Long episodes of PAC's

[whalersailor]

71 yr old male, history of AFIB for 15 years.  AFIB is pretty much under control - 1 episode per month about an hour long.  Meds, Lopressor 50mg twice a day, digoxin .125 twice a day, amiodarone 200 mg once a day, coumadin, pravachol 40mg once a day, lopid, 600 mg twice a day, micardis, 40mg once a day.  Was doing fine until December, got a cold, (no extra meds) and started to have long 8 - 48 hour episodes of PAC's, about 20 Beats Per Min. missed, etc.  These episodes happened 4 - 6 times a week, of varying lengths.  Other than the jaw and shoulder pain I have with AFIB episodes, the feeling is the same.  I have tightness in the chest, neck, throat, can feel heartbeat in chest, neck, temples, ears, shoulders.  During the PAC episodes, if I walk 50 - 100 yards I am fatigued and need to lie down.  EKG has verified diagnosis of PAC's and my EP says little can be done to decrease the frequency and severity of these episodes.  He has changed my lopressor to topryl xl, 200 mg once a day, and discontinued the lopid because of possible interactions with the lopressor, digoxin, and amiodarone.  Has not been enough time to evaluate these changes.  I do not feel that I can handle this constant fatigue and disconcerting minor pain much longer.  Any ideas?  Thanks

[Cleveland Clinic]

Whaler,

Thanks for the post.

Its tough to really get a full handle on your symptoms as they could be caused by a number of different etiologies. These include more frequent episodes of fibrillation or dysrythmia, underlying coronary disease, structural heart damage or medication side effects.

I would want more information about your episodes and potential testing would include holter/evet monitoring, stress testing and echocardiography to ferret out the root of your symptoms.

It may be helpful to have someone else take a look at your history with a second opinion.

good luck

[whalersailor]

In addition, Stress test shows no problems, and Echo shows "slight thickening" (my EP'words).

[yellowrose]

hi. hope your feeling better since you wrote this, i know how you feel i have bad days and right now am going through 3 months of bad pac/pvc. so bare with them, hope they go away soon for you . ekg are great and you should relax that all your test are good, stress will make the pac worse and more of them because your thinking about them and waiting for them to happen , i do the same, so try and not think about them, but i know its really hard. barbara

[momof6]

I am sorry you are having a bout with the extra beats! They can become so bothersome. When I start to have more of them I try to keep my mind busy on other things and this seems to help mine. And I try to do deep breathing as this seems to help lesson them and help with anxiety. Prayers being said for everyone, Im so sorry for everyone that feels crippled by these odd beats. I have times when mine get to me too, but then I usually get mad at them! I dont want to spend my whole life thinking about every scarey extra, missed, doubled, tripled, fast, corkey beat. May every one have peace in their hearts. Peace feels so good! :)Debbie

P.S.~ I also find myself thinking of everyone here on this board when Im getting some runs, and I say to myself ok, somewhere out there someone else is expierencing the same thing as me, Im not alone. Sometimes just standing in the checkout counter in the store I wonder how many other people standing close by me are having the same thing! Arent we good at hiding them?! Its just plain living with them. Here's to a palp free day or at least a worry free day!

[stlcard1521]

Hey, this is kind of unrelated, but to the PVC/PAC/Sinus tachy crew, I was going to donate blood next week, and I've never done it before. I get PVCs and sinus tachy, have any of you guys donated blood and did it aggravate that stuff?

[Fran71]

Yes palps can feel awful! and I too feel many people around me may have them. After all, I don't go around telling everybody! LOL. And when I talk about it it turns out the one I'm talking too has some tachy or PVCs, or knows someone who does!

I just got my holter report and I "only" had 1988 PVCs! Uniform and isolated, only occasional sinus tachy. Not bad being on only 20 mg Inderal. I actually thought that was a relatively bad PVC day when I wore the holter (though I've certainly had worse days), and I was amazed I had less than 2000 PVCs, less than 19 beats over 1 thousand. I hear many on this board have over 10000 a day and I wonder how one copes with that! I guess if I ever get to that point I'll learn to cope with that too....

