Long-term prognosis of tachicardia and PVCs

[Lamar1]

Dear Doctor,
I’m a 33 year-old girl. I suffer from occasional tachicardia and frequent PVCs. Last October was the worst it ever got –the holter revealed a mean HR of 120 with peaks at 200, with 3500 isolated uniform PVCs (many trigemini, a few very short bigemini, normal QRS – no PAC). I took a mild betablocker for about 1 month which I’ve now discontinued and I’m currently taking no medications. I feel a whole lot better, but now and then I still get episodes of tachicardia, and PVCs are still frequent, on and off, often occurring for no reason, or triggered simply by digestion, standing up, walking, or by very slight stress, even in the absence of severe tachicardia (though my HR at rest is usually between 90 and 100).

Echocardiography and blood tests were normal. I don’t smoke, don’t drink too much coffee or alcohol, and exercise regularly. My cardiologist says this is a benign arrhythmia because I have simple PVCs,  but it’s hardnot to worry!

Here are my questions:
Are complex PVCs and VT a complication of uniform isolated PVCs, or do they have different physiological mechanisms?

Can tachicardia along with frequent PVCs damage a structurally normal heart in the long run in any way? Should I take medications to slow my heart down and prevent damage, even when symptoms are bearable? I’m kind of woried my heart will get tired of racing…!

I thank you so much for taking my questions and for the wonderful service you provide.

[Cleveland Clinic]

lamar,

thanks for the post.

1) Are complex PVCs and VT a complication of uniform isolated PVCs, or do they have different physiological mechanisms.

while pvcs and vt are similar in nature..ie each are ventricular beats independant of atrial initiation, there is no interaction to worry about.

2) Can tachicardia along with frequent PVCs damage a structurally normal heart in the long run in any way?

Sustained tachycardia can be detrimental to cardiac function and should be further investigated. PVCs do not fall into this category. I'm not sure exactly which you have.

3) Should I take medications to slow my heart down and prevent damage, even when symptoms are bearable?

Im unable to answer without more data and investigation.

good luck

[Lamar1]

Hi Pluto, thanks so much for your comments and support. I'm new to this forum but I've read some of your posts and greatly benefited from them. My tachicardia and PVCs are currently bearable, but I'm worrying about any long-term problem. My cardiologist doesn't seem to think I should take any meds if symptoms aren't too bad. She never mentioned the higher chance of cardiomyopathy...Are you taking the betablocker to suppress symptoms, or to prevent damage to your heart? Was your HR at rest usually high before taking the Bblocker or did you only
experienced short episodes of tachicardia?

Hope you don't mind all the questions...

Thanks so much

[noreaster]

Hi. I have a similar problem - high heart rate at rest, frequent episodes of tachycardia and presumably PVCs (never had a holter but that's what I think they are). It does make me tired but most of the time the symptoms are, as you said, bearable. I don't know if I'm doing the right thing but I only take beta blockers when it gets really bad (like when it gets painful or when the higher heart rate is making it difficult for me to fall asleep).
It will be interesting to see the doctor's answer to your question as I've also wondered about the long-time effect of fast heart rate.
Kate

[I'mallheart]

i suffer from the same thing also..i take atenolol once a day 25 mg..it works well and also green tea has helped along with magnesium oxide 500mg a day..hope all feel better
thanks

[lak]

Does anyone know if the ejection fraction can make you feel tired and lethargic????  Mine is 42%.  I have bigeminy, trigeminy, sinus tachycardia, hypertension.  Around 18,000.00 pvcs daily.

I have alot of problems sleeping and take atenol and 05 xanax at night to help me sleep.

I was told not to worry about it unless syptoms (symptoms) worsen.  How could they be worse.

I have otherwise a normal heart as far as the tests, and I have had all of them, show.

Also, have left bundle branch block but they say that won't hurt the heart either.

Any comments????? Does any one know the answer to the question about ejection fraction?

Thanks Lisa

[Lamar1]

Hi! Your condition sounds a whole lot like mine. I'd be interested to hear about the diet adjustments that are helping you. I think I'm on a healthy diet, and I exercise regularly. I'm sure stress plays a huge part in arrhythmias in healthy hearts, but I can't always find a connection between my tachicardia episodes and stress, though stress usually brings up tachicardia and PVCs.

