Advice for exercise with PVCs

[monicaq]

I have completely quit exercising since last October when I began experiencing frequent PVCs-at least that's what I think they were-when I ran.  The frequency was variable, but, in general, one for every 3-5 normal beats, sometimes more than that. This happened to me several times while running, and I do not get them with this frequency at any other time. Each time, I stopped running, and they would go away once my heartrate slowed.  The onset was abrupt.  I used to run 3-4 times per week 3-4.5 miles at a time, and was in great shape.  I've had this checked out with an echo, stress echo and holter, although this never happened while I was hooked up--only rare (2-4) PVCs during monitoring. No structural heart problems, other than slight MVP and most recently, mild aortic regurg. I have been told by my cardiologist that I will live to be an old lady.  I'm 37. My questions are: 1)Is there anything that I have described that raises questions or causes concern with you? 2)If I were to take up running again and this continues to happen, what advice do you have for me if this recurs?  Do I just keep running and ignore the 6-12/minute PVCs that I'm getting when my heart rate is up around 150-160? 3)Is there any more danger with PVCs like this at a heart rate like this? 4)Why would I be getting these in this pattern only during exercise?  Otherwise, I get them occasionally every day--which does not bother me.  5)And finally, if the PVCs can come on at a rate of one every other beat or two or three, etc., what is it, physiologically, that keeps them from deteriorating to VT or V-fib?

[CCF-M.D.-RCJ]

monicaq,

Thanks for the post.

Q1:"Is there anything that I have described that raises questions or causes concern with you?"

A diagnosis is necessary so that you can feel good about exercising again.  If a holter monitor is ineffectual, then have an event monitor or Cardionet placed.

Q2:"If I were to take up running again and this continues to happen, what advice do you have for me if this recurs? Do I just keep running and ignore the 6-12/minute PVCs that I'm getting when my heart rate is up around 150-160? "

First, you need to establish that the palpitations are indeed PVCs.  It is unusual for a person who doesn't feel PVCs at rest to then be troubled with them during exercise.  If indeed they are PVCs, and you have an otherwise structurally normal heart, then it is generally thought that the presence of the PVCs is not associated with an adverse prognosis.

Q3:"there any more danger with PVCs like this at a heart rate like this?"

See Q2.

Q4:"Why would I be getting these in this pattern only during exercise?"

I don't know.  Some people do get stress-induced PVCs, but it is less common.  First, a diagnosis of PVCs needs to be established.

Q5:"And finally, if the PVCs can come on at a rate of one every other beat or two or three, etc., what is it, physiologically, that keeps them from deteriorating to VT or V-fib?"

A PVC is caused by an automatic focus in the ventricles that "fires" every now and again when the conditions are right.  VT requires a circuit, which is most commonly produced in humans by scar formation from heart attacks.  VF is different again altogether.  VF requires varying refractory periods or conduction times in the heart to setup local wave forms whose "sum" does not add up to a contraction.  Varying refractory periods or conduction times requires an abnormality of the heart muscle cells, like from a genetic disorder or from a heart attack.

Hope that helps.

[Clenn Camp]

PVC's can be very upsetting and also debilitating at times. Light feeling pvc's aren't very bad, but the more forceful ones that make you lightheaded, dizzy, fainty, etc., are the kind that 'take you down'.  That's the kind I have.  I walked for only 0.2 miles last evening and then pvc's hit so often and forceful I could hardly make it back to the house.
Dr's always tell me... "we know they are uncomfortable but they are not life threatening".  Sorry, but they are not the ones having them and they don't know how uncomfortable they are.

If you can continue to run while pvc's are happening, I say keep on running.  I hope you never have them as I do.

Glenn

[trrtrix]

Hello
I suffered from the exact same thing you describe. I thought I made them go away by agressively hydrating, but they would still happen with exercise. So much so that I felt like I had very few nl beats, with frequent feelings of fluttering. A cardiologist running partner and I were actually subjects of an office pool to see who had the most ectopic beats during a 15 min treadmill run. I won, primarily because I was given extra points for bigeminy and trigeminy, as well as couplets and triplets.

