pacs/pvcs and normal activity

[oneil420]

My question is in regards to pacs/pvcs. Since they are benin and pose no real threat in the short or long term then is it safe to assume that despite the frequency of said pacs/pvcs that normal activity(ie sports,exercise,sex etc) should not be avoided? I mean if i am playing basketball and a start having a episode of palps and i feel otherwise uneffected by them then should i continue to play? or should i rest and allow the episode to subside? I guess i can use this same question for pain medication, i have crohns disease and from time to time need pain meds but i am afraid to take them because they cause pacs/pvcs but should i just ignore the palps yet again? In summery regardles of where i am or what i am doing with the proper diagnoses of eptopic pacs/pvcs then i should ignore(to the best of my ability) the episode? thank you.

to all my pac/pvcers!! "It is better to die once then fear death a thousand times" Julias Ceaser. I hope you all find peace of mind we have our whole lives ahead of us only you can take advantage of the time you have left here(nothing is promised) make the best of it every day. Heres to the good life:)

[skippyheart]

Just speaking from experience:

I sometimes have very frequent pvcs - 100s/hr with rhythms like trigemniny, bigeminy, (and I think a little samba and reggae thrown in for good measure), and used to be scared to exercise during them. Found out they have no effect on my exercise capacity. Mine tend to disappeare at higher heart rates and come back later.

At any rate, after a stress test my cardio also suggested I don't let them prevent me from exercising (or any activity). I asked him if he'd let me pilot a plane with him as the passenger while having these beats. He said absolutley. However, he admitted a lot of GPs wouldn't. (my GP was never concerned about my beats).

The joke's on my cardio though - I don't have a pilot's license :)

[madgrad92]

You're not going to drop dead. Doctor after doctor after doctor will tell you that. There are people on this forum who have had PVCs, SVT, a-fib, IST, etc., for 40-50 years and are here to write about it! True, most of us on this forum are between 20 and 50, but if you thinka bout it, by the time someone has had PVCs for 30 years, they're probably past message boards, y'know? They're probably so used to them, they think, ah, hell...what's the point of the message board anymore? Take heart. Read skippyheart's post from 05/08/06 (it's on one of the two questions from that day. Copy it, save it to your hard drive and read it every day. You have a better chance of being struck by lightning than to die of a heart arrythmia if you have a normal cardiac workup. I used to sit there and think, "I'm so alone in this." Once, however, I read and read, I realized that up to 40% of the population (40%!!!) have PVCs. Only 3% of those know about them. So, I look around and think, "Almost half of these people are having PVCs right now." It just makes you understand how common your "problem" is.

[madgrad92]

If you want to email me, my email address is ***@****. I, too, have lots of PVCs after eating. I've also suspected my Toprol XL as perhaps causing more PVCs than actually helping them, but I'm not sure (I know they don't feel as "hard" since taking it. Maybe we could compare notes. If you don't want to email, I totally understand (lots of loonies out there!), but your situation sounds similar to mine, and my cardio also says that there's no connection to the GI issues. I think he's full of s***. Did your doc give you the Toprol just for PVCs, or do you have another arrhythmia, too? I have a yearly or so bout of SVT for about 10 seconds. He gave me the Toprol for that about a year and a half ago, and the PVCs just really started up for me about six months ago. I hate them. And yes, we deserve to have anxiety, but we have to talk ourselves out of it, or we're not living life the way we should. It's sad.

[Carey01]

I'm so glad to have found a forum where people understand the same things I am going through.  I see my Dr regularly due to PVC's and Hypertension (which is generally under control) but they scare the heck ut of me.  He never gives me any suggestions as to what I can do to "fix" them  -- I guess because there is not tried and true answer.  I am soooooooo afraid thatg I am suddenly going to drop dead of Atrial flutter or something like that.  Anyone else??? Help!

[jan]

I called my cardio about a pain med that was causing palpitations and he didn't want me to continue with it and told me to have my dr. switch pain meds.

