What is the difference between palpitations, ectopic beats, PVCs, SVTs, VTs?

[Tos92]

Good evening.

I’ve noticed that there are a lot of questions around palpitations on this forum, and I too have them myself; however, not medically treated for them. Sometimes I experience these with pain (with a constriction type of feeling) and sometimes I experience them without pain. I’ve noticed some doctors will put SVTs and VTs on my medical reports; however, never explain whether it is the same as having palpitations and how I can differentiate between them.

Can somebody kindly advise?

Thank you.

Acronyms used:

PVCs (premature ventricular contractions)

SVTs (supraventricular tachycardia)

VTs (ventricular tachycardia)

[MummaSoap]

Hi Tos

I seem to experience a number of these myself and I could be wrong but this was my interpretation…

I believe that the term palpitations is a bit of a blanket term to describe the racing, pounding or fluttering feelings that people can experience.

There are 2 types of ectopics (extra heartbeats) PVCs (premature ventricular contractions) and PACs (premature atrial contractions) and these relate to the area of the heart that the additional beat comes from.

SVT (supra ventricular tachycardia) is a type of heart arrhythmia like AF (atrial fibrillation) and I believe that VT (ventricular tachycardia) is also a heart arrhythmia.

SVT occurs above the ventricles, in the atria and VT occurs in the ventricles.

I hope this helps and that if I’m wrong on any of this there will be others better informed than I who can support and correct me 🙂

Best wishes

Soap

[Fitbit-Joe in reply to MummaSoap]

I bought myself a wellue ecg monitor, and during Apr, while I wasn't feeling well, and would describe what I was feeling as palpitations. The software analysed the data, and it came back with high number of readings. In a 24 hr period, it has noted I have had around 12,000 pac(premature supraventricular contraction). On average these ranged 10 - 45 in a one minute period

Waiting to see cardiologist about this, and have things looked over

[Tos92]

Thank you so much for that explanation Hidden . I hope others on the forum benefit from this response too!

So when is an arrhythmia diagnosed? Do the heartbeats which you mention above fall into the category of arrhythmias?

[Tos92]

Interesting that you note bradycardia as an arrhythmia. My pulse rate on resting is quite often in its 50’s, and has been low as the 40’s before; however, I do think my medication plays a role in this. My GP advised that this type of bradycardia is harmless, didn’t even mention it was an arrhythmia and I shouldn’t be concerned unless I was passing out/becoming unconscious. So I assume not all arrhythmias are bad. Is that correct?

[Tos92]

Thanks for the visual representation!

[Tos92]

That makes sense. Thank you 😊

[Hidden]

It feels like I have a student doing that dance in my chest some times !

[JenWro]

quick question since this is the third time of writing. My question disappears 😂. I have a resting heart if 89. Walking heart of 48. Realised three weeks ago after doctors were treating me for asthma for years even though mother and brother died young with heart conditions. Prior to this cardiologist had prescribed medication but GP withdrew the prescription stating it was asthma. Ecg and blood tests state concern. Now question is heart not pumping enough blood into lungs so does anyone know what this is called and cause.

Any help would be appreciated

[JenWro in reply to JenWro]

I use to run up 17 flights of stairs now I can’t walk three without chest pains and gasping for breath…..doubled up and really fighting fir breath and the pain is not good The testing heart versus 48 walking was identified by new doctor in surgery and I was rushed to hospital twice from GPS

I do yoga three times a week but the deterioration over the last months been terrible. I can’t walk or do normal activities since Christmas.

[MummaSoap in reply to JenWro]

Hi JenWro

I’m not a medical expert but I’m surprised and a little concerned that a GP would withdraw a prescription without consulting your cardiologist (if they haven’t done so), when was your last review with cardiology and is your consultant aware?

Has the GP who discovered this change in your heart rate referred you to your cardiologist for an urgent review?