I have been lucky to have been able to make dietary changes which have reliably completely eliminated them. I have eliminated all products with sig amts of glutimate, including soy milk, energy bars, prepared frozen meals to list a few. Glutimate is an amino acid used to increase the protein content of foods and as a flavor enhancer. People recognise one form, MSG, but it also the main ingredient in: yeast extract, calcium or sodiun caseinate, soy or milk protein isolate, hydrolyzed vegetable protein, natural flavors and more.

Interestingly, if you search and read about MSG, the studies sited mention that women seem to be more sensitive to the arrythmic effects of glutimate, particularly with exercise.

Good luck! and keep running!

[sophie163]

im 28 probably 40-50 pounds overweight and a smoker and have been having pvc for atleast 6 years they are getting worse and leave me out of breath and very light headed i get them every single day but i know they are aggravated by caffeine and im addicted to coke soda but i do notice when i stop drinking the soda they become less much less but i have frequent chest pains that come and go also weakness on my left side but i dont know what to do myself its been about 4 years since i have checked my heart i have family history of heart disease and im paralysed with fear sometimes i think im making myself sick anyone with advice can email me at ***@**** thanks so much

[regan]

I get more pvc's with exercise. I use to run 2 miles three to four times a week but I stopped completely a year ago because I started getting the pvc's. I try to walk twenty to thirty minutes two or three times a week but it's hard because the pvc's scare me. They really have taken over my life. If anyone has a good workout plan to ease into I'd love to hear about it. ***@**** Thanks

[kat23]

i have exercise induced PVC's as well - i have had them for years but in the past three years they have increased during exercise.  i also have them very occasionally when i am not exercising.  i admit i have stopped exercising as much, simply because of the worry but in the past month i have cut out caffeine completely, which has really helped.

[Mel22]

I don't understand why the doctor would find it unusual to have more PVCs with exercise, given the established link between PVCs and other stimulants in some people. Adrenaline is a stimulant, right?

That said, I get more PVCs with an unhappy stomach than anything else. That is, if I've had a heavy meal the night before, with onions or alcohol, I may get 2 or 3 PVCs during exercise the next day. Most of the time I have no PVCs during exercise, and my heart rate gets up to 164.

[Kimma]

you said VT was caused by scar tissue from a heart attack. could it be caused from scar tissue from an ablation for PSVT and AVNRT. this may be a stupid question but i always wondered if the scarring from the ablation has something to do with my pvc's. its my worse fear that it will turn into vt or even vf.
kim

[as1723]

have PVC's sometimes several daily, some wake me up at night with stomach upset/gas like they are doing as I write this. sometimes I go days without a one. My Cardiologist too told me to keep running during exercise when I feel them. he said "Just run through them." Well, like most have said here, it is easier said than done. It messes with my head too even with reassurance from a Cardio. If I have one, I can usually ignore it and keep running, but if I have a couple 2-3 in a row or in a minute, I usually stop and quit. And it really stinks, because we are all trying to get or stay heart healthy by running, jogging, walking. I'm sure many can relate to this: You are really feeling great, going to the gym, had a good day, and the first few minutes on the treadmill are awesome. You have that euphoric feeling of accomplishment, you are enjoying some stress relief and you have now been running for 5-8 minutes striding it out. Bam! A PVC. OK, no big deal you think, keep going. Another PVC. Why me I say. Why can't I be like all these people next to me jogging and working up a sweat. All that enjoyment I was feeling is gone and usually I'll stop not wanting anymore PVC's. I love the days when I exercise and have none, about 50% of time. When I'm rested, well,well hydrated, not had alcohol night before, and had some carbs before running, have had my best success w/o the PVC's.

[gordieo]

I've had mixed information on PVC's after working out. I seem to have afew extra, Maybe 6-7 per minute, for 5- 10 minutes.
I've read where PVC's after a workout can be significant. Do they mean 6-7 per minute or do they mean bigeminy PVC's.

