Atrial bigeminy, ectopics, PVCs and low heart rate

[PaulMichaels]

I'm 57 and have atrial bigeminy which is almost constant, my resting heart rate ranges between 38 and 44 on average. I've had ECGs and EKGs showing my heart is strong but misfiring. A 24 hour halter monitor revealed very frequent ectopics and I've been waiting over a year for a treadmill stress test (apparently the machine is "broken"). I don't really feel the symptoms apart from light headedness when getting up quickly. I do 15 mins on a cross trainer most days at a good pace and a daily walk. Anxiety or thinking about my heart rate makes it worse. My cardiologist says they won't attempt any treatment unless the symptoms get worse and want to leave well alone. It would be good to know if my daily exercise is causing damage, but I feel fitter than I have for many years. I'll be glad when my NHS trust fix the treadmill. I wonder if I can get a test elsewhere?

[BC-10]

Hi. How are you testing your heart rate? Finger on your pulse or a machine?

Counting your pulse with your finger will result in you missing out most proper beats when your getting loads of ectopics. It'll seem like it's very low but it'll be overall within proper range.

You're fortunate that you don't feel them. I get around 20 "thumps" a minute some days and not only can I feel them, they overtake my life when they're at their worst. ie I can't stand, I can't walk, I can't do anything - but I do remember a time about 30 years ago when I couldn't feel them and was only aware of it when laying on my side at night.

Anyway - exercise? Over exercise will generally result in them getting worst over time when at rest. A strong factor for developing atrial fibrillation is over exercising.

But you may never develop this of course. Unlike myself; the ectopics got more pronounced over time. I continued strong exercise and felt better when exercising but later on while resting I started getting atrial fibrillation. And once this starts, then it's all downhill from then on in my experience.

If you can't feel them then consider yourself fortunate. As the cardiologist said, if they're not causing any symptoms, they're best left alone.

I'm guessing they disappear for you when exercising? Good sign. IF they got worst while exercising - bad sign.

You'll be fine.

Kindest regards to you.

[PaulMichaels in reply to BC-10]

Many thanks for your kind advice, I hope you feel better.

[BC-10 in reply to PaulMichaels]

Thanks. I go through good and bad periods. It's a complete paroxysm and an enigma.

I can go through a whole year and be totally asymptomatic - then one day it'll start up again with up to 40 thousand ectopics per 24 hour period and I feel each one! I'll be back to taking 2 full beta blockers per day just to feel more "normal".

And I just noticed in your original post, you said "Atrial bigeminy ". So if your getting ectopics, then those that originate from the atria are almost certainly always benign.

It's surprising how little exercise we really need to keep a healthy cardiovascular system. A brisk walk, a bit of gardening a few times a week. An increase in the heart rate of around 20-25% will work the heart sufficiently to induce health.

Best of health to you. Don't do too much and don't worry.

[Ianc2]

When you exercise try to get your daily activity level to 4,000 steps a day to keep your muscles and you cardio vascular system going. Doesn't have to be blasting off the gym walls , just regular, steady exercise like walking and avoiding sitting around too much.

If you walk and you can do 15 minutes on a cross trainer and your cardiologist is happy, you may not have a lot to worry about, as long as your blood tests are coming back with reasonable electrolyte levels, along with triglyceride and blood sugar levels.

Your cardiologist is the expert. If he is happy, go with the flow and enjoy life.

[PaulMichaels in reply to Ianc2]

Many thanks for the advice

[Niki_ in reply to PaulMichaels]

Hi, you said you had very frequent PVCs .. can yo I share what your number was? I’m always curious of others 24hr holter monitor numbers on patients who’s drs are being conservative with treatment.

[PaulMichaels]

Hi sorry the consultant never gave me a number, he just said very frequent.