hi everyone, I was told recently that my Apple Watch ECG had picked up a few ectopic beats, I hadn’t really noticed them .
this week however they have kicked off big time and I’m wondering if this is common in Afib , and how do we know the difference between a pause or a missed beat .
I have anxiety and it’s in over drive at the moment.
any advice greatly received.
It’s not really possible to tell the difference between a PAC, PVC, or a pause just by how it feels—only an ECG can show what type of beat it is. I’ve read comments from people where they claim they can tell the difference and even count them individually but I’m just not sure that’s really possible.
PACs and PVCs both feel like skipped or extra beats, but they come from different parts of the heart, while pauses are a moment without a beat. AF as you know is the atria.
Personally, I sometimes have over 10,000 extra beats a day, but I couldn’t tell you what each one was or how many I have - but I’m not anxious about each sensation so maybe that’s why.
I’m guessing I’ll need a 48hr monitor, it doesn’t happen all the time and I’m worried it may not show up on an ECG for the short time it’s on .
Because my anxiety is so bad I’m not sure wether it’s the ectopics or the anxiety that is triggering my symptoms of feeling jittery and making my heart rate higher !!
Don’t be anxious. Ectopics are harmless although they can feel really scary. They’re like headaches - we can all get them and for a small number of us they can be really bad and debilitating. But for most, they’re just a little annoying. You have no risk of death through ectopic beats.
You need a monitor for longer than 48hours, it took 7 days of monitoring to catch my problems which resulted in needing a pacemaker, up till then I was constantly told nothing to worry about !!
If you are getting pauses you will know as you can feel it and you will start to feel dizzy and faint. If Drs are fobbing you off with “it’s normal and harmless, nothing to worry about” but you are feeling something is not right then be persistent and insist on further testing, sadly being a woman puts us at a known disadvantage because many Drs won’t take us seriously 😡
if you had a pause worth worrying about you’d know - you’d start to lose consciousness or pass out. Ectopics are not harmful except that they make you feel jittery and that feeds the ectopics 😰
Anxiety will always exacerbate any tendency toward ectopics and you can easily tell from a kardia ECG trace the difference between PAC and PVC and see from the pattern how often and if they come in multiples, I don’t think the iWatch trace is accurate enough for sure.
Using LSD breathing techniques will lessen your anxiety and may well lessen the sensations of the ectopics which I have to say make you feel horrible. Certain actions will also trigger ectopics - bending over was a big one for me.
LSD breathing - long, slow, deep breath in for at least count of 4-11 into your diaphragm, hold for 5-6, very long, slow exhale to count of 8-11.
May I also suggest your look at the Human Givens Techniques for reducing anxiety. Google Anxiety and dealing with Panic Attacks and go to the hgi.org site which should come up no2 on the list.
Thank you for those suggestions, I do practice deep breathing and do meditation but this sudden spell of them had me worried.
And you are very sensibly having them checked out but don’t allow your anxiety to control you, get that sense of control back.
Breathing exercises do nothing for me. I even had an AF episode starting up 20 minutes into a breathing/relaxation session. So much for people preaching about breathing exercises (who I suspect don’t do them regularly anyway).
Do breathing exercises by all means. I practice daily and did so before AF and before ectopics became an issue about 12 years ago. I do so as a means of managing my ME/CFS. It takes the body into the rest state and activates the parasympathetic nervous system. I recommend breathing /relaxation/meditation/mindfulness, in whatever way works for the individual, but for general health and wellbeing. I’m not an anxious type. My husband will say “But aren’t you worried about xyz?” and I’m like “Nope!” I have a friend with anxiety and I don’t get how people like her think up all these things to worry about that would never cross my mind! So I can’t blame ectopics on that.
Sometimes the heart has areas of rogue cells that fire off beats at random, and you just have to wait until they settle down. I’ve lived with constant ectopics, all day every day, every 4-5 beats on average, thousands caught on a 24h ECG, and I was not the worst case scenario. Then they decreased a lot. I did nothing. I had no AF episodes either. Why? I have no idea. I don’t chase after magic cures, I don’t take supplements except vitamin D which I was taking for years before AF, I don’t follow anybody’s made up food rules. The ectopics almost vanished. Then I had Covid and that set everything off. Sometimes you just have to wait it out.
My GP suggested once I give up caffeine, so I did. No change. I stayed caffeine free and the ectopics got worse over time. Then AF happened. So being caffeine free made no difference. Now I have the arrhythmias AND I’m now I can’t have caffeine because abstinence has made me sensitive to its effects. A lose/ lose situation.
You can paint yourself into a corner and micromanage everything to the point you don’t have a life. You have to give your mind a break. Sometimes you’re better off looking at cute cat videos or cute doggies than logging into HU. TBH, that might be better for your ectopics than anything else that might be suggested here.