I do bibliographic research in the hospital and every day I read of terrible diseases that really cause me anguish. When I feel miserable and have self-pity about my PVCs and other health issues I have, I tell myself I should just count my blessings. Of course that's easier said than done. Let's just all hang in there!

Fran

[Fran71]

Hi, I'm so sorry to hear about what you're going through. Won't your cardio consider ablation for your PACs if they're so debilitating?

You say your PACs increased after you had a cold. The same thing happened to me! I actually caught a gastrointestinal virus, not a real cold, with a temperature (38°C). The day after I got sick my PVCs increased drastically. The flu only lasted a couple of days...PVCs are still here 2 months later! :-)

Good luck

Fran

[veryanxious]

here you go everyone:

http://www.comcast.net/sports/colleges/index.jsp?cat=COLLEGESPORTS&fn=/2006/04/07/363099.html&cvqh=tis_dixon

She was 28, from rythmn problems.

I have seen other state this as well. I am sick and tired of being told that pvcs, pac runs are benign. They are not. These beats are CLUES to an underlying PROBLEM. Once doctors do the standardized tests and find the heart to be normal, THEY are COVERED in that, essentially they have done their job and WILL NOT be LIABLE when you drop. Please don't write me off as some nut. I have extensive medical and cardiac training. If you are getting PVC's bad and PACS and shooting pains and they cannot tell you why, then THEY have not done THEIR JOB in finding what is wrong. Please be weary of the meds they give you as well...THESE are MASKS and can AGGRAVATE worse problems. I don't want to cause undo concern, but having a comfort forum to apply a false sense of security to one of the most impending and serious medical conditions is a shame.
We sufferers have a LEGIT condition. One that needs monitored, cared for, and IDENTIFIED by society, just as people who have seizures or other disorders are.
We need HELP and WE NEED answers. THIS IS SERIOUS.

[tickertock]

She died of an irregular beat but what was her problem or condition? Yes it's very sad, but was it PVCs, Pacs or what, Was it some underlying undiagnosed cardiac condition that led to the lethal rhythm? What was it? I'd really like to know.

[veryanxious]

I dont know Ive been looking, but this happens EVERY DAY.
I have spent thousands and put myself into debt trying to understand what is going on with me. You think heart disease killed this healthy young woman who had accomplished so much?

NO.
Her heart killed her, and her docs failed to help her. Understand this folks, we have an electrical problem that can fill your days and nights with fear and take you in a second. Please dont let society group us with the people who drink smoke overeat and sit on thei rears for years while they slowly clog their arteries.
If I could post a question on this forum I would ask that why, in 2006, do docs have SO MUCH TROUBLE diagnosing, accepting and treating rhythmn disorders!!?? WHY WHY WHY!!!!!!!!!

Anyones response would be good. If anyone wants to respond and there is no more room on this thread, hijack an above thread, Ill be looking.

thanks

[Fran71]

It's strange you say you have extensive medical and cardiac training. If you really do, you should know that there are very different types of arrhythmias, and they're caused by very different mechanisms, and are totally different one from the other.
My friend's brother  collapsed one day and it's a miracle he's still alive: 38 years old, no history of PACs/PVCs/tachy. Nothing. And he was found to have ARVD and now takes tons of meds plus has an ICD implanted. He was asymptomatic, yet unfortunately he has this progressive dangerous heart disease.

Symptoms don't always indicate a serious problem. It's like saying that since stroke may cause a headache, all people suffering from migranes should be scared to death that they're going to suffer a stroke!!

I'm not saying it is certain I will never have cardiac arrest. I'm just saying, it is as likely as it is for anyone else and it does not depend on my PVCs, with good echo and ECG results.

I understand your frustration, which we all share. Your nick says it all! PVCs can drive us crazy...but for the poor quality of life, not for the danger. Remember: with all your cardiac tests and regular follow-ups, your risk of developing a serious heart problem is much smaller than the risk of those poor young people with no palps, who suddenly die because their problem was not diagnosed......

