Hello and welcome to the forum. Your description of the event mentioned sounds to me as though you merely experienced an episode of paroxysmal atrial tachycardia, or PAT. It is actually common in otherwise healthy persons and indeed has been observed in persons with GERD. It would also be quite remarkable to develop any type of vascular occlusion such as sclerotic plaque that would produce an ischemic condition within such a short interval after the previous diagnostic studies. The conditions which produce ischemia have a very insidious onset, taking years to develop and early clinical signs are almost always evident.  

The suggestion here simply arises from my own preferences of conservative medicine. There are several less invasive diagnostic procedures which can help support or rule out the need for an actual catheterization, which frankly is used more commonly in cases where a range of clinical evidence all supports the presence of conditions that would merit such intervention. To simply go on the prowl for evidence of occlusion based upon a single test is a bit too liberal in my opinion.

The position of the patient in my estimation should always be one that challenges the medical community to provide substantiated reasons for any invasive procedure. Other less invasive measures should be discussed and should the results of these tests collectively support the presence of conditions producing ischemia, then catheterization would be the next logical step. Using a catheter loaded with stints and traveling within the vascular network of a patient looking for signs of occlusion is akin to performing a colonoscopy because there is evidence of dyspepsia.

My general rule of thumb is to act sequentially to warrant an invasive procedure. If the tests are unanimous, then proceed. If not, then a repeat of the test within 60 days or so through a secondary cardiologist would provide the litmus test of whether a problem exists and warrants further investigation.

Best regards,

Rutheford Rane, MD (ret.)

Update: Well a year later I am still experiencing palpitations on a fairly regular basis. My second cardiologist dismissed any heart issues and suggested that I not think about them and follow up with him.

I still experience lots of skipping and pvc's but I have noted a couple of things...

They are much more active during warmer months.. in fact I had a severe episode almost a year to the day from those last year... then I noted that my original episodes took place at about the same time.. May 2010, 2011 and now 2012...

Living in Atlanta it's not easy to keep cool all the time but I notice that the palpitations are more active and noticeable when I am not very active... in fact several times when I have felt them while working I have stopped working and gone for a walk, usually about an hour... I still feel them a little afterwards sometimes but I usually feel a lot better...

Now I have been looking at this differently with a focus on my GERD which I believe to be at the root of my palpitations...  Several years ago I was diagnosed with GERD and a small hiatel hernia...  I was on a 40MG prescription of Zegerid. In 2010 Zegerid became available OTC. My insurance company said it would no longer cover my prescription at that time... and made several recommendations ... I never got to worried about it and just began taking 2 of the 20 MG Zegerids each morning and on occasion I would take a tums or a pepcid complete in the evening if I felt like I needed it.. the 40 MG zegerid never seemed to last 24 hours for me and my dr. didn't seem to think it was an issue when I told him I was taking 2 zegerid... A couple of months ago I had run out of pepcid complete but had plenty of zegerid and if I needed something in the evening I would take a 3rd zegerid that day... and two more in the morning as my routine dictated...  

Recently, my palpitations became worse, more frequent and more disabling... unable to focus on work, sluggish and not sleeping well... I hadn't really thought anything about taking the zegerid.. but last week I had an appointment with my gastroenterologist... while talking to the nurse I mentioned my zegerid intake and she expressed alot of concern telling me that it was alot of sodium and wasn't good ...  I didn't really know that that much zegerid was harmful...  To shorten this up some, My gastroenterologist had me do a food emptying scan to see if food was leaving my stomach fast enough because of other symptoms I was experiencing recently.  

The results were that I did have a slow stomach..  So I began researching what that meant and learned that an imbalance in blood pH was a possible cause... never heard of that before...   but what could cause that? ... taking too much Zegerid OTC? ...
I have done a couple of things in the last week since learning about my slow stomach issue..  it was suggested to drink cranberry juice or pineapple juices to help balance my blood pH in case that was the cause... the second thing is that I stopped taking zegerid OTC.  I am now taking just two 20mg prilosec in the morning and drinking more water...  

I need to give this some time but just in the past few days I have begun to feel them easing a bit...  I see my PCP on Wednesday and have to follow up with my gastroenterologist in a couple of weeks...  

Can too much zegerid create a pH imbalance that could be a factor in palpitations?...

I noted that I began experiencing mild palpitations a few weeks after switching to zegerid OTC and taking 2x in the morning and felt the were worse during warmer months...  can anyone else relate?