Multiple Bigeminys

[Barbara]

I have been getting runs of bigeminys lasting up to an hour all day long. They will start with a hard skip and continue. I do get a break in between, but lasting no more than half an hour. This has been going on for a month.  My cardiologist wants to put me on tambacor, .50mg twice a day.  I'm a little afraid to go on that pill. What is your opinion of tambacor?  I take atenolol now, .50mg a day ( cut in half twice a day.) Also I take avapro 150mg daily. Also I take synthroid .112mg.  Atenolol does nothing for me but slow my heart down.  I have been plagued with heart skips for 20 years.  Been through every test possible, and tried everything possible.  Nothing works.  I know I can't continue this way. It is leaving me paralyzed with fear.  Any suggestions?  Do you think I could wean myself off of the atenolol?  I have been taking it for many years.  Ablation is out, too many horror stories about that.  Do you think the slow heart beat (56 to 62) could be a culprit? I just want my life back, I'm so depressed.  Thanks for listening.  Barbara

[CCF-M.D.-RCJ]

Barbara,

Thanks for the post.

Q:"What is your opinion of tambacor?"

We frequently use flecainide (tambecor) for a variety of conditions.  It is a useful medicine when used correctly.

Q:"Any suggestions?"

Once a person gets to the point of "I know I can't continue this way. It is leaving me paralyzed with fear.", it is past time to seek help.  Many possible therapies exist, including medicines, learning coping skills, and ablation procedures.  You have to decide which bothers you more: the therapies or the palpitations.

Q:"Do you think I could wean myself off of the atenolol?"

You need to talk to your doctor about this possibility.

Q:"Do you think the slow heart beat (56 to 62) could be a culprit?"

It could be, but unlikely.

Q:" Ablation is out, too many horror stories about that"

The stories that you read on the internet tend to be extreme.  Many people benefit greatly from ablation.  It's at least worth discussing with your doctor.

Best of luck.

[dquenzer]

As someone who has had a similar experience there is no easy solution.  I can remember times where I would have a PAC every other beat for hours, then it would quit, and then it would go active again.  This lasted for quite some time.  However it did eventually subside.  I thought I would go crazy.

It sounds like you are very stressed.  I would suggest going to a psychiatrist.  I know for me I took anti-anxiety meds to start out with, and then I took some bio-feedback to help get me relaxed.  I was very stressed out by the PAC's like yourself.  Eventually they subsided to a tolerable rate. It sounds like your body is in a fight-flight mode.

Antiarrythmics may help, but not necessarily.  Atenolol did not do much for me.  In fact sometimes slowing the heart too much may increase PAC's.

I did eventually get an ablation for AFIB, which the PAC's developed into.  I'm doing much better, not perfect.  I still get some PAC's but not nearly as many.   I haven't had AFIB for some time.  It could come back at any time, but at least it would probably be treatable with meds or I could try another ablation. I can actually sleep at night which is a wonderful feeling.

I would listen to your cardiologist, but I would also deal with the mental side of it as well.  It will be interesting to see what the doc says.

[flip-flop]

I know how everyone feels...I have had PVC's since I was 20...with occasional bigeminy. I am 48 and still flip-flopping away. I hate it and coping is hard. I appreciate the coping tips very much. I previously posted at this site under the username heartdancer but had to re-register because the email address I registered with changed and I forgot my password and there was no way for them to email it to me. Hank it is great to see you posting again and feel free to email anytime...the email address you have for me is still correct...Hope all is well with you....flip-flop

[Clenn Camp]

I am 68 years old. I had ablation to eliminate afib nine weeks and two days ago and haven't had any afib since the procedure. I suffered with severe pvc's for thirty-five to forty years along with afib and separately as well.  I still am plagued with pvc's and some bigeminy throughout each day. Lots of bigeminy the past two days.  I noticed Pluto takes cozaar along with atenolol, 25 mgs four times daily.
I also take atenolol, 25 mgs twice daily. I notice that cozaar (what dosage?), and this dosage of atenolol has helped control your pvc's quite effectively.  Pluto what dosage(s) of atenolol were you taking and how often daily when it made your pvc's worse?  Also, does atenolol cause you to be fatigued?  It causes me lots of fatigue.  It doesn't slow my heartrate below 70 bpm as I have a twin-lead pacemaker.

I also am still taking 100 mgs of flecainide (Tambacor) as I was taking before my ablation and also 10 mgs of coumadin daily.
These PVC's are terrible. They prevent me from doing anything and going anywhere because many times I go somewhere and have to have help because they get so bad. I know exactly how Barbara feels as these things drive me up a wall.

The Dr. that did my ablation expects the pvc's to subside as my heart heals and he has told me to allow three to six months for my heart to heal and see what happens.  That does nothing as far as adjusting to the problem now.  I have been wearing a 30 day event monitor and all the tracings are not in the doctors hands yet.

