Dealing with the anxiety around AFIB

For me, this is absolutely the worst. And I don't even have a right to complain based on the posts I read here from time to time, as I don't really have it bad at all.

I'm 47, very active - jog every day, martial arts 4 times a week. I've had three AFIB episodes in three years. Once a year. Each episode was a bunch of factors that might have triggered it - lack of sleep, alcohol, and lots of food. Two times I was on prednisone and had just been sick with a sinus infection. But I cannot get it out of my mind. It's driving me nuts.

I sleep on my side (left or right) and when I am falling asleep I am constantly listening to my heartbeat, waiting for a skipped beat. This, of course, raises my heartbeat level and makes it harder to get to sleep, which contributes to more anxiety and the vicious circle goes on. My biggest issue is not being able to identify the trigger mechanism. I know, there may be more than one - probably is.

I read this blog post about vagal afib and I nearly fell out of my chair. It almost describes my issues perfectly. All three occasions were waking up at night. It seems that heavy eating causes PACs etc sometimes when I'm trying to fall asleep. And all of this began when I started having issues with my neck and shoulder muscles (which continues to this day) which I thought was a completely unrelated problem, three years ago.

I'm literally losing my mind worrying about this. How do you guys cope with this?

The very first time I've had afib, I didn't know it was afib. I wasn't feeling good, but I was thinking it would not last long. It stopped about 15hrs later, just as I was leaving home to see my GP. Of course, everything was normal. Quiet NSR on the ECG.
The stress came a tenth days later, when I had my 2nd afib episode, diagnosed in the ER.
Since then, I've had more than 250 episodes in three years, tried some different meds without success and been ablated 4 times.
I think afib in itself is harmless if well controlled and doesn't generate stress by itself.
The stress is
- Will I have afib today ?
- Will this episode last long ?
- How can I stop this ?
- What the hell have I done to feel as if afib was about to start ?

I've noticed that as soon as I'm in afib, I'm taking things quietly. Mainly because I know it'll stop spontaneously less than 2hrs later.
The stress comes from things I don't know. So, knowing my body is crucial, as well as being well informed.

I've no particular advice to give, but in your post, you're talking about things you know they are likely bad for you. Isn't it a good start ?

I'm still wondering what's really bad for me and what causes my afib. I still don't know. I've tried different diets and supplements, with mixed results that are more coincidental than anything else.
The only thing I'm sure is if I'm more than one week afib free, the next episode is just behind the door.

I guess I'm looking for the defect and I can't find it. Perhaps that's what drives me nuts. When I had my first event, they did all these tests - shoved me in that torpedo tube thing to map the heart, then did it again after the stress test. Found zippo. Ultrasounds, EKGs, nothing. My BP is 120/80 - textbook. Cholesterol and all readings are right down the middle of what I need. But something is clearly off as this is occurring.

I don't take any meds but who knows, maybe I need an anti-anxiety or something.

We recognize vagal AF here, for sure. I had (have) it. Similar story. 45 yrs old, run 30 miles/week, also cycling in the summertime. No diabetes, normal BP (well, normal by the old standards anyway), no tobacco, BMI very near normal, structurally normal heart on echo, etc. In these cases medicine sometimes can't resist its fallback position of "blame the patient" (you must be a raging alcoholic or on drugs, you name it). It's really tough to find practitioners who understand. So - you're not alone!

Personally, as far as the anxiety meds (especially the benzos), I'd try to avoid them if at all possible. They may help in the short term but wow, think of what you're doing to your brain over the long term. I would try careful supplementation if you're not already, starting with a good form of magnesium and then following up with dietary sources of potassium in reasonable quantities to see if those pesky (and nerve-wracking) ectopics can't be put to bed or at least muffled enough that you can enjoy a good night's rest which is also critically important to long term health.

I don't have any words of wisdom but wanted to say I can totally relate. My Afib diagnosis was in late November and I too had very little knowledge (pretty much the Eliquis commercial).

Did you have trouble with anxiety before your episodes began. I did....in fact the couple of years leading up to my episode I stayed stressed 24/7. Those stressors are still there but I'm trying to get a handle on it.

Tests found nothing wrong with my heart either. All blood tests good, Calcium and Potassium low side. After some research on this forum, I had my VitD level tested and found it was 11......way too low.

My BP was high and I was prescribed Bisoprolol and Amlodopine. I take magnesium, Vitamin D3, Mk7, B12 and Taurine.

One thing I have noticed is that it seems a large number of those with Afib seem to have no other issues with their heart.

