how do identify eptopics

[Electricblue1]

can anyone tell me how I know if I’m having an eptopic. My heart jumps out my chest and I have HHR, just shows up on Apple Watch as HHR. I’m confused. Today I had 5 hours of HHR 158, is it just HHR or an eptopic as sometimes it misses a beat or I get an extra beat. Didn’t do or eat anything that normally triggers me. I don’t know how anyone is supposed to function properly at work when the symptoms are bad . Any advice would be a comfort 😊.

[OzRob]

I use a Wellue monitor when sleeping.

One type of ectopic is a PAC (Premature Supraventricular Contraction) which I find is noticeable. You will see from a screenshot below from my ECG last night. With PAC's you get from 1 to 3 normal beats and then you get a premature beat.

1 minute ECG showing 33 PAC's

[Electricblue1 in reply to OzRob]

thank you, I find this all so confusing.

[OzRob in reply to Electricblue1]

As BobD said, a HR of 158 is quite high. With my ecg with Pac's I was only having a HR of 70 to 80bpm. It may be worth investing in a monitor that records 24 hours like the one I use. When I see a cardiologist I go armed to the teeth with my own data.

[Electricblue1 in reply to OzRob]

thank you.

[BobD Volunteer]

To be honest, with a rate that high and irregular my vote would be AF not ectopics. Try the slow deep breathing but maybe time to see your cardiologist and get an ECG done.

[OzRob in reply to BobD]

They are PAC's, not Afib.

[OzRob in reply to OzRob]

Sorry BobD, I thought you were responding to my ECG screenshot.

[Electricblue1 in reply to BobD]

hi bob, it doesn’t show up on my Apple Watch as AFIB, just HHR , before the ablation it always showed up as AFIB. I was just sitting doing nothing and it came on. I’ve had HHR a lot since ablation but nothing coming up saying AFIB. I try to do the pressure point on the wrist which is supposed to calm HR but I’m not sure I’m pressing in the right place.

[Autumn_Leaves]

I suggest posting an Apple Watch ECG app reading as a few people here have an apple watch and someone will then be able to identify PVCs and PACs as they have a distinctive pattern. Your best bet is to have a 24h ECG if you haven’t had one yet. That will verify how high your ‘ectopic burden’ is.. As for your high HR you could be experiencing an episode of SVT or another arrhythmia, or you could be in normal sinus rhythm but are tachycardic for some reason. If it happens again and is still going on after 20 minutes you ought to take yourself to A&E or phone 111 at the very least I have ectopics all day long, so I know how distracting they are. We’re told they’re benign so there isn’t much we can do about them unless they are so frequent that it justifies ablation.

[Electricblue1 in reply to Autumn_Leaves]

hello, thank you, how do I post my apple reading on hear, I’m not very technical. I did notice on my notes after 2nd ablation that the word tachycardia was on there. I know they had to zap me when I was under as they could not get my HR under control. All this is so annoying as when you are symptomatic it’s so hard to get on with being at work. Do you know of the pressure point on the wrist to calm the heart.

[Autumn_Leaves in reply to Electricblue1]

Firstly you need to save your ECG by choosing Export PDF. If you have an iPhone you can Save to Files to store it on your phone. (I don’t know about how it works on other phones.)

To post your ECG here, when you type new a message, select the ‘picture’ icon at the bottom of the text box and select Choose File. Assuming you have an iPhone, this should take you to your Files folder. Select your ECG PDF which should be in this folder

If you have another brand of phone, perhaps someone else can advise as I only know the phone I use.

[needlestone]

I ended up having to leave my job for a while to get it all sorted out. I traveled extensively with work and spent many frightening nights alone in a hotel room with HR up to 250 bpms. After ablation SVT was gone but continued having ectopics until I went gluten/wheat free and avoid artificial sweeteners like the plague as they bring them on in an instant. I try to stay as anti inflammatory as possible as I think that may be a piece to my puzzle. I do not take any meds only supplements and only have mild bouts of e topics now with alcohol consumption which I have decided is no longer worth it.

[Electricblue1 in reply to needlestone]

hello, wow 250bpm that’s high, I had 200 bpm on my very first episode and that was an ambulance job and made me feel very ill. Sweeteners are a big no no for me but they come in liquid form on some food like honey peanuts. It’s a pain looking at all the labels. What supplements are you on if you don’t mind me asking. I try to eat healthy but I lack knowledge and don’t know what meals to do.

[needlestone in reply to Electricblue1]

I did go to ER once with my high rate but before long I was back to normal while there and felt kind of dumb for wasting their time. These events were happening daily and multiple times. I would feel it coming almost in my throat and then feel faint and had to sit down. I have to read labels of everything and now try to mostly just make all of my own food. Ultimately, that is healthier for me anyway. My body forces me to be healthy. I guess that’s a good thing.