Thanks a lot to you and everyone else who has replied to my post.

[Lamar1]

You're right. Betablockers are safe drugs and I'm not particularly against taking drugs. It's just that for long periods of time the tachicardia and PVCs get much less intense and I hardly notice them, so I feel taking meds would be kind of useless. But then a new episode comes...If the doctor says I should, I'll talk again with my cardiologist.

Thanks so much

[Clenn Camp]

I have pvc's and take beta blockers, 25 mg atenolol twice daily for pvc's and 100 mg flecainide twice daily to prevent afib from breaking through after ablation in March.  The atenolol hardly does me any good as the pvc's I have are unberable and certainly debilitating.

Glenn

[Clenn Camp]

You only absorb approximately 4% of whatever dosage of magnesium oxide.  Magnesium citrate, liquid magonate, etc., are the best forms to take for at least 30% absorption rate.  My cardiologist prescribed mag oxide for me one time and I told him oxide was the poorest form to absorb and he then wrote it for mag chloride.  You have to keep a check on chloride livels though and not let it get too high.

Glenn

[pms_barbie]

You have that many a day?  Have you seen an electrophisologist?  Surely with that many they could do an ablation.  I couldnt imagine having that many a day I would surely be bokers.  So far the highest count I have had was 972 mostly in bigeminal cycles.  I know how badly this situation can be.  God Bless you. You have to be a very strong person to deal with that many a day.

[pms_barbie]

I would think a falling ef fraction may make you tired and maybe even breathless.  Not to mention the pvcs making you breathless.  Since you say you have had all the test and a normal heart.  I believe I would look into seeing an ep dr. maybe they could ablate and give you some relief.  I have also heard of a person ef going up after the pvc's were ablated.

[fizzixgal]

18,000 pvcs in a day is a lot, how long have you had that many? If my EF were 42% I would be concerned that I was developing a cardiomyopathy, either induced by incessant pvcs or from some other cause. Also, LBBB may not be harmful by itself but I understand it is often a marker for more serious conditions. If my doctor kept saying "don't worry" I would want to know why, or get a second opinion.

[Momto3]

Yes to your question on a 42% EF causing tiredness. I had tens of thousands of pvcs each day...10,000-25,000. Long story, but when my echo showed an EF at 40% (55% a year earlier), my doctor was quite concerned.  Up until then, I managed the pvcs on my own or took beta blockers for symptomatic relief.  When my EF was at 40%, I was dragging and short of breath. Although I did not have hypertension, I was in bigeminy, trigeminy, etc....a LOT!!

I also had bundle branch block but can't remember if it was left, right or both.  Ablations have resolved the issues for me.

I cannot believe how much energy I have now that my EF is back up to 55%!  So, in answer to your question, I would say...ABSOLUTELY, a compromised EF could lead to tiredness.  Good luck!!

connie

[Clenn Camp]

You are taking 25 mg of atenolol four times daily.  Are you experiencing excessive fatigue from taking so much of it?

When I went from 25 mg once a day to twice a day I noticed quite a bit more fatigue.  Some days I take three doses.  All because of these dadblasted pvc's.

The past couple of weeks I have had more than I 'normally' have of bigeminy beats.  Frequent runs several times each day.  Just have to stop what I am doing and wait for heart to decide to get back in rthym again.  Then will do pretty good for awhile and BAM! here we go again with more of them.

Glenn

[Clenn Camp]

Pluto I apologize for saying you are taking 25 mg of atenolol four times daily.

I should have addressed the previous post to:

lamar1

Sorry about that.....
Glenn

[ADrocks]

The most common presentation of low ejection fraction is fatigue.

[MR SPEAGLE]

Hello,
I was diagnosed in 1999 with tachardia but of course "NOTHING TO WORRY ABOUT". My problem is that everything I read about this condition refers to it as a fast heartbeat and that is not my symptoms. My symptoms are irregular beat or "extra beat" that I can feel in my chest.I had echo,stress and many EKG'S and everyhting came back normal but I worry that it has been 5 years since those tests and I am afraid that something has developed since.When do you stop worrying? HELP!

