Please help! Sudden Onset of Rapid He... - British Heart Fou...

British Heart Foundation

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Please help! Sudden Onset of Rapid Heart Beats and Nighttime Palpitations During Sleep


Does anyone have nighttime palpitations during sleep or sudden onset of rapid heart beats? The symptoms are driving me crazy and any advice is greatly appreciated.

I'm 28 years old female. Since young, I have elevated heart rate (normally above 100 bpm, but not too high, during daytime and my heart rate would go up easily with slight exercise, but would gradually go down as night approaches and completely normal during my sleep).

About two years ago, I started to visit cardiologists, went through various heart checks including blood tests, electrocardiograms, echocardiogram, 24-hr Hotler, treadmill test, and one month Holter. Everything showed normal, just showing I have elevated heart rates at random times. So my cardiologist diagnosed me as Inappropriate Sinus Tachycardia (IST) and I started taking low dosage beta blockers to control my heart rate.

In the first year after I start taking beta blocker, I felt great. However, after the first year, I started to have sudden onset of tachycardia that happens at random times, with a lot of them happen during nighttime when I'm sleeping. I would suddenly wake up from my sleep finding my heart pounding, mostly around 120 bpm - 130 bpm, but sometimes would go up to 140 bpm to 160 bpm. It also accompanies with icy and wet hands and feet, sometimes dizziness, numb hands, weakness, nausea, and spasms. It normally lasts about 3-5 minutes and my heart rate then gradually goes down (occasionally I would have 2nd onset after about 10-20 minutes of returning to normal heart rates). The Holter captured it few times and showing as sinus rhyme.

When it happens during my sleep, it really disrupts my sleep as I find myself hard to fall back to sleep again. I've talked to my cardiologist about this and I experimented different beta blockers but none works well. I'm currently taking Bisoprolol 2.5mg daily.

Does anyone have similar issues, know a way to fix it, or know how to cope with it? Any advice is deeply appreciated!!

6 Replies

It's something where you need to sort it out with your health professionals sorry.

If it were me, I would look at de-tuning the fuel mix to the carburetor. Carbohydrate is only needed for intense activities. I keep my intake to less than 120g per day of mainly low-Gi carbohydrates, getting most of my energy from natural fats, about 3:2 monounsaturated to saturated, even though I do 20 minute runs and weight train on alternate days.

Too much protein is also easily converted to glucose, so we don't need much more than the RI.

God bless you.

Thank you for the advice!

Hi there

YES definitely this! My heart does somersaults and likes to wake me up at night. A holter has shown very high bpm and on one occasion it started and didn't stop (literally day or night) for three days or so.

My cardiologist thinks upping the beta blocker is a solution. I am prepared to up the dose at night time, but if I increase it all round I am very lethargic. Or should I say MORE lethargic :)

Which beta blockers have you tried that didn't work well for you?

huangmy1328 in reply to TRST

Yes, my cardiologist also suggested to increase the dose of my beta blocker, but I was a little hesitant because my blood pressure is already low and I'm pretty lethargic most of the times.

I tried metoprolol tartrate, metroprolol succinate, and bisoprolol fumarate (I'm currently taking it but also doesn't work well).

TRST in reply to huangmy1328

So the next step my cardiologist wants to take is give me an implantable cardioverter defib (ICD). This would straighten out these nighttime episodes, which quite frankly leave me feeling that I'm going to peg out any moment!

I am thinking about it ...

I seem to remember someone here had success with Nebivolol (Bystolic), and there are others to try also, so have a search and perhaps suggest trying another to your cardio?

huangmy1328 in reply to TRST

I'll keep Nebivolol in mind and talk to my doctor about it (as well as other options).

Thanks for the advice!

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