Diagnosed PVCs with v-tach, safe for exercise?

[KiuneCailin]

I am a 24yr old female, non-smoker, non-drinker who exercises 3-4X a week. I have been in excellent health until about a year ago when I started having panic attacks, most likely due to stress from graduate school  I was put on lexapro for six months and panic disappeared. Five months off of lexapro I went through a very stressful time at work and started having heart palpitations every day. I documented them for a month and finally made an appt. with a doctor. Three days before the appt. I ended up in the ER after a day of very bad palpitations. Blood work was fine and chest X-rays were normal. 24 hours Holter showed 48 unifocal single PVCs, 13 double and 1 triple. Last February when my panic attacks began I was given an echocardiogram and everything was normal, no signs of heart disease. I cannot get an appointment with a cardiologist until the beginning of July, so I have a month to wait. The only reason I was referred was the one run of 3 PVCs. Since the ER visit I took a week off of work and palpitations decreased dramatically.While I wait to see the cardiologist, is it safe for me to continue exercising and playing sports? Also, I have planned a trip away with my friends to an amusement park. Is it safe for me to do this? I feel fine except for the anxiety now of knowing that something might be wrong. If I didn't have this information, I would continue doing everything anyway because it is not stopping me from doing anything. Any help would be greatly appreciated.

[Forum-M.D.-MJM]

Hello,
Those type of questions are difficult to answer without actually seeing you in clinic and reviewing your studies.  I can generalize to your situations, but individual circumstances vary.

In general, people with structurally normal hearts and PVCs/NSVT are very safe to exercise and resume normal activity.  There is some evidence that people with increased PVCs during exercise are at higher risk for events, but is important to note that 'higher risk' is not the same is 'high risk.'  The overall of incidence of events is still very low in people that have increased PVCs during exercise.  

In general, people with structurally normal hearts, normal EKGs, and no family history of premature sudden cardiac deaths, SIDS, personal or family history of syncope (transient loss of conciousness), or seizures, are safe to resume normal activity because they are not at increased risk of cardiac events.  This would include amusement park rides (assuming other contraindications are not present like pregnancy, back problems, etc).

I hope this helps.  Thanks for posting.

[oneil420]

I feel you as i am currently waiting on a holter but from what i understand in a "healthy" heart that is free of disease or deformities even unsustained v-tac is benign. Considering you have had all the standard tests i would try not to worry about cardiac events that "might" happen or else you will never leave your house:) focus on your lifestyle and try to relax. IM not too sure about the roller coasters so i am curious about that myself but from what my ep told me pacs/pvcs and even unsustained v-tac dont effect mortality. LIke you said you feel fine other then  knowing(or not knowing) that you do have a arrythmia can steal your focus but like i already worrying about stuff that hasnt happen yet isnt healty in itself. HOpe you get some relief soon , oneil

[wmac]

Well your one step ahead of me then. If this isnt stopping you from doing anything then go for it. I have nsvt and it scares me on  daily basis. It does however stop me from living my life. So good for you!! If you can mentally overcome this then your ahead of the game.
wmac

[wildcat27]

I think I can relate to where you are coming from. About a year ago I had a-fib...and then a bad bout of palps that were picked up on a precautionary holter about a month later. The cardio said he saw a run of NSVT...maybe 4 beats and referred me to an EP (I was out of town when the episode occurred).

The EP is a regionally respected guy and he immediately helped alleviate my fears as he sees palps everyday. He said, "I don't even think what showed up on that tape was NSVT"...he checked all my tests and said I was fine to do everything I normally do. I exercise (run about 3 miles) every other day and the exercise absolutely helps me feel less stressed and often relieves bad days of palps.

I recently stopped taking my cardizem and am doing the sinatra solution...

I bet the online doc and your own cardio will say something similar.

Best of luck...

