I am concerned about my skipped heart beats and palpitations. Please help.

Hello,

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I have gone through your reports (attachment removed to protect patient identity). There are extra beats or ectopics in your ECG (electrocardiography). These are usually benign and not serious in most of the individuals. However, we would want to rule out the possibility of any associated structural heart disease by echo and if necessary, then stress test. There are certain precipitating factors like smoking, alcohol, caffeine, stimulant drugs, sleep disturbances, anxiety/stress, gastric disturbances, etc. Certain medications may precipitate these, if you are on any medications other than Hydroxyzine. So try to identify any triggers. If these are too troublesome, then you may request your treating doctor for beta-blockers to suppress these. So usually these are benign, but you should also undergo echo along with Holter monitoring. Identify the triggers and have a healthy lifestyle and try to achieve weight loss. I hope this helps.

Hello,

Welcome back to icliniq.com.

12 lead EKG may be normal in ectopics, as these are intermittent and may not be picked up always. But your attached EKGs show the ectopics, which confirms their presence. Now regarding the possible causes, these can certainly be related to drugs. Drugs itself can precipitate these and even drug withdrawal may precipitate these. Drug withdrawal or tolerance can cause anxiety and anxiety can worsen ectopics. Even ectopics can worsen the anxiety. So everything is interrelated and everything appears to be related to drug-related. Now this may take a few months before all this subsides. You should focus on gradually withdrawing the drug. During withdrawal, these ectopics may subside in a few months. You should convince yourself that these will be there and go with time, these are unlikely to cause any serious consequences. You may try some meditation and yoga to calm yourself and try to remain as busy as possible. Regarding medications, the first medication should be tried is Propranolol which can suppress these ectopics and anxiety. If it is not helpful after gradually escalating the dose then you should try to move other antianxiety medicines, as Prozac or other psychological medications may itself cause palpitations. So it should be tried only if Propranolol is not helpful.

So it confirms the presence of atrial and ventricular ectopics, which are responsible for your symptoms. This is not a serious or worrisome issue usually. So, take above mentioned precautions and actions. As I mentioned earlier, echo should be obtained just to rule out possibility of structural heart disease. All the best.

Hello, Is it Ziprasidone? Geodon (ziprasidone) is basically for psychiatric issues like control agitation, bipolar disorder or schizophrenia. It will not be directly helpful to suppress ectopics. It will be helpful only if you have any psychiatric issues. So I wouldn't go for it unless one is having psychiatric issues. Toprol (Metoprolol), infact a drug of choice for ectopics. You may have it for some time period and gradually taper it once ectopics are suppressed. It's an good option.