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

[Mark14705]

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.

[CCF-M.D.-KE]

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

[squeala7]

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?

[dblaso]

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

[karie]

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.

[hbp702]

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.

[dblaso]

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?

[dblaso]

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.

[dande4]

I'm on L.I. also. Found a good Dr. who has been helpful? (saw your posts on about.com), I have many of the same symptoms. Hope you are feeling better!

[itsa4847]

hbp702
(03-Oct-02)

i agree with your statements 100% i have heart spasms and had many many pvc's was on toperal and now iam on cardizm and imdur for the spasms and was taken off the toperal but it took along time for them to figure out the dizzyness and when they added florniff (spell) to raise my bp the dizzyness went away, and it was scarry driving around and thinking ok its not to bad if it gets a tad worse ill pull over.  There is no reason for this!  my bp was averaging 90/40's and now iam 112/60's  and that did it for me.  I was simply not getting enough salt and with the meds i take for my heart it was knocking me down.  I have never felt better since that one little pill, however took me 6 months and a lot of complaining and two heart dr.s to get there!  They need to listen to us!
and now iam almost pvc free!

[squeala7]

Thanks for the website! Im gonna check that out right now. It makes me feel a bit better knowing that I would be able to continue on the toprol since its such a low dose anyway during pregnancy. Im almost 40 as well, so Ive got the other hormonal drama going on too - there is definately a link between pvcs and hormone fluctuations - men too. With women though, when estrogen fluctuates more dramatically as you get older, it causes your vessels to dialate and constrict - causing pvcs. Its pretty interesting, and then it gets so deep into estrogen vs progesterone and levels of both, and they both affect blood sugar which also can cause pvcs (which happens to be one of my problems - I get pvcs if I dont eat / they go away as soon as I eat. Then Ill get pvcs if I eat something like pancakes with lots of sugar - definately a correlation)  There is SO much that can cause our pvcs - and when I first started getting these much worse (after pregnancy) I thought I had CHF or CAD since it runs in my family - now I realize that as you age, **** just gets worse - now instead of trying to figure out WHERE and WHY and WHAT caused THIS particular PVC, I just try to put it out of my mind IMMEDIATELY and calm / like you said - its the only way to prevent more.  It really is a mental thing if you have been dx with a normal heart. What else can we do??? Gotta live w/em cuz they aint goin nowhere! LOL
Good luck to all!

[Mark14705]

What is ablation?

[dblaso]

Ablation is a procedure in which a cardiac surgeon threads an electrode catheter up to the heart through one of the main arteries (usually the catheter is inserted through the groin area).  The purpose is for the surgeon to find the cells in the electrical pathway of the heart that are "missfiring" causing the heart to have irregular rhythms.  Once these cells are identified, they are zapped so they won't cause any more irregularities in the heart rhtyhm.  I hope this helps.

[karie]

Currently I am taking 250 mg of Magnesium, 500 mg. of Calcium, and the Potassium is I think 995mg: Klor _ con /EF they are taken in water . Went in for blood work today to see what levels are at now. Thanks for all the pvc messages. I have had the heart murmurs and mvp since birth and started having : low b/p dizziness, pvc's,pac's, chest pain and tired on hikes 7 years ago which brought forth many cardiac tests. I follow all my guidelines. I will look into the increase in salt for b/p and pray the road to recovery is here for all our hearts ..............

[Arielle]

Hi! I am a 45 year old female with a history of mitral valve prolapse which docs say is mild. About 15 years ago, I started to develop heart palpitations, went to a cardiologist, and was put on 50 mg. of Tenormin (Atenolol) per day.  I had a bout with cancer this past December, had surgery, chemo, radiation and came through it just fine.  About 6 months ago, I decided to take myself off of the Tenormin (don't know why!) and several weeks later, started developing the frequent palpitations all over again.  I was admitted into the hospital, had a thalium stress test done, echocardiogram, EKG's and blood work to see where the PVC's were coming from. All tests were negative, except that in the ER, the nurse said that my magnesium was "a little low".  Docs put me back on the Tenormin and everything was fine until the beginning of October when I learned that my job had been eliminated due to financial problems within the firm. The day after I received the phone call, the PVC's kicked back up and have been terrorizing me ever since.  Went to the cardiologist and after he checked everything out, he said that the stress and my resuming smoking was causing the PVC's to come back. He increased my Tenormin to 50 mg. a day and because the flip flops still didn't stop, increased me again to 75 mg. a day.  The increase in the meds just does not help.  I get them the most between 1:00 PM and 5:00 PM every single day.  I am usually sitting and watching the TV during this time. Some times my PVC's are very frequent (more than 6 per minute) and sometimes they aren't.  They sometimes wake me up in the middle of the night especially when laying on my left side.  I have no dizziness or shortness of breath with these, but they are just frightening and cause me to be more anxious, which causes more PVC's.  A friend of mine who is a nurse told me that because of the cancer surgery (it was sinus cancer but they went in through the top of my head to get the tumor out), I may have become intolerant of the Tenormin and it may simply take a medication change to another beta blocker to cure the problem.  My doctor is being so stubborn and though I adore him, I feel he just isn't listening to me.  He has tried changing the times I take the medication, lowering the dosage once again to 50 mg. per day - everything and nothing seems to work.  Do any of you have any suggestions?  I would greatly appreciate your help.