I can relate to the obsession with your heartbeat. For the entire month after diagnosis, I had my fingers on my pulse. Friends and family don't seem to understand. They try to help by telling me it won't kill me, would I rather have a terminal illness, etc. I've tried to stop talking about it. The others on this forum do understand.

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Ghost
For me, this is absolutely the worst. And I don't even have a right to complain based on the posts I read here from time to time, as I don't really have it bad at all.

I'm literally losing my mind worrying about this. How do you guys cope with this?

Hi Ghost -

I'm in a bit of a similar boat as you, I've had a-fib only a few times in my life and I have been very active - probably too active considering some positions here.

But I have a wrinkle compared to you - I'm home for the last few months, recovering from open heart surgery and a stroke. Prognosis is 100% recovery, and you'd be unable to tell from my presentation that I've suffered at all. I'm still resting at home, to be cautious (that my wife doesn't kill me for doing too much).

Most importantly, it's given me time to think and feel.

I have been getting PAC's during my recovery, and at the oddest times. Although I'm willing, capable and fairly strong, PAC's would still happen, freaking me out. (I would use other language not suitable here.) Any activity would make me worry, any worry would increase the probability of PAC's, and the cycle would continue. It was worse not to have the distraction of work, my regular heavy exercise and all that goes along with those.

Here's what could help you. What I've figured out quite recently is that there is a reason for what happens. I just don't know it at the time, and my go-to answer boiled down to some version of "This is evidence of something bad, wrong, horrible and I'm screwed.

But the sentence of having to rest on the damn couch day after day and restrict my activity genuinely gave me the opportunity to look at what was happening to me. I discovered my own internal reasons for certain benign-looking events and thoughts to create bucket loads of silent, undetectable stress, which in my recovering condition, would produce PAC's and kick off a cycle.

So I started taking things apart in my head - lets assume some thing came up that I didn't like or someone noticed that I had a possibly strong reaction. I'd answer a series of cascading "why" questions about it, maybe do some writing, something similar to cognitive behavioral therapy. Yes, it was kind of stupid at times, but I also went off into areas that in hindsight surprised me a bit.

Lo and behold, after a few of those times, my PAC's subsided. Almost embarrassingly, I had to admit that my heart felt better, beat more regularly, seemed healthier after I wrote a bunch of drivel in an old notebook. So I did it again, and it works.

I cant find the study right now, but researchers in Adelaide have the idea that a lot of a-fib and related issues are lifestyle related - meaning that internal stress, demands, presuppositions, perspective and relentless activity contributes to the high incidence of heart arrhythmia. Concurrently, changes in lifestyle, necessarily including internal attitude is at the very least beneficial if not able to clear up symptoms.

You can be a "laid back" counter-culture hippie surfer with high internal stress, and a 60-hour/week Wall Street derivatives trader with low internal stress. It's all inside.

Simply put, if the worry is driving you nuts, I think that maybe is something there - the worry itself is an indicator that maybe there is "something there" for you and maybe look into it.

Hope you find your peace.

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Ghost

I'm 47, very active - jog every day, martial arts 4 times a week.

I think a lifestyle change may stop your afib, if you cut back on jogging to a brisk walk and see how that goes.
Also goto afib resources (tab above) and have a read of the The Strategy in fact all of Jackie Burgess reports, I think that will help you.

I certainly appreciate the comments. I am on 800mg of MG (400 twice a day) and Potassium. I don't take any Taurine, because as I understood it you get that from eating meat, which I do. Perhaps I need to supplement with it? Other than that I take a multivitamin.

I'm not sure that cutting back on jogging has anything to do with it. I feel great when I'm running and after I run. I don't run before sleep or anything.

And I never had anxiety issues prior to this. But I swear a night doesn't go by where I'm listening to my heart before I fall asleep, waiting for it to go off the rails.

If it is vagal induced, is there a strategy to apply to minimizing the effect? Ie, is it better to sleep in a particular position...etc? I've already cut out the idea of not over eating or eating too much before bed and allowing digestion prior to going to sleep (which isn't a bad thing for many other reasons). I don't really drink often, I just enjoy my red wine - a few glasses every weekend is the max. I'd hate to have to give that up.

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Ghost
I'm not sure that cutting back on jogging has anything to do with it. I feel great when I'm running and after I run. I don't run before sleep or anything.

I wouldn't stop the jogging. Just keep the "dose" where it's comfortable. Don't over do it, which it certainly doesn't sound like you are.