It seems, from posts here, that many AF sufferers get discreet episodes, with NSR in between, while some get AF as part of a wider atrial ectopic background. I’m in the latter group. My palpitations are frequent and sometimes persistent. They seem to me to be like “micro-AF”, with actual AF occurring when the ectopic beats “join up”. They can feel worse than AF because of their infrequent nature.
Unlike AF, they are said to be safe since they don’t carry the risk of causing blood clots. Also, unlike AF, they don’t, in my case, cause tachycardia.
The ectopic beats arise prematurely but can force a pause before the next NSR beat. Many of mine don’t create the pause. AF beats somehow block the usual pulse from the sino-atrial (SA) node will always show on an ECG trace as missing the tiny “P wave uptick before the big ventricular peak (although the tiny P wave can be hard to see).
Steve
You have summed my thoughts perfectly, I’ve been NSR all week but these have felt like mini afib events that last about 10 secs . You’ve accurately summed up how I’ve felt this week .
The mini pause is the most disconcerting and last about a second, the extra beats don’t really bother me that much and I know I’m super sensitive about my heart and its beats !
I'm glad that I'm not alone, but I do sympathise with you. Some people, presumably with a different kind of ectopic beat, write in here that they are "benign" and a bit of deep breathing will sort them out. I wish! 
I have recently started to get a lot more of these "micro / mini AF" episodes, ranging from pairs or threes, then up to a minute of AF. It is a strange feeling. Mine are often wide, too, and can look truly odd if my left bundle branch block is affecting my heartbeat at the same time.
I attach a recent one which Apple calls "Inconclusive". I sometimes feel like writing to them to introduce a new category, something like, "Goodness me!"
Steve
Oh yes, if only we could breathe it all away! 🤣
It’s not that simple. If you have an area of rogue cells kicking off, you can’t just tell them to behave by doing a few breathing exercises! I wish!
A couple of months ago I was doing my bedtime breathing exercises which I do every night. At that time I was in a period of rare ectopics, just the odd one here and there, which I consider as good as it gets. Then it was suddenly big thumping ectopics going off randomly. I persevered trying to see if the breathing exercises would calm them, but no. They’re going all over the place. I fell asleep and woke up a couple of hours later in AF. It’s unpredictable and not under our control. Sometimes I can’t tell if I’m having ectopics or I’m in slow AF. Whatever it is, I can’t breathe my way out of it.
Much the same here. It can be hard going, poor us! Mind you, my AF is slower than some here seem to have, so I’m luckier that way.
I’m hoping there is a clear bunch of rogue cells for the ablation to sort out when my turn comes round.
Steve
Did you show your ECG to your cardiologist? I’ve got a few to share at my next appointment, hopefully it won’t be cancelled like the last one !
I do understand that the ECG on our watches are not as good as a 12 lead so I do try to not take it too seriously. ( easier said than done )
Hi! Yes, I have shown him many. He says it's the usual problem, that is, ectopics and AF arising from the left atrium and, in my case, added to by a left bundle branch block that comes on and off.
I gather that a 12-lead ECG performed carefully in a clinic while resting will give the least electrical noise and, as a result, much more detailed information about heart defects. However, a single lead ECG, as done by home machines, does tell all that is needed, arrhythmia-wise, once other abnormalities have been ruled out by a 12-lead and an echocardiogram. It seems to be muscle movement that causes the extra electrical activity that reduces the quality of home ECG traces, which then have to use algorithms to hide the noise to present a nice-looking trace as well as reveal if the important P-wave is present or not (i.e. whether the arrhythmia is either AF or frequent ectopic beats).
The one I use these days (along with he Apple Watch) is a Contec / Emay. This does have a 6-lead option, but I rarely use it that way.
Try not to worry as the problem almost always feels much worse than it truly is. The atrium is not as important to our health as the ventricles are and much more commonly becomes affected by arrhythmias. The ventricles cope well despite the chaos going on up above - it just doesn't feel that way as any heart arrhythmia sets the nerves jangling.
Steve
remember that because of your previous heart issues your brain is on high alert and will pick up on any extra or missed beats and will ring the alarm bell - that’s why we notice these things more than others. Also helps to remind yourself of all the previous anxiety you’ve had re heart health - how much of that stress and worry was credible and helpful ? My guess is that you’ve stressed and worried a lot over the years and it’s been over nothing in the end (that’s exactly what I’ve done)
You are absolutely spot on . I’ve given myself a bit of a talk to today and I’m revisiting some of my CBT exercises, I do feel like I’m always on a heightened alert concerning my heart .
This is what’s so wonderful about this forum !
Ectopics?
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