[amby78]

I swear this forum has given me more info and more piece of mind than any cardiologist, gastrologist, gp, the many other ER doctors I've seen this year!!
  I describe it as chinese water torture but the most rescent doctor explains it to be the "garden variety" pvc's or palpitations.  Wow so I'm a vegtable now that's the best diagnosis  yet.  Although the way these things make me feel,being a vegtable seem like one of the better alternatives.  
   So my story....I think my IBS if it's IBS is causing my skipped beats ...sometimes I get severe attacks after I eat...it took 7 months of tests for my doctor to finally believe its not just ANXIEYTY... anyone that feels these deserves to have anxiety.  It feels like there's a really little alien kicking my throat and diaphram...
   Anyway I'm on a 30 day monitor now Really fun..I'm too scared to eat to get an attack but if I dont show something the doctor wont see what i'm feeling..
  I also think it could be acid reflux irritating my lungs and my heart thereafter.  Most look at me like I'm crazy I'm still not absolutley positive if thats it but I'd like it to be atleast then I'll have a curable diagnosis My cardiologist put me on toprol xl 25 mg I took it twice and I had the worst episode EVER although I ate a lot and drank 2 beers I usually dont eat and I cant tolerate alcohal anymore bummer.  It would really help if anyone knows what I'm talking about
Good luck to all!!!

[sniggs]

I get these things something terrible, too.  Well, not as of lately, because I've been taking Toprol 50mg a day.  That has reduced them by about 80%.  I got my Echo results back to day too.  I have Mild Left Ventricular Hypertrophy and Mild Atrial Enlargement (YAY !). I'm just curious if anyone knows how much higer of a chance of sudden death I have now.  I'm 30, obese (trying to get weight loss surgery) and don't smoke or drink and have no other symptoms at all.  I still get palps, but not as many.  Thing is, they seem to be getting worse and now I get like 2-3 in a row instead of one at a time.  It worries me.

[Momto3]

Hi!

Yes, the CM has resolved since the ablation.  I had two ablations (August and November) in 2003 for multi-focal pvcs. Prior to the ablations, my EF was at 40%.  It took awhile to completely resolve, but my last few echos show the EF holding at 60%!!  I'm so glad I decided to try the ablation(s).

[sandro]

hi, i hope you recieve this question. did the CM diminish ounce the ablation was done?
thanks!

[oneil420]

Thank you  all for your support and comments they are all appreciated.

[madgrad92]

Anxiety, as you know, can manifest itself in many ways. However, I think you need to give the Toprol XL (I'm on it, too) longer to get out of your system. If you're still having bradycardia after two weeks or so off the Toprol, I'd go back to your doctor. But if it's only been a few days, the drugs are probably still interacting, especially the XL form of the Toprol - by nature, it stays in your system longer. If the same liver enzyme is breaking down the two drugs, they're going to be magnified and take longer to completely leave your system. If you've had the full cardiac workup and everything's coming back normal, I'd say you've nothing to worry about. You say that lying down brings them on - standing up makes them go away - sounds a little like reflux or even irritable bowel syndrome (which I also have). Anxiety makes this worse, and both reflux and IBS can cause wacky heart things because of vagal nerve communication. Hope I helped a little.
Dyan

[RSTING69]

I really needs ome guidance and help here.  I am a 34 year old male, i am overweight and on Toprol XL, Synthroid for Hypothyroid condition, Zoloft, Benzapril, and take a baby aspirin each day.  For the last couple of weeks I have noticed that I have been having these episodes where my heart will take long and hard beats, it almost feels as though my heart is gurgling at the end of each beat.  When these episodes occur it may be three or four at a time and then back to normal rythm, other times they last for a minute or two with my rate going from 68-72 down to 48-52.  I have also noticed that when this occurs I tend to feel like I have to cough or it brings on coughing episodes.  I feel as though I have a ton of flem in my chest and throat.  These episodes usually hit between 11am and 5pm and at times have lasted all day into the evening.
     When I lay down at night, at times, they start in especially when laying on my back or on my left side.  They are only relieved if i sit up or stand up.  At times they get so bad I begin to have stomach pains or gas pains.  I have had many anxiety and panic attacks in the past.
     I have had ekg's, ecg's, stress tests, blood work, echo, except for wearing a halter monitor they have found nothing.  I went to the emergency room last week when an episode would not go away.  All they found was a bachcardyia condition and felt it was due to a drug interaction.  My doctor the next day found that my toprol and zoloft had an interaction so he had me split my toprol pills from 50mg tablets to 25mg.  I was good for a few days no palps or these wierd beats, but then it started up again yesterday.  I am worried as to what this may be.  My doctor keeps assuring me its anxiety related, but why would i get coughs, and a weird feeling in my chest.  
     Can someone give me some insight or if you have had similiar issues.

