Heart failure is not generally expressed by palpitations of the type you're describing. Please provide me with your age, sex, tobacco use, family history and any medications or health issues. Also tell me whether an ECG, echocardiogram or stress test, inclusive of blood work has been performed and when.

I'll be better able to inform you once I have more relevant information.

Best regards and Good Health

The fact that your tests are negative and that the palpitations mysteriously fail to make an appearance while under diagnostic testing constitutes undeniably strong clinical evidence that the underlying cause is anxiety. You must come to understand that anxiety doesn't exist purely in the situational context. Chronic anxiety manifests by inducing very specific physiological changes which are universally misinterpreted by the sufferer as symptoms of some underying disease. This type of anxiety has no relationship to whether you feel anxious or not, but rather based upon the relative state of the central nervous system.

The palpitations you are expereincing are the mere consequence of inappropriate stimulation of the heart by the vagus nerve. It's the rough equivalent of a muscle twitch elsewhere in the body, except in this instance the affected muscle happens to be the heart. You are misinterpreting the events as originating from within the heart as a potential warning sign of some impending cardiac event. It's highly critical for you to understand that vagus nerve-induced palpitations of the type you are encountering do not have the capacity to cause your heart to suddenly stop beating nor damage the heart muscle in any manner. In fact, you are at no risk whatsoever from these events and the only consequence is the sometimes crippling fear which arises that in many instances can actually alter the lifestyle of the individual experiencing them. Fear of leaving the safety of home surroundings or avoidance of social gatherings are but two examples of the broader exent of changes made in order to increase safety and reduce anxiety.

Like most other individuals who experience benign palpitations, you also firmly believe that the medical community must "catch" the events in order to determine their status. This is entirely inaccurate and supports the reason that the palpitations are so crippling in the lives of the sufferer. When we evaluate diagnostic tests such as an ECG, we're actually looking for very particular evidence which would explain the palpitation events being described by the patient. This evidence is highly consistent as the cause for true pathological arrhythmias of the human heart. It is the absence of medical education and training which causes the sufferer to draw their own conclusions regarding what must take place with the diagnostic tests in order for them to feel safe. The patient reasons "well, the doctor saw it actually happen right there on the equipment and he said it was nothing to be concerned about."

Patients are often just as frustrated by the paradoxical absence of the palpitation events when under scrutiny of the medical practitioner as they are the palpitations themselves. You need to realize that true cardiopathology does not possess the ability to hide from detection and the actual cause for such pathology is very easily observed on clinical diagnostic testing. The reason for the disappearance of benign palpitations upon presentation to the doctor is that anxiety factors have changed relevant to the environment. In other words, the patient experiences an element of safety in surroundings which are capable of responding to a cardiac event should it arise because they believe the events to pose an imminent threat.

You need to understand that the type of palpitation events you are experiencing are absolutely no different than the ones experienced by persons who have been suddenly frightened by some external event such as a loud noise. Surely you've heard people who have been suddenly frightened by something to exclaim "That made my heart skip a beat!" or "That made my heart stop!" These people are actually describing benign palpitation events exactly like those you and others on this forum are experiencing. The difference is that under normal circumstances, this type of response only occurs during isolated events that are brief in duration, ie a loud noise.

What occurs in the anxiety-ridden patient is that the fear response which normally engages very briefly, is alternatively engaged in a chronic state over an extended periods of time and induces an elevated state of the central nervous system along with other physiological manifestations that are part of normal human response sets. You become perplexed by these manifestations, including the benign palpitation events by means of irrational fear. Such persons regularly exclaim "But I don't feel anxious! I know what anxiety is and this is different. There is something wrong with me and if they don't find it, it's going to kill me! I can't even go out of the house or out with friends because these palpitations keep interrupting my entire life!"

It's important to understand that panic thresholds are not independent events, but rather the end result of a cumulative anxiety process. Like most people with anxiety and panic disorder, there are factors of your life which produce a constant fear under the control of irrational beliefs.

We'll talk more, but you are in no danger whatsoever. There is nothing actually wrong with your heart and the palpitation events won't shorten your life by even as much as a second in time. Only your fears are defining them as a danger because you don't understand their true origin and nature.

Best regards and Good Health