I have questions about two abnormal heartbeats:

(1) When I get a pulse beat every one second (60 beats per minute) but occasionally have a one and one-half second period between beats, what is this called? It is like occasionally there is an extra half a second between beats. I have in the past called these "pauses". I don't call it a skipped beat, because it doesn't seem to be double the normal time between beats; only one and one-half the normal (previous) time. I have had these for years, and since my ablation almost three weeks ago, I am also getting quite a few of them. An additional confusion factor is that I was getting some while in the hospital in Cleveland the day after the ablation, and I felt them when I took my pulse at my wrist. However, I was hooked to a heart monitor and I could see the abnormal beats. However, they were only about half an inch wide on the monitor, while the normal beats were about an inch wide. This would seem logically to indicate that the "pause" is only half of the normal time between beats, while my wrist pulse feels like one and one-half times the normal time between beats. I do not understand. Can anyone help? Are these maybe what many people on this board refer to as PACs?

(2) I had a new, strange heartbeat episode tonight. I transmitted it over the phone to the CCF. A doctor came on the phone to discuss it. He said it is called "bigeminy". My dictionary defined it as: "A cardiovascular condition wherein the pulse occurs in groups of two rapid beats with a pause after each pair of beats". Before my ablation, my NSR pulse was usually about 50 BPM resting. I was taking TOPROL XL, which accounts for the fairly slow rate. Since my ablation, I have been again taking the same dosage of Toprol XL as before, but my resting NSR heartrate in usually about 80 BPM. Well, tonight, I felt a little funny (like AFIB always used to make me feel), and I took my pulse at my wrist and it was about 50 BPM in what appeared to be NSR. I thought "what is happening"? For almost three weeks my NSR has been 80 BPM, but now all of a sudden it is 50 BPM (like the old days before my ablation). The doctor said it might feel like 50, but it is really about 100. I would get two beats that were a fraction of a second apart, then a normal one second pause, then another "pair", etc. The double beats were so close together, they seemed like one beat, but they showed up as pairs on his monitor, thus I thought I was at 50 BPM, but was actually at 100 BPM. Does anyone have any information on this strange heartbeat? Has anyone experienced it after their ablation?

I wonder if this is just part of the heart's healing process after an ablation, and if I can expect these PACs??? and this bigeminy to diminish and go away with time. Oh yes, a few minutes after the bigeminy started, it stopped, and I went back to 80 BPM NSR ((by jiminy!). Any info would be appreciated.

Newman

Newman,

By Jiminy indeed! You are experiencing ectopic beats. I will attempt a crude laymans' description. Assuming one's heart is beating at one second intervals and throws in a single ectopic - it goes BEAT(1)-----one second pause-----BEAT(2)-----one second pause-----BEAT(3)----HALF A SECOND PAUSE-----BEAT(4)-----ONE AND A HALF SECOND PAUSE------BEAT(5)-----one second pause------BEAT and so on.

BEAT(4) was an ectopic beat - i.e. a beat which did NOT originate from the heart's own pacemaker (sinus node) but instead from an ectopic focus of abherrant electrical activity occurring at a site other than the sinus node. Ectopic BEAT(4) occurred hal a second AFTER BEAT(3) i.e. BEFORE the sinus node could start normal BEAT(4) one full second after BEAT(3).

If this ectopic or 'irritable' focus is in the atria, then the ectopic beat is a PREMATURE ventricular contraction (PVC), and if it is in the atria, then the ectopic beat is PREMATURE atrial contraction.

Note that BEAT(3) and BEAT(5) occur TWO full seconds apart. This is the result of the sinus node kind of 'resetting' the heart's timing: it has, after all, been denied (by the firing of the ectopic focus) the opportunity to provide a normal BEAT(4) . So it carries on with its own intrinsic timing and instigates (normal) BEAT(5) not one but two seconds after (normal) BEAT(3) - i.e. NOT one and a half seconds after abnormal BEAT(4).

Having braincramped myself, I'll let someone else explain bigeminy, except to say that it's when two ectopic beats are bunched together followed by a pause whilst the heart 'resets' its timing.

If you think that the above is a little tough to follow, you should have seen how it read the first time I wrote it!!

Mike F.

Shucks,

WHen I said

"If this ectopic or 'irritable' focus is in the atria, then the ectopic beat is a PREMATURE ventricular contraction (PVC), and if it is in the atria, then the ectopic beat is PREMATURE atrial contraction."

I obviously meant to say:

"If this ectopic or 'irritable' focus is in the VENTRICLES, then the ectopic beat is a PREMATURE ventricular contraction (PVC), and if it is in the ATRIA, then the ectopic beat is PREMATURE atrial contraction.

Mike F.

It's ok Mike :-) at 142 years of age one should be excused a slight mord wixup; i mean word mixup nyuk nyuk

Adrian

Thanks for this info!
I often have ectopic beats, and have throughout my adult life. (I'm 68 now.) I called them "skipped beats," but the picture is clearer now. About 15 years ago an electrocardiogram showed something irregular about the "ventricular blah blah node..."
In the past it seemed related to excessive caffeine consumption. I have only had a couple of A-fib attacks, two years apart, but the b-beat goes on. I'm down to one to two cups of coffee per day. Obviously, I have trouble quitting coffee altogether.
Question: Am I flirting with another A-fib attack owing to that small amount of caffeine??? If not, I don't care about the random ectopic beats -- from a few a day to quite a few.
mcc

Newman: If you don't stop worrying about all this and trying to measure every microsecond you are going to put yourself in afib, or flutter. If your doctor said Bigeminy. Assuming it's ventricular bigeminy and not atrial bigeminy, that means that every other beat is a premature ventricular contraction (PVC). PVC's always have a complete compensatory pause, and that means that if you took a caliper and measured from the last normal beat (R wave) over the rogue beat, to the next normal beat (R wave), you would roll the calipers completely over 1 time. While it feels like a skip or a missed beat, it's actually an early ventricular beat, pause normal beat, premature beat, pause. So, every other beat is a PVC. Like this:
A...V..........A...V..........A...V..........A...V..........A...V..........A...V..........
A means normal sinus beat or atrial contraction - V means PVC.

I hope you don't worry too much, all that is to be expected. I hope you are otherwise feeling well.

NSR to you Newman,
Pam

Thanks for your responses.

Pam: Thanks for the advice. I guess a couple of beers tonight would be in order.

Newman

Newman: Can I come over ?????

pammie416