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Ghost
If it is vagal induced, is there a strategy to apply to minimizing the effect? Ie, is it better to sleep in a particular position...etc? I've already cut out the idea of not over eating or eating too much before bed and allowing digestion prior to going to sleep (which isn't a bad thing for many other reasons). I don't really drink often, I just enjoy my red wine - a few glasses every weekend is the max. I'd hate to have to give that up.

This is the tricky part for us vagal a-fibbers. You want something in the evening hours that is both vagolytic and a CNS depressant. This will run counter to everything you've probably heard, but you might try the red wine. Ethanol is vagolytic, depresses the CNS and actually works on the brain in the same way that benzodiazapenes do. If one glass in the evenings works, that's inside of the limit for long term harm. The downsides are that it's habit-forming (but so are the benzos), and it will deplete electrolytes (magnesium) so keeping on top of supplementation will become ever more important. It can also wreck sleep by causing middle of the night awakenings. So it's a huge double-edged sword but it's an experiment I've tried and found some benefit back in my active AF days. That being said, it won't work for everyone. I'm well aware of that.

My bit on exercise. Chronic fitness was my path to afib at age 49, neatly 15 years ago. This is true for many who come to afib in their 40’s and 50’s. Detraing endurance exercise is part of my successful afib remission program. I focus on minimum effective dose. Our founding moderator, Hans, wrote this: <[www.apoe4.info] For those who are metabolically challenged with afib, exercise may be beneficial (i.e. couch potatoes), for those who are fit, it can be an issue. Most who are fit will strongly resisit detraining. I did for two years. I remain very fit, but avoid endurance activity. Yes, I can feel really good during it, and it can still be a delayed trigger. For example, adding hiking to each lap skiing the steeps on a powder day.

George

I can certainly relate to the anxiety brought upon by afib. Benzodiazepines excel at hushing anxiety, but can cause their own problems, and they can be addictive. That said, I'll still take it if anxiety is an issue, and I'm thankful to have it available. I work out 6 days a week, but not at endurance levels, and I find exercise, diet and proper rest are the best tools to battle anxiety. And when that doesn't work, I'll take a benzo. Anxiety, no matter the cause or origin, can be debilitating, and is often the worst immediate consequence of an afib episode, and as you know, that consequence has staying power. And IMHO, there is no shame in getting help with that consequence. Live well and be well and best to you.

I'm with AB Page with additional suggestions:

1. Take a class in breathing and breath training. I'm sure when you awaken in anxiety you're breathing short rapid breaths and maybe doing the same worrying about going to sleep when you go to bed. Slow, deep breaths work wonders when you learn to use them. Any Qigong class will teach it or you can practice it yourself easily: [www.energyarts.com]

2. Also, Dr. Weil's classic 4, 7, 8 breaths works wonder for me and has for maybe 20 years. [www.drweil.com]

3. Don't forget the non-prescription sedatives like L-Theanine and Chamomile tea, Neither are dependency creating nor do they leave a hangover. I keep a few Ambien around and a few Clonazepam but seldom need them. It's comforting and calming to know that you do have something that with get you through a rocky period if necessary. The longer acting benzos seemed to work better for me as they don't "whoosh" in and out like Xanax, Ativan, et. al.

4. I always found comfort knowing that, properly medicated, Afib will not be the cause of my ultimate demise.

5. For us vagal types first ablations have a high rate of success, particularly with the best ablationists.

Gordon

There’s also the Pharma-GABA from Natural Factors. That’s useful at bedtime. Not so much during the day.

Stress is the root cause of illness, certainly as it relates to our hearts. Cancer, as well.

There is a thread on stress posted by Jackie, full of valuable infirmation.

Link to Javkue’s thread:

[www.afibbers.org]

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wolfpack

I'm not sure that cutting back on jogging has anything to do with it. I feel great when I'm running and after I run. I don't run before sleep or anything.

I wouldn't stop the jogging. Just keep the "dose" where it's comfortable. Don't over do it, which it certainly doesn't sound like you are.


If it is vagal induced, is there a strategy to apply to minimizing the effect? Ie, is it better to sleep in a particular position...etc? I've already cut out the idea of not over eating or eating too much before bed and allowing digestion prior to going to sleep (which isn't a bad thing for many other reasons). I don't really drink often, I just enjoy my red wine - a few glasses every weekend is the max. I'd hate to have to give that up.