Try to take it more lightly, and focus on your quality of life. It's easier said than done, but it seems as if you're trying so hard to see PVCs as dangerous. They're not! They're already bad as they are...annoying and irritating. Keep doing your regular follow-ups and try to relax about the danger. Your attitude sounds a little masochistic to me...I've been there too...but it doesn't help, it only makes things worse.

Have a nice day everyone

Fran

[stlcard1521]

"If I could post a question on this forum I would ask that why, in 2006, do docs have SO MUCH TROUBLE diagnosing, accepting and treating rhythmn disorders!!?? WHY WHY WHY!!!!!!!!!"

If you had extensive "cardiac training and knowledge," you'd understand that. They dont have that much trouble diagnosing, and they're difficult to treat because because it takes 1 cell in the heart to cause a PAC or PVC and there isnt a good target for a drug to act on a single cell that causes an early beat. Beta blockers slow the entire heart down, and that's the best there will probably be for a long time. plus there are many diffrent causes and diffrent types of arrythmias. Medicine might be making leaps and bounds but it isnt perfect.  

Most people that drop dead suddenly as in this case have an abnormal conduction pathway like long Q-T syndrome or Wolf-Parkinson-White or a congenital birth defect. If you go read some medical journals, pretty much every study has found that there is not increase in mortality for people who have PVCs with no specific cause vs the general population. Don't scare people...

[catattack15]

I believe she had an enlarged heart & mitral valve problem. I dont know what arrythmia ppl get with mitral problems.

[CollegeGirl143]

i think its really irresponsible for somebody without a medical degree to inferre to suffering people that they are going to "drop dead" because of pvc's and pac's.... If these where not generally harmless conditions, do you REALLY think we would be told they are? do you think there is a conspiracy theory or something? why would a doctor want to knowingly put a patient at risk without his or her knowledge? and the fact that you think doctors are unwilling to accept people have rythem problems is outrageous.. what do you think ep doctors do all day long? pvc's and pac's can be indiciative of a larger problem.. yes.. but its the patients responsibility to seek out further treatment. many people probably dont in the belief that if they dont know, they dont need to care.. i had pvc's and pac's due to svt.. i had an ablation less than a week ago and guess what?! no more palps.. and hey i havent dropped dead yet either. I hear alot of people saying they are sinus tachy and have palps.. they are common to eachother. My cardiologist has SVT as well, so he is VERY sympathetic to me, thank you very much. I sometimes have runs of sinus tach and a few palps due to exersize, or anxiety. i believe 99% of cardiac patients have big anxiety problems.. who wouldnt after being told they have a heart problem? Cut down ur anxiety.. chill out... i bet you'll feel better.. and quit telling people they're just gonna drop dead.. we're all gonna drop dead one day.. but not from something like you're insinuating.

[tickertock]

I 'm not a doctor but I would tend to agree with the comments of stlcard, Fran and collegegirl.

[kitcurious]

Basketball player and then coach huh? This is just a guess, but...
http://www.ecureme.com/emyhealth/data/Marfan's_Syndrome.asp

[veryanxious]

Im not trying to scare people.

You said it when u said beta blockers are all we have, its just not good.

Im not going to say what my medical background is, but let's say it's extensive and we wil leave it at that.

Folks, this happens all the time. I've seen it myself hundreds of times over the course of several years.

I do not want people to be scared what I DO want is for you to:

-Not be satisified until a proper diagnosis is given. True, it takes one cell and one pathway to creae a pvc pac, but chronic? 10,000-20,000 a day? There IS a catalyst. It must be found.

-DO not ever stop until the reson is found, until some form of effective treatment can be administered (shocks, ablation, cath, whatever....) We do have the technology to do this.
I'm sorry if my passion may seem to border on ignorant and insensitive. but this hits home for me.

