Many Different Arrhythmias daily

I am 58 years old female and have a three generation (women on maternal side) history of serious heart disease in my family.  Although I did everything to avoid it (healthy eating, lifestyle, exercise, etc.), I got it 20 years earlier than any other relative.  
I had Triple By-Pass in April, 2001 and was hospitalized for atrial fibrillation and tachycardia in June, 2001 and November 2002.  I then learned my left atrial is enlarged.  
I just discovered (via a 30 day EKG monitor)  that I am having PAC triplets, supra ventricular ectopy, ventricular ectopy, ventricular triplets, ventricular couplets, sudden rate increase (55-98), sinus bradycardia and SVPB.  I am having all of them on a daily basis for about 5 weeks now.  They are very uncomfortable and I am concerned about sudden death. I read that pvc triplets w/increased heart rate often results in sudden death.  I have also read that anti-rhythmics are not effective on pvcs.  Can you please suggest treatment options, physical restrictions, risks and prognosis. My liver enzymes are elevated (62) this month.  I never drink alcohol, have a long history of exercising and eat extremely healthy.  My cholesterol is 130's.  My resting heart rate is around 50..  
I have worked out (treadmill 30 min. @ 3.2 mph w/1.5 incline, 90 sit-ups, light (7.5 lbs) weight training) in a gym until two weeks ago to keep my heart strong.  I am now afraid to go back.  Can I work out and if so, should I do an easier work-out?
I am on Sotalol, 80 mg., BID, Zetia, 10 mg., OD, Warfarin Sodium, 5 mg., OD, 5x/wk. & 7.5 mg. OD 2x/wk., Caduet, 5mg/20mg, OD, Niaspan, 500mg., OD, Folic Acid, 1 mg, OD, Sertraline Hcl, 50 mg., OD, Fexofenadine Hcl, 180 mg., OD, Co-Enzyme Q10, 120mg, OD and Calcium w/D, 500mg., OD.  
Thank you sooo much for your attention.

[Forum-M.D.-MJM]

Hello,

Family history is a difficult risk factor to change.  I am sorry to hear about your health problems.  

I read that pvc triplets w/increased heart rate often results in sudden death.

PVCs in people with coronary artery disease and/or structural heart disease have an increased risk of cardiovascular events.  You have to be careful with this statement though.  Hypertension, diabetes, smoking, and other risk factors usually are associated with a higher risk -- the difference is that you feel these events and that makes you worry about them more.  I think there is too much emphasis put on this risk and it causes much undo worrying and stress.

I have also read that antiarrhythmics are not effective on pvcs.

They can help, make it worse, or have no effect.  The only way to know is trying.  In general, we only use antiarrhythmic meds if beta blockers don't help and you have lots of symptoms from them.


Can you please suggest treatment options, physical restrictions, risks and prognosis?

I don't think this significantly affects your prognosis.  There is a slight increased risk of cardiovascular events, but like family history, this isn't a risk factor we can change.  I would focus on changing modifiable risk factors like blood pressure, cholesterol, diabetes, and tobacco. I am now afraid to go back. Can I work out and if so, should I do an easier work-out?

Unless if you feel exercising, I would only refrain from strenuous exercise, but please leave this to the advice of your treating physician since they have more information about you.  It might help your confidence to ask your doctor about cardiac rehab -- a monitored exercise regimen to help you build confidence in your safety.

I hope this helps and thanks for posting.

[Slowboat42]

You certainly have a variety of arrhythmias.  While in ER last year, a cardiologist told me I had three different simultaneous heartbeats.  That did not surprise me as I am an addicted multitasker.  Several days later I had a quad BP and had an ICD installed.  

My story is similar so I won't bother you with the details but I do have chronic PVC which keep my ejection fraction in the 20's and have recorded about 700 episodes of ventricular tachycardia on my ICD.  My exercise routine was degraded from a 8 minute mile run down to a moderate walk.  That's almost as troublesome as the abnormal rhythms.

I have kept a daily log for the past 15 months and have concluded most of my issues are related to low blood sugar coupled with another event such as excess exercise, coffee, large meals, alcohol or stress.  It's not just one event that causes the issue but blood sugars are the root cause (the heart prefers high quality glycogen for fuel).

I have now moved from a low carb diet to a hi quality carb (fruits, veg, whole grain, legumes) eating plan and eat frequently to keep blood sugars at a normal level.  I also take mineral supplements and eat plenty of bananas expecially before exercise.  Coffee and alcohol are in moderation.

My VT's ( I feel them every time) and PVC's have dramatically declined.  I need more time to evaluate my changes but I think I am on the right track.  Avoid anything made with sugar and refined flours.  Hi fructose syrups and trans fat should be zero.

Hope that helps.  

[bama jane]

I also have multiple arrhythmias and notice eating to be a big trigger.   I try not to  eat so much that I feel bloated.  Last night I did and started having an extra beat every 2nd or 3rd beat.  I am always amazed at how my stomach growling can cause extra beats. I exercise daily but could improve on what I eat although my weight is very good. I find I crave sweet things and feel better when I keep my blood sugar really high I have less misbeats.  I had a test years ago and it came back that I had hypoglyecmia but then I moved and  the endocrinologist I saw said that reactive hypoglycemia was over diagnosed and that was the end of that. I find it interesting that a lot of people with rhythm disturbances have the same problems. I avoid all caffeine and have never smoked. I tried flecinide in the hospital and it did not help me.  I am also a little wary of that class of drugs.  I experienced a lot of side effects.  Everyone is different though.

[Quality Woman]

Hi Everyone
This site does rock.  This is my first time on it and I am touched by the support and appreciative of the information.  
Thank you for sharing your experience with sugar and arrhythmias and I am going to try it out each way and see.  
I noticed I am craving magnesium for the past few weeks (spinach, avocados, etc.) and just read magnesium may be helpful.  I believe it may have decreased the frequency of the arrhythmias.
Thank you  :)
Quality Woman

[horsebreeder]

I am new to this site and to my symptoms.  so far I know much of nothing about heart issues.  Like  - what are PVC's?  I am a 53 year old woman in reasonably good health but the palpitations are keeping me up at night.  I have them during the day too but I think I just notice them more at night.  They are not every 2 or 3 beats but after every 100 or so, my heart just skips a beat or two.  My reflex is to cough to get things going again.  I am a non-smoker, only 1 cup of decaf in the am, a vegetarian except for an occasional fish.  It was interesting to me to hear that hypoglycemia is an issue.  I do have low blood sugar and sink at times.  Also low-blood pressure - 90/60 sometimes is normal for me.    Should I be worried?

[Momto3]

Hi and welcome to the site : )

I am not a doctor, but what you describe sounds like pac's or pvc's.  PAC's originate in the top chambers of the heart (atrium) and PVC's originate in the bottom chambers (ventricles) of the heart.  The feel like skipped beats, but are actually extra beats.  The are considered benign in people with a structurally normal heart.  Have you ever mentioned the extra beats to your doctor?  Sometimes, they will give you a monitor to wear so you can record what you feel.  Other times, they may order an echocardiogram, and sometimes they can make a pretty good determination based on your medical history and maybe an EKG.  It's probably a good idea to check with your doctor, but you'll likely find that the beats are benign, but weird.  Hope that helps.

Try posting your question as a new question and maybe more people will see it since it will appear higher up on the page.

Have a great day!
Connie