If it was me, I would contact the surgery (preferably in writing) and ask how the GP arrived at their decision and whether cardiology was consulted before proceeding, what has been done with the results of your ECG and blood tests and also if there are any recommended limitations/precautions that you should be imposing until such specialist review takes place especially as you are symptomatic with the changes.

I hope this response doesn’t send you into a panic as that isn’t my intention at all; I just think there are number of questions that need to be raised so that a) you can keep yourself safe and b) you get the appropriate care and treatment that you need and moreover, deserve. Also, for some of us, we want to be fully informed so that we’re equipped to make our own decisions about what is and isn’t sensible for us and to empower us to have a bit more control in our lives.

I really hope you get some answers and are able to find a path forward.

Let us know how you get on.

Best wishes

Soap

[Lezzers in reply to MummaSoap]

Sadly GP's can & do change meds that consultants have requested. I believe as your GP is primary care, if they feel something isn't working for you or is detrimental to your health then they are legally liable as they sign the prescriptions. My husband's nurse & GP often clashed about his medication, as soon as he was discharged from the nurse his GP immediately stopped a lot of his meds, even though he was still under the care of his cardiologist. His cardiologist was ok with that as it didn't cause any problems. However, the next time she changed my husband's meds it caused a lot of problems, his cardiologist wasn't happy & said if she does it again to tell him & he will sort it out!

[MummaSoap in reply to Lezzers]

That makes sense about the legal liability side of it, I understand that.

My GP has recently stopped one of my meds because it wasn’t agreeing with me but she emailed my cardiologist the same day to give an overview of what has been happening and to request to move my review (due in May) forward. I thought that was a standard practice out of courtesy and to keep specialists in the loop 🤷🏻‍♀️

It’s interesting how it varies but not particularly helpful for patients necessarily.

[Lezzers in reply to MummaSoap]

Sadly not all GP practices are equal. We're now registered with a different surgery and twice now the new GP hasn't opened letters from the cardiologist asking for a change of meds! The last time we realised this (it was a dosage change and we had enough meds to cover this for a few weeks) was after a hospital spell & the discharge papers showed the incorrect dosage. We immediately phoned the surgery, the prescription clerk knew nothing about the change, looked on the computer and saw the letter from the cardiologist dated 5 Jan hadn't been actioned, that was on 5Feb! ! A Dr phoned back and said the hospital had changed the meds, err no it didn't, the discharge papers clearly say the list of meds were taken from GP records! Absolutely shocking!

[ILowe]

Thanks for the video. Fun and helpful.

I have heard that most irregularities are nothing to worry about, at least in the short term. except for VT. "Episodes lasting more than a few seconds (sustained V-tach) can be life-threatening. Sometimes ventricular tachycardia can cause the heart to stop (sudden cardiac arrest)." (Mayo Clinic). I was offered an ICD (Internal Cardiac Defibrillator) when hospital thought I was high risk. I was shown how even on home ECG equipment I could see this--- the shape is quite obvious.

[Tos92 in reply to ILowe]

I hope the VTs are not so much of an issue for you anymore.

[Qualipop]

What a brilliant way for a visual learner to see the differences.

[ILowe]

Thanks Tos92. Consultant last week thought the risk of VTs was still there, so the average heart rate needs to come down. So I am to try and tolerate an increased dose of bisoprolol and I should report to him via the Cardiac nurse if I saw something. The balance of risk for an ICD may tip in favour of having one.

[Lezzers in reply to ILowe]

I hope you don't mind me jumping in here but my husband has been having severe VT's & his HR is always low, he has an ICD and that paces him at 50 because it dips into the 40's which they don't want. Can I ask what your average HR is? My husband had just had an ablation to try & stop the VT's, have you been offered that?

[ILowe in reply to Lezzers]

My 24 hour rate in November was 85 and has gone up to 93 (measured twice last week, on the Wellue 24 hour Holter). Last year I turned down the offer of an ICD. I have a metallic mitral valve, still working after over 29 years therefore I am at a very high risk if I have an ICD, and the balance of risk is against it. It is too late now for ablations for Afib and again, they were too high a risk because of the valve.