I take:

Zinc, milk thistle, D3 with K2, kyolic, NAC, flax oil and omega 3 plus a vitamin drink mix.

I don’t know that any of these are helpful but I think they help with inflammation among other things.

[Hidden]

Good morning Electricblue1, you may find our 'Ectopic Heart Beats' info sheet helpful: api.heartrhythmalliance.org... it mentions that some schools of thought consider that ectopic episodes or palpitations lasting more than 30 seconds actually are AF. If the symptoms are impacting your wellbeing and ability to function in day-to-day life, then it would be advisable to speak to your GP or cardiologist for medical advice.

ectopic heart beats info sheet

[Electricblue1 in reply to Hidden]

thank you that’s helpful. I noticed it said if you are on bisoprolol you should not take it if you have asthma. I’m on a low dose bisoprolol and so far it doesn’t affect me.

[Tomred]

if you go onto you tube sanjay gupta explains it all [york cardiology]

[drdubb]

I find my Apple Watch is very inaccurate. I rely more on my Kardia. With a rate of 158 I would be headed to the emergency room

[Autumn_Leaves in reply to drdubb]

I would also agree that the Kardia is better. My cardiologist said the Kardia is an ECG whereas the watch is not, but if all someone has at hand is the watch, it’s a lot better than nothing. If it’s on your wrist you might as well use it in the moment if something doesn’t feel quite right. But I would advise the OP to perhaps save up or budget for a Kardia. Once we has AF we have to think in terms of lifelong vigilance, and it is our heart we’re talking about here after all.

[Qualipop]

I started having constant ectopics a week or so after my c ovid booster. Coincidence? I don't know. Just had a 24 hour monitor which was a disaster as two of the leads came loose after about 5 hours so I don't know if it got enough to diagnose. I've had 3 doctors say they are atrial and 2 say ventricular but they happen about every 3 beats and started completely out of the blue. Although I don't feel most of them, the way I have with ventricular ectopics for years, I do feel some and they make me absolutely washed out. It's going to be at least 3 weeks before the monitor results and GPs won't do anything until then. Because I keep feeling faint and dizzy, I'm scared to drive. LOoking at the reading above that shows 33 apparently regular PACS, how on earth do you c onsider something like that benign and just live with it? My BP is normal and pulse usually in the 80s.

[Electricblue1 in reply to Qualipop]

hello, I know it’s all so very annoying. There is so many different things to do with the heart I get confused. I’m very symptomatic too and it’s horrid.

[Qualipop in reply to Electricblue1]

I just want answers and to know if there's any treatment. But I'm getting conflicting opinions from doctors even after 3 ECGs and a trip to Urgent Care. The doctor there said they were atrial yet when the head of the dept rang me ( They did things wrong) he insisted he was looking at my ECG and it only showed ventricular ectopics. I've seen 3 different doctors at our G P practice, one did bloods and ECG, one ordered the monitor but no one is in charge and I don't know who to contact- if it's even possible to contact anyone by name. I just had a GP I've never seen in my life prescribe some tablets for me. Luckily I didn't start them because I got a phone call 2 days later from the pharmacist almost screaming "Don't take them; they would be highly dangerous with your painkiller" The GP who prescribed them hadn't even looked at my records. I don't have much trust in their system.

[Autumn_Leaves in reply to Qualipop]

I have had problems with ectopics for 10 years. They all kicked off when I had a severe respiratory illness in 2012. A few months later I had a 24h ECG and it was 200-300, mostly PACS. Fast forward to winter 2018/19 when I had flu and from then on I’ve been having more or less constant ectopics. I had a 24h ECG in 2020 and was in the thousands, mostly PVCs although there were PACs too. You may observe that each period of worsening ectopics was preceded by a viral illness, and this was before anyone had heard of Covid, let alone the vaccines for it.

The reasons why this happens, as I under it, is that the immune system has an inflammatory response to infection which means our temperature will rise and our HR will increase, and inflammatory cytokines will be circulating around our bodies and all sorts of things that our immune system does to attack an invader. It’s not the virus in itself that causes these symptoms, it’s our immune response. As to why some people develop ectopics and other arrhythmias probably means we’re already vulnerable. I used to have very occasional ectopics, from once in a blue moon in my 20s to 2-3 a day that I was aware of in my 40s. So perhaps I was heading that way. Vaccines are supposed to provoke the immune system by introducing the body to a faux infection so it will know how to respond when it meets the real deal. I’ve had the full on flu-like symptoms for 24h after the vaccine but when I had an antibody test 4 weeks after my 2021 booster, my antibody levels were right up in the highest range, so that’s the best possible outcome as far the vaccine is concerned, and better than than the people who failed to produce any antibodies and hence don’t have much protection. So I’m honestly not concerned about the flu-like after effects.