[squeala7]

Hi Arielle,
You know I have been on toprol and it has worked for me - I just take the most minor dosage too - 25 ml - which is 1/2 of the 50ml pill. It works good - but when you said the nurse said your mag level was a little low - it wouldnt hurt you a BIT to supplement your magnesium everyday - I read several places that people are taking MYLANTA as a supplement and its actually helping - unk if its because it eases stomach distress, or because of the magnesium in it - Im going to try it too. Stress will DEFINATELY play a huge part in your pvcs. It makes sense that the next day after hearing of your job , you got them. They can last a year  or more in stressful situations - but you can combat them if you work hard at relaxing / (if its due to stress) - Ive lived w/them now for 20 years and I havent died or had a heart attack yet and I get icky pvcs - ones that hurt - ones that feel like someone punches me in the chest, etc etc - Im still here - With all you have gone through with the cancer etc - and your heart did fine thru out / I would think you have a strong heart. I was in a car accident that landed me in ICU for 4 days and although my heart rate was in the 90's due to the internal bleeding, it never skipped a beat! I had a baby and during pregnancy I had terrible pvcs - but I went through a grueling 36 hours of labor and was so tired and never skipped a beat while pushing or anything...so I think you can look at the things that you have been through - TOUGH things - and your heart never skipped a beat - kinda shows me that I pay too much attention to them - Cuz thats when I notice them - but when your in serious stress, like an operation or having a baby, your heart does fine - I cant help but think its cuz our minds are elsewhere - just my though- try the mag tho!!! And calcium and occasional potassium helps - eat bananas!
There was a guy here named steve who suggested 2 books in the above posts - by claire weekes for anxiety - check em out I think Im going to - "hope & help for your nerves" PPeace from Nervous Suffering"....
Good luck Sheila - if you would like to email me- IM at ***@**** -

[sprimm]

I began having PACs back in July caused by taking too much Thyroid and cold medicines.  I did have a stress/echo test which showed everything OK, the doctor changed my thyroid medication and everything seems normal now except that I still have minor PACs which don't cause any pain anymore, but they are still there.  Does anyone know if they will eventually go away since the cause of them has been corrected or will I always have them.  The doctor seems to think that they should have gone away within a month after my thyroid medication was changed.  I am hoping that it can still go away even months on down the road.

[Steve-M]

I'm curious. Did you get one of the books I recommended? If you did, has it made a difference in your life?

[Ianna]

Hi Steve,

This is Ianna-
-
I am curious too.
Why is it so important to you to know if the books of Dr. Claire Weekes have made a difference in someone's life?
I noticed your asking the same question in posts before.
As I said: just curious...
-
Greetings - ***Ianna***

[Steve-M]

Hi ianna,
The reason I have been showing so much interest is that when I read most of these posts that revolve around the anxiety aspects of PAC's and PVC's I see myself. When I found this forum I was at a real mental low point with my own condition. My doctors did not understand, (or at least did not treat), the anxiety I felt with my heart beats. I learned about these two books from someone else's comments right here on this forum. It started me on my road to improvement and those two books have played an important part.

I can now see myself and many of the peolpe that post comments here as textbook examples right from the pages of those books. Since they made such a difference in my life I would love to pass the information along to others. I continue to read posts of people consciously and unconsciously asking for the very answers contained within those pages. And yet, hardly anyone has shown an interest.

I wonder why they don't buy a book just to see if it could help them also. Maybe some have bought one of these books and found their answers and no longer come to this site. I know that when I was at my low point I would have spent much more than six dollars to find comfort.

So that's why I am curious.

Nice to hear from you again. Steve

[Ianna]

Hi Steve,

Look under the postings 'HEART SKIPS'.
I have a question.
-
Bey,  -***Ianna***