[monicaq]

trrtrix,

TOO FUNNY!!  Now that's the mental state I need to get to...let's have a bet to see who can get the most ectopic beats during a run!  I will have truly beaten these things if I can get to that point!  Thanks for the story.  It's a great one.  Does this still happen to you when you exercise?  How often?  I think I need to go out running and have these things hit me like they've done in the past, and just press on and finish a four-mile run, even as they keep coming.  I can so relate to as1723's post, because that is typically what I do--I quit once I start getting them.  And now, I don't even try at all because I'm afraid of them...and these aren't the occasional ones.  I can live with those.  It's the repeated, every-so-many- beats ones that I can't run through.

[trrtrix]

I know EXACTLY how you feel when you start a run and want to stop when they start rolling. I remember stopping to feel my pulse, in some sort of denial that they weren't really happening. One thing that helped me run through them before I figured it all out, was to run on the treadmill at my gym. Normally, I only run on a treadmill as a last resort in inclimate weather, but I found some sort of sick comfort knowing that if I dropped dead while on the treadmill, there was a reasonable chance that someone would revive me. Obviously, I never dropped dead, but it helped me run through some disturbing palps, which gave me confidence.

I am so grateful to have found a dietary solution. My cardiologist friend thinks I'm full of hooey, but he's still palping, and I'm not. Every now and again, I throw caution to the wind and eat things that I have blackballed, and I get return of my palps, not nearly as bad, for about 48 hours, only if I exercise.

I look forward to reading a post from you letting us know you've conquered them!

[trrtrix]

Very happy for you that dietary changes have made a difference for you. It sort of gives one a sense of control over the whole thing. I think we are all very different and sensitive/not sensitive to various things.

I am not at all suprised to hear that slimfast products are loaded with glutimate. Perhaps you, like I was, are having unpleasant effects from it.

There is a website called www.naturodoc.com. Very informative site for all sorts of things. If you go to the site index, page 2, under the category of nutritional concepts, you will find a page about glutimate (MSG). The list of ingredients to avoid is the same as all the others I have found. I avoid the ones under "always contain MSG" and don't worry about the others. I spend a lot more time in the store and in the kitchen than I used to, but WELL worth it.

Hope the same for you!

[netrox]

So, you actually FEEL the skipped beat despite rapid beats during exercise?!?!

I never noticed anything unusual during exercise.

-jeff

[heartdancer]

I have noticed I have more skipped beats with exercise as well...it makes me not want to do anything but sit still. I hate feeling that way. I know exercise is good for me but I am afraid to do it. Also I notice more skips when I have a full stomach, and when I need to have a bowel movement. Why would this be so? Does anyone else experience more skips at these times? heartdancer

[RALLY]

