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Heart Disease  (Expert Forum)
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A-fid?/PVCs( Why the connection)
Answered by
Cleveland Clinic -
Cleveland - OH
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MedHelp Member's Question

A-fid?/PVCs( Why the connection)

by hankstar, Aug 19, 2003 12:00AM


Dear DR.



   Thanks for taking my question. I have notice that many diagnosed with PVCs also sometime go on to develop A-fib. I know that they are 2 completely different arrhythmias, but I'm curious as to what the connection might be , if any?

   I am also curious as to why sometimes I get a PVC and it triggers a fast heartbeat, it as been documentmented as sinus tachycardia with PVCs on an ECG, other times it remains completely normal Is it anymore dangerous to have PVCs at an higher heartrate 140-160 bpm than at a normal rate?

    I have seen ECG print outs that suggest the patient was having A-fib

and PVCs and the same time, Again I'm just curious as to what the connection might be. I'm just wondering if a disturbance in the atria might actually trigger the ventricles to contract  prematurely,rather than the actual trigger being in the ventricles.



  Thanks for taking my questions and for answering all questions posted on this forum with patience and understanding.



    Have a nice day.



           Hank.
Doctor's Answer

by Cleveland Clinic, Aug 19, 2003 12:00AM
Hankstar,



In short, the atria and ventricles are independent.  There isn't a direct connection with the pvc triggering afib or afib triggering PVCs, unless the beat influences the electricity of the other chamber.  However, both can be indicators of structural heart disease. So people with one type of arrhythmia may sometimes have coexistent other arrhythmias.



Sinus tachycardia generally is not triggered by a PVC, although some other types of atrial arrhythmias can be. A PVC can delay conduction through the portion of the heart that conducts between the atria and ventricles, this usually slows the next impulse down. Often times it can also change the conduction through the ventricles and this beat often appear as a different morphology. This is called abberancy and these beats are often mistaken for a PVC.  



Sometimes, atria can also have premature contractions. These are known as premature atrial contractions, PACs. These can trigger the ventircles to beat earlier then if the regular atrial contraction caused it. These are also benign.



hope this is a start



Member Comments (14)

by EricaM., Aug 19, 2003 12:00AM
Hi,



I just have a question (for anyone to answer!) about the event monitor (which I have now).  Does it always send *all* of the "events" that are recorded on the monitor?  I mean if I record one and send it...and then record another and send it- will they be getting both recordings the second time I send, or only the second one.  I just want to be sure.  I don't think that I will be recording all that much, and I want to make sure I do it right!



Also, I had another episode this morning and I discovered that my heart is not beating as fast as I thought it was.  It is only about 120-130bpm (that is still fast, but not as fast as I imagined!).  The thing is though- it feels really strange- like it is beating extra hard and I can feel it more than usual.  Does this sound consistant with either anxiety (sinus tach.) or PSVT?  I have the monitor now...so, hopefully (and not so hopefully) it will happen again so that I can record it!



Thanks,

Erica

by LynnSB, Aug 20, 2003 12:00AM
To: Erica
I have an event monitor on too. Ask the technician when you call in your "events" but I believe you need to wait 60 seconds between events  ( and after the beeping has stopped) before pushing the button again.



The recorder will still catch much of the info from the second event because it will have stored some of the info before you hit the button the second time. However,i you hit the button immediately after having just hit it the first time, you will hear a sound when you transmit the data via the phone that sounds like a French ambulance siren.. it means there wasn't enough memory and nothing is captured on those few seconds. hope this helps.

by Momto3, Aug 20, 2003 12:00AM
To: Event Monitorees
Hi guys!  When I had an event monitor, it was able to record 4 separate "events" and I could send 1,2,3 or 4 at a time.  Then the technician on the phone will tell you to reset the recorder.



Because you may not be in a location where you can transmit the recording after each occurrence (ie: at work), the recorder can sometimes store more than one "event".  



On my monitor, there was a continuous 60 second loop, so it was recording all the time, but erasing over itself every 60 seconds.  So, when you push the button, it is able to capture about 30 second prior to pushing the button (in case you didn't push it right away) as well as the rhythm after you push the record button.  Hope that makes sense.



Whenever I have had a monitor, the technicians were GREAT about answering my questions.  Feel free to ask, they are used to it and you will feel better knowing that you are doing it right : )



GOOD LUCK!!

by Cleveland Clinic, Aug 20, 2003 12:00AM
Hankstar, that would be correct. The beat that is abberant originates above the ventricles.



by Anne 35, Aug 22, 2003 12:00AM
Has anyone ever experienced a rate in the range of 250bpm while wearing an event moniter.  If so, what was your diagnosis, and course of treatment. I recorded a couple of times in the 256bpm range.

by BillyboyAA, Aug 23, 2003 12:00AM
Hank, can you email me about an older post you had on here about PVC's during sex.  It happened to me the other day and scared me to death and I think I was in Afib or Vfib or something deadly.  Please email me so I can talk to you about it.  ***@****



Thanx a million....