[tickertock]

I'm a 42 year male with a lifelong history of Palps, PVCs. PACs, sinus tach(not to mention anxiety disorder from those things) and even had a 5 beat run of NSVT recorded on a holter in 1987, nearly 20 years ago , I was 22 at the time. I was assured by the EP back then, rated one the best in world at that time or so I was told By the former Chief of the Miami heart Institute at the time.

He assured me even then that my heart was totally normal and I had nothing to fear, I saw the seem EP again in 1993 where he was visiting the Island where I lived( what a coincidence) he told me never to take anything other than atenolol or a similiar beta blocker for this "benign" problem. I have been on atenolol 100mg daily in divided doses now for over 4 years, i took it previously but stopped for 2 years, It's been over 5 years since I had a back episode of prolonged episode of PVCs.I still get an occasional one probably 10-20 a month that I feel maybe less on occasions. I've been made to understand that with a normal cardiac evaluation NSVT in a normal heart it poses no more increased risks than normal isolated PVCs. I think if you put a holter on 100 persons around 4% in 24 hour period would come back with what would be defined as a run of NSVT. In fact I was encouraged to exercise moderately, these days I can't exercise like how i should other than walk along with other activities because of a connective tissue autoimmune disease that I have, other than that I keep moving, but I personally believe in exercise in moderation and not in excess. I trust you will fine some reassuring answers that you can what you want without living in fear. Good luck, chances are you have nothing to fear.

[frs87]

My English is not good at all so maybe I am misunderstanding something.

When you guys say “a run of 3 PVCs”, you mean a) a bigeminy of PVCs (three times) or b) a NSVT (three beats)?

If you are talking about the second possibility, then my question is: is it possible to have some PVCs (or PACs) ‘faster’ than a bigeminy, so that technically you are having a NSVT (or NSSVT)?

That would answer why sometimes I get 5 of 6 beats extremely fast when I’m laying down. Most times I get bigeminy but rarely I get these tachycardias. I was wondering if it is possible to have something like this without having an abnormal circuit. You know, just a PVC or a PAC sending many impulses for a few seconds. Can anyway answer this? Thanks.

[Forum-M.D.-MJM]

It may also help to check the following web link.

http://www.askdrwiki.com/mediawiki/index.php?title=Palpitations

www.askdrwiki.com is a medical wiki (like wikipedia) started by one of my colleagues.  It is intended for medical professionals but the information is still very helpful.

Good luck.

[Abeybaby]

I am curious why did you go off Lexapro if it helped? I am on the same meds for panic/anxiety taking 5 mg for 3rd wk now and it has helped alot. I can function again which is great.  I too have PVC's / tachycardia which I believe are largely induced by anxiety. My cardio said "go excercise" given the normal heart I have and normal cardiac work up. Check w/ your cardio as well. Are you in canada by chance?

Did you get weight gain with Lexapro? My only worry at the moment.

tks and good luck,

[KiuneCailin]

I had tried other drugs (Prozac, Zoloft) that made me horribly sick which is why I moved to the lexapro. I stopped the lexapro because I did not like the side effects. I was on 10mg and would go through spells of being dizzy or feeling drugged. My doctor raised my dose and it made me very sick. We decided to try stopping it all together and I was fine. I have recently started again (4th day) at 5mg. Now my doctor thinks the 10mg may have been too high a dose for me even though it is usually the normal starting dose. I am very sensitive to any medicine that I take and so far the 5mg works fine. I am getting over the side effects and starting to feel better. I did not gain weight with the lexapro last time but I also exercise regularly and eat pretty well. My personal opinion is that when some (not all! so please no one take offense!) people gain weight on lexapro, they blame the medicine and feel there is nothing to be done. Exercise and eat right! Finding a sport you enjoy or an exercise class can help battle off the weight that you might gain and also help fight the anxiety. I am not in Cananda, I am in the United States.

[maggiemag]

Ok, I had to think about it for a long minute, but you meant by the Sinatra solution that you are gonna do things your way, right??  That's cute, I have never heard it put that way!

