Arrhythmia//PVC's

[twhgait]

I am a 39 y.o. female with no big PMH.  I am a nurse and on occasion check my radial pulse.  While doing this for the past couple months, I have noticed frequent "skipped beats" in my pulse (just a pause in a chain of beats).  I do have the occasional palpitations that I can feel in my chest also. I cannot consciously feel these radial pulse "skipped beats" in my chest and wouldn't have even noticed them if I had not been checking.  They seem to disappear when my heartrate increases and are most noticeable at rest (at least every 40 beats or so).  I went to my FP doctor and my EKG was normal. I pick up my holter monitor on Monday (48hr) and will also have some fasting labs drawn at that time. He also ordered an echo which I have not scheduled yet.  My thyroid size appears normal although there were some cysts on it.  My doc feels these are probably benign PVC's as I have normal cardio results so far.  I've read thru these forums extensively and most pt's describe the "fluttering, flipping over" sensations.  Can PVC's like mine (not noticiable unless I am checking my pulse) still be benign?  Or, is this another possible arrhythmia that I may be dealing with?  How reliable is the ECG stating "normal sinus rhythm"  considering other possible arrhythmias?  Of course, my heart behaved in the doctors office (I was very nervous and my pulse shot up to 96 bpm).  I am worrying myself into a panic over this

[CCF-M.D.-MJM]

Hey,

Stop worrying.  Your biggest problem is that you work in the health care industry and you see all the worst case scenerios--you are acting like every other health care professional I know.

Consider  yourself fortunate  you don't feel them.  For some reason, some people feel every blasted PVC or PAC and others don't notice anything.

A 24-48 hour holter should answer the question of PAC versus PVC.  A normal EKG, echo, and holter should reassure you to move on.  It is normal to PVCs and PACs and does not indicate there is something wrong.

If you are not having symptoms of chest pain, shortness of breath, lower extremity swelling, passing out or almost passing out, increased exertional shortness of breath.....the echo probably wasn't even necessary, although a normal echo will certainly help reassure you.

After you get you normal results back, stop checking your pulse (just kidding, but don't convince yourself you are sick when you are not.  The mind is a powerful tool, don't let it work against you).

[Erik36]

The doctor is right. You are lucky that you don't feel your PVC's and PAC's. I am a 36 year old male and have been feeling my Premature beats for 18 years. They used to be scary, then annoying now I ignore them. They have caused me years of grief. I had all those tests that you are having and more and my heart is normal which mean my PVC's and PAC's are benign. Try to find something else to obsess about. Something not health related. It can really drive you nuts, especially when you work in the health field. Good luck!!!


Erik

[twhgait]

LOL, thank you both for the GREAT advice, which I will take!!!!  I'll stop checking my pulse, promise! I know I am fortunate to not feel every stinking PVC; the ones I DO feel are more then enough to remind me that they are there!  I will be happy to put this aside after this testing and move ON.

[pms_barbie]

yes be very happy you dont feel manyof the pvcs.  I had bigeminy and I know what its like to feel each and every one of them.  I got rid of my bigeminy.  Now I tend to feel my pulse.  I have noticed skips in my pulse and dont feel them in my chest....Those I can live with.  I also sometimes still feel the pvcs however they are soooooo much better than they wore......Stephanie

[mrbh]

I don't understand the sense of relief here.

Are you diabetic, hypertensive, overweight? What about alcohol, tobacco or excessive stress?

I would suggest a stress test and a workup by a cardiologist. A GP simply does not have the knowledge to deal with these issues.

My own diagnosis was sinus tach and unifocal PVC's. I was told everything was fine. Then I found not one but TWO letters warning of sudden cardiac death in my records.

Doctors are notorious for telling you what you want to hear, not what you NEED to hear. Please seek another, better informed opinion regarding your case.

[twhgait]

Hello mrbh,
I guess saying "sense of relief" is not totally descriptive of my situation (I still have tests to finish....), but in all honesty, it provides me with an optimism I didn't have before.  It's one thing to sit at home and feel an irregular heartbeat and imagine the worst, but it's another to read stories about other peoples PVC's and start to understand this "disorder" (for lack of a better word) and that it's NOT a life-ending event in and of itself.  I am completely healthy, no other medical conditions to speak of.  I could stand to lose about 25lbs, I smoke and I drink coffee.  I have no other signs/symptoms of a cardiac nature. I usually handle my stress well (I think that's where the cigerettes come in, so "well" might not be accurate).  I think when these tests are complete and if all's well, I will not dwell on this anymore.  Life's too short and I have too much left to do.  I guess had I not checked my pulse that night (and I'm still not sure why I did), I still wouldn't know this was even going on.  I've worked with the Cleveland Clinic in my past job and have nothing but respect for the clinic and it's MD's.  Thank you so much for your concern and I will not allow myself to be brushed off until I am completely satisfied with the answers and long-term outcomes.

[charchar]

hi , I have a daughter that had a pacmaker placed a year ago for slow heartrate now she went for a routine pacemaker check and her resting heart rate was 130 bpm and they couldn't check it(the pacemaker) because they didn't want to speed the heart up anymore than it already was. They put her on Toprol morning and at night and her pulse still runs around 110bpm she has really bad tremors (her hands shake and always have) she is 19 years old and feels ok . Is it normal for the heart to do the opposite of what it was before? And should we be concerned about anything? If anybody can help me understand this I would greatly appreciate it.  Thanks

[Erik36]

Her Primary doctor is more than adequate to follow this up. Are you trying to scare this woman? If the tests she is having checks out ok, then she need not go further. Everyone's case is different and you shouldn't go injecting ideas into the mix, especially when it goes against what the nice Doctor from CCF told her. I agree totally with the CCF doc and stand by his response.

[Erik36]

It might be a good idea to have a fresh set of eyes look at her records and be re-evaluated (in other words a second opinion). You should go to a teaching hospital or a high volume center where they have a lot of experience with these types of things. Good luck!


Erik

[mrbh]

No, I am not injecting ideas. No, I am not trying to scare anyone. I was urging a better qualified second opinion based upon my own ugly experiences with doctors who say one thing to your face and then write something completely different in your records.

BTW...this forum is NOT the private playground of a handful of regulars (with multiple user names) attempting to dominate and factionalize the discussion. From what I read, there is a lot of idea injecting going on here.

[Erik36]

No, this is not a playround. This is a small community of nice people with Cardiac issues who share information and gain insight on each other's questions and the Doctor's responses. All of us here welcome your ideas and opinions. I just thought that when you started your comment to this person as "I don't understand the sense of relief here" and then went on to suggest that there may be something more sinister going on and telling her that her GP doesn't have the knowledge to handle her situation, I was taken back a bit. The Cardio Doctor echoed  my sentiment in his response.

Back to the Playground for regulars and multiple screen name users. I shortened my screen name so it wasn't so long. If that's mutiple screen name using then I guess you've got me there. Maybe in a figurative sense you could call this a playground, and if you continue not to play nice, then maybe no one will want to play with you anymore.

[~*CaMeO*~]

Ahh - a touch of humor!  Much needed among all the seriousness on this board (which I read every day, BTW).  You guys are great with the information --------- has helped me enormously just from reading!

[chi-chi03]

Thank you for starting this thread!!!

I am 40 with PVCs diagnosed a couple of years ago. I have only felt PVCs lately when I have slight indigestion.  I started a diet last week, and started having sinus drainage, then acid reflux, and then came my PVCs.  

1)I don't know if the diet change is making my sinuses drain?

2)OR eating less and my stomach is used to bigger meals and is used to sending out more acid? So now I have alot of excess acid?  

3)Could sinus drainage create alot of acid in my stomach?  

4)AND could that extra acid then cause my PVCs? Putting pressure on my heart?

I took Tagamet last night and my PVCs stopped as did my reflux (for the night)?  Or just coincedence!  And I feel my PVCs! :(

[chi-chi03]

I forgot to add, that about an hour to an hour and a half after I eat, my PVCs seem to subside????  If I eat around 11:00 am.. my PVCs usually start around 4:00 pm?

[kat_in_texas]

I am new to this board. Just found it today. I have had an "irrregular" H.Beat for as long as I can remember) I am female, 45 ( 46 in Dec) and Sort of learning to live with these horrendous, "life altering" for me at least, PVC's. I can take the Occ. pvc/pac daily. But the past 2 yrs., I have had episodes that have lastd for months on end. I even wore the event monitor. I am living just outside Austin and go to a wonderful electrophisiologist.(sp?) he has , though after going over my 30 day event monitor, related to me that ablation is out of the question due to the fact that my electrical system is firing these early beats from more than one area( good for me! I always did want to be the best at everything)ha..(totaly not really funy) I am on Corgard ( beta blocker) and I also take Luvox which was prescribed to me 5 yrs. ago for depression. All my newdr's think it isn't the right med for me as I am not obcessive compulsive, which is what Luvox or (generic) fluvoxamine) is used for. I also take xanax daily. It does seem to soothe the forcefulness of the pvs's. TRUST ME   I know I am probably addicted to them, but only take 1 mg. a day and I wpuld eat dirt if it would help. I am VERY med sensitive, and cannot even have caffeine or sugar. I had to stop drinking orange juice because of the sugar, Made my HR go really fast. I should also mention that my family is extremely dysfunctional. Not my husband or children . But My brothers, and two sisters. My mother is extremely critical and I just , for some reason am the black sheep so to speak. They don't understand these irregularities at all! They think I should be able to just "buck" it up and go. Anyway. sorry to stray, just wanting you all to know that when I get these  malicious phone calls from them, about a day to two days later, here go the PVC's FULL FORCE. I used to lay down on the floor, or on the bed with my feet propped up, and take a xanax and they would subside, now, they have made a Happy little Home in my system! My Dr. did have me take a stress test last october, and it was a stress echo. Everything was normal with a 65% ejection fraction. No signs of any previous heart attacks and normal size heart. He said that when he worries, it is usually when there is an UNDERLYING heart condition. I pray .. truly PRAY  that these will go away someday. But right now , I am sitting here with them just rumbling in the pit of my stomach.(that is where I feel them.. right in the pit of the tummy)  Dr. said he had never had a pt. that  was so symtamatic.. ( good ole Kat)  I try to put some sort of positiove spin on all this, but tonight, I cannot get past the half circle!  Seriously.. sometimes I think "how wonderful" my life would be if not for these irregular beats.  then I think about how shallow I possibly am being, since I do not have cancer etc. BTW.. I have become a little anxious, and somewhat confined to my comfort zone. I don't like to drive by myself etc. ( what if I have sudden cardiac death?!) I even saw where the FDA has just approved the defibulator device for the general public and told my hubby I wanted to purchase one. Thanks to all. I just needed to vent to someone, and I am also really scared...

[patune]

Hi everyone. I'm a 48 yr. old male and over the last 3 or 4 weeks have been experiencing PVC's that seem to be becoming more frequent (worse in the AM and PM). They are very rare when lying down, but when I stand up and move around they start right in again. I've never had any previous heart issues, but this has me really concerned. Any input would be appeciated.

[cuaco]

I have had pvcs like yours, all quiet until I get up.  I believe this is due to the release of catecholomines and adrenaline the body needs to provide activity.(See archive questions)  Some people's hearts are more sensive to this than others.  I am currently on 2.5mg of bisoprolol fumarate (cardicor) per day for the last 2 weeks and so far (praise the Lord!) this apppears to vuirtually stopped them stone dead(I have had nil per day exept for 2 stressful days when I had probably about 2!!)  At the time of starting the tablets I probably was having about 2-4000 per day, so this is a blessed relief to me. In the past I have tried atenolol and propanolol  both of which had absolutely no effect on the pvcs and gave me a constant headache.  I have had these things for 17 years and only now have I had some peace.  I wish I had been offerred these pills 2 years ago when I become phobic of these things when I chanced to read an article in the daily paper that pvcs are dangerous and cause suden death! (wholly innacurate i now understand, but at the time it put me in state)

[owens]

I am a 77 year-old male and had triple by-pass surgery 16 years ago. Since 1947 I have had PVC's and I can feel virtually every one of them. I have had several cariologists and internists, FP's, etc. indicate to me that they were benign and not life-threatening. Sometimes I can go a month or two at a time and not have any heart skips. Sometimes, I will have a period of skips 4 or 5 times a minute and sometimes, although rarely, I will have a period of skipping 12 to 14 times a minute (this situation usually lasts up to two hours). Many times I will have an episode of PVC's after I eat a full meal, especially foods like pasta/pizza. Afetr the meal is digested, the PVC's go away. On occasion, at night, if I lie on my left side, I will have PVC's -if I turn on my right side - they stop.

When I tell these things to my cardiologist, she will ease my mind by telling me not to worry. However, I wonder why they come after eating cretain foods or lying on my left side at night?

[Karenbeth]

I totally understand where you all are coming from. I had an AFIB attack back in Feb of this year, it was the first AFIB attack I ever had. I was put on Toprol XL 50mg just to control the heart rate should I ever go into AFIB again. I went into AFIB because my potassium levels were REALLY low, and I woke up with acid reflux and was coughing so hard I was getting PAC's that lead into an AFIB attack.. Since Feb I have been fine with the occasional PVC or PAC, maybe a couple days before my period, or once a week if I was doing something stressful or something..

Just last week I started getting them alot in a day.. then it was going on for a couple days, I was getting VERY unearved at this time. After 3 days of them going on about 10-20 times in a day, I got concerned.. went to the hospital, they told me they were just PVC's.. my EKG was good, blood was good, BP was perfect, I had an echo done back in FEB and that was great too.. maybe it was stress the DR said.

Went home, accepted it and it got worse again, and this time I was going into anxiety which everyone told me was the WORSE thing you could do is get anxious over it, it will make them come more. My DR told me to up my Toprol to 100mg to see if they would sibside and BOY did that mess my system up.. DEPRESSION, worse anxiety.. after a week of 100mg, I went back down to 50mg toprol where I was before.. I am starting to feel myself again.

Just today I felt a rattling in my chest when I breathed in, got XRays and guess what? ACUTE BRONCHITIS.. the DR told me that I could have increased the PVC's due to this Acute Bronchitis that came on.. I am not on Zithromax to get rid of the Bronchitis, and geuss what? I started my period.. GEE can I have anything on me that could be the trigger for this onset increase in PVC's?

I know what you are all going through.. I get very upset, start crying sometimes when I get them, thinking something is wrong with me, and I have learned the hard way that reading all kinds of things on the internet is BAD! I love reading the board because people tell the story better than websites that think they know what you have wrong with you.

We are all together in this and we just have to take one day at a time.. that's what we are here for!

Karen

[toulouse]

I am 67 and have lots of pvc's and pac's.  i have discovered this last year that i have moderate aortic stenosis.  i do 4 miles a day speed walking and have quit drinking anything and do not smoke.  my cardiologist and internist tell me after ekg's and a stable echo that i can do everything with limited or no restrictions.  my problem is that i "feel" or hear each and every beat normal as well as abnormal in my right ear.  it is like tinnitus but is only the heart heat. I try to ingore them  and especially at night when they occurr.  i have not tried a beta blocker and am on a mild ARB but have good conttol of my pressure and use the DASH diet.  i have lost 25 lbs.  my problem is that when these beats occurr i get very concerned and even get to anxiety but not true panic yet.  i have tried ativan with little success and am afraid of betablockers from what a lot of people say on the forum.  has anyone had the problem of mentation or tentation of the beats in the ear? also is there a "support group" for these things.  thank you all for your comments it makes me feel like i am not "abnormal" and just need some where to vent and not do something drastic.  thank you in advance

[hankstar]

I am constantly aware of my heartbeat whether fast , slow regular or irregular, PVCs or no PVCs. I have learned to live with it . I'll be 40 on Nov 3 and have had this all my life, apparently some are just more in tone with whats happening in their bodies. I take atenolol 100mg in divided doses 25mg 4 times daily, a beta blocker, and a ARB (cozaar) losartan 50mg. is the generic name. I have a high tolerance of beta blocker , no side effects but night mares.

In general beta blocker are safe medications, be assured that they are many out there like yourself, just keep an eye on your aortic valve, I think you said you had moderate stenosis, some persons with aortic stenosis tend to have or complain of more frequent palpitations,  only your cardiologist can reassure or confirm to you if your palpitations are of any significance with this problem, some are given the green light with no restrictions depending on symptoms and after several echos within a 8-10 year period with no change.

Defining abnormal and normal can be quite a task, kinda like a thin line between love and hate!! Consider yourself normal, remember no one is without some kind of blemish.

Hang tight and you'll be alright.

Regards.

[toulouse]

Thanks for the excellent suggestions.  i would ask if you have had any experience with other betablockers and or combinations of med that have worked in addition to what you are using now.  how about any supplements e.g. magnesium?  what bugs me is hearing them continually in my ear and being unable to sleep on one side or the other rather than my back when i am having an attack.  i have just started trying lorazpam with some limited success.  how long in general does it take to "accept them" as being basically benign?  thanks in advance.

[hankstar]

Hi,

   My only other experience with another beta blocker was Inderal(propranolol) 20mg 3 times from 1983 to 1998, I stopped for a few years from 1987 to 1991 after a visit with a EP doc associated with the Cleveland clinic in Florida suggested I did not need it after a stress test and holter monitor. I saw that seem Ep in 1993 again and told everything with my heart was completely normal and that living or coping with the symptoms was the only issue, he suggested atenolol as his drug of choice.

  Inderal is a safe and good beta blocker, might actually work better for some persons, I find it has a more overall relaxing effect on your body as whole, atenolol mainly affects the heart making it a more cardioselective beta blocker.

  I tried magnesium oxide 500mg daily, but has stopped for months now because I suspected it might be causing more frequent PVCs, once stopping they went away, who knows, could be purely coincidental, it sall trial and error with medications, they stopped for from time to time for a period or needs switching, we are all different and respond differently.

  I take valium 5mg(diazepam) twice daily also , not for anxiety, but for ankylosing spondylitis as it has muscle relaxing benefits along with 325mg of aspirin daily. It might also play a role in the reduction of palpitations who knows?

  The best reassurance is to converse with persons that experience similiar symptoms as you get comfort that you are not alone because persons with this condition tends to feel all alone in the world, but never take the advice or comments posted here on the forum no maatter how reassuring they might sound without a true diagnosis and treatment from your trusted doctor or physician as only they know your history and significance of your condition.

Take care, keep us posted and try to ignore them, they feed off attention and anxiety.

Kindest regards.

[hankstar]

On another note how long does it take to accept them as "benign", to give an honest opinion for most never, it just like knowing something will not harm you but because of the distressing nature of the symptoms, it is really hard for most to really accept them as "benign" even though it is obvious that persons have them nearly all life and nothing bad happens to them, you just can't convince that it will be the same for you.

Try coping skills, i found that to be most effective. Good Luck. Just an honest opinion.

[hankstar]

What I meant to say is convincing yourself that they are"benign" for you even when you are aware that some had them nearly all their life and nothing bad has happened to them is the hardest part because the symptoms and anxiety can be so distressing to the person experiencing them.

If you really work at it you can, you can learn coping skills that they interfere less with your quality of life and the symptoms might become less frequent or disappear altogether.

Once again. Good luck.

[toulouse]

thanks again for good people like yourself.  i have another appointment with my internist to discuss the possibility of either an anti-axiety med or beta blocker. keep up the good work of helping others. i hope that in life we can all attempt to continue the "good work"  Via con deos.

[BlondieCO]

Does everyone here have one specific type PACs or PVCs?  I saw my surgeon today (had my gallbladder out 3 weeks ago) and told him about my skipped beats.  They started last Tuesday (3 days before my cycle and had slowed since my cycle ended yesterday), I had 0 yesterday, today I have had about 100 again. Last week I had them every minute, sometimes back to back for hours on end, then they would stop for an hour or two and return.  I went to the ER I was so scared,they took blood, did an dEKG, monitored me and said not to worry.  But in the ER I had them every minute or two for three hours, and some were back to back. My surgeon  told me to see a cardiologist, but if I get two to three PVCs back to back it's bad and it could mean sudden death???.  And I have definitely had two and three right after each other in addition to singles and it happens more than once.  Now I am REALLY worried?  Can anyone discuss this?  PLEASE? I don't drink caffiene, my thyroid was normal, electoloyes normal, magensium normal (I do take 250mg daily with B complex).  I am stumped and scared as can be now.

[gurkha]

I'm 58, exercise heavily for my age and am unusually fit, with normal BP and no shortness of breath. Normal resting heart rate is 60. I've had occasional PVCs for 4-5 months, with significantly more the last two weeks. These manifest primarily as a slightly delayed heartbeat, but one beat before the delay I usually feel slight stomach distress, as if gas is about to pass. I haven't heard PVCs described this way. The PVCs correlate closely with a long course of Augmentin XR tablets for prostatis, prescribed by my urologist starting about 6 months ago. About 3 weeks ago, we doubled the dose from 1 tablet twice daily to 2 tablets twice daily, and shortly thereafter the PVCs increased. I find it likely that the PVCs are a result of a slight anxiety reaction caused by the Augmentin. I used to have significant anxiety problems 20 years ago and the heavy exercise routine got rid of most of the problem, but don't recall anxiety showing itself primarily as PVCs, also with much increased awareness of heartbeat. My urologist does not consider my diagnosis a likely one but before I go the time-consuming route of a visit to my internist and a referral to a cardiologist, I'd like to know if it would be reasonable to suggest to my doctor that we first try a beta blocker or other anti-anxiety agent as a realistic test of what is going on. The PVCs ONLY occur at rest, and I'm fine during heavy exercise.

[medskier]

For the last 2 weeks I have had PVCs that are palpable throughout the day.  Often as many as every three beats. The Holter monitor showed a single hour with over 2000 PVC, and another hour with only 10.  My stress test showed no PVCs above 120 bpm, but many between 80 and 110, both ramping up the exercise and recovering. I found the best way to stop them was to go for a run, but I can only run for some many hours? I am taking atenenol (0.25 mg) with no noticable effect.  My GP prescribed some lozapram to calm my panic and get me to a cardiologist (10 days away)- happens later today.  I am hoping for answers.  My blood work is normal, thyroid, kidney, electrolyte and heart enzyme, ..., and was told by doctor to start living with my "benign" PVCs.  But they just started, and i am 36, active healthy male.  It doesn't add up.