Glenn

Glenn

[Clenn Camp]

I forgot to say that I also take 5 mg of Norvasc for labile hypertension.

Glenn

[pms_barbie]

I suffer from ventricular bigeminy myself.  Which drives me insane as hell.  I took tambocore it seemed like a miracle for about 2 months and then it didnt help  at all.  I do smoke which I know I need to stop.  So I dont know if my smoking eliminated the tambocore from my system faster or what.  I also tried an ablation but because I dont stay in bigem for days on end they couldnt find the spot causing the bigem.  However if they thought they could find it I would do it all over again.  Because Bigeminy really sucks and makes life hell.

[Gaspipe]

Hi know just how you feel and I posted a very similar question see archives on 3/22/04 {Gaspipe}. I bet you will get the same answers. I was on atenotol far years and when it no longer conrolled the PVCs went to flecainide {Tambacor}which stopped the Pvcs cold. Iam now off Tambacor and back to atenolol and back to PVCs. The decision you will likely need to make is if you can mentally tolerate the skips if not Tambacor will need to be considered. At present my solution is stay active and don,t sit there and take your pulse all day or you'll go crazy. Ive had the skips for 20 years and know how you feel.Keep your chin up stay active drink your Gatorade and don't look back. Iam with you

[Dr. Erik]

That would be a great discovery if Cozaar turned out to have an anti-arrhythmic effect. I'm curious to know if it was the magnesium, the Atenolol or the cozaar or all of these combined or just a coincidence. My cardiologist started me on Magnesium Oxide 400mg after my A-Fib episode two and a half years ago. I haven't had A-Fib since that time. However, my magnesium was a little low at the time of my A-Fib episode.  Glad your doing well.

Erik

[sheryl1945]

Forgive my ignorance...but what is bigeminy?  Hello to all...this is a great and helpful forum!

[Rocko1]

Hi Hank... Im new here.. really have benefited from your insight. Pvc's whether frequent or infrequent can be very disturbing. I know this isnt the right thread but i viewed with interest your views on nsvt.. of which im sure ive had a few bouts. With at least one of them a three beat run coming during heavy excersize. Anyway, in your view could a slightly weak heart, brought about by stress, heavy exercize and border hypertension along with a little too much to drink bring on pvc's all of a sudden? I had echos done, and ekg, and holter and a topnotch cardio said my heart was fine, with the echo report all showing normal with an ef of 60% In other words could it be between benign and something else? I know your not a doc but i do value your opinion. thank you

[Clenn Camp]

Pluto, in your above post addressed to me you described the kind of pvc's I have had in the past and am still having after my PVI in March. In fact I have them everyday. Sometimes I have to grab something or someone before 'hitting the floor'. Sometimes I have lighter ones and just just know I've had a pvc.  When they are in secession, one right after the other without any good beats in between them is rotten.  There's no way I can function.  It's 'down time' and there's nothing that can be done until I start having a good beat or two in between pvc's.  Then I also have some bigeminy as well.

You and another couple of persons are the only ones I can relate to that have these kind of pvc's.  I am reluctant to go anywhere by myself because they are so bad sometimes that I have to have some help.  I can't even walk very far, like a half mile, occassionally one mile, and not everyday.  It depends how furious the pvc's are.  Sometimes I go for days without being able to 'take a walk' and I get weak from sitting and laying around so much.

The EP that did my ablation in March for afib claims the pvc's will subside after my heart heals.  It's been over nine weeks since the ablation and I'm still having as many or more severe pvc's.

Oh well,   blah blah blah,  same old song, same old ver huh?

I wish there were some majic pill,.......

Glenn

[Clenn Camp]

I might also mention the EP that did my ablation said I had a lot of fibrous tissue in my heart.  Then after all the heart tests I have had performed, the cardiologists and EP's say there's nothing wrong with my heart, no underlying heart problems.

Kind of weird huh?

Glenn

[dewitt]

i had two ablations the 2nd one done in aug of 2003. i have very few episodes of a fib now and if i do have them it only last for a couple of minutes. i still get pac's or pvc's almost everyday but luckily they aren't debillitating. i think you have to give yourself at the least about 12 weeks before you can tell if the ablation helped. i know that it took me that long and the first 5 weks were absolutely miserable but then my tach's and premature beats slowly subsided. i also take 160mg of sotalol each day and i think that has helped, but i'm still looking for the magic formula to eliminate preemies. don't despair give yourself another few weeks. if need be maybe you will need another ablation. has anyone had any success with tikosyn for premature beats?

[pms_barbie]

Do you mean tykosyn for pvc?  I was given that but it didnt help a bit.  Its for aflutter or a fib or something of the sort.  I even spoke with Pfyzer they dont recommend using this medication for premature ventricular contractions. They said they had thought about trials with this medicine for that but because it has a ventricular pro arrythmia effect they didnt follow through with it.  That drug has the potential to cause a longqt interval.