Thanks

[CCF-M.D.-MJM]

You nailed it.  These are the right questions to ask and that quote is the right outlook -- the last question starting with "in summary" is the take home message.

"In summery regardles of where i am or what i am doing with the proper diagnoses of eptopic pacs/pvcs then i should ignore(to the best of my ability) the episode?"

The key is with the proper diagnosis.  You have to believe the diagnosis before you can do this and this can be very difficult for some people. I worry about people crippled by there symptoms.  It deeply affects the quality of life for some people, partly by the symptoms but partly by the fear of symptoms and the fear that they could die from them.

1. Since they are benin and pose no real threat in the short or long term then is it safe to assume that despite the frequency of said pacs/pvcs that normal activity(ie sports,exercise,sex etc) should not be avoided? I mean if i am playing basketball and a start having a episode of palps and i feel otherwise uneffected by them then should i continue to play?

If you are having the same symptoms as your usual PVCs/PACs, it is perfectly fine to keep playing.

I guess i can use this same question for pain medication, i have crohns disease and from time to time need pain meds but i am afraid to take them because they cause pacs/pvcs but should i just ignore the palps yet again?

People have different triggers for PVCs. If your trigger is pain medications, then you just have to weigh your desire to avoid symptoms from PVCs with the pain from crohns.

Thanks for your post.  Good luck!

[wmac]

I have been told the same thing who knows the right answer. But a month ago I had a stress test at the cardio office and I had two single pvcs and a couplet they did not make me stop so Im guessing unless you feel really bad that its ok to keep going. Im curious to see what the doc here has to say.
wmac

[Momto3]

I think the research you are referring to may have been done at the CCF by Dr. Michael Lauer.  Does this look familiar?

Frolkis JP, Pothier CE, Blackstone EH, Lauer MS. Frequent ventricular ectopy after exercise as a predictor of death [erratum appears in N Engl J Med 2003 Apr 10; 348(15):1508]. New England Journal of Medicine 2003 Feb 27;348(9):781-790.

The farthest back I can actually remember hearing anything about a "weird" heartbeat was when I was in my early 20's (48 now). The Dr. said I had the "heartbeat of a 70 year old man." When I asked what THAT meant, he said something about the way it sounded. Got similar reaction from my OB/GYN during pregnancy related physicals.  I don't think I really had a name for the strange beats till I was about 25 or so.  Over the years, they would wax and wane, but when they were ON, they were pretty frequent. In my late 30's until my early 40's, I was having a lot of pvcs, but I am not sure how many as I didn't ask for copies of reports back then.  Besides, they were benign...I was pretty much seeing a cardio for a leaky valve and periodically I'd ask about the pvcs cuz they were so frequent.

By mid 40's, I was having over 20000/day.  I didn't notice any change in the way they felt, or in their frequency, but this time I had a copy of the report.  That's the only reason I knew how many I was actually having.  So, I guess to answer your question...I'd say I was having thousands/day for years, but I don't know exactly how long.  I can't say there was a time when I was slammed with them...

Oddly enough, the CM didn't show up until a least a year after I had a holter that documented 22,000 pvcs in a 24 hour period. At that point, everything was still fine and I was just getting checked for the valve.  Despite the high numbers.

Hormonal fluctuations seem to play a role in pvc activity, at least for me.  Since the ablation though, their frequency is somewhat insignificant.

[momto3girls]

Wow, sometimes it's really so comforting to hear others who are suffering the same problems.  I definitely get pvc's during exercise, one time it was like a huge THUD and I thought for a minute someone had thrown something at my chest!  It never makes me stop, it's just an annoyance that I think, hey that was a pretty big one.  It's hard to ignore them when you're exercising though.  I agree with madgrad, if you've never had them before and them bam, you get them with exercise I'd be a little concerned.  I get mine whenever the heck they decide to show up!  I don't notice any food triggers or even caffeine.  Lots of times I'll exercise and not have any so who knows.  Most times I'll notice them at rest while dropping off to sleep or while sitting and relaxing.