It’s certainly feasible that the immune response and inflammation can make the heart more vulnerable to ectopics and AF episodes, but chances are that any viral illness might do the same. So it comes down to personal choice. It’s whether or not the Covid infection will be more risky in an unvaccinated or under-vaccinated person compared with the potential risk of an increase in ectopics or an additional AF episode following the vaccine. Ectopics won’t kill me but Covid killed my neighbour who was a healthy, active dad in full time work and with no obvious risk factors. At my age and because I now have AF I consider myself at moderate risk of more serious complications from Covid. I hope not but I have to be realistic. If I was my fit, healthy self at 20, my risk would be negligible. But I’m not 20, I’m 60. So we all have to weigh up our own personal risk in our decisions.

I’m not entirely convinced that ectopics are harmless if the ectopic burden is high. If it’s 1% probably not harmless but 40% ectopic burden probably means there is an underlying cause that needs to be investigated eg valvular disease. My ectopics became progressively worse and then I developed AF. So I don’t buy the “benign” thing at all.

[Qualipop in reply to Autumn_Leaves]

Mine must be into the thousands as they are every 3 beats or so. The surgery nurse did say they've seen a LOT of such responses after covid boosters. I'm not even thinking about whether to have another until I know just what these are. MY ventricular ectopics have never been a problem; 2 or 3 a day and often none for months . Having now had a heart attack I'm told I'd be more prone to AF. I'm just praying it doesn't go that way and that the immune response might calm down and take the ectopics with it. Like you I don't buy "benign". For now I'd be happy just to find out exactly what hey a re and why I feel so awful. Once I know I can start looking for the whys and what ifs. I can't imagine living with thousands of them and feeling like this.

[Autumn_Leaves in reply to Qualipop]

I certainly hope the ectopics settle for you. My worst escalation was after flu but it didn’t really settle down much at all after that. I’ve had periods of feeling better but it hasn’t lasted long. Unfortunately ectopics aren’t taken seriously and many people with AF seem to have them AFTER ablations, though some aren’t troubled at all. I think you need a 24h ECG and an up to date echocardiogram if things don’t improve soon.

[Qualipop in reply to Autumn_Leaves]

Thanks, so do I. If it was the booster that caused them I hope once that calms down the immune response it may improve. I could understand them ignoring the ventricular ectopics years ago which were infrequent but not this which is constant. Another thing they ignore is a low diastolic pressure which research is now finding is just as important as high systolic. Mine has recently dropped to 108/50 at times but mostly between 50 ad 60 and when it does I feel washed out and half asleep. GP doesn't want to know and there's no treatment. I'm eating crisps just to get my salt level up a bit because I cook from scratch and without salt.

[Autumn_Leaves in reply to Qualipop]

My diastolic BP is between 50-60 on 2.5mg Bisoprolol, and I don’t think that’s good. I’m thinking about cutting down to 1.25mg. My most recent was 96/62 which is “normal” but only just, but the time before was 80/56 which too low. Low BP isn't considered a problem at all in the UK, just as when I was underweight it wasn’t seen as a problem, yet it also results in poorer health outcomes. Thankfully I’ve restored my weight, so that’s no longer a concern but the frightening thing is that the weight loss in underweight also means loss of muscle and 50% of that muscle loss is internal - which includes the large intestine and cardiac muscle. And I didn’t have much fat or muscle on me to begin with. I do wonder whether the worsening ectopics and AF were possibly one response to losing muscle mass internally. But I don’t know. I’m guessing. I do believe that all conditions are multi factorial and there’s never just one cause, mostly it’s a cascade of various factors over the years before symptoms show. Then just one more thing comes along eg a virus and the tipping point happens. So, persevere we must. I hope you get the checks you need if these ectopics carry on like this.

[Qualipop in reply to Autumn_Leaves]

Thanks. It's the waiting that's horrible. I also lost over 2 stone after my HA without trying.

[Autumn_Leaves in reply to Qualipop]

I believe there is a connection although I was weight restored (just about) when AF happened, though this was after spending several years hovering around the BMI 18.5 borderline between clinically underweight and “normal”. I really do believe the health impact of being underweight is seriously underestimated. I tried to discuss it with my former GP and he just about laughed me out of the room.

[Qualipop in reply to Autumn_Leaves]

I'm not underweight but it was almost all muscle that I Lost