What causes high BPM rate during nights?
Patient: For the past 4 nights i woke up around the same time with a rapid heart beat. I've been to the cardiologist about this. My EKG and Echo were normal.  I also wore a holter but it didn't happen that night but it did show my heart beat per minute as high as 120. The doctor says there is nothing wrong and my heart is healthy but to follow up in a month if it doesn't go away. What do you think is wrong. I am 24 yrs old, 5ft 11 in and weigh 212 lbs. Doctor: Hello. Thank you for asking on HCM. I understand your concern.During sleep, there is a predominance of the parasympathetic system acting on the body. However, there is a phase - rapid eye movement phase - which is characterized by a flush of catecholamines (adrenalin) in the system, causing your heart rate to go up. You said that you tried a 24-hour Holter rhythm monitoring. My opinion is that you have nothing to worry about. However, If you continue to be worried, I would recommend you to be put on a episode rhythm monitor, which allows you to turn the machine on right at the moment when your symptoms happen. Then you can go at your physician's office and read the EKG registered at the moment of your symptoms. I hope I was helpful. Take care.