[CollegeGirl143]

and just as an after thought.. i just read that article, and it clearly says this girl had symptoms days if not weeks before she passed away... persistant coughing (maybe a clot?) and fainting.. like i said.. the people who tend to get in trouble are the ones who tend to ignore their conditions. The only problems i would be worried about SCD are VT VF and maybe WPW... Many underlying health problems can cause an "irregular heartbeat"... blood clots... heart attacks, mixing meds.. To everyone out there who is suffering anxiety due to everything that was said today, trust your doctors.. they are trying to help you.. not kill you.. and if you dont, get a second opinion, but be willing to accept the fact that your not going to drop dead and move on from the thought... Be willing to help yourself as well.. dont let yourself suffer because you are too scared to have an ablation or pacemaker or anything of the sort. i feel soooooo much anxiety from this board it seems that alot of people are hurting themselves more than helping :(

[tickertock]

I trust the CCF EP docs, what better medical background to have than they do. FWIW I too have a medical background(not a MD) and personally know many persons with PVCs in 1000s daily and even short runs NSVT for up to 10 +years, they participate in competitive sports and never have any problems whatsoever. This unfortunate SCD only happens to a very rare person, even persons with HCM and WPW, the SCD events linked to these conditions are not as high as once thought. Most persons that suffer SCD suffer from an undiagnosed cardiac anomaly. I don't think (veryanxious) is deliberatly trying to scare anyone but is unconsciously caught up in their own anxiety over a very scarey experience to which not much explanation can be offered, these events are a fact of life , but applys to only a very unfortunate few.

[momof6]

Oh I feel and am so sorry for those reading and being filled with so much fear. What does fear and anxiety have to offer? I ask myself this question when ever I fill fear is ruling my heart! It only stops us from living! And does not CURE my arrhythmia but induces it! If I chose to live in fear I would not have the six children and the one in heaven awaiting us. I have chosen to live by faith which has brought me life! IF you have had your heart 'checked out' and all has come back normal and your Dr. has said all is benign then be at peace. Peace is so good! Hope of a bright future! Dont let these darn things stop you from living life to the fullest. Matter of fact a word fitly spoken is like healing to the bones and medicine to the heart. That means when your Dr. says you'll be ok, be encouraged:) I know this is hard but we have to do it! Or we will live our whole life worried about the next beat,oh what fun:( Ive had some pretty scarey rythmns thank the Lord they only last a few moments but I take a deep breathe quickly calm my self down and thank the Lord it has passed. I used to ask the Dr.'s why too over and over, but why, whats causing it?,are you missing something, are you sure your not missing something? If I wont except my Dr.'s word after many tests then why go? Ive seen three Dr.s and all have said the same thing, if any of you have had the same done then its time to choose to be at PEACE and LIVE. For those of you who get 1,000's a day and feel every one of them I am so sorry, my heart truly does go out to you! I pray that they would lesson or even better go away! Be of good courage, take heart, and be well.

P.S.~Be careful what you read, most articles leave out things making you think darn some one died of a simple pac or pvc? NO

Living by Faith~Debbie

[cosmic_m]

Hello to all!  I've been a lurker for over a month now but have to finally respond.  First off I want to say ... THANK GOD for this forum!!  

A little over a month ago my hell began with these PACS and PVCS and little by little I have been trying to pull myself out of the "what if" thinking as it causes more PVCS and way too much anxiety.  So far I've had one visit to the ER with one ECG reading that noted "Sinus Tachy with occassional Premature Ectopic Complexes.  Otherwise Normal ECG"  I was handed an Ativan and sent on my way wondering if I was dying of heart disease as no one in that ER told me anything relevant.  I didn't even know what the reading was on my ECG until I went to medical records to pick up a copy to show my current DR.  In fact the ER doc was so rude to me all he said was I have Acute Anxiety. When I asked if there was something wrong with my heart he added... "I'm not saying you don't, but you are having an anxiety attack right now"  Can you believe he tells this to someone who he first defines as having "Acute Anxiety?" So I go to my regular doc and he says.. just relax.  You are causing more PVCS by worrying about them.  How can you not?  I not only feel them but I can hear them when they are hitting real hard.  The more I focus on them the more they are there and of course worrying causes stress, causing more pvcs, and coupled together higher bp.  Vicious cycle.  My regular Doc wasn't concerned but for my own piece of mind I am seeing a Cardio this tuesday.  God I hope these aren't a sign of some underlying heart problem.  This board has been a blessing as I have read many who have lived a looooooooong time with these things and no significant health problems other than these crazy thuds.  I'm trying my hardest to not focus on them but after meals and after exercise they really kick in.  I've come a long way in a short time beginning to not fear them as much.  All I want to hear from a Cardiologist is that they are benign.  My reg doc says they are but adds it's up to me to accept it.  What bothers me is when someone posts things like above about the army coach who dropped dead of irregular beats... but does not add that the coach had an underlying heart condition.  If my Cardio says these are benign then I will try my hardest to let the fear go.  Thanks again for this forum and all those that offer thoughts.

