Get your health question answered instantly from our pool of 18000+ doctors from over 80 specialties

124 Doctors Online
Doctor Image
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

I will be looking into your question and guiding you through the process. Please write your question below.

What could cause episodes of arrhythmia with heart rhythm varying between very low and moderately high?

Answered by
Dr.
Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 6314 Questions

default
Posted on Wed, 21 Nov 2018 in Hypertension and Heart Disease
Question: I have theese episodes where i can feel my heart "working hard" and my pulse becomes low 40-50bpm. I get them specially after food. Not everyday but several times a week. I was at work and took a 3lead ecg and got this rhythm. Heartrate was jumping forn 35-80bpm. I have not seen this before. I took a 12 lead ecg after the episode and that was normal with some VES. So i was windering what rhythm this is?
doctor
Answered by Dr. Ilir Sharka 1 hour later
Brief Answer:
Explained as follows

Detailed Answer:

Hello,



I read carefully through your recent medical history and the uploaded ECG recordings and would like to explain that besides the presence of extrasystoles from the ECG strips, the appearance of epsilon waves just at the end of QRS complexes can be identified.

The presence of epsilon waves is a marker of ARVD (arrhythmogenic right ventricular dysplasia), which is a rare disease of myocardium leading to fibro-fatty degeneration of cardiac muscle with subsequent cardiac dysfunction and heart failure.

Both ventricles may be involved with predominance of the right ventricle. The ominous side of ARVD is the presence of life-threatening cardiac arrhythmia.

Coming to this point, I recommend discussing this with your cardiologist for a comprehensive evaluation of cardiac structure by means of cardiac ultrasound and other imagine modalities (cardiac MRI etc). Additional rhythm study should be performed with an ambulatory ECG monitoring and if necessary electrophysiological study.

You have to consult your attending cardiologist on the above mentioned issues.

Hope I have been helpful to you. In case of any further uncertainties, feel free to ask me again.

Regards,
Dr. Ilir Sharka,
Cardiologist
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Ilir Sharka 49 minutes later
Hi Thank you for your answer. I uploaded the 12 lead ecg taken 2 hours after that episode. But i guess i still have to se my doctor anyway
doctor
Answered by Dr. Ilir Sharka 25 minutes later
Brief Answer:
You should discuss with your doctor.

Detailed Answer:

Hello,

I reviewed your uploaded ECG. It's the same I talked about what I have mentioned earlier.

What I see is normal sinus rhythm with the presence of extrasystoles and epsilon wave.

I recommend to consult your cardiologist for a careful clinical investigation.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Ilir Sharka,
Cardiologist
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Ilir Sharka 1 hour later
Hi, I have provided some attachments. Please review them.
doctor
Answered by Dr. Ilir Sharka 9 hours later
Brief Answer:
Explained

Detailed Answer:

Hello,

I reviewed your additional uploads, it is exactly the same rhythm: normal sinus rhythm. But the problem with the next two ECG records is the increased strips speed 50 mm/s instead of the normal speed of 25 mm/s.

This gives a wrong impression of slow heart rate, but in fact you have to double the heart rate value to give the exact number.

Meanwhile, I strongly encourage you to consult your cardiologist without delay and discuss the above mentioned issues.

Hope I have answered your query.

Regards,
Dr. Ilir Sharka,
Cardiologist
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
premium_optimized

The User accepted the expert's answer

Share on