This is the tricky part for us vagal a-fibbers. You want something in the evening hours that is both vagolytic and a CNS depressant. This will run counter to everything you've probably heard, but you might try the red wine. Ethanol is vagolytic, depresses the CNS and actually works on the brain in the same way that benzodiazapenes do. If one glass in the evenings works, that's inside of the limit for long term harm. The downsides are that it's habit-forming (but so are the benzos), and it will deplete electrolytes (magnesium) so keeping on top of supplementation will become ever more important. It can also wreck sleep by causing middle of the night awakenings. So it's a huge double-edged sword but it's an experiment I've tried and found some benefit back in my active AF days. That being said, it won't work for everyone. I'm well aware of that.

I certainly like the idea of the red wine glass. I guess I've been hesitant about that because all three episodes of Afib I have had involved copious amounts of alcohol (oddly enough, not wine, though).

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ggheld
I'm with AB Page with additional suggestions:

1. Take a class in breathing and breath training. I'm sure when you awaken in anxiety you're breathing short rapid breaths and maybe doing the same worrying about going to sleep when you go to bed. Slow, deep breaths work wonders when you learn to use them. Any Qigong class will teach it or you can practice it yourself easily:

2. Also, Dr. Weil's classic 4, 7, 8 breaths works wonder for me and has for maybe 20 years.

3. Don't forget the non-prescription sedatives like L-Theanine and Chamomile tea, Neither are dependency creating nor do they leave a hangover. I keep a few Ambien around and a few Clonazepam but seldom need them. It's comforting and calming to know that you do have something that with get you through a rocky period if necessary. The longer acting benzos seemed to work better for me as they don't "whoosh" in and out like Xanax, Ativan, et. al.

4. I always found comfort knowing that, properly medicated, Afib will not be the cause of my ultimate demise.

5. For us vagal types first ablations have a high rate of success, particularly with the best ablationists.

Gordon

Number 4 is a key point. But getting to that level of understanding is the trial.

Here is one more question for the group.

I seem to be able to feel my heart beating regularly (when not distracted) and particularly as I am trying to fall asleep. Searching for this online comes up with issues with palpitations, but I'm not having palpitations. I've used the Kardia app/gadget and the EKG is just fine. I can simply hear and feel the heart beat. The pace isn't fast. My at rest pulse is around 55. But I can feel the beat - hear it when it is quiet and I am going asleep. This, of course, makes it difficult to fall asleep and is distracting (as I'm worrying about the afib, etc). Am I just losing my mind?

Is it normal to feel the beat like this?

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Ghost
Here is one more question for the group.

I seem to be able to feel my heart beating regularly (when not distracted) and particularly as I am trying to fall asleep. Searching for this online comes up with issues with palpitations, but I'm not having palpitations. I've used the Kardia app/gadget and the EKG is just fine. I can simply hear and feel the heart beat. The pace isn't fast. My at rest pulse is around 55. But I can feel the beat - hear it when it is quiet and I am going asleep. This, of course, makes it difficult to fall asleep and is distracting (as I'm worrying about the afib, etc). Am I just losing my mind?

Is it normal to feel the beat like this?

I can too. It's very annoying. I think that some people - especially those of us with a "condition" are just hyper aware of our heart and other bodily sensations. I can have a stomach pain or something but if I get distracted, busy, on the phine, etc. I forget about it

Ghost:

I usually can feel and hear my heart beat when lying down to sleep, I had a heart doctor once say to me that I had a strong heartbeat. So if everything checks ok with your heart then I don't think there is anything wrong, you just have a strong heartbeat.
I have learned to just relax and think of something else before falling to sleep Also, I had this strong heartbeat even before AF.

liz

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Ghost
Here is one more question for the group.

I seem to be able to feel my heart beating regularly (when not distracted) and particularly as I am trying to fall asleep. Searching for this online comes up with issues with palpitations, but I'm not having palpitations. I've used the Kardia app/gadget and the EKG is just fine. I can simply hear and feel the heart beat. The pace isn't fast. My at rest pulse is around 55. But I can feel the beat - hear it when it is quiet and I am going asleep. This, of course, makes it difficult to fall asleep and is distracting (as I'm worrying about the afib, etc). Am I just losing my mind?

Is it normal to feel the beat like this?

Before being an afibber, I didn't mind my heart. I only cared about its rhythm while exercising, but never while trying to sleep or things like this.
The fact is I'm now nearly always "tuned" to my heart. Even when it's quietly beating, I may hear it, feel it, worry about it. Forgetting my heart is something really hard to do; and it's bad, because it generates stress and stress is bad for the HR.
While in bed, I've to sleep. If I don't, I listen to my heart or I think about things I'd better not worry about. The result is ectopics and, sometimes, afib.

