Q:
Im 56 years old. 6 ft and weigh 180.In good health. Last checkup everything was fine. Perfect ekg heart checked out ok lungs clear.
My question to you is recently I have been experiencing unusual skips in my heart.I am used to the normal skipped beats and had them all my life ,sometimes aware of them and sometimes not.But recently I will have skipped beats like the following. beat beat skip beat beat skip beat beat skip..These will come in a series but seems its centered around having gas..I know that skipped beats aren’t suppose to be dangerous and also have asked my doctor about them but she said they were nothing ,but I haven’t asked about these particular ones..They usually come when Im standing up doing something after a meal.. when you stand your heart rate goes faster and then this is where they come in but like I said seems to go with gas as I don’t have them during times that I don’t have gas. My resting pulse is usually about 66 to 72 and my pulse goes to about 100 to 112 when walking around. I was just curious if there seems to be anything sinister about these….or they are just normal vagus nerve interactions. Thanks in advance for your advice.
PS I really don’t have any symptoms of any type of heart disease.
A:
It sounds like you have something called a “Bigemini” rhythm.
This is the way a normal conduction of your heart beat happens. It starts in the Atrium, after which the Ventricles contract and the process repeats itself:
And this is what it looks like:
A Premature Ventricular contraction (PVC) begins in the ventricle instead of the usual place, the sinus node in the Atrium. They are very common, and are sometimes perceived as a palpitation. They often occur without the patient being aware of it at all.
Bigeminy is the occurrence of a PVC every other beat. The main point with this type of arrhythmia is that the PVC’s are more frequent in these circumstances. They are otherwise little different from other PVC’s. Since there seems have been a change in your rhythm, you should have it checked out with some blood tests, an EKG and probably a Holter monitor test and a cardiac ECHO to check the function of your heart.
In patients with some types of heart disease, PVC’s or ventricular tachycardia do indicate an increased risk of serious arrhythmias.
Some cases are simply “normal variants”, occurring in otherwise normal individuals.
This is what a normal heart beat looks like on EKG:
This is what a Bigemini rhythm looks like (the arrow points to the PVC):
The general principles of treatment are:
- Correction of any underlying abnormalities, such as electrolyte imbalances, disorders of the thyroid, etc.
- Avoid stimulants or medications which may worsen the situation. Get enough sleep. Pursue an appropriate exercise program.
- Treat any underlying disorders of the heart appropriately.
- If the problem persists:
Consider medications for selected cases.
Some patients may benefit from a procedure called ablation.
Devices, such as implantable cardioverters or defibrillators are indicated only for those with very serious problems who are at risk of sudden death.
The fact that you essentially have no symptoms is a good sign, and much of what read on my webpage may not apply to your situation. I recommend however, that you nonetheless have your heart and this new rhythm checked out.
Hope this helps,
Dr T