I had my AVR on 10/19/11 and have been doing really well,just feel a skipped beat every once in awile. Then last night I awoke from a bad dream and became aware that my heartbeat was fast with a skipped beat here and there. I couldn't lay back down like that so I sat up waiting for it to resolve. I fell asleep in the recliner and when I awoke again my heartbeat was regular but still about 100 bpm. I took my metoprolol at 7ish and my heartbeat slowed and has been okay all day. Has anyone else experienced this? At what point is it time to go to the ER? I didn't have any other symptoms.