Hi there -
I think I can clear up this mystery for you. It's funny (well, maybe not funny, but interesting) how some medical people look at things without the patient's viewpoint figured in.
Your Holter monitor report, while very good, actually, also most certainly does explain your palpitations. It states very clearly there were a few premature atrial contractions (PACs) and some occasional, isolated premature ventricular beats as well. No sinus pauses (all the better), and a generally very normal and unremarkable set of findings, except -- you feel the occasional PACs and
PVCs, and some of us perceive these as "fluttering" or something else that feels like more than just an isolated event. No one has been able to account for this entirely, although in some cases it can be due to a random pairing of premature beats,which just didn't happen during your particular monitored period.
Neither has anyone as yet advanced a convincing theory as to why some of us feel every premature beat (or even other activity that doesn't even produce ectopy), while others never feel any of it, even those whose every-other beat is a
PVC!
The good news is that this is a very good, very normal, healthy result, but the problem is in the perception, and
anxious people are more tuned in to what's going on with their bodies, especially their hearts (I personally am perplexed by the fact that some people are unaware of these things -- I feel every one). What's important is that just about everyone has some of this, some have more than others, some feel them more than others, but in no case are
PVCs and isolated PACs of any medical significance whatsoever. This, unfortunately, doesn't mean just telling you that will prevent you from reacting reflexively when you feel one (or a series of them, which still doesn't mean anything as a rule). While it may help, there's no guarantee that knowing this is normal will make you more able to ignore them (or forget them more quickly). You suffer from something much more troublesome than premature beats: you suffer from
anxiety.
Anxiety is a very real and often disabling problem. The fact that it can precipitate more premature beats than one might otherwise normally feel (and there's no rule there -- again, some people have thousands of them per day while others have them only rarely) just complicates the issue. It's not your fault! I do believe it's a doctor's responsibility to reassure the patient by explaining what's there and why it's not significant and that's what I, no doctor, am trying to do here. Working on the
anxiety problem will, if successful, minimize the seeming importance you perceive in the premature beats. Trust me, one can change the other, and perception really is everything.
I hope very much this is helpful to you. Please follow up with us here as needed. Best of luck to you.