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Pompon

Here is one more question for the group.

I seem to be able to feel my heart beating regularly (when not distracted) and particularly as I am trying to fall asleep. Searching for this online comes up with issues with palpitations, but I'm not having palpitations. I've used the Kardia app/gadget and the EKG is just fine. I can simply hear and feel the heart beat. The pace isn't fast. My at rest pulse is around 55. But I can feel the beat - hear it when it is quiet and I am going asleep. This, of course, makes it difficult to fall asleep and is distracting (as I'm worrying about the afib, etc). Am I just losing my mind?

Is it normal to feel the beat like this?

Before being an afibber, I didn't mind my heart. I only cared about its rhythm while exercising, but never while trying to sleep or things like this.
The fact is I'm now nearly always "tuned" to my heart. Even when it's quietly beating, I may hear it, feel it, worry about it. Forgetting my heart is something really hard to do; and it's bad, because it generates stress and stress is bad for the HR.
While in bed, I've to sleep. If I don't, I listen to my heart or I think about things I'd better not worry about. The result is ectopics and, sometimes, afib.

I feel like I could have wrote this post. I never paid any attention prior to afib. Now it's like a constant distraction, like I'm just waiting for it to go off the rails. It really sucks. Especially at night. And I've only had three incidents in three years - it's not like it is a regular occurrence at this point.

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Elizabeth
Ghost:

I usually can feel and hear my heart beat when lying down to sleep, I had a heart doctor once say to me that I had a strong heartbeat. So if everything checks ok with your heart then I don't think there is anything wrong, you just have a strong heartbeat.
I have learned to just relax and think of something else before falling to sleep Also, I had this strong heartbeat even before AF.

liz

Thanks, Liz. Yeah, everything has checked out. I also had the strong heart beat prior to AF, but now it draws my attention to....AF. Argh.

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Ghost
Here is one more question for the group.

I seem to be able to feel my heart beating regularly (when not distracted) and particularly as I am trying to fall asleep. Searching for this online comes up with issues with palpitations, but I'm not having palpitations. I've used the Kardia app/gadget and the EKG is just fine. I can simply hear and feel the heart beat. The pace isn't fast. My at rest pulse is around 55. But I can feel the beat - hear it when it is quiet and I am going asleep. This, of course, makes it difficult to fall asleep and is distracting (as I'm worrying about the afib, etc). Am I just losing my mind?

Is it normal to feel the beat like this?

Ghost,

It's normal to me. I've taken my resting pulse almost every morning for the last 40 years (mostly for training/recovery reasons). I could always feel my heart beating, and I was aware of it the same way I was aware of my breathing or whether my eyes were open or closed.

From a child to 2016, I experienced violent pauses and thuds in my heart a few times a day, every day. I just thought it was normal, and paid no more attention to it than other physical characteristics I had.

I had a-fib three times before 2016, and that year I changed my lifestyle a bit, and started a very amateur supplement program. I noticed that from that point on I had no daily thuds.

As ridiculous as it sounds to some, I always, consciously and deliberately, thank my heart for doing what it does, and giving me the life and opportunities I've had.

Ghost: You've described a real anxiety creating situation in hearing, (feeling), your heart beat whenever you lie down or even sit in some unusual way.

I've had that on and off for maybe 30 years, frequently wondering when it will quit or change rhythm, usually on my way to sleep or during a middle of the night wakeful period.

The things that have helped me the most with this are: Getting a firm but squishy down pillow that I can scrunch up so that my head is supported the way I like but my ear isn't resting on anything; and, breathing SLOWLY and DEEPLY into my nose, through my heart down to my solar plexus, dan tien, third chakra, whatever you call that area, in deep breaths, holding it then sending it throughout my lower body to wherever might be sore and out my feet. Sort of mentally spreading my heart energy over most of my body.

I know it sounds juvenile, new age or whatever but give it a try for maybe a couple of weeks. I found that my mind and body sort of became trained so the process became a habit when going to bed or napping without having to think about it.

Nothing works every time but every little bit helps.

Gordon

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ggheld
Ghost: You've described a real anxiety creating situation in hearing, (feeling), your heart beat whenever you lie down or even sit in some unusual way.

I've had that on and off for maybe 30 years, frequently wondering when it will quit or change rhythm, usually on my way to sleep or during a middle of the night wakeful period.

The things that have helped me the most with this are: Getting a firm but squishy down pillow that I can scrunch up so that my head is supported the way I like but my ear isn't resting on anything; and, breathing SLOWLY and DEEPLY into my nose, through my heart down to my solar plexus, dan tien, third chakra, whatever you call that area, in deep breaths, holding it then sending it throughout my lower body to wherever might be sore and out my feet. Sort of mentally spreading my heart energy over most of my body.

I know it sounds juvenile, new age or whatever but give it a try for maybe a couple of weeks. I found that my mind and body sort of became trained so the process became a habit when going to bed or napping without having to think about it.

Nothing works every time but every little bit helps.

Gordon

It doesn't sound juvenile at all. I've been a martial artist all my life and know exactly what you are talking about with the meditative breathing. I'm glad so many here can hear their heart like I can. Makes me feel better to know that it is normal, just a healthy, strong beat causing it. The EKG beat is very pronounced - always has been. When googling "strong heart beat" or "can feel my heart beat" it always brings up palpitations and the sort, no one is out there saying that it is normal.

Ghost said:

The EKG beat is very pronounced - always has been. When googling "strong heart beat" or "can feel my heart beat" it always brings up palpitations and the sort, no one is out there saying that it is normal.

My cardiologist had no problem with it.

Another thing that could cause it is if your blood sugar is low. I always have a protein snack about an hour before bed, I know if you need food your heart can beat a little harder.

Liz

Ghost, I've sometimes strong heart beats too, but my cardiologist didn't bother with that. If it's regular rhythm and the heart is normal, it seems there's nothing wrong with it.
I feel stronger heart beats when I'm laying down, especially on my back or on my left side. I'm skinny ( BMI 20), which may explain this.
There are moments I hear it in my right ear, but nothing to worry about, apparently. This sound in my ear (woosh woosh...) was more frequent two years ago, after my PVI, but I was full of stress.
I believe those heavy beats, when the rhythm is regular, are anxiety related. Hard to get rid of our stress, I know, but it's likely the key opening the door to a better life.

What you are discussing is inotropy (Force of muscular contractions) and the number one factor in all of that is calcium. More calcium = more force.

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wolfpack
What you are discussing is inotropy (Force of muscular contractions) and the number one factor in all of that is calcium. More calcium = more force.

Well, maybe. But what's the reason for this happening only during a couple of minutes from time to time ?
Isn't it more likely induced by stress ?

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Pompon

What you are discussing is inotropy (Force of muscular contractions) and the number one factor in all of that is calcium. More calcium = more force.

Well, maybe. But what's the reason for this happening only during a couple of minutes from time to time ?
Isn't it more likely induced by stress ?

There must be several reasons for the "whoosh" sound in ears.

I first noticed it several years ago when I was pregnant with my first child. I was trying to sleep and thought my neighbor was playing his music too loud 😀 Visited doctor next day because he wanted to check my blood pressure. It was perfect. He told me it was likely the extra blood circulation from being pregnant.

I have it sometimes now, but I'm pretty sure its anxiety related at this point.

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Pompon
Well, maybe. But what's the reason for this happening only during a couple of minutes from time to time ?
Isn't it more likely induced by stress ?

My guess is you're going to "feel" the ventricular systole. You probably can't sense atrial contractions because they are so much smaller. The ventricles are innervated really only by the sympathetic nervous system. The parasympathetic (vagal) doesn't have a huge effect on what goes on in the heart's lower chambers. So anxiety, or anything that makes us excited or "jumpy", can have an inotropic effect on the ventricles. If the cells are under the influence of an excess of calcium then that effect is going to be amplified. I would further theorize that there is probably some threshold above which you "feel" the hard beat and below which you don't. So as inotropy varies throughout the day, or even from beat-to-beat, there could be periods of time when you become aware of hard beats and other times you don't thus giving rise to the notion that they are appearing "out-of-nowhere".

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Elizabeth
Ghost said:

The EKG beat is very pronounced - always has been. When googling "strong heart beat" or "can feel my heart beat" it always brings up palpitations and the sort, no one is out there saying that it is normal.

My cardiologist had no problem with it.

Another thing that could cause it is if your blood sugar is low. I always have a protein snack about an hour before bed, I know if you need food your heart can beat a little harder.

Liz

Actually, I've found that for me, eating before bed actually makes it beat harder. Particularly anything that can easily be converted to blood sugar. I make it a habit to not eat two hours before bed (which is also good diet practice as well).

Thanks, Wolfpack, for those explanations.