PAC followed by pause and waveform similar to AF.

[John3333333]

Has anyone had similar PACs? The AF-like waveform has really thrown me. I don't think I have experienced these kind of beats before - the pause is very noticeable, although I think it is shorter than 2 seconds.

[mjames1]

Yes, I have. That's what a PAC looks like.

Jim

[John3333333 in reply to mjames1]

Blunt response but you are most likely correct.

[Paulbounce]

Hi John.

Don't panic too much. We can't post links anymore without admin permission. As it's 6 am they are unlikely to be there right now.

Google pacs heart university of michigan and click on the Frankel Cardiovascular Centre link. This might reassure you a bit - if you are concerned it's best to talk to your doctor.

Paul

[John3333333 in reply to Paulbounce]

Call me a rebel or call me childish but I don't think I will be seeking 'permission' from admin anytime soon.

[Paulbounce in reply to John3333333]

Rebel 🤣🤣🤣

[Ppiman]

I am sure I get similar and daily at present. I think mine are, essentially, "mini AF" since once that sets in, the ECG looks the same but just more joined up and faster. I sometimes get 10-60 sec runs of that, also.

The QRS peak on your sample looks wide, like my own, although mine varies. Like mine detecting a P wave can be difficult. You might have mentioned it before - my apologies if so but do you have a bundle block? I have LBBB and that causes the wide QRS peaks. Your heart rate is normal, I see. My LBBB causes bradycardia - often in the 40s or 50s.

Steve

Contec ECG

[John3333333 in reply to Ppiman]

Thanks for responding. It does appear that we are currently experiencing similar heart irregularities. However, I don't have LBBB and the PACs I experience rarely link up, at least no more than triplets (very rare) at the very worst. I can pretty much eliminate PACs with 200mg flecainide daily, which I am thankful for. Although, it is frustrating that I can't seem to avoid these PACs without the aid of an AAD - bisoprolol does little to mask my ectopics. I have had them for a while, albeit without the odd waveform during the pause before the sinus beat, and they have yet to lead to AF (although bigeminy can feel like AF).

For what it is worth, my Kardia report has now come back as sinus rhythm with PACs. I guess the AF-like waveform can just occur after a PAC in some cases. It does feel odd though. I hope you are managing your ectopics and other heart issues well.

[Ppiman in reply to John3333333]

"Managing well" - yes, I try! They are, as you find, a source of worry, worse at times than others. I am glad your report came back well. I think the atrium is able to perform all kinds of acrobatics and is hard to stop from doing that. Luckily whatever happens "up there" generally allows "down below" (the ventricles) to cope well enough.

Steve