All Aboard the PAC-Train!

Since I was diagnosed with Paroxysmal Afib about 10 years ago (and a little while before that, as I had been experiencing what I came to understand were episodes of afib for a while before diagnosis) my heart rhythms have kept to a pretty regular story: Normal Sinus Rhythm for 95% of the time, once or twice a month episodes of afib that last 12-24 hours and self-terminate. The afib episodes are also run through a pretty predictable pattern, beginning with a period (30 min or so) of tachycardia, then hours of slower but irregular, mostly afib beats, with a few 'normal' beats thrown in for good measure, then slower, kind of bouncing back and forth between afib & normal, and finally, back in NSR, usually during my morning walk. I have also, typically, experienced a short run of missing beats (probably PACs) in the evening, maybe once a week or so. All of my non-normal heart rhythms are associated, at least at their beginnings, with mild to medium disturbances in my guts.

Now something new has been added.

A few weeks ago I made the mistake of eating some beans that pretty seriously disagreed with me. As is often the case, I didn't puke, but I could feel those beans working their way through my guts like a knot in a rope. Accompanying this gastro-intestinal distress, my heart was having a field day, and not in a good way. Since that day I have been experiencing what I am calling the 'PAC Train.' PACs, as often as every third beat, sometimes interrupted with periods of NSR, but always back to the PAC Train, every third, fourth, tenth, twentieth beat - just sitting here, writing this, 4*4*6*8*4*5*14*6 (the numbers are 'normal' beats, the * are missing beats (PACs, I'm assuming)). I have even experienced a 'normal' episode of afib ON TOP OF the PAC Train.

So, just wondering if I have any fellow travelers on the PAC Train, or, perhaps, some who have had a ride and gotten off.

Try adding some taurine supplements by NOW company. Not only is it good for any arrhythmia but also one of the best supplement for improving digestion and bile flow anytime you eat carbs. Start with 4-6 grams a day and see how it works for you, at one point I was taking 10-15 grams a day and it eliminated my bloating and gut problems.

I am on the PAC train with you. I, in fact, only had Afib and flutter in the EP lab, and my primary problem is a huge burden of PACs and Atrial Tachycardia (basically runs of PACs). That is my main issue and one that has caused me many symptoms and discomfort, even if not a life a threatening rhythm. It is not fun. I have tried all sorts of meds and repeat ablation, to no avail. I'm definitely on the train....

Can you tell me what these PACS feel like, how do you know what it is?



Edited 1 time(s). Last edit at 03/28/2024 04:55PM by calvin.

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calvin
Can you tell me what these PACS fee, like how do you know what it is?

Most people describe them as feeling like a particularly strong beat. You know what it is by having felt the sensations and then seeing them recorded on an ECG. Once you've felt a few and see what they are, you know the next time you feel one even if you don't have some type of ECG device.

Thanks I feel some stronger beats some times and along with the feeling of breathlessness. Never have caught this on my kardia or on the 12 lead in the EP office

Yeah, PACs can sort of take your breath away momentarily. I think what you've felt were likely PACs.

It takes my breath away, makes me have a weird empty feeling in my chest. I get them constantly. So I get other symptoms, but mine are constant, sometimes 30-80% of my hourly burden at night. But I can tell what they are when I check my pulse. I get a beat+++beat+++beat+beat+++++beat. A quicker beat followed by a longer pause. Its uncomfortable.

Calvin...

Most of the time I do not notice them at all, and I can only tell that I am having them by palpating my radial pulse where they show up as 'missing' beats...or, more precisely, very weak beats, or by recording with my Kardia Mobile 6L. I also notice that the weak beat (PAC) falls just a bit early...hard to figure out how to communicate in writing...

Imagine you're having a nominal rate of 60 beats per minute, one beat per second. That would be one beat every 1000 milliseconds. So, you feel a beat. Then, the next one comes along at 700 milliseconds instead of 1000, and it feels not quite as strong as the previous one. And the next one comes 1300 milliseconds after that. So you're still averaging out at 60 beats per minute, but you can't really call it NSR.

On the other hand, in the 'old days' (before the PAC Train) I would get a slight feeling in my guts, something you might describe as your stomach 'turning over' though that might suggest too strong a feeling...more like a little 'flip-flop', just briefly, Then I would check my radial pulse and, sure enough, missing beats. These strings of PACs never went long enough to give me time to get my ECG out (and turn the smart phone on, and find the app, and turn it on...)

Of course, now that they are mostly continuous, I can record them any time I want. Lucky me! The only other symptom I experience is a decrease in my stamina...get more tired on my 3xdaily walks. Although, strangely enough, I tend to get fewer PACs while I am walking than when I'm just sitting around the house.

Sent some tracings to my cardiologist. His response was "They're only PACs. Live with it!"

And remember, it is important to distinguish between PACs (Premature Atrial Contractions) and PVCs (Premature Ventricular Contractions). While PACs may be 'ignored' (according to cardiologists...and, what do they know??), PVCs are a more serious concern. If you are not certain which you are having, it would be prudent to find out.

johnnyS...

Been taking 1000mg/day taurine for, oh, 'bout 10 years now. I'll try increasing. Thanks.

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wwoofbum
PVCs are a more serious concern.

Not so much. They're both fairly benign. Most cardiologists will tell you that you don't need to treat PVCs until the burden is very high, on the order of 20%.

PVCs are like PACs, generally innocuous. As Carey says, it's the burden....AND....how it makes you feel, the quality of life, the intrusiveness into your calm and ability to focus on tasks....that are more the factors. They're just extra beats.

VTac, now that's a serious problem.

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gloaming
PVCs are like PACs, generally innocuous. As Carey says, it's the burden....AND....how it makes you feel, the quality of life, the intrusiveness into your calm and ability to focus on tasks....that are more the factors. They're just extra beats.

VTac, now that's a serious problem.

This is the part that I struggle with, though, as my daily burden of PACs averages 25% and at night can be 30-70%. The research is really unclear, however, on the risks of carrying this kind of burden long term, other than definite increased risk of stroke and overall mortality.

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MeganMN
This is the part that I struggle with, though, as my daily burden of PACs averages 25% and at night can be 30-70%.

Really, it's that high? Anything above 20% is in the "needs treatment" range. I really hope you can get this addressed.

Carey, my 'average' daily burden is 20%. However, when looking at the monitor report, it is very nocturnal, and my nighttime burden is very high. If I actually look at daytime vs nightime, it is much higher than 20%. I have a telemedicine appt on 4/29 with Natale and have been trying medications to address it with little success.

I hope your consult with Natale yields a way forward for you. I'm sure it probably will because that's what he does.