palpitations/arrythmias

[cynthiaG]

what is the difference between palpitations and arrythimias??

[Pam Alexson]

Hi Cynthia,

Although we tend to use the terms loosely, palpitations are a symptom or a descriptive term to define a sensation in our chests when our heart seems to be thumping or beating different for us.

An arrhythmia is a term used to describe a broader spectrum of patterns of abnormal heart rhythms as observed and documented . They would be referred to and differentiated when observed by a trained individual and recorded via a devise or piece of equipment one of which is an EKG.

Does this help?

Pam

[NoCrash]

Cynthia,

I feel a palpitations when I have a Premature Ventricular Contractions (PVCs--an out of sequence "squeeze" of the ventricles). Typically I only feel these when I'm relatively quiet, particularly while I'm lying down, and then only occasionally. I can feel my heart sort of go "thump."

I think of arrhythmia (without a rhythm) as the "heart" vibrating instead of squeezing. The vibrations can be for short periods of times (some limited number of beats) or for a longer period of time. If the "buzzing" is at a high enough rate and goes on for longer than it should then an ICD will kick-in to try and revert the heart to a normal rhythm.

I don't think arrhythmia's are felt as palpitations. My chronic atrial fibrillation is an arrhythmia that I live with but don't feel (other than in the side-effects).

Regards,
Rob

[progers]

That's presuming you have an ICD that can "kick in"! I don't and have been told that I probably need one given my septum is around 30mm and have had numerous arrythmias since my myectomy which have made me real dizzy. I haven't passed out yet though. Right now I'm wearing a holter to see if the arrythmias are dangerous or not. I do know that I have had atrial ectopics, PVCs etc, all of which are arrythmias. The dangerous ones are ventricular tachycardia, so hopefully I'm not having these ones.

Cheers,

Paul.

[Pam Alexson]

For more information and a good Q&A regarding the arrhythmia; A-Fib please go to this site. A-fib is the one that is most common and it discusses the the different types and the "rogue node" phenomena that we hear about when many are candidates for radio frequency ablation.

http://www.afibbers.org/faq.htm

Pam

[NoCrash]

add ventricular fibrillation to the list of dangerous ones, too. My ICD, put in on March 8, has the capability to pace me out of v-tach, but will go straight to shocking me out of v-fib. Please don't ask me the exact distinction between ventricular fibrillation and tachycardia-it may have to do with the frequency (beats per minute) of the arrhythmia.

(I sure am glad there's a spell check function on this board--I'd never get "arrhythmia" right, otherwise.)

Cheers,
Rob

[progers]

Rob,

How is your ICD? Any problems or drawbacks from having it? My cardiologist was listing all the negatives the other day and made it seem that it is kind of a last resort. She is not a HOCM specialist per se, but does have HOCM patients.

Cheers,

Paul

[NoCrash]

Your doctor's opinion about an ICD puzzles me-I don't know why it would be considered a last resort--when you need it you REALLY need it, there really isn't any good alternative. I'm really glad to have the ICD and my wife is very relieved now that it's in.

It's just over a month since it was implanted and I've pretty much recovered from the experience. The first week moving my arm much was painful, the second week I was just sore, and the last two weeks I've been working-out the kinks that the first two weeks left behind. My only real problem is I can't sleep on my left side anymore as the ICD gets jammed-up in my shoulder. If it was floating in the pocket instead of secured as it is this might not have been a problem--hard for me to know at this point.

If you need it, you should to it. I have some arrhythmia's that are worrisome and an adverse BP reaction to exercise, making me 2 of 5 for SCD risks. My decision was pretty easy to make.

I haven't been shocked, but the device is pacing me a fair amount of time--I didn't realize how often my rate was falling below 60 bpm.

Hope this helps some.

Good luck,
Rob

[NoCrash]

I should add:

the doctors do list a whole bunch of drawbacks (possible infections, lead problems, recalls, etc.) to an ICD but you have to consider that the whole technology and implant procedures are pretty mature (pacers have been around for quite awhile, right?) Ask the doctor to quantify those risks and then compare that to whatever you estimate the risks (and expected consequences) of v-tach/v-fib. That's the decision that was a no-brainer for me.

Rob

[Sarah]

definitions

Palpitations are when you feel the arrhythmia. Many people never feel any of their arrhythmias. Even healthy people sometimes have a palpitation, simply a skipped beat or two, once in a great while.

