I'm suffering a lot of ectopic beats at the moment, very annoying and worrying, I went to my GP with an unrelated matter today, and as luck would have it my heart was jumping and skipping so at last I got him to hear it for himself with a stethescope. He confirmed the 'extra beat' or ectopic beat, which was gratifying.
Anyway, I've cut caffiene out and halved my alcohol intake and things did improve for a few weeks, but it's happening again several times a day. What I find really frustrating when I look up the effect of caffiene on the heart, the articles are 50/50 as to whether it causes palpitations.
My doctor also recommended I cut out fizzy drinks. Now I'm not one to guzzle down cola drinks (nasty stuff, especially the sugar free) but I like ginger beer, and I'm fond of sparkling wine. What is it in 'fizzy drinks' that may cause or trigger palps? Should I cut out everything with a bit of fizz? I'll hopefully see him again soon after blood tests and will ask, but if anyone here has any insights in the meantime I'd be glad to hear them.
Thanks in advance
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LesleyJ59
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I believe it's the artificial additives in drinks that cause your problem. In wine it's the sulphites. Artificial sweeteners are a definite trigger for my AF and tachycardia.
Jean
Ectopics aren’t actually extra beats, they’re early beats. It’s the slight alteration in rhythm as a result that makes it seem like either a beat has been missed (if you’re aware of the pause) or there’s an extra one (if you’re aware of the beat itself). Palpitation also just means an awareness of your heart beating, be that in normal rhythm or otherwise, so ectopics frequently occur without palpitations: current thinking on the back of recent studies is that most people probably have ectopic beats, they’re just unaware of them. Because they are benign for the vast majority of people, not that much research has gone into them, meaning we still don’t really understand why they happen or what causes them, but we do know that they can arise from both the top and bottom chambers of the heart, often in response to the sympathetic and parasympathetic nervous systems, and that once you start noticing them, your body becomes even more attuned to spotting them. However, medically, it’s been proven that there are a number of things that can increase the frequency of ectopic beats for some people. These are:
Caffeine, including in teas, chocolate and medications
Dark chocolate
Alcohol
Nicotine including in vaping and nicotine replacement therapy
Medications including - but not limited to -antihistamines, inhalers (particularly relievers like salbutamol), pseudoephedrine and other decongestants found in cold and cough remedies, and adrenaline containing drugs like lidocaine
Recreational substances, particularly stimulants
Stress and anxiety
Insufficient sleep
In addition to those, anecdotally quite a few people cite spicy food as a reliable trigger, and ginger seems to cause issues for some (myself included). There’s also emerging evidence regarding foods high in tyramine, as well as sulphites and msg. One of the potential links between eating/drinking triggering ectopics generally is that the vagus nerve runs between the brain and stomach in close proximity to the heart: there is an arrhythmia triggered by ectopics called supraventricular tachycardia (SVT), whereby one of the first treatments that will be tried in A&E if an episode isn’t self-limiting is carotid massage to manipulate the vagus nerve and stop the abnormal heart rate that way. There are also positional elements for some people, again including me, whereby lying a certain way or bending forward can trigger them, too. Unfortunately, there are people out there where excluding foods or changing lifestyle factors makes no difference to their ectopics, but I went from several hundred a day (noticing around a dozen) to only a dozen a day (but I still notice them all 🤷♂️) by working my way through the list and seeing which ones seemed to apply. By doing that alongside medication, I managed to stop my episodes of SVT when I’d been having bouts two or three times a month, sometimes a week, for several years. The primary way to manage SVT is to reduce the frequency of the ectopics that trigger it.
If you haven’t come across them yet, there’s a couple of videos by a well-known UK cardiologist on YouTube explaining what we do understand about ectopics - including information about the sympathetic and parasympathetic nervous system triggering them. His name is Sanjay Gupta, and he practices in York both for the NHS and privately.
Thankyou so much for your comprehensive reply. I've come across Dr Gupta. I've had the palps since long before my HA and console myself with the fact that my grandmother had them and lived into her nineties, with no other heart problems that I'm aware of. I can have bouts several times a day for weeks and can't say they correspond to anything I eat or drink (though they did stop for a couple of weeks when I cut out caffiene and cut down on alcohol). The one trigger I do notice is stress as one bout started when we were about to travel for my duaghter's birthday and she was unwell and waiting for a COVID test.
I guess I'll have to bite the bullet and cut out all the triggers.
I have cut out caffeine, I'm happy with decaff coffee and tea and have given up alcohol, tried a slightly fizzy drunk the other day and my heart started racing so don't know why but have given those up too.
This is not compliacted. 1. No one should ever be drinking fizzy drinks, they are all bad for everyone. 2. Alcohol is a poison, but with some redeaming features in moderation. I small amount of alcohol is good for you but consuming too much for too long will be very destructive. 3. As for sugar, it is probably the biggest killer today.
I hardly have sweet stuff now. My son's fiance made carrot cake with sugary frosting which I couldn't politely turn down - it was very nice but I felt sick afterwards...
