RBBB and palpitations

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Submitted by Dr T on January 25, 2011 – 2:01pm

Question: 
I have RBBB, and occasional PVC’s, sometimes during exercise. Should answer 1 say ‘or you have PVC’s with right bundle branch block morphology on EKG’?? Could you tell me, are there PVC’s with a left and right bbb morphology (and which is visible on the EKG?) The first answer scared me a little bit, to be honest.
Sometimes I have a tachycardia which I cannot explain. It starts with me feeling my heart beating in my throat. It feels like my heart has suddenly shifted 20 cm upwards in my chest and I can feel it beat high in my chest / throat. One time this happened before going to the gym. It started to accelerate to about 160 bpm, then I tried to relax and it went back to about 100 bpm. I refused to give in to anxiety, so I started to work out anyway. However, as soon as I started lifting weights (and thus my heartrate would go up) I would immediately feel it back in my throat. It was so annoying (and still scary) that I gave up working out after 10 mins, because it didn’t feel good.Could you say anything, based on this story, about the type of tachycardia? I mean, it would accelerate and slow down based on whether I worked out or rested. This let me to believe that it is in fact a sinus tach. Is this indeed correct? And, could this be anxiety, or something like inappropiate sinus tach?
I should note that I have had numerous EKGS (like 12 total), a 24h + 48h holter, normal echo and stress test. Everything was fine according to the electrophysiologist (I had 0 PAC’s and 2 PVC’s during my 48h holter). Thanks in advance.
 

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