An arrhythmia is simply any irregular heart beat (regardless of duration), and there are many different kinds, as noted elsewhere in this thread and board.

The most common arrhythmias (and their names) distinguish between the rate and the regularity of a heart beat.

Tachycardia simply means "too fast." You can have atrial or ventricular (top half or bottom half) tachycardia. When the doctor says you have vtach, it means the bottom half of your heart is beating in a normal sinus rhythm, but over 100 beats per minute.

Fibrillation means irregular. The heart is beating whenever it feels like it. Also comes in atrial and ventricular flavors. Atrial fibrillation is one of the most common of arrhtyhmias and can be caused by many things, of which HCM is one.

Just to muddy the waters, any heart in fibrillation is probably also beating way too fast. However, doctors call "regular but too fast" tachycardia and "irregular, and too fast or not," fibrillation.

If you can stand it, please let me mention supraventricular. This silly word means "atrial." Supra is Latin for "above," so it literally means "above the ventricle. Yes, it trips people up all the time.

And one more thing, ventricular arrhythmias are more dangerous than atrial ones because it is the bottom half of the heart that is pushing the blood out of the heart. If there isn't enough force and volume behind the beat, then your blood doesn't get to where it needs to be, like your brain.

Ok, my last note: PVC stands for premature ventricular contraction. This is the only ventricular arrhythmia that isn't a potential killer b/c the ventricle is just beating a little early and doesn't really wreck the rhythm. However, if you have PVCs AND vtach, then you have cause for concern and an ICD evauation.

Please let me know if anything wasn't clear.

(side note: i am in afib and sometimes i feel nothing and other times i feel every single beat clearly, usually when the fib is worse or slow.)

[Toogoofy317]

Bigeminy you forgot arrythmias Sarah . OK OK that was a horrible attempt at humor just thought I'd try since it is an arrythmia as well Trigeminey is too. Those mean that a pvc is occuring every other beat or every third beat. And that is only the tip of the ice berg.


Mary S.

[NoCrash]

Oops. I typed:

I don't think arrhythmia's are felt as palpitations.

what I meant to say was:

I don't think arrhythmia's are always felt as palpitations.

Not the first time something silly has rolled-off my finger-tips, so to speak.

I like the afibbers.org site's description of fibrillation as "chaotic"--which certainly falls within the definition of irregular.

Thanks for clarifying. I learn something new here every day.

Rob

[julie]

I had palpitations for 4 days - my cardiologist described them as infrequent ventricular extrasystoles. To me they felt just like 1 extra heartbeat every minute. My cardiologist wasn't really worried about them because the holter test showed negative VA's (?) etc. All I feel at the moment is the occasional very light flutter lasting about 2 seconds probably once a day - which I assume is a palpitation. The holter did pick up some isolated beats and trigemini - still don't understand what trigemini is or are. My pulse rate is for the majority of the time under 60. In the mornings between 9 and 12 is averages about 50. However, sometimes the strength of my heartbeat almost my whole body sway. Don't know why it beats so strongly at times.

[cynthiaG]

Wow! thanks for all the input! I believe my doctor had mentioned in the past (after wearing a Holter monitor), that I was having either PAC's or PVC's. It skips a beat about every other 3-6 beats....been having them for 4 days now. I notice it more when sitting still. Sometimes it's a sign that AFIB will be coming soon. I get a bout of AFIB every 6-8 weeks. It usually goes back to sinus rhythm on its own, but last month, it didn't and I had to be cardioverted. I feel o.k. otherwise, no SOB or anything else, but it is annoying. I'll give him a call on Monday and see what he says. I don't think he can up my verapamil dose as he had mentioned last month that my pulse would be too low. I'm taking 360 mg. now...now, here's a question...how can the doctor know if a person is taking too much of a medication? Could I be on too high a dose? I'll have to ask him that.

[Sarah]

doses

Yeah, well, if I had listed every kind of arrhythmia, we'd be here all day.

As for Cynthia's question about dosing, there are generally guidelines for how much to take of certain drugs, and also some drugs can be measured by a blood test (eg digoxin can be toxic and they can take levels to see).

The other measure would be what your doctor measured --your blood pressure. Calcium channel blockers (like verapamil) lower bp (as do betablockers). Too much and you won't have any bp at all. or not enough, anyway.

There are other medications they can add to the verapamil reduce your afib; it isn't unusual for a calcium channel blocker to be used with another medication since it is only a Class I anti-arrhythmia medication (as in not the strongest).

S