What is the cause of low heart rate?

Brief Answer: Need to focus on noncardiac causes also Detailed Answer: Hello, Thanks for your query. I appreciate your efforts for medical consultation in so much distress. Important aspects of your query are: • 28 year old male • Known case of PAC and PVC • Complaints of: anxiety, skipped beats and palpitations. Skipped heart beat or premature ventricular/atrial contractions (PVC/PAC) are among the most common arrhythmia and occur in people with and without heart disease. In some people, it can be related to stress/anxiety, too much caffeine or nicotine, or too much exercise. As you had already evaluated by cardiologist and tests are fine, then we should suspect anxiety or stress for cause of skipped heart beat. Same time control caffeine and nicotine use (if present). In drug treatment of anxiety two types of medicine used. For immediate relief of anxiety benzodiazepines group of medicines (like clonazepam) are used for short duration (due to risk of dependence). For long term relief most commonly SSRI (selective serotonin reuptake inhibitors like escitalopram) are used. SSRI takes around 3-4 weeks to show its effect, till that time benzodiazepines control the anxiety symptoms. All these medicines are prescription medicine and given after in person examination by psychiatrist. I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups. Wish you good health. Regards, http://bit.ly/Dr-Ashish-Mittal