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20,000 PVC's per day - How unusual?
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MedHelp Member's Question

20,000 PVC's per day - How unusual?

by Mark14705, Oct 02, 2002 12:00AM
I am a 44 year old male in what I thought was reasonable health except that I've had PVC's for 20 to 25 years.  At first I didn't think they were heart related nor did I know what they were.  The symptoms have worsened over the years to the point where they are now quite frequent, although I can go weeks, months, and even years without any.  Over the past 7 weeks they've increased tremendously.  They've also worsened to the point where I can get a string of 8-10 fairly large PVC's in a row lasting 5 or more seconds.  This has prompted me to visit the ER, see my family doctor and eventually visit a cardiologist.  The end result:  A normal nuclear stress test with an EF of 69% and blood pressure averaging in the 140/90 range.  However, the Holter monitor I wore was able to catch quite a few PVC's.  They were reported at the rate of 20,000 per day.  That's a 2 with four zeros.  My doctor and cardiologist suggest 50mg of TOPOROL XL daily.  My question:  How serious are 20,000 PVC's per day and is TOPOROL a reasonable place to start.  I hate taking medication and would like alternatives if at all possible.  Thank you.
Doctor's Answer

by CCF-M.D.-KE, Oct 02, 2002 12:00AM
Dear Mark14705,



PVCs in the setting of a structurally normal heart are not of great significance. However, if a person is experiencing 15,000 to 20,000 PVCs per day, they are at risk for developing a cardiomyopathy (weakening of the heart muscle). Toprol XL is an excellent medication for controlling PVCs. If this does not help you may consider discussing the option of an ablation with your doctor.



Thanks for your question,





CCF-MD-KE
Member Comments (20)

by squeala7, Oct 02, 2002 12:00AM
Mark - I had a male friend who is your age and started having the same problems. It turned out to be hormonal - even for a man, middle age can sometimes play with hormones - lack of magnesium, potassium - or in his case, his testosterone was outweighing other hormones and causing his pvcs - I dont know the specifics - and its a long shot - but soemtimes hormones and mag levels can be checked? I also had another friend who was actually SHOCKED by electricity while working on a construction site and it threw his heart off for a year! So many things can cause it - but like u - I know there is a cause - I really doubt its just because ya know?



I just wanted to toss in that I am on Toprol 25mg per day (the least you can take) and I really love it. There really is no side effects (or hasnt been for me) and it really has cut my pvcs and pacs by about 80% - especially when I lay down at night. I still get pvcs around my cycle (which Im sure is hormonally driven) but just wanted to say how awesome Toprol is for me.  I had a question if someone else may be reading this and know - I would like to get pregnant - is 25ml of toprol ok for pregnancy? Anyone out there been pregnant with it before?? I have read both that its OK and also that its NOT ok. HELP?

by dblaso, Oct 02, 2002 12:00AM
Hi!



I have PVCs (not that many fortunately - my last Holter showed 138 PVCs but I only felt three).  I do not take any meds for my PVCs.  I did read, though, quite a few times, that beta blockers are safe during pregnancy.  I too would like to get pregnant and was worried about taking beta blockers if my PVCs increased where they would be bothersome.  I was told by three cardiologists and I also read that they are ok to use during pregnancy.  Here is a link that might be helpful:

http://www.heartcenteronline.com  Use pregnancy as a search word.  This website has lots of useful info.  



I also believe that there is a link between hormones and PVCs.  I always get more PVCs in the middle of my cycle and around my period.  I think the relationship between hormonal fluctuations/levels and heart palpitations warrants thorough investigation.  



Hope this helps.



Delia

by karie, Oct 03, 2002 12:00AM
My holter yesterday said 34 year old female with recorded 495 pvc's and this was an extreme increase from years ago. When I was having 3 every minute and so dizzy I was concerned. I had only felt 15 on the day 495 recorded where in the Urgent Care before taking Klor-Con / ef for Potassium had helped some. I am now taking that with Magnesium in that my levels are low. I am very thin and consider my diet very plain and never eat out. The heart murmurs,mvp was reviewed yearly . I was given Inderal , Propanolol and told to take as is basis when it is too much for a day. My b/p generally is 93/60 and the pharmacist said it can lower b/p and cause cold hands and feet.

by hbp702, Oct 03, 2002 12:00AM
Dizziness due to an arrhythima should never be tolerated!



That means blood flow to the brain is compromised.



If that ain't considered serious, I don't know what is.



