I'm a 62 year old male - avid runner - 40 miles per week or so... resting heart rate of about 44bpm. Cardiologist says I'm in great shape. Have had pvcs/pacs for over 40 years and told often that they are benign... I accept that but still a nuisance... notce that once in awhile I get a different kind of "skip." sometimes out of the blue I'll get three or four "quick" beats in a row, followed by a pause... might do this two or three times in a row... makes me feel like I have to cough to get my heart back in rhythm... and that usually works. Is this just a variation of the normal 'pvcs/pacs?

Has this been happening more recently? Are you on any meds at all?

I have to say that 44 BPM is a little low, it's called bradycardia, but it is pretty normal with healthy athletic type people.

What is happening is of a little concern to me, as you feel like you have to "cough" to get the rhythm back, this is called vagal stimulation. Have you approached your cardiologist with this concern? If not, I would do it sooner rather than later.

It would be abnormal to have a 44 BPM heart rate if you were not athletic however since you are very athletic it is normal to have a low pulse/ blood pressure. As to your skipping beats this may be caused by a cardiac arrythmia you may also have premature heart beats when the atria do not fully fill with blood and contract prematurely. You should seek further advice from your cardiologist and if you feel shortness of breath or excruciating pain at any given time always call 911.

If you have pvc's/pac's then they should NEVER occur back to back or a few in a row. If you have more than three pvc's in a row its called a run of v-tach (ventricular tachycardia). If you are having these often you should seek medical advise from your physician. PVC's become lethal when they occur too close to a normal beat. This is called the R on T phenomenon and can send you straight into cardiac arrest (asystole/flat line). You should have a stress test done to see if your dr can induce the pvc's. Your heart fluttering can also be atrial fibrillation, paroxysmal supraventricular tachycardia (PSVT), or even atrial flutter.