Irregular Heartbeat?

[firewatcher]

Hi Cardiactec, I have a question about irregular heartbeats: is an irregular heart rate technically an arrhythmia? When I did my orthostatic BP reading, once I stood, the heartrate monitor would not register a regular heart rate, it bounced up and down between 88-101 bpm. The nurse said that it should become regular since I was not moving. Is this true? I had a holter monitor and stress test and the ECG showed "normal" on the graph. Is this a typical POTS thing, should it be noted? She finally just averaged it at 96 bpm since it would not settle after 5 minutes of standing without moving.

Thank you for sharing your knowledge!

Jennifer

[mkoven]

I'm sure cardiactec can answer this better that I can. I think one of the main things they look at is whether the beat is a sinus rhythm. You can have sinus tachycardia, or sinus bradycardia, where it's fast or slow, but still "normal." I've always been told I have normal sinus rhythhm with some tachy and brady.

[jump]

My understanding is that if you have a harmless irregular heartbeat they call that a sinus arrhythmia, and don't really consider it an arrhythmia at all because it's harmless. At least that's what my doc told me.

jump

[morgan617]

Your heart seldom stays the same at all times, unless you are completely pace maker dependent. The same is true of BP's. I virtually never have the exact same BP at all times, or even minutes apart, even when I was a nurse, no one was ever the same every time you took it. it would be within a range, but not the same. Sinus arrythmia occurs with breathing. When you breathe in, it speeds up, when you breathe out, it slows down. This is completely normal.

An arrythmia occurs when the beat itself is abnormal...irregular means the spaces between the beats are abnormal in some way, other than speeding up but at an even pace or slowing down at an even pace.

There are so many kinds of arrythmias, it's just hard to know. If you were on a monitor, they would have had a chance to see why it was jumping around. You may have been having early types of beats, which make the monitor misread what it is seeing. Typically as long as the beats are sinus in origin (they initiate the way they are supposed to and look like they are supposed to, no one is going to actually say you are having arrythmias. She would have said you were having premature beats, which are an arrythmia. Sinus arrythmia is actually pretty easy to pick up, because even though it is speeding up and slowing down, the beats are very regular, whether faster or slower.

88 to over 100 is a pretty big jump for sinus arrythmia, it's typically only a few beats faster or slower. My pulse tended to go over 100 for no reason all the the time before I started atenolol and it's still considered normal by my doctors, regardless of how I feel with it.

Arrythmias are considered abnormal beats that do not resemble your normal rythym, and are disruptive to your natural rythym. So it's hard to answer your question and it wasn't even directed at me, so sorry. maybe cardiatech can explain it better. I shouldn't do this when I'm foggy. I can't even spell today and I was a cardiac nurse for years and years. morgan

[cardiactec]

hey there,

I would agree with the others here that have posted to your question.

if you break the word arrhythmia down, simply it means "a" = without and "rhythmia" = rhythm........ = without rhythm.

There are very very benign arrhythmias and one's that are considered more serious. Sinus arrhythmia is most common "arrhythmia", and more common in younger folks. this type of "arrhythmia" is only classified as arrhythmia for its irregular waveform appearance on ECG (as morgan already mentioned -- wont get too technical here). this arrhythmia is not dangerous but just indicates a slight RATE change due to respiration (breathing in and breathing out) and NOT a rhythm change (the rhythm still is originating in the sinus note, just changing in conduction speed). increased autonomic tone (parasympathetic or sympathetic) on the heart causes fluctuations in heart rate (still remains sinus rhythm with sinus arrhythmia but just suttle increases and decreases in your heart rate/pulse).

the arrhythmia's that are most concerning are not as the one mentioned above. one's that cause a rate/pulse change and also cause a RHYTHM change can be concerning. you can have a heart RATE in the 80's, 90's, 100's and the RHYTHM can be benign (such as with a sinus rhythm, low atrial rhythm, wandering atrial pacemaker) but you can also have a heart RATE in the 80's, 90's, 100's with a RHYTHM that is not considered completely benign (such as with atrial fibrillation).

It is a bit confusing, as morgan already expressed (i think i'm a bit foggy right now too morgan, you did well to explain) ....hopefully I didnt confuse you more.

I do believe from what you describe that this is probably just sinus arrhythmia, but is most important to capture the "arrhythmia" on paper to differentiate between normal variant arrhythmias (such as sinus arrhythmia, normal sinus rhythm with occasional PVC's or PAC's, etc) and serious arrhythmia's (such as ventricular tachycardia, heart blocks, etc)

[firewatcher]

hey there,

I would agree with the others here that have posted to your question.

if you break the word arrhythmia down, simply it means "a" = without and "rhythmia" = rhythm........ = without rhythm.

There are very very benign arrhythmias and one's that are considered more serious. Sinus arrhythmia is most common "arrhythmia", and more common in younger folks. this type of "arrhythmia" is only classified as arrhythmia for its irregular waveform appearance on ECG (as morgan already mentioned -- wont get too technical here). this arrhythmia is not dangerous but just indicates a slight RATE change due to respiration (breathing in and breathing out) and NOT a rhythm change (the rhythm still is originating in the sinus note, just changing in conduction speed). increased autonomic tone (parasympathetic or sympathetic) on the heart causes fluctuations in heart rate (still remains sinus rhythm with sinus arrhythmia but just suttle increases and decreases in your heart rate/pulse).

the arrhythmia's that are most concerning are not as the one mentioned above. one's that cause a rate/pulse change and also cause a RHYTHM change can be concerning. you can have a heart RATE in the 80's, 90's, 100's and the RHYTHM can be benign (such as with a sinus rhythm, low atrial rhythm, wandering atrial pacemaker) but you can also have a heart RATE in the 80's, 90's, 100's with a RHYTHM that is not considered completely benign (such as with atrial fibrillation).

It is a bit confusing, as morgan already expressed (i think i'm a bit foggy right now too morgan, you did well to explain) ....hopefully I didnt confuse you more.

I do believe from what you describe that this is probably just sinus arrhythmia, but is most important to capture the "arrhythmia" on paper to differentiate between normal variant arrhythmias (such as sinus arrhythmia, normal sinus rhythm with occasional PVC's or PAC's, etc) and serious arrhythmia's (such as ventricular tachycardia, heart blocks, etc)

Thank you! I did not think it was an arrhythmia, just an irregular heart-rate. But, everything I googled with "irregular heart rate" came back with arrhythmia... My heart has never shown irregular wave forms on the ECGs, just irregular heart rates. The nurse had told me that if I am just standing there, doing nothing, that my heart rate should become regular (like a metronome?) like it does when I sit or lie down. When I stood up, it never settled into a regular rate, it would beat at 88 for two beats, then speed up to 101, and then at 96-98 for a couple beats and back down...Even when I held my breath. How do you note that? Is that a typical POTS thing? Which number should I use (the lowest heart rate, highest or an average?) It is all very confusing, and you both did a much better job explaining than I did. Thanks!

Jennifer