by BillyboyAA, Aug 23, 2003 12:00AM
To: Hankstar
the previous message was for you...sorry

by freo, Aug 25, 2003 12:00AM
I had my 1st visit to ER 10 years ago, just after ceasing breastfeeding my daughter - racing heartbeat etc... sent home with reassurance & valium... After years of suffering and medications/medical checks I still get these things, although more irregular (skipped)beats, my life is sad I don't exercise I stress out all the time I just wait for the next episode to happen and then perhaps I'll die. What I want is some real answers as to WHY I get these, are they going to kill me, what can I do about them - Ive seen a cardiologist who told me I needed to do yoga!!!! These bloody things control my life I believe they are hormonally controlled as I get them just before and after menstruation. I am 42 and I want to be normal again. Exercise sometimes triggers off fast beats for me... anyone got any answers for me?

ps no doctor has called these beats anything ie pac/pvc

thanks freo

by Momto3, Aug 25, 2003 12:00AM
To: Freo
Sorry to hear about your palpitations.  Have you followed-up more recently than 10 years ago?  Maybe a second opinion from a more empathetic cardio would be helpful.  I have found that when a doctor takes the time to explain and answer any questions I might have, I feel so much better.  Since cardiologists and GPs see this stuff everyday, perhaps some of them forget the fear we have when they occur to us.  I have a terrific EP in the Cleveland area and there are a number of great doctors at the Cleveland Clinic.  Are you in the area?  Other people on the board can also suggest doctors if they know the general area you are in. Although yoga may be helpful, you would probably be more comforted if a doctor took the time to really explain what is going on and what options you may have to relieve the symptoms. Even though something may turn out to be benign, the sypmtoms can run your life...Sounds like you already know that : )



As for the correlations to hormones....there are a number of us who see some definite merit to that theory!! I've had an irregular heartbeat for at least 25 years, but right around age 38-40....WHOAH!!! Oh, and there are a bunch of women out here who would swear that monthly hormonal fluctuations are contributors.  If I would you, I would consider checking with your doctor/insurance and getting a referral to an understanding cardio...As you can see by the doctors who respond here, they are out there : )  Good Luck!

by PMarlene, Sep 03, 2003 12:00AM
Thank God!  There are more of us out there.  I recently had to stop my medication for VPB's & APB's- Quinidex Ext.  I was totally skip free on this drug and then they took it off the market.  The Cardio put me on Propafenol 225mg twice a day and I have been plagued with numberous skips.  My whole chest hurts when it bounces.  My results from the Holter monitor were relayed to me 15 minutes ago.  They said, "Oh, there were only a few skips and not anything at all to worry about."  Easy for them to say!  I am so anxious and I just anticipate each new series of skips.  I appreciate all of your comments and know I am not alone.  I have an appointment with cardio next week. Thanks for listening.

by LynnSB, Sep 07, 2003 12:00AM
To: Freo
You sound JUST LIKE ME! It took my being a "bad patient" and b*tching that I KNEW something was wrong  and numerous holter monitors  until FINALLY the last one caught atrial tachycardia.

I say don't give up and insist on at least a consult with an arrhythmia specialist ( EP doc).. I'm now set for an electrophysiology study and ablation and I'm terrified but then I think of the fear and misery I've lived with since these things started 20 years ago. I was laughed at , yelled at ( by my ex husband), ignored, belittled, and told it was " anxiety", and "Panic" and "MVP" and a host of other stuff.. It was an electrical glitch in my heart that is hard to "catch".



Dont give up! get your arrhythmia documented and go from there.

by valger, Sep 10, 2003 12:00AM
Hi, I just wanted to comment also on the hormone connection, it seems like that is the case with me, I started getting PVC's and PAC's in my early thirties, and that was about 10 years ago, and they got progressively worse as I went through menopause.  I went through this early, and just had a terrible time with the PVC's mostly, and not really any other symptoms of menopause.  I would have rather had hot flashes!  Anyway, I still get them all the time, and I once had a short episode of atrial fib caught on a moniter, and at that point, my doctor put me on one aspirin a day, which I am still taking.  I was wondering about the PVC's, though, do those cause an increased risk of stroke?  Also, I guess I should go back to my cardiologist, it's been a while, because the last time I saw him, my palpitations had slowed way down, and he said to go down to a baby aspirin per day.  But, since then, the PVC's have really picked up again, and I suppose I could be having runs of atrial fib again, and maybe should be on something stronger than aspirin to prevent stroke.  I get PVC's every 5 beats or so sometimes.  It just drives me crazy, but I am learning to live with it.  I've tried different medications, but they mostly made it worse eventually.  Well, thanks for any help!!  Val

by Fender1, Sep 17, 2003 12:00AM
Hi,



I have had three episodes of PVCs over the past 5 years.  The first was caused by Golfing, Lifting Weights and Scuba Diving all on the same day.  I was 40 at the time and my week of vacation was too intense.  The PVCs went away after 4 days and a trip to the local Hospital.  The second episode was 2 years later during Christmas and I figure I just got exhausted staying up too late.  Coffee could also have been the cause.  The latest episode has been on and off for the past four weeks and was brought on by a business trip with too many late nights and lots of Coffee.



My wife said "You must change your eating habits, trim down (240 fat and muscle) and start taking vitamins".  So I did and I have not had a PVC for four days now.  I would get them for three hours (or so), every 4 to 6 beats.



I think that stress (work) and fatigue are the cause.  For eight years now I would get this bumpy feeling in my throat when I was tired.  It <