Still a weakness of mine, couldn't you ask for the carrot cake without the sugar coating? I never heard of doing that to it. The whole point of carrot cake is that it isn't sweet, indeed I will put an order in for some and wean my sweet tooth away a little.
The commonest cause of ectopics is the anxiety caused by worrying about the ectopics.They become self perpetuating.
You will find that if you exercise, they disappear at high heart rates - the opposite of what you would suspect. If they were a sign of a cardiac problem, you would expect them to increase.
Once your experience the truth of this, you will stop worrying about them and they will disappear
Good point, but if you cut out the rubbish and feel the benifits, you will worry less. Removing the cause of stress is easier than blanking it out. But, essentially yes.
I’m going to have to disagree with you just a little bit. I’ve had PVCs and PACs noticeably for more than a decade now, without the slightest worry about them for at least the last 6 years, and I notice as many now as I ever did before although the frequency at which I have them has massively decreased as a result of lifestyle changes alongside medication. Anxiety and worry can absolutely make them more frequent, and the medical opinion is that awareness of them does seems to stem from a physical sensitisation - the more you notice, the more your body becomes alert to noticing them, making it a bit of a vicious circle as you say - but that doesn’t mean that when you stop worrying about them the sensitisation will definitely go away. It’s also not true to say that people don’t have ectopics when exercising: for many people they may decrease as the time between beats decreases, leaving less ‘room’ for ectopics during exercise, but they can and do still occur, which is how bouts of SVT and AF can still start during exercise. Ectopics are the trigger for these arrhythmias, exclusively so with SVT: you can’t have SVT without an ectopic kicking it off.
Thanks, I already record my food intake using a weight loss app that's worked very well for me. Stupidly, I hadn't thought of ginger beer as 'fizzy drinks' as I'd kind of clocked it as the rubbishy Coke/Fanta/Lilt high sugar or artificial sweetener drinks, and sparkling wine hadn't occured to me either - or beer. I was only having half a small bottle of ginger beer every day or two, and a glass or two of sparkling wine at the weekend. I'll cut them out altogether and see what happens.
You sound like your on the right path, good luck with it all
After a holiday about 12 years ago my heart suddenly started racing, and I had a cramp like pain in my chest. I went to see my GP. He said my heart rate was very fast and my blood pressure was up, but otherwise my heart was fine. He asked me a lot of questions about stress, diet, etc, and eventually diagnosed me as having overdosed on caffeine. On holiday, I couldn't drink the strong, local tea, so had been drinking coffee instead, something I only ever had occasionally at home, and my system couldn't cope. Two weeks without coffee, and I was fine. I now have AF, and find that the odd coffee, more than one glass of wine, and more than 4 squares of chocolate cause flutters, so I just avoid them altogether.
Yes, my intollerance to caffine has increased. I still have a little and think that is importand, no science behind it, just a feeling. "If you don't use it you lose it", same with a little alcohol.
I can't say I miss it really. I never had that much anyway. I might have one glass of wine if I'm out for a meal, but I'm in no rush to start socialising in pubs or restaurants again.
I have read a lot of these replies with interest. I started with ventricular ectopics in December and they occur every minute throughout the day. From every 3rd beat to every 30th beat and anywhere in between. I have cut out all coffee and only 2 very weak cups of earl grey tea. No chocolate, alcohol or fizzy drinks. Nothing seems to have made a difference and despite having a 24 hour cardiac monitor no health professional seems concerned. I had hoped that my practice of sea swimming might shock it back into a normal rhythm ... but no joy.
Ectopics aren’t classed as an abnormal rhythm, they’re just a variation in rate. Although unpleasant to experience, they’re also benign in the vast majority of cases; the only time they’re considered of concern in their own right is if the total PVCs and/or PACs in a day is a burden of more than 10%, so experiencing something like 8 to 10 thousand ectopics in 24 hours assuming your average heart rate was between 60 and 80bpm, or if you’re having runs of PVCs (ventricular ectopics) that are three or more beats in a row without any normal beats in between. If you suffer with SVT or atrial fibrillation then they’ll usually give you meds to try and reduce the number, as ectopics are the trigger for both of these arrhythmias, and they may also give you beta blockers if you’re feeling dizzy or otherwise unwell, but apart from that, it is generally a case of learning to live with them. If you haven’t watched them, I’d recommend the videos by Dr. Gupta I mentioned further up just for the understanding of what can contribute. One medically sanctioned home remedy to try and stop bouts of SVT is to submerge your face in cold water: the temperature triggers the nervous system which in turn alters (or tries to, as in SVT it doesn’t always work) the rhythm and rate of your heart. Unsurprisingly, submersion in cold water like sea swimming leads to the same release of adrenaline and stress hormones, which in turn can cause/increase ectopics in the same way that stress, anxiety, and insufficient sleep all do; whilst it’s probably great for your fitness, my understanding is that it’s entirely possible that the cold water swims could be adding to your issue, rather than helping.
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