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Another PAC Question
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MedHelp Member's Question

Another PAC Question

by Sondra Elmore, Mar 05, 2003 12:00AM
Is there any number of PAC's that are "too many."  With the information that came out last week, it is confusing - with reference to PVC's after a stress test.  Did this information just apply to people with other heart problems?
Doctor's Answer

by CCF-M.D.-RCJ, Mar 05, 2003 12:00AM
Sondra,



PVCs and PACs are very different things.  When PACs degenerate, they generally degenerate to atrial fibrillation, a common arrhthymia that can be successfully managed in most people.  When PVCs degenerate, they do so to ventricular tachycardia or ventricular fibrillation.  These arrhthyhmias are life-threatening in most people who suffer from them.



A person has reached the point of "Too many" PACs when the PACs are bothersome or uncomfortable.  They are not considered life-threatening.



Furthermore, the study that came out last week in the New England Journal referred to all of ventricular ectopy (not just PVCs) during the recovery portion of exercise. AND, ventricular ectopy during recovery only occured in approximately 2-3% of patients tested.



Hope that helps.

Member Comments (12)

by wailan, Mar 05, 2003 12:00AM
Hi,

    About 2 years ago I had suffered with pacs daily like 3000 or more lived with them day and night! I had suffered with them for years until one day they led into atrial fibrllation. And I am a 31 year old female. I was put into the hospital and converted on my own. They gave me atenolol and diltiazem and eventually the pacs went away but yes if you get to many they can turn into atrial fib and when the pacs went away I never got atrial fib again. Thank Goodness! Ipray everyday that tose beats never come back because they were so dibilitating that living was impossible. I do wish you the best of luck.

by Sondra Elmore, Mar 05, 2003 12:00AM
To: Follow up for Doctor
Hello.  I am confused, as I thought PAC's were benign?  I had a 48 hour holter that showed two short runs of "supraventricular" beats - one of 9 beats, one of 3 -- the heart rate went from 70's to 90's.  Are these PAC's?



Thanks!

by wingtip, Mar 06, 2003 12:00AM
I've had bouts of A-fib for years until it became permanent, and I have never found it debilitating.  I need to try a little harder at some thing, but my EF is fine and I've never had to stop an activity.  Don't give in to the idea that PAC/PVCs will ruin your life and it won't.

by chicago17, Mar 07, 2003 12:00AM
Well what a breath of fresh air this is. My PAC experience will come at the end of this message. I am an ex college and professional athlete that has experienced irregular beats since the age of 14. almost all happened when I was at rest. They said they heard a slight heart murmur.Scared the hell out of me even though all the doctors and tests said it was benign. No echo though. At 20 started to have irregular beats right after vigorous conditioning for my sport. As my heart rate would come down 30 seconds to a minute after stopping it would happen. Had a halter monitor, and of course no beats. Echo was fine. So I had a stress test and they caught one beat when they laid me down directly off the treadmill. Said it was an extra beat thrown in from a shot of adrenaline that wasn't supposed to be going to my heart anymore. Well that was the diagnosed problem and about a week later they stopped and I never had that type again. Still had the occassional irregular beat from 20-26 yrs but no problems and was in the best shape of my life. I had been dipping tobacco and

drank caffeine with no problems. Also partied like a 20 something. Then about a year and a half after retiring from pro athletics and gaining some weight I had a problem. I was watching a game with a dip in and had just finished a large DR Pepper, loaded with caffeine. I then hought of something that made me a bit nervous and boom I went into an irregular beat I had never had before. It wouldn't go away, which was new and scary as hell. I went to my car and started to the hospital. Then I stopped and called 911. By the time the ambulance got there it had stopped. Of course. BP and ECG at the scene was fine. Then about 6 months later I was on the golf course with a dip in, swung the club as hard as I could and the same heartbeat started again. I left the course with it going on and went to the Hospital where the doctor looked at the ECG and said nonchalantly, oh thats a PAC. He says I'm gonna give you a pill to take the edge off. He told me to check in with my primary care Doc and then he left. The medicine was Atenolol. That heartbeat lasted for at least 40 minutes. Quit dipping for good as well as caffeine. Finally I went to a Cardiologist. Didn't hear anything abnormal. Then he did an echo a few months later. He watched it in his office as I wait then came in to my room listened really carefully to my heart this time. You have Mitral Valve Prolapse he said. If you don't listen really quietly you cant hear it. OK, Finally someone told me something concrete. I take Atenolol 25 mg a day, sometimes an extra 25mg when I have an irregular beat or two. When I have alot of gas, especially at night when I lay down to bed, I have irregular beats that make me get up and watch TV until the gas exits my body. I assume the pressure in my stomach does something to my heart. Long story is that I have had irregular beats forever, many very different feeling, still scary, and should technically have nothing to do with my mitral valve prolapse. I am 29 now, back to running and trying to lose the 40 pounds I put on since 1998. My hope is that getting myself back into great shape will lower the incidence of the beats back to the level they were prior to age 26. Who knows. To all you heart frustrated people out there, I feel ya and keep staying with it.

by alexa's mom, Mar 07, 2003 12:00AM
I have a question...... Can you tell the difference between whether you're in a-fib or v-fib? Or do they both feel the same. Would it be safe to say what I experience is a-fib due to the fact I'm still alive. As I've read that a-fib is non life threatening but v-fib is? It's never been caught on an ecg but I can feel it when it happens and it usually lasts about 30 seconds but had it happen for 10 minutes once a few years ago. Any feedback would be greatly appreciated.

