Feeling PVC'S in multiple spots

[Carey01]

Does anyone know if you feel the PVC'S and PAC'S from different spots --- sometimes I feel mine lower, like in my upper stomach.  Sometimes in my throat and most often to the right.  Kind of wondering if that menas they are "multi focal" and would be hard to ablate or if it really doesn;t mean anything.  

[va_tony]

Canon A waves are fairly common in certain arrhythmias, in particular PVCs, NSVT, ventricular bigeminy, trigeminy, & VT.

The jugular veins (at your throat) normally collect oxygen depleted blood from the head and neck.  The blood then flows from the jugular in the direction of and to the right atrium.  Normally, the right atrium pumps the blood through the tricuspid valve into the right ventricle (and from there thru the pulmonary valve to your lungs to receive oxygen). The timing of atrial and ventrical contractions and the opening and closing of the valves to keep the blood flowing properly depends critically on electrical signals (which start in the sinus node) arriving at the atria and ventricles at just the correct time.  

If, however, you have a PVC causing the right ventricle to contract (prematurely &) at nearly the same time as the right atrial contraction, the tricuspid valve will close prematurely.  So when the right atrium contracts, instead of sending blood in the right direction, blood will instead be pumped back to the jugular (i.e., in the wrong direction).  This causes a strong jugular pulse which causes the neck to throb momentarily.  Some people feel this as a throat tickle or a momentary tightening and cough. Surfgirl once told me that in some cases (ventricular bigeminy) the neck seems almost to have a permanant bulge (called a frog neck).

Anyway this is not uncommon and it's not dangerous (just annoying). PVC sufferers are always complaining of a throat "sensation" and having to cough. I think it's also caused by tricuspid valve stenosis, AV block and AV dissociation, besides the arrhythmia I mentioned.

[jpcox]

can you explain a cannon a wave. I think I have experienced this. Thank you

[va_tony]

You really can't tell where a foci is located in the heart by sensation. What you are feeling is a difference in timing between the PVC and the following compensation pulse.  Depending on the timing, the PVC is closing one of the heart's valves at the wrong time relative to the heart chamber attempting to pump blood through it.  This leads to a backwash pressure pulse which can travel some distance from the heart.  For example, the atrium attmpting to pump blood through a closed tricuspid valve leads to a Cannon A wave which travels backwards up to the jugular giving a sensation in the throat.

[Dootles]

Hi  I as well get pvc in my stomach. As a mattter of fact it really bothers my stomach. I almost feel bloated. I apply pressure to my stomach at night that seems to help. I get pvc every other beat for days at a time. Im in an attack of pvc right now and i hate it. I do feel them in the upper area when there calmer. When im every other beat its deffinetely in the upper stomach. I dont think it matters where you feel them if you have a normal heart there harmless and just a pain in the butt!
Good luck!
Deb