[pms_barbie]

I have mvp so is that considered a structualy normal heart?  I have the thickened leaflets.  No one around here seems to think any of this is a big deal.  When I was tried on Sotalol I became bradycardic.  Heart rate of 47 up moving around.  I went to the cardio in tears and one of the cardios laughed in my face.  Pissed me off I justt wish one day he could walk around with these things and see how funny the are NOT.  Anyways the tambocor helped at first then it was like I was taking nothing.  There are just some times when I dont think I can handle any more of this ****.

[Clenn Camp]

Fibrous tissue is in the right and left atria.  They haven't ever said it was in the right ventricle, but that ventricle is the one that is having all the pvc's I have.  All the EP that did my ablation told me was people with fibrous tissue usually had a higher incidence of recurrence for afib.

Supplements I forgot to mention in earlier post that I take are 20 mg of phamaceutical grade potassium three times daily and 400 mg of magnesium oxide.  The cardiologist is supposed to call me tomorrow and tell me if he will okay or deny an increase of atenolol.  I'm willing to try most anything to get some relief from these dogged things.

Glenn

[glassheart46]

Just wanted you to know that my ablation was a success.  It was done six months ago for avnrt and trigeminies.  I have not had any tri's since.  It might be worth your while to look into seeing an EP doctor.

[pms_barbie]

Well its moderate to severe prolapse but only mild reg.  You mean I am not considered having valvular diease?  My mitral valve is the only valve that is even effected.  I asked the dr how thick it was.  He said they didnt measure the thickness.  So I had an echo last Monday so I watched the screen myself.  Honestly I am no dr but it didnt look like a whole lot to me.  I was expecting to see this really thick mitral valve.  With this great big bulging back into my atrium.  It looked like it buckled a little bit a couple of times but that was it.  Maybe a little thicker than normal but not what I expected.  They never said anything in my last echo about the chordae tendons or my mitral valve annulus being deformed or thick or anything.  I am still awaiting last Mondays report. The only other thing they said I had mild left ventricular chamber dialation.  It was 5.7 .  Why dont all drs have a set standard on their measurements?  On this board I read were 6 was still normal?  I had not atrial enlargement at all. I am just so confused about it all.  Can this mvp becausing my bigeminy.  Is it an electrical problem.  Or is it my smoking?  Oh God I need a life this is driving me nuts....lol Thanks for any help you can give Pluto or anyone else.

[Clenn Camp]

Hi Pluto,

Thanks for your comments.

I notice that you are taking 500 mg of magnesium oxide.  I have been taking a prescription of pharmaceutical grade of 400 mg of magnesium oxide and found out that one only absorbs approximately 4% of the mag oxide they take.  I have switched to magnesium CITRATE because it is more absorbable than the oxide is.  You will absorb a minimum of 30% mag citrate which is quite an increase of magnesium you actually get.

The test for mag, potassium, etc., levels is a Ionic or RED CELL MAGNESIUM TEST ..... but not done everywhere.  Tell your doctor you want it tested that way.

Good luck,
Glenn

[PMarlene]

You know, it really, really helps to know there are so many of you out there.  Sometimes you feel that you are all alone in this hell called PAC's, PVC's, bigeminals ETC.  I was on Quinidex Extentabs for 22 years and was very well maintained. Well, they quit making it so cardio put me on propafenone (rhythmal) 225 mg twice a day. I started having serious bronchial spasms and just could not breathe.  So after 7 months of treatment had to be put on Tambocor 50 mg twice a day.  I know some of you out there are scared of it but at least they have taken care of my skips so far and that is worth the risk to me.  I too, have had days that I just go to bed and stay there.  I am now 71 years old and want to at least live a normal few years I have left.  I cannot do that living with these skips.  My Electrophysiologist has been most helpful and seems to understand so much better than the stupid cardiologist who told me he never saw anyone die of the skips but sure has from the medication.  Very reassuring!  I was told that the bigeminals was a "pro-arythmia" caused by the Medication I was taking.  Anyway hope the tambocor works.  Thanks

[Tommygun]

Throw my hat into the stack as well. I'm a 29 year old male who has had the occasional bout of PVCs since I was twelve, until two weeks ago. I was using the "facilities" so to speak and they started, only this time my normal methods of stopping them (getting up, changing positions) had no effect. after a very long anxiety attack and trip to the ER they were diagnosed as focal point PVCs and I have had them non-stop now, every day since then. I am on Toprol, only 25 mg a day which definately helps with my anxiety but does not seem to affect the number of PVCs I get. Trying to cope is a struggle at best. It is good to see that I'm not alone in this battle.