Thanks,

Michelle

by dartmouth03, Mar 07, 2003 12:00AM
To: alex's mom
hey, sorry that u've also had to deal with this stuff and such a young age and on top of that dealing with the responsibilities of raising children.  that is admirable.  don't worry, if u had vibb u would either not be here or need a defbrillator to bring u back!!  it's not vfib!  take care, and be well.

by Sondra Elmore, Mar 07, 2003 12:00AM
Thank you for all the feedback on my original post.  I've spoken to my cardiologist again regarding my holter test.  They still say it's benign and stress related.  I appreciate the support.



Sondra

by squeala7, Mar 11, 2003 12:00AM
To: Chicago17
Hello! What you went through sounds exactly like what I have been going through as of late. I had pvcs since I was 13 as well. But they got worse about 4 months ago where I have runs of them 30 seconds to a minute after walking up stairs or exercising or whatever. Is this how yours was? I was curious if your runs were kind of like Bigenemy, where you skip a beat, then have a normal beat then skip a beat - sometimes I get a few normal beats then a skip - or several normal beats and a skip. They feel like they come from my gut and are breath taking. DId they determine these to be PACs? I was curious if you now know the difference between a pac and a pvc?  Did you have the runs for several months? THey finally went away right? If you want to email me instead of here - its ***@**** - thanks for any info you might have - Im goin thru testing now - echo & all - I wonder if I havent developed MVP? hmmmm

Thanks again! Sheila

by badroad, Mar 11, 2003 12:00AM
I have always read that PVC's were benign. In your 3/5/03 response to Sondra Elmore you state that they can degenerate into ventriculal tachycardia. Which is correct?

by charisma, Mar 12, 2003 12:00AM
Thank you all for your comments, I am not insane!! I am 29 years old and I just began this whole process 5 days ago and was sure life was over.  I began having PAC's out of the blue and they just never quit.  It is nice to know that you are all able to cope with it.  To Chicago17, how does your heart respond after excercise?  I keep thinking I don't want to ever do anything to raise my heart rate on purpose but I know excercise is important.



What different drugs have you all tried?  The drug I am on, 50mg of Metaprolol makes me feel so sluggish and tired...do you just get used to it or are there better drugs out there?

by DWINE, Mar 20, 2003 12:00AM
I HAVE HAD PAC'S FOR 12 YEARS NOW. I HAVE SPENT $1000'S TRYING TO FIND OUT WHAT WAS WRONG WITH ME. I AWOKE ONE NIGHT WITH TINGLING IN THE BACK OF MY NECK AND IRREGULAR BEATING OF MY HEART. AFTER SITTING IN THE ER FOR AN HOUR NOTHING WAS FOUND WRONG WITH ME. IF IT WASNT BEATING IRREGULAR IT WAS EPISODES OF RACING BEATS SO FAST I COULDNT COUNT IT AND FEELING LIKE I WAS GOING TO PASS OUT. FINALLY I WENT TO SEE A CARDIOLOGIST AND WAS PUT ON A HOLTER MONITOR FOR 2 WEEKS. OF COURSE NOTHING HAPPENED DURING THAT TIME. STRESS TEST, ECHOS, EVERYTHING CAME UP NORMAL. THE DOC SAID IT WAS PROBABLY PAC'S AND NOTHING TO WORRY ABOUT. HOW CAN YOU NOT WORRY WHEN YOUR HEART SUDDENLY STARTS RACING OR IT STARTS BEATING OUT OF SYNC AND YOU FEEL LIKE YOUR GOING TO PASS OUT? MY MOTHER SEEMS TO HAVE THE SAME THING. DOCTORS TOLD HER BACK IN THE 50'S THAT SHE HAD A "NERVOUS" HEART AND NOT TO WORRY ABOUT IT. EASY FOR THEM TO SAY. I KNOW IT SEEMS TO BEAT MORE IRREGULAR WHEN IM STRESSING OUT BUT THE RACING BEAT COMES AT ANY TIME WITHOUT NOTICE. I HAVE TO BREATH DEEP BREATHS FOR ABOUT 5 MINUTES AND THEN IT WILL FEEL LIKE MY HEART ACTUALLY STOPS BEATING AND WILL GO BACK TO A NORMAL RYTHYM. I FEEL LIKE IM ALL ALONE AND NO ONE UNDERSTANDS WHATS HAPPENING TO ME. IF ANYONE ELSE IS OUT THERE THAT IS GOING THRU THE SAME THING YOU CAN EMAIL ME AT ***@**** I WOULD APPRECIATE IT.MAYBE YOU HAVE HAD A BETTER DIAGNOSIS THAN I CAN SEEM TO GET....THANKS DWINE
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