Hello,
1. Could the PACs/PVCs be caused by a gastrointestinal problem?
I am intrigued that both posts today mention belching and
gasAdjustable gastric banding
Bacterial gastroenteritis
Barium enema
Blood gases
Blood gases test
Chagas disease
Culture of gastric tissue biopsy
Feeding tube insertion - gastrostomy
Gas - flatulence
Gastrectomy
Gastrectomy - series, but am still at a loss for the cause.
AtrialAtrial fibrillation/flutter
Atrial myxoma
Left atrial myxoma
Right atrial myxoma fibrillation during eating and while falling asleep is usually attibuted to vagus nerve or the parasympathetic nervous system. The vagus nerve is active during digestion.
2. Is it really safe to continue to run when it increases dramatically when I do?
Yes.
3. Why does it happen when I eat?
It could be increased activity of the vagus nerve.
4. Is there a procedure such as ablation that may work?
With the atrial fibrillation as infrequent as you describe, I don't think an ablation is the right option yet. If it becomes more frequent, you are a very good candidate for an atrial fib ablation. Pac ablations are difficult unless there is a single morphology (location) PAC that is easy to map.
5. Is this a trigger for A. Fib.?
It may be, but you will have to wait and see if it comes back.
It seems from my research that a cure for this appears to be ambigous. Is that the case?
The personalities that are drawn in to cardiology is one that likes to fix problems. There is no easy fix to pac/pvc's and think that frustrutes you and us alike.
There is some research into the origin of ectopic beats. Just last month in the heart rhythm society journal there is an article about neural crest cell migration and the origin of pvc/pac's. I do not think we are very close to a 'cure' yet. Ablations can help, but people have multiple morphologies and are difficult to treat with ablation.
I hope this helps. Thanks for posting.
Thanks, Tim
If they stay at the PAC level, they are absolutely harmless, but of course, may be difficult to ignore, especially when running. I have found that a focussed effort to ignore them, in particular, by avoiding pulse checking, carried out for several weeks (or months, patience!) will produce two beneficial effects: (1) anxiety will be reduced and (2) you will notice the 'skips' less. For me these two effects also resulted in less PACs. Easy to say, hard to do. In fact, it's extremely hard to do, but worth the effort. Remember, the reverse is true...that is, checking up on your pulse will train your nervous system to remain at high anxiety, which of course, will cause adrenaline levels to remain high, and result in more PACs.
After you have been checked out with a normal heart, get back to running and ignore the buggers!
-Arthur
I agree with previous post as to cause. The main thing that you will need to be concerned about is that they will develop into AFIB for Flutter. This is what happened to me. I woke up one morning with AFIB when I was 46. I then tried to treat it with meds for 3 years. It didn't work, so I got an ablation at Mayo 3 years ago. That did the trick. It not only stopped the AFIB but also the large amount of PAC's I would get during the day. Still get a few, but nothing like before. I continue to run at a modest rate. No more 8 to 10 milers, but 2 to 3 a day. Course I'm now 52.
The doctors stated at Mayo that runners are susceptible to this. Ironically my brother (a runner) just got Flutter and had it ablated successfully. Also a fellow track coach (former distance runner) just got diagnosed with AFIB after I hounded him to get his irregular heart beats diagnosed.
If they are PAC's/PVC'st I would do is simply try to relax about these things and not obsess about them. I know it is hard to do because you think something is dreadfully wrong. It isn't. They will ebb and flow.
But I would also monitor for AFIB; especially since you got this before. Also remember that if they do develop into AFIB for Flutter than an ablation is a cure (albeit expensive).
"No, not all PACs lead to afib. In some persons with atrial fibrillation the trigger is thought to be PACs but if everyone with PACs developed afib the whole planet would have afib. Only about 5% of the population develop afib in their lifetime."
Excellent advice Arthur about breaking the habit of checking your pulse. As if there was anything I could do about it if I did feel it happen! I am a little concerned about this being a trigger for A fib but I will chew that food when I have to.
As far as running goes, I am concerned that it increases the frequency and my heart rate tends to stay up longer post-run than it used to. I can still hit the gym without too much trouble but long sustained runs of 8 miles or more are out of the question for now. Writing this seems a little silly compared to some of the problems posted here. I wish I could help you all.
Again, thanks to all for your posts here. I will pray for each one of you for Gods blessing in your lives.
