Ectopic Atrial Rhythm and Extreme Fatigue

Please forgive my naivete as I await my first Holter monitor, echocardiogram and probable stress test ECG.

Every 30-second ECG there's at least a few PACs, and sometimes a string of 10-15 in a rhythmic pattern seems triggered by my breathing. In 30 seconds my heartbeat varied from 47 to 93, P-P ranging from 1.2 to 0.7 seconds. Heartbeat goes back and forth, slow to fast.

See the ECG below in this thread. O

Any kind of exercise or exertion brings on a run of PACs, with thankfully very few PVCs.

1.2 seconds feels like an awful long time between beats. It's as if my heart is tired and trying to rest but then O2 drops and it has to catch up.

Maybe I'm simply deficient in a nutrient like taurine or carnitine.



Edited 1 time(s). Last edit at 05/27/2024 11:37PM by NewMexican.

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NewMexican
1.2 seconds feels like an awful long time between beats. It's as if my heart is tired and trying to rest but then O2 drops and it has to catch up.

Are you well conditioned, from an exercise perspective? Many of us who are well conditioned have low resting heart rates. My overnight average heart rate is commonly in the low 40's with the slowest rate in the 30's, sometimes in the low 30's, depending on the night. It is perfectly fine for me. During the day a resting heart rate from the high 40's to low 50's is common for me.

PAC's can be nutrition as you note. Electrolytes, such as magnesium, potassium and potentially an excess of calcium are possible issues as well as taurine or other nutrients.

Oh no. I'm not well-conditioned.

I can hardly walk a mile.

I have questions about that Omron. It says your HR was 47 but by my count it was 58. I don't even know where it got 47. Most consumer devices are really bad at counting HRs with irregular rhythms, and I suspect that's the case here. Get a Kardia if you want a more accurate count.

Also, are you on any meds? Rate limiting drugs in particular like beta blockers or diltiazem?

It's the BP7900 Omron Complete and 47 is the lowest value it's given me. 57 is common.

Olmesartan Medoximil 30 mg for hypertension.
Metformin 500 mg with a lot of berberine for prediabetes.

Here's recent 30 seconds where it measured 53 beats, with the same pattern of long beats over a second long, followed by a string of short beats.



Edited 2 time(s). Last edit at 05/27/2024 11:20PM by NewMexican.

I hope my question won't be an unwelcome intrusion.........but....if you are approaching Type II, are you what could be described as obese, or seriously overweight, say by about 40-60 pounds? If so, some or all of what you may be experiencing might be related to the effects of visceral adiposity around vessels, nerves (especially the Vagus nerve which DOES have something to do with AF and PACs), or your heart and other organs. IOW, it might be a wee bit too crowded in there finally. No amount of supplementation will fix that; you will have to reduce the adiposity...period.

That aside, a good solid blood assay will reveal where any deficiencies lie, if they are there at all.

No I've never been fat.

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NewMexican
It's the BP7900 Omron Complete and 47 is the lowest value it's given me. 57 is common.

No matter, I wouldn't trust its numbers because it was just plain wrong in at least one case. Numbers in the upper 50s are of no concern.

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Carey
I have questions about that Omron. It says your HR was 47 but by my count it was 58. I don't even know where it got 47. Most consumer devices are really bad at counting HRs with irregular rhythms, and I suspect that's the case here. Get a Kardia if you want a more accurate count.
...

It's accurate. Look at the durations of the first two beats and especially #2 which clearly exceeds 1.2 seconds on the graph:
60 / 47 = 1.2766 seconds.

Later "long beats" after the NACs are all shorter than 1.2 seconds, which means my "heartbeat" increased from 47 to well over 50 bpm: 60 / 50 = 1.2 seconds.

The Omron reports heartbeat calculated from the longest P-P interval in the first 30 seconds.

It's my underlying "heartbeat" that varies significantly as apparent on both my posted ECGs.

If this "varying heartbeat" is an extreme anomaly I'm reluctant to submit myself to medical investigation with Holter monitor, echocardiogram, stress test etc. Maybe all I need is dietary taurine.

My extreme fatigue only began when I completely stopped taking Monster energy drinks which were giving me taurine. It's been only 5 days I've been using the Omron machine to look at my ECGs.

A month ago my PCP was very concerned and ran a 12-lead in the office but after looking at it they stopped being interested in it.

Maybe I am physically fit based on my healthy weight and musculature.



Edited 1 time(s). Last edit at 05/28/2024 03:54PM by NewMexican.

Respiratory Sinus Arrythmia RSA with increased heartbeat on inhale, decreased on exhale, moderately, is beneficial. It's found not just in almost aall human children, but some say it's found in all mammals, all vertebrates, and one guy says similar patterns are found in also birds and fish. It's beneficial because it's economical of energy, giving more gas transfer for less pumping effort.

I posted two ECGs above that show alternation between slow and fast heartbeats. They started slow at 47 and 53 beats because I was tensing up and holding my breath at the start, then goes fast, slow, and then fast again. If this cycling is smooth and natural it's a sign of good health.

But if it's cycling between ectopic PACs and long-delayed compensatory beats, if it's harsh and uncomfortable then it's very not good.

My heartbeat in the posted ECGs was reported ~50 bpm because the first two beats were ~1.2-sec long. Later beats varied widely but only small changes to Heartbeat, up or down a point or two.

Duration of my heartbeat varied by almost a factor of two, with the shortest beats ~0.65 sec, or 92.3 bpm. Because 60 / 0.65 = 92.3.

In the 30-sec ECGs my heartbeat started around 50 bpm, increased to ~90 bpm, then slow and then fast again. But the 47 and 53 bpm values remained.

If instead of starting with holding my breath ... with some kind of forced breathing I could make it report a high heartbeat. Whatever bpm it calculates from the first two beats sets the tone for the entire ECG.

So what's the heartbeat value? There's no single value. It varied between ~50 bpm and ~90 bpm.

[theskepticalcardiologist.com]

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Given that Alivecor’s Kardia Mobile ECG device is capable of accurately identifying atrial fibrillation, the Complete.... "