[cosmic_m]

I wanted to add that when I have my PVCS I experience no pain, no shortness of breath, and have never felt faint.  Although the level of anxiety and panic that comes after they hit is incredible.  As I said I am slowly learning to work through them.  It's odd about these suckers.  I never knew I was having PVCS.  I would have a lot of digestive problems after dinner and it would feel like a strange internal hiccup in my stomach and neck area.  I thought it was gas.  Then late one night my stomach was all upset and I got those crazy internal hiccups so for no real reason checked my pulse.  The second I felt that "skipping" feeling I FREAKED out. And from that moment on they elevated to loud constant thumps I could feel and hear all day and night as I was freaking out.  I had created a monster just be realizing it was my heart.  This is when I ran to the ER.  My personal Doc has been great trying his hardest to calm me down but it's been a month of constant fear. Actually the phrase is horrifying fear.  I have so much sympathy for others that are going through this.  It has been life altering for me.  I'm afraid to take the BB my doc gave me until I see the Cardio.  The only reason he gave me the BBs is because my BP is so high in his office.  It's well within normal at home so I'm not ready to take the BB.  Right now Ativan at night has chilled me a bit and reading how others are living with these things has helped.  I'm scared to death to exercise but do It reluctantly at this point.  When does it all kick in that its going to be ok?  I just keep waiting for that one moment when you finally resolve the fear of dying and say... ok I have these nasty things lets move on I got things to do now.

I still go back to that one post about the Army coach.  I feel bad for the poster because it's obvious they need to hear there is something wrong because we all feel this shouldn't happen.  It would be easier to hear there is something wrong.  Yet to that person I say... the story you offered as "proof" proved nothing in regard to all irregular beats causing sudden death.  Yet you have tons of proof on this board with those who have lived YEARS with irregular beats.  I say lets lean towards the positive and if the cardio ( a pro in the feild) says you're gonna live then lets live and be done with worrying?  Thats where I want to be.  I hope to God my Cardio tells me everything is ok.  I would think from my ER ECG that he will say it all looks ok. To those that believe in God Pray for me Ok?  I will pray for you.  If it's bad news I will be strong. Ok ... enough babble from me.  On a side note... boy how does anyone ever get to ask the DR's a question?  I've tried and tried and can never get through.

[fearfactor]

Bottom line, folks...if you've been through all the testing, tried all the "home" cures, are on meds (even for anxiety), etc. then what are you going to do, sit around and worry about death?  We all have to die, I would rather die not worried, happy and enjoying life than worrying about stupid, stupid PACs/PVCs and enduring a living hell of sitting in my house waiting to die.  Not saying I won't ever get more testing, but for now I'm not letting these things consume me anymore.

[fearfactor]

P.S. I agree that the woman in the article likely had underlying undiagnosed problems.  But, I used to run 6 miles a day, have been through anorexia (which is known to cause electrolyte imbalance and rhythm problems), took ephedra for weight loss when it was legal, drank a lot in college, used to drink a pot of coffee a day, in short I didn't live a healthy life (except for the running).  If I were going to drop dead from arrhythmia, I would have by now - I had them even when I lived an unhealthy life and still have them now that I live a healthy lifestyle.  I'm living proof that "symptoms" don't always mean death.

[catattack15]

I just read that the coach was a former basketball player herself. Why is it atheletes get the enlarged hearts?  Is it from simply overdoing? Also, read that some tall & lanky ppl can have heart problems similar to hers.