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Palpitations, paresthesia and sinus pauses (Read 3907 times)
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Heart Palpitations

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Palpitations, paresthesia and sinus pauses
May 16th, 2013, 12:20pm
Hello all. I'm a 37 year old male with a reasonably high fitness level (did an Ironman last year, and have done many other triathlons and half marathons/marathons). Have never smoked and drink very little alcohol. Consume 1 or 2 espressos a day.

About four months ago I started to get pins and needles in my feet and hands. I also started to experience transient periods of lightheadedness and the feeling of my heart beating hard.

My GP did a resting ECG (normal), blood tests for the usual suspects (diabetes, B12 deficiency, etc) which turned up nothing, listened to my heart (nothing unusual) and took my blood pressure (very good).

Physiotherapy was suggested, and this seemed to help a little, as my posture is poor and was thought to cause some of the symptoms, but the paresthesia persisted, along with the odd ectopic beat when I was feeling stressed about the situation.

Since then I have continued to exercise, but find that my heart rate is about 10bpm higher for a given pace. I have also noticed that my heart rate does not drop gradually immediately after exercise, but instead has a series of what I think are sinus pauses - going into a much slower rhyhm for 2 or 3 beats, then back to the faster pace. This feels different to an ectopic beat - there isn't the same sensation in the chest - it just feels like a normal resting beat before it goes back to a series of gradually declining faster beats.

These pauses are more pronounced after a brief period of exertion, like climbing a couple of flights of stairs, than after sustained exercise, although they are often present then as well. I don't experience them during exercise or at other times.

I thought the cause of the paresthesia might have been hyperventilation, but as it is still present during hard exercise (at say 180 bpm) I can't see how this can be the case. It does lessen with exercise, but doesn't disappear completely, and is worst when in bed. I don't get it when swimming, strangely. The lightheadedness seems to disappear with exercise.

I would appreciate any advice on these symptoms - are the pauses in rhythm (they can be increased by breathing deeply after exercise, but this apparent respiratory sinus arrythmia decreases greatly as the heart rate decreases) anything unusual or dangerous?

Many thanks,

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