Hi,
i'm a 33 yr-old female, non-smoker, non-drinker, 5'8", 145lbs. My normal resting heart rate is 55 - 60 bmp. For the past 3 months I have been experiencing (what I perceive as) bradycardia, where my detectable heart rate is about 30 bpm. Episodes would last anywhere from 15 seconds to 3 minutes with a steady slow, strong beat. The would end abruptly, and my heart beat would return to a normal rate with no palpitations. Episodes occur up to 20 times a day, sometimes at rest, but most often are induced with a very small amount of exertion (like getting up from a chair and walking across the room). I notice them because they occur with strong palpitations, and are often accompanied by shortness of breath, lightheadedness and/or chest tightness. My exercise tolerance has been greatly reduced. Going up the stairs seems like considerable effort. I visited my gp, where an episode occured in the office while she was listening to my heart and taking my pulse. She also confirmed a pulse of 30 bpm, but heard possible multiple beats in the stethoscope that weren't detectable in the pulse (nor could I feel them in my chest). Her first worry was av block, and I was referred to a cardiologist. After a normal 24-hour holter (no episodes) and echocardiogram, I had a 2 week loop test, after which the cardiologist told me I was simply having benign ectopic beats, and not to worry, as my symptoms weren't related to a serious heart condition. I was advised to reduce stress and get some exercise. I asked him why it appeared to be bradycardia with these "extra beats", but he didn't really explain very well.

I have since started taking effexor to reduce anxiety/stress, which seems to have helped with my mental and emotional balance. Before these episodes started, I was mildly active, but only in the summers, playing soccer for 2-3 hours a week. Now i'm leary of exercise, as I become symptomatic with exertion, and the episodes often occur as soon as I start to recover from exercise.

Here are my questions:

1) can ectopic beats/pvcs/pacs present as bradycardia? I've been trying to research this, but I can't seem to find anything.

2) why would "extra" beats present as fewer beats (bradycardia)? Why would I only feel a few of them? As I said, my cardiologist's was vague at best.

3) should I get a second opinion or am I still worried without cause?

Thanks for your time,
alison