What could be the reason for episodes of bradycardia, tachycardia, and palpitations?

Hi,

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Thanks for the query. Please send me your electrocardiogram (ECG), echocardiogram, holter report so I can guide you accordingly. Without these, nothing can be inferred. Thank you.

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Your echocardiogram shows only mild mitral regurgitation (MR) and tricuspid regurgitation (TR), which are normal. The rest of the echocardiogram is all normal. No need to worry. Holter monitoring is also normal. Premature ventricular contractions (PVC) and premature atrial contractions are normal occurrences in normal people. The burden is less than 1 percent. They are considered a high burden when they are more than 10 %. Regarding postural tachycardia syndrome (PoTS), it occurs when one stands up from a lying position. Heart rate increases suddenly with palpitations and dizziness and normalizes in some time. BP remains normal. Your average heart rate is 78, which is perfectly normal. The lowest heart rate is 50, which is normal in sleep. Orthostatic hypotension is when blood pressure drops upon standing. Vasovagal is when both of these drop upon standing. A tilt table test is done to confirm these. What is your average blood pressure? Amlodipine, which You are taking for Raynaud's, is also an antihypertensive. Thank you.

Hi,

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I understand your frustration and concern. Please be sure I am here to help you. Your 30 days holter monitoring did not show that bradycardia, though it can occur in normal people if it is sinus bradycardia, especially at the time of rest. How do you count heart rate? The best way is manual counting. Non-medical wearables may not show correct info in some cases. 45 heart rate is considered normal in healthy people and if asymptomatic. The tilt table test formally assesses heart rate and blood pressure drops or elevations upon standing from a recumbent position. If u have symptoms upon change of posture, I recommend a tilt table test. POTS, Vasovagal, and Postural hypotension all can be assessed with a tilt table test. Your holter did not show any single episode of atrial fibrillation. Wearables may show wrong information at times, as I told you. Now note when you feel bradycardia, count your heart rate manually for one minute. Count your heart rate and check your blood pressure when you have dizziness. Also, check blood pressure and heart rate on lying and upon standing. Please ask someone to stand by your side if you feel dizzy or fall. He or she may keep you from falling. Thank you.