What Causes Irregular Heartbeat?

Posted on Sat, 22 Aug 2015

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Sat, 22 Aug 2015 Answered on

Mon, 14 Sep 2015 Last reviewed on

Question : My husband has been dx with pvc with bradycardia he just had a heart XXXXXXX with came back normal..blood test are normal as well we r worried because his heart will beat 3 times skip a beat and then beat some more skip a beat then beat real fast. He does not feel faint or dizzy. He is tired after doing anything. They say pvc are normal. Are they suppose to so erratic like this.

Answered by Dr. Ilir Sharka (42 minutes later)

Brief Answer:
I would explain as follows:

Detailed Answer:

Hello!

Welcome and thank you for asking on HCM!

I understand your concern, and would like to explain that when dealing with arrhythmic events two important clues should be investigated:

(a) a possible pathological myocardial substrate (that is a possible cardiomyopathy, which may be ischemic, hypertrophic, dilated, etc). Seems that this possiblility is excluded (cardiac ultrasound, coronary angiography, etc.). This is the good news.

(b) an intrinsic adverse implication of the specialized cardiac system (responsible for generating and conduction of cardiac electric impulses). In such case Holter monitoring would bring an exact view of qualitative and quantitative evaluation of arrhythmic events. The first disorder to exclude form such a result (PVC and bradycardia would be a sick sinus syndrome).

As his doctor hasn't concluded for such a disorder, it looks that arrhythmia isn't significant, and bradycardia not persistent.

It is important to directly review Holter results for a better professional opinion.

Please, could you upload his Holter data?

Hope to have been helpful to you!

Feel free to ask me whenever you need! Greetings! Dr. Iliri

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ilir Sharka (12 minutes later)

I don't have the haulter results. But when he was in the hospital for 2 days his heart rate stayed in the forty's and the beats were consistant with beat 5 then skip then five. but now its all over the place there is no normal rate or normal skips its erratic. and when he does anything strenuous it beats so fast u cant get a heart rate. the doctor we have now says everything is fine and pvc and XXXXXXX cardia is fine. we see him in two weeks. the doc says he can go back to work and everything what can happen with this kind of heart rate.

Answered by Dr. Ilir Sharka (45 minutes later)

Brief Answer:
Further diagnostic work up is necessary.

Detailed Answer:

Hi again!

Having a symptomatic bradycardia (persistent tiredness) and furthermore coupled with frequent PVCs, can't be underestimated.

This couldn't be a normal cardiac condition!

But, coming to this point, I would say that it is hard for me to give an exact opinion without reviewing first his Holter results.

I remain of the persistent opinion that there are strong suspicions for a sick sinus syndrome, but it should be confirmed by a specialist after facing with unequivocal underlying tests I mentioned.

I would advice you to re-consult his attending cardiologist for a current review of his clinical scenario (frequent symptomatic arrhythmic events) and other performed tests (including Holter monitoring too), as I believe that further diagnostic work up is necessary to come to the right diagnosis.

Best wishes,

Dr.Iliri

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar