Coping with extreme increase in PVCs

[Tommygun]

My story is the same as so many of those here. I am a 29 year old male in good health who has had the occasional PVC since I was 12. My life has been extremely stressful for the past two years and I have been dealing with anxiety and depression. Five weeks ago I begane having PVCs nonstop. I have had a complete workup, Holter showed ~300 PVCs/hr. No structural problems, BP issues, defects, etc. etc. So I'm given Toprol XL. My main issues are as follows.  

When I exercise, especially vigorously and suddenly (wrestling, lifting heavy objects, etc) the PVCs become so frequent and violent it's terrifying. Ramping up to physical activity has better results but I'm becoming increasingly frustrated with the "restrictions" I have to put on myself to cope with these things and it is affecting me mentally in a negative way.  

I _really_ want to seek ablation, as everything I have read seems to indicate I could benefit. My Cardiologist has confirmed that my PVCs have just one focus, but refuses to even discuss ablation with me as I do not have SVT.
  
1. Should I be looking for another opinion? Would anyone recommend ablation for me?  

2. Is there _really_ anything to be scared of in my case, even with intense physical exertion that makes the palpitations occur in trigemeny and worse? I'm near the end of my rope here.

[CCF-M.D.-MJM]

tommyguy,

I am sorry to hear about your PVCs.  300 pvc's /hour is certainly a lot and I am sure cause significant symptoms.  If these truly are unifocal PVC's, an ablation certainly is not out of the question.  That many PVC's certainly has to be affecting your quality of life.  You don't have anything to worry about as far as increased risk of death.


The Cleveland Clinic does PVC ablations, but I am not sure how  close you are to Cleveland.  Where ever you go, make sure it is a high volume center that lots of ablations.

Good luck and thanks for posting.

[pbanders]

I have similar problems and concerns with PVC's, multi-week episodes for several years now, little help from my cardiologist. I'm 46, male, athletic, my question - is it SAFE for me to continue to do aerobic/anaerobic exercise during these episodes? I cannot get a straight answer no matter how hard I try. I can live with the irritation of the extra beats, PVC's, dropped beats, etc., as long as I can keep active.

[Missing You]

I was just wondering why CCF-MD-RCJ is no longer answering questions?  I thought his responses were fantastic.  Seemed like a very caring and smart doctor.  I'm sure you're also very good too.

[fpd3hm]

i've posted a few times over the last year or so and find this site very useful, both for substantive information and for moral support.

i am a frequent pac/pvc sufferer and often get an "extra" beat or two in the first minutes of exercise.  often, these beats are accompanied by a strange sensation in my chest and throat. luckily, they usually subside with continued activity.  i also suffer from high anxiety and episodic panic attacks (both during the day and at night, arousing me from sleep).  i strongly believe that constant worry about my health is the source of my anxiety and triggers occasional panic episodes.

in the last year, i've been able to accept the pacs/pvcs and, not surprisingly, my overall anxiety level (and the beats themselves) have markedly diminished.  i don't have any sage advice for you, other than to stay positive and maintain your exercise regimen in spite of the palps.  good luck!

[Momto3]

Oh my!!  There are a number of us who can really relate to your story. In my case, pvcs began in my late teens/early twenties and lasted on/off for about 25 years.  They would wax and wane over the years, but never really went away for good.  Anyway, like you, I had zillions per day and they were occurring nearly all of the time.  Stress or no stress; caffeine or no caffeine; didn's seem to matter much what was going on.  HOWEVER, stress and anxiety could certainly set off a series of pvcs somewhat like the firework Grand Finale on the 4th of July!!  Sorry to hear the past two years have been so stressful for you. Hopefully, some of your stressors have been eliminated and you are feeling better. Stress is a trigger for many people.

A holter in 2001 revealed over 900 pvcs/hour, or 22,000 in 24 hours. I really do know how you feel...Lub-dub, lub-dubdub, lub-dubdub, lub-dub....YIKES!! Believe it or not, even those numbers were not considered medically significant.  But, as the good doctor pointed out, they certainly can affect one's quality of life.  I have had a number of holters, EKGs, echos, etc. and ultimately 2 successful ablations. What a difference!!  My situation is different in that I have a leaky valve, but nonetheless, the pvcs were treated as a separate issue. I guess what I'm saying is that I think it might be a good idea to approach your doctor (or another one) to discuss the option of a pvc ablation -- not because they are dangerous, but because they provoke so much anxiety and discomfort for many people. Gather as much information as you can and you will be ready to make an informed decision.

For me, the ablations were a blessing! Oh, I was multifocal (that's why 2 procedures); did not have SVT; and was in bigeminy a LOT!! I did have some NSVT, but primarily the issue was TONS of pvcs!!  In my case, the pvcs were actually harming me, so I opted for the ablation as opposed to anti-arrythmics for the rest of my life.  This is very likely NOT the case for you, but you may still want to consider an ablation to improve you QOL.

Good luck
connie

[Tommygun]

I appreciate the responses from everyone, and thank the Doctor for your response as well.

As you all know it is difficult to ignore these things when they are so frequent. However I must admit that having them all the time allows me to deal with them better than having them on occasion like I used to. The Toprol XL also works wonders for me, not because it helps with the palps (it really doesn't) but it calms me down tremendously. I'm what you would call a high-strung person (understatement).  

I actually live about three hours from the Cleveland Clinic, so my plan is to give it another month or so and see what happens. If they have not started to abate I'm going to go for a consultation and hopefully get them zapped.

[Clenn Camp]

I have had pvc's that 'take me down' for several years. First experienced them in July 1964.  Afib joined in in 1971 and experienced both since that time.  Had pva this past March and facing a touch-up ablation in a month or two.  Ablation for pvc's wasn't addressed at the time of ablation for afib.  They will be addressed next time.  I'm so fed up with them as the pvc's I have completely debilitate me. There is no such thing as walking around much less exercising.  I do not understand how some folks function like excercising to control pvc's.  It has never happened with me.  If I am walking, it's get on the ground time or at least sit down.  Like someone said in an earlier post, feels like somene is grabbing you by the throat and jerking the breath out of me plus the bam bam kawomp bam kathud kathud bam bam of the aggevating irregular beats.
It is very upsetting and disturbing. The adrenaline gushes and I haven't been able to suppress it either.  Sometimes take a little bit of xanax.  Maybe helps a little.  Haven't taken any xanax since last Sunday.

Glenn Camp

[annecky98]

I am a 53 year old female.  Have had PVCs for a couple of years.  Wore a heart monitor for a week that sent an EKG strip to a technician whenever you were having an episode.  Even though I was feeling like I was dying, the numerous strips I sent that week showed only PVCs.  I've also been to the ER a couple of times with chest pain, that was determined to be gastric reflux.  Oddly enough, the PVCs get worse about 20 minutes after eating; although all the Drs say there's no connection.  

I'll have PVCs for several weeks and then they'll disappear for a few months.  But I started having them again a couple of weeks ago and now they're almost constant (12 per minute).  I noticed last week that when I ate a banana, I got almost instant relief for awhile.  This morning, I was practically ready to go to the ER because the PVCs were so constant that I was exhausted and out of breath.  But I remembered the banana incident and went to the cafe at work and ate another banana.  Once again, instant relief.  

Obviously a potassium deficiency is making this worse.  How much potassium a day is needed?