get back to enjoying life with my wife and 6 year old son, he deserves more from me, and worrying about anxiety / palps etc just drains my time and life away. It's a hard cycle to break out of though, even when you know the facts.

Thanks so much! that does clear a lot up for me - you are the only person I know that has actually explained why palpatatins really happen! it's very enlightening - thank you

What are your thoughts on exercise, as I mentioned above? and do you think it actually helps to minimise palps at all or is there no effect as the palps are caused by a signal from the Vagus nerve and so are actually nothing to do with the way the heart is operating?

That is really helping me see things more logically and calmly, the weird thing is they dont even hurt at all, they are just a nuisance and catch you unawares. So why do we spend so much time thi8nking about them. If we had the same feeling in our knee or somewhere we would most likely just get on with it.

I'll will certainly try my best to ignore them more, in the knowledge that they are not harmful.