[KiuneCailin]

The run of 3 PVCs on my report was listed as v-tach. I am not sure exactly what definitions apply to what situations.

[wildcat27]

LOL....no it's actually the name of a supplement program (non-drug) that has had very positive results with any number of heart related issues from palps all the way to CHF.

consists of D-Ribose, magnesium citrate, l-carnitan (sp?), and co-Q10.

Dr. Sinatra wrote a book...I have not read it but it is supposed to be excellent.

[KiuneCailin]

So I spoke with my doctor  and other friends who are doctors about being restricted on anything while I'm waiting for the cardiology appointment. They all told me that with the test results that I had, there should be no reason that I couldn't do everything just as before. I went to the amusement park, had a great time and absolutely no problems. Short lines, lots of food and lots of roller coasters. I felt a few palpitations in the morning, probably just due to anxiety about going. Once I got over it, it was fine. I say if that you have been given the ok from you doctor, get out there and enjoy your life and don't let these things stop you. We don't always understand why things happen and we may never know, but the best you can do is accept it and keep going.

[Slowboat42]

Please see my comment posted on June 10 to hdhtr.  As you exercise, you may also have low blood sugar.  Increaseing your complex carbs may help.  Also, low magnesium levels due to excessive exercise can cause palpitations.  Cortisol produced from too much stress is also a cause of PVC and other arrythmias.

GL

[KiuneCailin]

So I finally got into see a cardiologist today. I was told that all of my PVCs are benign, I have a structurally normal heart and no signs of heart disease. I wore a holter monitor for 24 hours and whenever I felt symptoms, there was nothing reocorded on the monitor. However, there were events on the monitor and I felt nothing. I have no clue how this is possible because I could feel my heart jumping around in my chest when I would mark down an event. But, I guess I have to take the doctors word that it is ok. I was told to go back to my primary physician and look into the possiblity of GERD or some other reflux problem as when I have what I would call bouts of PVCs, they are associated with alot of burping. Also, I was told to increase my intake of potassium as my bloodwork showed that it was low and that I need to to drink gatorade to keep my electrolytes in balance when I exercise. Does anyone else have this problem of burping alot with what I can best describe as PVCs?

[Ginasouthcarolina]

Hi my name is gina i am new to this, last month i was in the hospital with chest pains while in the hospital i had a wierd feeling it felt like my heart was doing summer saults in my chest the looked at the monitor and they called a cardiologist..uggg!!! i was so scared i was always told by my docs that i had a heart people would kill for it was so strong...The cario dr said i had short burst of v-tach, 3 then 1 then 4..the cardiologist admitted me to the icu for more test he did a nucleur stress test and and echo the stress test showed no blockage...but to those out there dont trust the stress test it can only detect 70% or higher...so ask for a cath or a ct scan with contrast...anyway the echo showed a strong heathy heart with very slight reguratation in my mitral and tricuspid valves bu the do said very normal most people have some slight regurg....so he sent me home with a clean bill of health...also i suffer from bad!!! panic disorder i am currently taking zoloft and xanax for it and i have bad!!! acid reflux (gerd) so i take nexium...i swear they are all inter-related somehow..ok so its a month later with no symptoms then 2 days ago boom!!! out of no ware there back i was at a friends house hanging out with my husband and again sumersaults..i was so upset it laster just a few seconds so back to er...they did blood test ekgs and they said i was ok the doc called my cardiologist and he said its all anxiety send her home then he told them i had 3 beats..totally different then what i saw in the er last month...i feel like there brushing me off cause im only 30...i know im talking alot but im scared and i cant speak to my cardiologist..its either the secritary or the nurse i want to know what i had is it just a run of pvc is it svt nsvt v-tach..he said short bursts of v-tach but my heart was not racing it would feeling like it was trying to beat then boom one or twh hard beats then it was fine..it has consumed my life and im just waiting for the next one and my heart will stop can someone please help me understand these things and let me know if they are gonna kill me....thanks so much for taking the time to read this...Gina