Severe palputations...explanation?

[Hypat1a]

Hi. I am 56 years old with a history of SVT, low blood pressure, and night time panic attacks causing a very fast heart beat. I have been on a low dose of bisoprolol for several years now which has largely managed my symptoms. However after getting severe anxiety upon menopause, I started HRT and Sertraline after panic attacks became unmanageable. I have not changed medications for several months.For the past 3 months I have been experiencing palputations. I am constantly aware of a pounding heart, feeling it in my neck and chest. I get numerous ectopics, feeling as if my heart skips a beat and then catches up with itself with a few extra beats. It is really distressing. I feel tired and weak and prone to swollen ankles when exercising or getting hot. I've put on weight as well .

I have seen my gp who says ectopic are harmless and have had a normal ecg, vitals and bloodwork.

I feel something is really wrong. Can anyone suggest a cause of this.

[bluemoon572]

Sertraline may play a role in your ectopics. Maybe you could be switched to a different class of medications that are less apt to provoke palpitations to manage your panic disorder. Regardless of a normal EKG you should have an outpatient cardiac monitor applied for a few days to determine whether you're experiencing high grade& frequent atrial or ventricular premature beats and to determine what is your heart rhythm & rate when you're having palpitations. Even in the absence of structural heart disease, symptomatic and benign PACs&PVCs are often treated with beta blockers like bisoprolol. Maybe your dose needs adjustment.

[Hypat1a in reply to bluemoon572]

Thank you for the advice. I am off to the doctors again tomorrow so feel more armed with info

[Hypat1a]

Yes I am. I agree, I dont think I could have managed to carry on with work etc without it.

[Anne498]

I’ve recently gone through a similar experience. I have been on bisoprolol for over 10 years and this year I started feeling hard beats, ectopic beats and palpitations, all more noticeable at night. I spoke with my specialist and she increased my dosage from 5mg to 7.5mg a day (split over the day) and it has helped ease the symptoms

[Hypat1a in reply to Anne498]

Thank you do much for sharing. ECG today which captured the ectopic but doctor says rhythm us normal. Due to the number of ectopic I'm having I've been referred to a cardio

[Annaelizabeth]

I am not a doctor, however am very aware all HRTs are not made equal, it may well be that the dose or method you are using is not suited to you. This is certainly not uncommon, one size does not fit all. The coincidence of the increase in your symptoms, with the start of HRT, points heavily in that direction.