Sinus Pause

So I'm on week three now of weird stuff. I believe it was PACs at the beginning and possibly some other junctional or branch block. My symptoms along with palpitations during any exertion (as discussed in recent posts), include a lightheadedness and pressure in head (quickly). I have noticed when I wake up my pulse is low 49. After some dizziness it recovers to 70s. So at times... sometimes at rest, sometimes in motion i feel palpitations , dizziness, head pressure unlike other times in my long afib experience. I began monitoring these with kardia and I do notice some pauses. Im wondering if the pauses are what im feeling. I did capture my heart rate at the beginning of one of these at 58 and then elevate to 74, I assume the program is averaging for each reading so at the end it is normal (70s). So now like the rest of you I have been internetting and find sinus pause (great something else to worry about). My EP is on vaca so Ill get a true EKG tomorrow at my primary care doc. Just weird all this happens out of the blue when I had been doing well.
My question is if it is just PACs do they cause a pause ?? Or is this some sick sinus thing. Ive never had this much dizziness with PACs in the past.

thanks Tim

PACs alone don't cause pauses. There are many possible causes, including meds. How's your BP? Low BP is the most common reason for dizziness.

Although the Kardia does average the sample to display a HR, any pauses would be obvious in the recording. Just look for unusually long gaps between beats.

My bp is ok and I am seeing some long pauses here and there.

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tsco
My bp is ok and I am seeing some long pauses here and there.

How long is long?

Do you see the grid displayed on your recordings? Notice that it's divided into large and small boxes. How many large boxes do you see between the beats that seem to be pauses?

I appreciate the help Carey. Looks like about 4-1/2 to 5 between the end of a T wave to the beginning next P wave (when I have a P wave). That's the longest. Most are about 4



Edited 1 time(s). Last edit at 01/22/2018 10:08PM by tsco.

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tsco
I appreciate the help Carey. Looks like about 4-1/2 to 5 between the end of a T wave to the beginning next P wave (when I have a P wave). That's the longest. Most are about 4

For future reference, just measure between the R waves, the big peaks, which makes it easy. But what you provided is close enough.

Each big box is 0.2 seconds, so five of them is one second. What you've described is a heart rate of about 60. A pause of significance would be two seconds or longer, which would be 10 large boxes. What you've captured so far isn't a pause and doesn't explain your symptoms. That's not to say you're not having them, but you haven't captured one on your Kardia, or at least not yet. I would recommend discussing this with your EP. Maybe they will want to have you wear a Zio patch or event monitor to see what's going on. Catching brief events with a Kardia is difficult.

Ok. I thought each small box was .2 seconds making each big one 1 second? That's a good thing. Thanks for your help

I really like this site for understanding ECGs. I think it's presented very well and understandably for non-medical people. The specifics of how to measure rates on an ECG are covered here.

The horizontal "little" boxes are 40ms (milliseconds).

The vertical "little" boxes are 1mV (millivolt).