It's so frustrating though to hear from the doctor you trust, "hey just relax, they're nothing" and when they happen you think, I'm going to go into an irregular rhythm.  I agree Oneil, you cannot sit around wasting your time being anxious.  I have a wonderful husband and 3 beautiful little girls to enjoy!  Life is good, even with life's little blips!!  Best wishes to you all!  You all make this forum such a great, insightful and assuring place to come to!  Have a great evening all (:

Loved your post skippybeat!

[Fran71]

oneil420 I LOVED the citation! We spend so much time trying to find out if we're at an increased risk of dying from our PVCs, even when we're told that the risk is 0. Even if the risk increase was slightly above 0, it would be so small that it would make no real difference. I'll try to follow Julius Caesar's teaching!

Madgrad92, great explanation! I think that's it. Those who exclusively get exercise-related PVCs  may have an increased risk of complications, though maybe it's just a slight increase.

Have a great day everyone

Fran (from Italy, the land of Julius Caesar!)

[madgrad92]

The only research I've EVER seen says that someone who does NOT have PVCs outside of exercise and suddenly GETS them before and after exercise is at greater risk, and that's only if the PVCs average over 7 a minute. Basically, if you have PVCs in AND out of exercise, there's no increased risk. It's only the people who never have a PVC who suddenly get them during exercise, and that doesn't sound like any of us here!! I'm sorry I have no documentation for you about that, but I do remember reading it somewhere. I actually read it a few times to make sure I understood it correctly.

momto3, I'm curious as to what your PVCs were like when they first started. At what point did they jump to the 20000 mark? I know you developed CM and had your PVC ablation, but did you have years of just occasional PVCs and then wham! they went up? Did you notice a huge increase during menopause (if you've been in menopause yet - sorry, don't know your age!)?

[Momto3]

Even with multifocal pvcs at 20000 per day, I had no exercise restrictions.  My doctors have always been OK with exercise and my pvcs...Generally, they slowed down during exercise and then resumed at rest.  Can't keep running though : )

Hope everyone is having a great day!!

[DebHasPVCs]

Does anyone notice a continued increase in PVCs hours after exercise?  My heart goes haywire with PVCs during exercise, and they don't subside until sometimes a day later.  I have heard recently that PVCs after exercise are extremely dangerous, but then it all goes back to, "They're benign, regardless."  I'm confused about the conflicting information.

[woodruff]

My doc told me they don't even regard garden-variety, unifocal pvcs as frequent until they're over 10,000 per day.  I run 4800 to 5000 at times, and everyone just snorts at that.

[madgrad92]

Anyone know how the doctors define "frequent" in terms of PVCs? My cardio has said to me before, "Call me if they become really frequent - we can always check you out again." How do most doctors define "frequent"? I know for some of us on the board, 200 PVCs in a day feels frequent, but as that is only about 0.2% of our heartbeats in a day, that can't be "frequent." Can anyone shed some light?

[tickertock]

I've had isolated PVCs before,during, and after an exercise stress test(Bruce). I also had isolated PVCs during the test with an heatrate at 170. I was monitored by the cardiologist performing the test who assured me that i could exercise with PVCs at that rate without any problems, also said I had an excellent test with excellent exercise tolerance,he also encouraged exercise even with PVCs. funny how in an emergency setting you dont feel that anxious about having PVCs at that high rate.

I have that found that your state of mind and anxiety can be worse than the PVCs themselves, but they are a real nuisance and frightening feeling to us who tend to feel everyone. Good luck to all. I have been luckily in the last 4 years not to have a bad episode PVC , only an occasional odd one now & then or a funny run of flutters and when I got my episodes they would last in the 1000s daily for months.

[madgrad92]

Great post, fellow PVC-er.

Looking forward to the doc's response. I know that exercise is so critical to keep all of us from getting too "keyed-up," so I know your question is relevant to a lot of people on here. I know that shortly into a run, IF I feel a PVC (not often, but sometimes), I think, "Should I stop?" My GP says yes, my cardio says no. I trust the cardio over the GP (sorry to any GPs out there!).

Just curious...what's your PVC/PAC frequency? Is it a daily thing for you, or do they "flare up" at times? Are you on any meds for them?

Great quote at the end - I'm a literature teacher; that quote has always struck me as SO true. We need to curb the anxiety - it's 90% of our problem. After all, if we got these things and had the attitude of, "Who cares???" none of us would be on this forum, would we?

Dyan