[jobob52 ford]

Hi,
Your comments raise alot of questions.
Do you feel these skipped beats all the time or are they sporadic? It could be that when you had your tests performed, all was infact normal. If the irregularities come and go, you might do well by wearing a monitor to track the "extra beats". Its suprising how acurately the Doctors can evaluate and treat intermittent symptoms, if only they can see them.
Have your symptoms changed over the last 5 years? Why are you affraid that something has developed?
As Mr. pluto stated, alot of us here deal with irregularities as a normal part of our lives. Some are more servere than others but most can be treated in one way or another.
The important thing is to know that your not alone.

Best of luck, Bob

[Rocko1]

Hi Hank... It is Rocky again. Well last evening i had my second event of i think tach that was caused by pvc's. Tell me if this sounds familiar? I noticed a hard compensatory beat, then maybe another... and then my heart went into  a very fast, 150 or so bpm sinus tach. I know it was sinus because believe me ive learned to tell the difference! It subsided after about 15 to 20 seconds  slowing down at a regular pace... this doesnt happen often at all. My Dr. said he could presribe me some Inderal if  I wanted but honestly on most days I only notice 4 to 5 pvc's and on days of hight stress a few more. So given that I dont know if the Inderal would be worth it since my resting rate is low due to conditioning. But Id still rather not have ONE pvc ever again... I guess too much to ask for!

[Rocko1]

Thanks Hank. It is comforting to know someone else has some of the same issues as ourselves. Some people apparently can cope with it and some like myself have a hard time. But one thing for sure, if a person has never experienced these things they have no idea how it ..can.. effect our lives. Fortunately I have begun to cope much better with it, partly because of echo's etc and a top notch cardiologist that said my heart is normal and that if i needed to worry about something to worry about something besides my heart. He did give me a scrip of Xanax which by the way seems to have really helped with the pvc's somehow. Well thanks so much for your help. I dont know if you know but you really do help out here on this board. Talk to you later.

[cruisincheryl]

Hi

I have daily PVC's.  I get them most when I am laying in certain positions.  When I lay in bed reading a book and my neck is bent down or when I'm sitting at work and I tilt my head to the left or right.  Does anyone know why this is???  Could there be some kind of blockage in an artery in my neck that makes my heart want to beat an early beat??  I take 50 mg of tenormin a day.  I have been on it for 10 years.  The pvc's seem to be worse lately.  I have around 5 or 6 an hour.  They drive me crazy.  I was on paxil a few years ago for anxiety due to these and that seemed to control them, but the weight gain from paxil was unacceptable.  I had an echo a year ago and all was fine.  I haven't had a stress test in about 7 or 8 years.  Why all of a sudden are these pvc's getting more often??

Thanks for any comments.

Cheryl

[Rocko1]

Hi Cheryl... Im plagued by pvc's also. Back in February they just abruptly started... Im 49 btw. Dont know if they are greatly reduced due to taking fish oil and magnesium but at the present I only notice 10 or so per day.Back in February they only occured in the evening but to the tune of 30 to 40 per hour for about 3 hours???? And yes I have noticed that they can occur due to body movements although this is not understood by the Drs. They THINK that id is due to a shifting  of the heart itself and changes the firing focus somehow? Oh well I had an echo done and a holter monitor done here in Oklahoma and one of the states top cardiologists said i was completely normal. I know this, these have taken my life away. I wish i would never have another one.

[cruisincheryl]

Hi rocko

Thanks for the reply.  I know what you mean about taking your life away.  Before I went on Paxil I felt the same way.  The paxil really helped, but the weight gain was awful.  I am 53 and have had these for about 15 years.  They come and go.  I really get stressed out about them.  I'm tempted to go back to my Dr. and see about another anxiety drug to see if that helps.  I am also thinking about reducing my tenormin.  My BP gets very low when I am sitting and that's when I feel them.  When I am up and walking or doing something I don't get them or at lease I don't feel them.  My resting BP can be as low as 95/50.  Mr. Dr. said I don't need the tenormin and use it only if it helps.  What I would really like is a full heart workup where they test everything and then if all is ok, then maybe I wouldn't worry.  I have no family history of heart disease either.  Thanks for responding.

[Rocko1]

I think the very good news is (and ive heard drs on this site comment on this) is that youve had them for 15 yrs and nothing bad has happened yet!!! But there is comfort in knowing that someone else has the same issues because people that dont have them I dont think have any idea what anxiety they can produce. (I was one of those people for 49 yrs!!:)Have a great day Cheryl