Multiple PVCs in a Row / When to Use Beta Blockers/Pregnancy

[Cathy]

A holter monitor showed that I experienced many PVCs over the course of a day, as well as several couplets and triplets. My internist recommends that I start a low dose (25mg) of beta blockers. I have a few questions:  1) Under what circumstances do you usually recommend beta blockers for patients with PVCs? Do you only recommend them when you see couplets and triplets (or more)?  What about PVCs in a normal heart vs. a heart damaged from a prior heart attack?  2) Is a 24-hr monitor enough to safely evaluate PVCs, or should I wear one for a longer period of time?
3) I would like to try to have a child (my first) next year. Are beta blockers safe to use during a pregnancy?
4) Which beta blocker will do the trick with the least amount of side effects?

Many thanks to all you doctors there at the Cleveland Clinic - this forum is great !

[CCF CARDIO MD - DLB]

I recommend beta blockers to all patients who have had a heart attack, regardless of whether they have PVCs. For patients with normal hearts, I do not recommend beta blockers for PVCs, unless the patient is extremely symptomatic and does not respond to lifestyle changes. A 24 hour monitor is sufficient for evaluation if you had the symptoms (that prompted the test) while you were wearing the monitor. Beta blockers have been used many times in pregnancy safely. However, they can have adverse effects on the developing fetus and can cause trouble to the fetus especially at delivery. Thus, I only recommend them if they are for treatment of a serious arrhythmia, not just for PVC control. I would not say one beta blocker is better than another, though certain patients find particular ones better.

[bernie martin]

i started having a rapid heart beat (100-120) when i was four months pregnant. i had a thyroid test and it was negative. i had a 2-d echo and showed my heart as healthy. i was diagnosed with sinus tachycardia. my cardiologist recommended that i take a low dosage of beta blockers but my ob-gyne objected stating that beta
blockers causes fetal death and iugr.i was therefore not given any medication but was put on observation.

i am now 33 weeks pregnant and is scheduled to deliver by c-section on march 18,2000. during my last cardio visit , my cardiologist said that she will put me on low dosage beta blockers two weeks before delivery and will pull me out right away. she said that the fetus has fully developed and it will do no harm to the baby.

can you give me some advice please regarding this.thanks.