HEY EVERYBODY.IM 31 AND HAVE FREQUENT PVC'S.ANYWHERE FROM 10 A DAY TO 1000 ADAY.I GET BIGEMINY,TRIGEMINY ETC. I OFTEN GET UP TO 10 PVCS A MINUTE.I HAD STOPPPED EXERCISING COMPLETELY,STOPPED LIVING BASICALLY DUE TO FEAR.MY SAVIOR HAS BEEN WITH MY DR'S. REFERRAL WAS TO JOIN THE GYM AT THE LOCAL HOSPITAL AND ENROLL IN THE CARDIAC REHAB PROGRAM.MOST PEOPLE IN THEIR ARE 3X'S MY AGE AND HAVE BIPASS/HEART ATTACK. AND ALL I HAVE IS BENIGN PVC'S.BUT I AM IN A CONTROLLED ENVIRONMENT,STEPS FROM THE ER.THEY HAVE ALL THE REAL EQUIPMENT A GYM HAS.YET THEIRS A NURSE THAT SITS IN THE GYM AT ALL TIMES,I CAN CALL HER OVER IF I FEEL SCARED AND SHE'LL CHECK MY PULSE,BP.I NOW DO 50 MINS. 3 DAYS A WEEK.IT HAS GIVEN ME STRENTGH AND PEACE OF MIND.THEY ACTUALLY KEEP A DEFIBULLATER IN THE GYM(YOU CAN'T GET MUCH SAFER THAN THAT.DESPITE OUR AGE DIFFERENCES I HAVE MADE WONDERFUL FRIENDS IN THE GYM.THEY PLAY GOOD MUSIC ON THE RADIO AND I CAN JUST RUN ON THE TREADMILL AND KNOW IM IN THE SAFEST PLACE TO REALLY PUSH MY LIMITS..I SUGGEST YOU ALL CONSIDER GIVING IT A TRY.DONT LET THE THOUGHT OF "CARDIAC REHAB" FREAK YOU OUT,AT MY AGE I WAS LIKE WHAT AM I DOING IN HERE.BUT ITS REALLY JUST LIKE A REAL GYM. YOU CANT TELL THE DIFFERENCE.ALSO I HAVE THE OPTION TO JUST GO TO THE HOSPITAL GYM AND NOT ENROLL IN CARDIAC REHAB.ITS CHEAPER AND THE DR'S. AND NURSES WORK OUT THEIR,AND IM STILL AT THE HOSPITAL.MOST HOSPITALS HAVE A GYM ,THAT ANYONE CAN BE A MEMBER AT.JUST CALL AROUND.MY VERY HEALTHY HUSBAND IS A MEMBER AT THE HOSPITAL GYM.DONT LET YOUR FEAR KEEP YOU FROM EXERCISING JUST FIND THE RIGHT SETTING THAT MAKES YOU FEEL SAFE AND GO FOR IT.HOSPITAL GYMS ARE GREAT.

[Momto3]

WOW!! CONGRATULATIONS on your new lease on life!  What a great idea. Have fun at the gym!

[fpd3hm]

just chiming in with additional, though similar, comments.  i have not visited this site in awhile, and it's always reassuring to read about folks suffering from similar maladies, as well as the creative approaches to dealing with them.

as for me, i was a state champion miler in high school, ran competitively in college, and, at 25, developed frequent exercise-induced palps.  in the years that followed, i quit running (and exercising, in general), began having panic attacks, and developed a constant, nagging fear that i was in imminent peril.  not good times.

now, at 32, i'm finally able to run again, although i'm still troubled by the palpitations (even though i've been given a fairly clean bill of health).  my suggestions, like most here, is to get checked out, and then forge ahead.  and stay well-hydrated.  and cut out caffeine.  and, to coin a phrase, just do it.  take care,

h

[njrob]

h,
  your story sounds very much like mine although I'm 40 and I never was a champion athlete; I cycle and weight train.  I'm now at the stage where I'm able to exercise again without the fear of palps/pvcs/panic.  I have been training at approx 65% of the intensity that I had prior to my problems.  I too have eliminated caffeine as well as alcohol, art.sweeteners, and are taking some supplements.  I feel much better than in the past and hopefully I can push a bit harder at some point. I'm holding back fearing an episode and setback in my progress. Are you able to run at the intensity that you once did?

Rob

[RALLY]

GLAD TO READ THE COMMENTS,LIKE I SAID I EXERCISE 3 DAYS A WK.AT THE HOSPITAL GYM,BUT I STILL AM BOTHERED GREATLY BY PVC'S,AND PANIC ATTACKS.TODAY IS A STRUGGLE TO JUST STAND ,BECAUSE I FEEL PVC'S EVERY FEW BEATS.AND IT STILL SCARES ME TO DEATH.BUT TOMMOROWS MY GYM DAY,AND I LOOK FOWARD TO IT.ITS A GREAT CHANCE TO SQUEEZE A LITTLE EXTRA REASSURANCE OUT OF THE Cardiac rehab nurse.I LOOK FOR ALL THE MEDICAL REASSURACE I CAN GET.AND I JUST KEEP CHUGGIN' ALONG.