Once the heart becomes too inefficient/unreliable as a pump

that the blood flow to the brain is compromised that crosses the line from annoying to disabling and dangerous.



Dizziness definately has a severe detrimental affect on quality of life. In addition, you could be driving and crash, or fall off a roof, or something similar. Also, there may be long term loss of function due to frequent cerebral ischemia. Doctors won't guarantee that such an eventuality is impossible. Additionally if the heart is failing to reliably perform its function, it may be at risk for further dysfunction, possibly including ventricular fibrillation (an arrythmia which kills hundreds of thousands a year in the US alone). You may be at risk of cardiomyopathy and heart failure due to the arrthymia and/or its underlying cause. You can't be sure. You need a GOOD doctor whos is WILLING and ABLE to get to the bottom of the problem and who WILL NOT treat cardiogenic dizziness as something which you must live with.



If you are dizzy from PACs/PJCs/PVCs or anything else cardiac, get to a doctor ASAP. If the doctor says live with it, get to another doctor ASAP.

by dblaso, Oct 03, 2002 12:00AM
To karie2:



Low Magnesium and Potassium levels have been associated with PVCs.  Magnesium, Potassium, Calcium, Chlorine are called "electrolytes."  Imbalances in electrolytes can cause heart arrhythmias. If you are defficient in these minerals I suggest you talk to your doctor about getting on some Magnesium and Potassium Supplements.  The most absorbable form of Magnesium is Magnesium Glycinate.  I take 400 mg of Magnesium Glycinate twice daily (and I do not have an electrolyte imbalance, according to my bloodwork).

  

It also seems that you need to make some changes in your diet.  I noticed that eating more veggies and supplementing my diet with omega-3 fatty acids (e.g. cod liver or fish oil) helps subside the PVCs.  Best cod liver oil is "Carlson."  You can find that at a health food store most likely.  It has a lemon flavor to it and a pleasant taste.  The dose for fish oil capsules is 1000 mg three times a day.  I heard the best fish oil source is Costco's fish oil (it is the freshest).  



Also, a contributing factor to your PVC might be your mitral valve problem.  



600 PVCs a day, assuming an average heart rate of 90 bpm is only 0.5 % of your heartbeats during the day.  I know that is not an alarming figure, even though I also know that is not very comforting when you experience symptoms.  On occasion I have had a few PVCs in a short amt of time (I would have 6-7 normal beats and then a PVC and that went on for a couple of minutes) so I can understand what you are going through.



I am not a doctor, but your bp seems a little on the low side.  Did you take it before or after taking propanolol?

by dblaso, Oct 03, 2002 12:00AM
In response to the comments before mine......you probably scared karie2 to death!!! PVCs are "dangeous" only in people that have had a heart attack or have coronary artery disease.  In that case many PVCs are an indicator of "impending doom."  I believe it is so b/c people w/ heart disease and PVCs are at a much greater risk of developing v-tach (3 PVCs in a row) and then going from v-tach to v-fib.  This risk is very minor in people with PVCs and w/out underlining heart disease.  Now, I am not a phsician so I don;t know how PVCs are weighed in the pesence of MVP.  





I do agree that if PVCs are frequent and accompanied by severe symptoms such as constant dizziness, beta or calcium channel blockers might be the way to go.  I never took these drugs but I know that they have potentially unpleasant side effect.  I guess it depends on the dosage and on how the person tolerates the meds.  It's all a trial and error process.  You have to try until you find the right drug for you.



I also have to say, having gone through this myself, that many times anxiety plays a factor on how you percieve PVC symptoms.  I know that when I first started getting them I was so freaked out I was not only causing more frequent PVCs, but every time I would have a couple of PVCs in a row I would go into panic mode, which gave me more PVCs and my heart was racing and doing all sorts of crazy things. I learned over time that the best thing when you have PVCs is to be as calm as you can.  I usually try to take a few deep breaths and that seems to break the cycle if I have frequent PVCs.  

I did hear of cases where people had PVCs constantly for days (or longer in a row).  One of my male friends who is my age (29) was going through some stressful times and he started having PVCs for the first time in his life.  He had bigemeni and trigemeni cycles going on all day for two weeks.  Eventually they subsided and he is fine now.  He gets PVCs once in a while but he learned to deal with them.  



If you want to read about PVCs there is a great article by Dr. Rich at www.about.com.

by dande4, Oct 04, 2002 12:00AM
To: dblaso