Question Title: Bigeminy and Bradycardia

I have been having PVCs for the past four years. During this time, I have twice been hospitalized because of bigeminy (most recently this week). My heart rate is always below 60 bpm (usually in the low 50s, although it dropped to 41 in the hospital) and my blood pressure runs between 70-90/50-60. I have been taking 25 mg. of Tenormin at night and an additional 25mg. as needed with the PVCs cause me to get very short of breath. My doctor said to raise my Tenormin to 50mg at night, but both times I was hospitalized the CCU nurses wouldn't do it because of the low blood pressure and bradycardia. I often feel like passing out when I stand for very long. I've had my blood pressure checked at times other than when I'm hospitalized and it almost always runs as low as stated. My echocardiogram was normal. Can anything else be recommended? It doesn't make sense to increase the Tenormin when my blood pressure and pulse rate are already low. Thank you for your response.

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Dear Robin, thank you for your question. It's a difficult dilemma that you face. You are having more frequent PVC's which can be suppressed by tenormin, but your blood pressure and heart rate are already so low that additional tenormin appears to be causing you intolerable symptoms. Thus, you may have to find a non-pharmacologic treatment for your PVC's. First, you should avoid tobacco, alcohol, and caffeine which all precipitate PVC's. Second, if stress or anxiety is involved, you should seek treatment for these problems. Finally, you should try to focus your attention away from the PVC's since they appear to be benign and a nuisance, but should not be harmful to you. Additionally, you should speak with your cardiologist and voice your concerns about the increased dose of tenormin.

I hope you find this information useful. Information provided in the heart forum is for general purposes only. Only your physician can provide specific diagnoses and therapies. Please feel free to write back with additional questions. Good luck!

If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter. The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.

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