[soupman]

Finally, some good discussion specifically about exercised-induced PVC's.  For myself, I like to run and play basketball.  My own experience has been that the PVC's only occur either when the heart rate is on the way up or during the cool down period.  (During the peak or height of the exercise - be it running or at a during a B-ball game, I rarely get them.  Having said this, there have been times when I don't get them at all during exercise which really leaves you confused.  

Like most of you, I have gone through the full gambit of tests and have been told to keep to my normal exercise routine.

I've experimented with some supplements and reducing carbs - I saw some improvment, particularly with the carbs, but didn't stick to it long enough to really know the true effect...must try it again.

As many of you have already said, we must find a way to fight through this...for me...I need to start running half marathons again which I really enjoy...can't let this annoyance get in the way.

[gordieo]

Has anyone ever explained to you why PVC's occur with HR going up and cooling down? I'm new with PVC's and still trying to find answers.

[arthur]

PVCs (and PACs) will have a tendency to increase with an increase in adrenaline (if they originate from foci).  Thus, you may experience an increase when first starting to exercise and just after finishing (since the adrenaline levels will remain high for some minutes).  As I understand it, for focally-induced PACs/PVCs, the foci respond to the adrenaline stimulation and increase their twittering both in frequency and in amplitude.  Their abberent signalling is thus increased and with it, the likelihood of some of that pulsing ion action reaching the pacemaker circuitry (eg, AV node)...and when that happens, boing, a premature beat followed by the engorged makeup beat.

I get them everytime I run.  It used to frighten me.  Now it's no more a bother than a hiccup.

-Arthur

[Clenn Camp]

When I try to even walk, I start having pvc's.  No, not just pvc's, but very debilitating pvc's that take me to my knees. Makes me feel like I am dying.  Shortness of breath, pressure in chest, etc..  I get so fed up with this going on all the time.  I can't even go anywhere by myself anymore for fear of needing help and most people do not have a clue as to what is happening.  I am not blaming them, it's just that it's so frustrating for all concerned.

Glenn

[gordieo]

Thanks,
That explains some of it to me. How long have you been dealing with this? I've only had them a couple of months and I'm still not comfortable with them.

Gordie

[soupman]

Thanks for the explanation....the cardiologist that I met with really didn't go into too many details regarding what is happening.  Whether it is running or basketball, there is always a period of increasing HR and of course a decrease.  

I would totally agree on the effect of adrenelin...in some instances before a b-ball game, the PVC's would kick in just as I was arriving the gym in anticipation of the game.  While very frustrating to say the least, it is also very intriguing to me as I find myself constantly looking for certain triggers, etc.

I guess it is reassuring in a funny way that other athletic/active people experience the same thing.  There are a number of different forms and chat rooms on this subject but there wasn't a lot about exercise-induced PVC's so this dicussion is much appreciated.  I think this area merits more research...I would certainly be a willing participant..or guinea pig in any type of research!

[ChristaLeigh]

I'm new to the board... I can remember having 'palpitations' (what I've come to realize are PVC's) since I was very little - maybe six or seven.  They are usually just few and far between, but the last few weeks they have been quite frequent and troublesome.  Of course the more you worry, the worse they become, so there is little help in worrying about them.  I did see a doctor today, and he said I have what is a slightly abnormal sinus bradycardia, but he said this is common in young women and athletes.  (I'm the former, not the latter)  The more reserach I do, there's a few things I think contribute to when and how often I feel them.  Hydration, for sure.  Caffeine and diet supplements do it every time.  Recently, someone suggested to me that even regular vitamin supplements can cause these responses.  I also feel they are greatly linked to a hormone problem with low progesterone in my body.  (Maybe an MD could tell me if there is any chance of a connection there, but lets say I've noticed that when my hormones and mentrual cycles are irregular, I have a much more marked problem with PVC's.)  I have an appt with a cardiologist on Monday to rule out anything major, but after reading this board, I am much more comfortable with what I have been experiencing.  Thanks to all for that.

