Rephrasing last question.waking mid night witha fast heartrate for wks.nothing over 100bpm.ekg,stres,echo,holt were norm.what else could cause thisbe?

Anxiety or distress?: If all the medical causes are reliably eliminated, then I would consider whether anxiety or distress may be the culprit. Anxiety is often associated with an elevated heart rate; with panic attacks, heart rate can be markedly elevated. Also, people can become hyperaware, making it worse. Rarely, medical conditions may cause high stress hormone levels, unlikely but sometimes worth checking.