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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What causes heart rhythm disorder?

Answered by
Dr.
Dr. Sukhvinder Singh

Cardiologist

Practicing since :1998

Answered : 1306 Questions

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Posted on Mon, 4 May 2015 in Hypertension and Heart Disease
Question: I have had all my cardiac work up done a few months ago. Everything came back normal back in January. My echo and stress tests were both normal. My 48 hour holter showed PAC'S which were in the 900 mark and very few pvcs. The etopic calmed down for a little while but the last week I have been getting a lot of pacs before bed and in the morning when I wake up. These are terrifying. I worry about them now but my cardiologist says they are benign and need no treatment. I also hhave a slow resting heart rate at night when I watch TV in the 56 bpm range. Is my cardiologist correct is this really nothing to worry about? He says that cardiologists hardly ever worry about pacs
doctor
Answered by Dr. Sukhvinder Singh 57 minutes later
Brief Answer:
do not worry.

Detailed Answer:
Dear Sir
Before we go into detailed discussion, I hope you do not have any alarming symptom of heart rhythm disorder like loss of consciousness, blackouts or unexplained fall. (consult your cardiologist on priority if anyone of them is there)
1. PACs and PVCs are common in normal population. As per one of the estimates, two-third of population will have them on a given day.
2. Since there is no structural heart disease, as your echo and stress echo are normal, these should be considered benign or harmless. Only issue is if you are symptomatic for them. If you are symptomatic you need to avoid the precipitants. These include smoking , caffeine, stress, anxiety and alcohol. They are also precipitated by anti-asthma drugs, lung diseases, thyroid disorders and a variety of other medical conditions.
3. If you are too bothered by them (physical symptoms), then you should consult your cardiologist for possible prescription of drug which can suppress them to some extent.
4. Your cardiologist told you rightly that you must not worry, as it will only increase them.
Sincerely
Sukhvinder
Above answer was peer-reviewed by : Dr. Pradeep Vitta
doctor
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Follow up: Dr. Sukhvinder Singh 34 minutes later
Hi Doctor Thank you for your response. I do not lose consciousness or faint. I just feel them more at night and in the morning. My holter report showed sinus rythm with the pacs. Do these etopic beats pass or are they a lifelong event? Also mine are mostly Pacs. Is it true these are less worrisome? My cardiologist says they hardly ever worry about pacs
Also I do not smoke, drink alcohol or caffeine. I do however suffer from anxiety.
doctor
Answered by Dr. Sukhvinder Singh 9 hours later
Brief Answer:
please see details.

Detailed Answer:
Dear sir,
1. They may or may not occur next morning. Hence we can not predict if they will occur in future or not.
2. PAC or PVC, are only important if they initiate a serious rhythm disorder, they indicate an underlying structural heart disease or they cause some symptoms. Otherwise they are as good as your normal beats. As I told you in last answer they do not themselves can be labelled dangerous in absence of structural heart disease and serious rhythm disorder, both of which you do not have.
3. If you only know them by counting pulse, just try to forget them. If you feel any symptoms when they occur like a chest thump and it is frequent and disturbing, you can ask your cardiologist for some medication. Long term future prognosis is not altered in any adverse manner by them when they occur in isolation.
Sincerely
Sukhvinder
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sukhvinder Singh 3 minutes later
Thank you for explaining doctor! I appreciate it.
doctor
Answered by Dr. Sukhvinder Singh 10 minutes later
Brief Answer:
welcome sir

Detailed Answer:
You are welcome sir.
Sincerely
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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