[Lezzers in reply to ILowe]

Ah, sorry I thought you were having VT's rather than Afib? Yes, it does seem that for an ablation for Afib to be successful then it needs to be done pretty quickly. Sorry to hear the ICD isn't really an option for you, it really has saved my husband's life recently as he had a VT storm which resulted in him losing consciousness several times. Even after the ablation he's was still having VT's & his ICD shocked him twice while he was in the hospital. I hope the increased bisoprolol works for you, they did try that for my husband but because it reduced his HR even lower, his ICD was pacing him nearly 50% and apparently too much pacing of the ventricles can damage the heart so it was too high risk for him & they reduced the dosage again.

[ILowe]

I was getting VTs, and the combination of Afib+ Heart Failure meant my heart was pushing in the VT direction. I was offered an ICD and the offer is still open, but, strangely, they did not offer me a portable defibrillator instead! I heartily wish they would develop a cheap wearable defibrillator.

[Lezzers in reply to ILowe]

Portable defibrillator? Not heard of that unless you mean an AED?

[ILowe in reply to Lezzers]

They are synonyms. In addition, there are wearable external defibrillators, only one exists on the market at the moment, and it costs a fortune to rent. I would consider a wearable external, if it were available at a reasonable price. I am rather surprised they do not yet exist since the market for them is huge.

[Lezzers in reply to ILowe]

How would a wearable one work when you're sleeping, are they quite cumbersome? My husbands ICD shocked him twice at 3 am. Just had a quick Google, are they known as life vests?

[ILowe in reply to Lezzers]

Current ones (life vests) are cumbersome. I really wonder if they need to be. Wear them day and night.

[ILowe]

Interesting and helpful. My consultant told me recently to try a higher dose of bisoprolol. I will look into Carvedilol as plan B.. But first, a Swiss friend drew my attention to Coenzyme Q10. It is always interesting how non-UK view medicine. It is commonly used with Selenium. I think I will try these first. CoQ touches the warfarin, so first I need to plan carefully. CoQ improves the energy supply in the heart, therefore, it might slow down, and that is probably worth a try in my case.

[MoyB]

Very good! xx Moy

[Sodp]

Hidden very precise and clear description. During Palpation can you feel your heart is thumping fast but your heart rate is normal ? I wake up occasionally with what feel like Palpation thumping chest but when I check my HR and BP its normal. my normal is low 50s as I am on small dose of bisoprol.

[Tos92 in reply to Sodp]

Sodp it is not unusual to feel your palpitations and it’s quite common. I tend to feel most of my palpitations and they are considered harmless for the most part. However, there are also a category of people that don’t feel / notice them and that is also normal. I think once you become aware that they are there, it becomes harder to ignore when we do feel them which can make us worry.

[Sodp in reply to Tos92]

Tos92 thanks ..I don't know if I had prior to stents..but I do notice now.. good to know that it is not unusual . I had more often since taking magnesium it reduced bit.

[Tos92 in reply to Sodp]

Did you have any tests to diagnose your palpitations and rule out arrhythmias?

Magnesium is commonly used to stabilise the heart rate. You may find that a few other forum members take this for this very reason.

[Sodp in reply to Tos92]

Not I have not, it only happened couple of times in last 8 months post stents, at least those one I noticed. I may ask my cardiologist on June visit. Thanks 🙏. So what sort of test is done to diagnose arrhythmias

[Tos92 in reply to Sodp]

A holter monitor is usually the most popular test. It’s a small device which you stick on your chest, just under your collar bone and it records your heartbeats on them. The duration of how long you keep it on varies from 24 hours to a month for some people. The cardiologist can then review the data stored on there and be able to determine if you having any arrhythmias or abnormal heart beats.