[arthur]

I have had these PACs for several years.  I don't think you can ever get used to them, but you can understand them, and through understanding, put them in their place in the scheme of things...ie, they are annoying, not life-threatening, and they will not take over your life.  Once that's established in your mind, things will rapidly change for the better.  In my case, they went from 2-6/min each and every anxiety-riddled day, to hardly noticable, and when actually checked, 0-1 min.  Quite a change!  and look mom, no drugs.

-Arthur

[amw]

Monicaq et al

I am new to the heart forum.  I am a 36 year old woman, and many of your posts might as well have been written by me.  I've been dealing with what I now know are PVCs for about 15 years.I have had months, maybe even a year, go by where I don't feel any.  Then, they will seem to come out of the blue and last for weeks. Most recently, after about 9 months with no symptoms, I had what might be the worst episode yet. But I also (finally!) had an ECG which indicates mild MVP.

Since this last ongoing episode, I have been afraid to run or exercise in any form.  Last summer I was up to 10 miles with my running - now I don't even like to go up a long flight of stairs.  Sometimes I see a link between PVCs and exercise, other times I do not.  I strongly agree with the people who say its much easier said than done to "keep going" in the presence of multiple and frequent PVCs - anyone who has experienced them knows they are impossible to ignore. I hope to start exercising soon - I guess I'm waiting for my follow-up doctor's appointment for reassurance that I won't be dropping dead. I have to admit I am intrigued by the hospital gym idea!!

Thank you to all for sharing your experiences - I really can't believe how similar they are to what I have been going through.

[gordieo]

I also just learned I have mild MVP. I also see many PVC patients with MVP. Any known relationship?

[nix37]

I hope you have all resumed your normal exercise routine. I have the exact same condition and stopped for the very same reasons you did.  I am convinced that my condition was driven by the use of dietary supplement. My first episode hit me so hard it put me on the ground, I would have sworn the fun lamp was going out permanently. I love to lift weights and I felt my day was not complete with out it, I felt more like a slug as the days went pass after my fall out I would not let it stop me I am happy to say that although I still have the little buggers I refuse to let them get me down.  They say they are not life threatening so I say if they are going to put me in the ground I am going out fighting. Oh yes a strange thing that works for me while running, I SING when they start it just seems to stop them, I dont know why but it helps. NOW get back at it and good luck.

[eddie 83]

Hello, first time poster.  Just wanted to let the group know what has helped reduce PAC's with me.  I used to chew tobacco all day.  Quit that and the severity went away NOW.  Used to have real chest thumpers, now real mild.  Gave up caffine, that helped big time too.  Now the only time I get them is when lifting weights (doing butterflys on my back).  If I sleep poorly the night before or drink, I'm more likely to get them while lifting.  I cut out as much refined sugar as I could and eat mostly complex carbos and protein.  (If I can do it, anyone can.  Trust me.)  I drink an MRP each (mid) morning with lots of vitamins and is seems to help also.  
Theses stink! Like a lot of you, I quit my workout as soon as I get one.  I pray someday there will be a cure for us.  Take care everybody.

[jelsaad]

Can Anyone Please Help Me?

I am a 24 yr old feamle, non-smoker, in good physical condition. After finding single pvc's on an event monitor, my cardiologist ordered a Holter, which found a run of 3 consecutive pvc's. She termed this paroxysmal ventricular tachycardia -- Clearly, I am horrified. A cardiac MRI showed no structural abnormalities, and blood work indicated no thyroid dysfunction and only mildly low potassium levels(3.3).

My question, then, is how dangerous is the vt? I live in a constant state of panic, worried that I could drop dead at any minute. My Dr says the 3 slow,extra beats are likeley no cause for concern, but I'm petrfied and seek others' opinions.


THNAKS, AND ALL HELP IS APPRECIATED!!

[greeneyes2]

A related discussion, How do we decrease adrenaline? was started.