Tim
-Arthur
All my runs since my diagnosis have been "test" runs of various lengths and speeds. Short runs of moderate paces have had little effect afterward. But the runs of 6 miles or more or shorter runs at a quicker pace (6-7 minute miles) have caused me the most problems. Another curious note may be that my heart rate takes much longer to normalize than it used to before this started.
I hope this helps. Like I said before, I have put my running on hold for the most part until I can get some more answers. I am still having to tweek my medicine and have a few more test the cardiologists want to run. Best of luck with yours.
PAC's are benign and I still get them from time to time. However my EP says they come from another foci in my atrium but not in my pulmonary veins. He didn't ablate that area because it was too close to my AV node.
As to "structural abnormality" is the reason for AFIB; that is only half the truth. I have found that many GP's don't have a clue about these things. In fact my doctor (GP) had no idea about the different types of ablations. I was the first patient he ever had that received one. I went through nearly 3 days of tests at Mayo before my ablation, and my heart was structurally normal yet I developed AFIB.
But not everyone who gets PAC's gets AFIB. Everyone has PAC's/PVC's. But only 5 per cent develop AFIB. So basically the likelihood of you getting AFIB is 5 percent.
And the bad part is a therapist for anxiety cant really help because I actually have these things. Its not like its in my head.
Your situation sounds EXACTLY like mine. My husband has been hounding me for a beach vacation...I'm terrified to get out of my "safe zone" for fear that I will have an episode and be too far away from a hospital to get help. I'm most terrified about the 6 hour drive that consists of long stretches where you are in the middle of nowhere!
I have been dealing with this since I was about 18, with my worst episode happening last year after I gave birth. I have been to 3-4 cardiologists and they all have the same concensus...it's just one of those things. I understand it may be a small thing to some people, but it's extremely hard to deal with when you are constantly afraid you are going to drop dead.
For everyone out there, the only relief that I have gotten from this is by taking an anti-depressant/anti-anxiety. I HATE taking pills, but this has improved my life dramatically. They make me extremely sleepy ( I almost feel sedated a lot of the time) which may be why they help. I have already tried the beta-blockers with no success...some of them even felt as if they made it worse.
Maybe one day there will be a magical cure, until then.........
Good luck Carey, and I hope you make it to the beach and have a wonderful time!
I think you've got the idea. PACs are one thing, and PAF another, and it's generally difficult to generate a PAF. For many, they do start with bunches of PACs, but the wiring in your heart has to be amenable to keeping the abberant signals going for PAF/AF, and that seems to happen to very few folks (5%).
PACs, PAF and AF will not kill you, EVER. Aside from the nuisance, you WILL NOT DIE from these critters. So, I am not sure where the fear comes from. Having said that, because AF causes some of the blood to gurgle around in your atria for a while before being sent out, there's an increased chance of blood clot formation which is not good. But again, that's only if you're in AF. So stop worrying and enjoy life. "Dealing with it" is not to keep worrying, it's to ignore it!
-Arthur
I am concerned about my PVC's as they seem to be getting worse during exercise, something that I had always heard would be of concern. So far, an echo and stress test indicate all is fine...tomorrow I get a holter.
I hear people have them here and there (isolated). I have them continuously for hours (three faster beats, gap, three faster beats, gap....)
Do others have them continuously as well?
It really drives me crazy (scares me really bad)
The EP doc recommends magnesium if my stomach can take it. One interesting observation though...I enjoy wine (good for the heart, right?) Well, I haven't had a glass of wine for a couple of days and the PVC's have decreased....hmmm, this is gonna make me mad. :)
Anyway, I am still convinced that much of the PVC/PAC thing has to do with digestive stuff, but thought I would share my observations.
Steve
I am a 35 y/o male. About 9 years ago I had two years of what seemed to be SVT episodes resulting in multiple ER trips and subsequent anxiety counselling. They subsided by themselves over time and I have been symptom free for the past 9 years. 4 days ago I had sudden onset of PVCs and am getting about 3 or for every minute.
It has taken me back to the level of anxiety I had all those years ago but at least the DR (I went yesterday) could see these things on the EKG! (they never managed to catch my earlier SVTs). He ordered a Holter which i wore today for 24 hrs.
So - here I am - constant PVC beats and feeling totally down about it.
Interestingly I too belch a lot recently. I also have GERD. I wonder if they are related. Breathing and Belching does seem to influence my PVCs and I concur - checking your pulse often makes them worse.
I have a consultation with a Cardiologist to discuss my Holter results next Wednesday.
Let’s hope medical science gets to the bottom of these unpleasant things.
I take a beta blocker, (bisoprolol fumarate) plus low dose diazepam, (2.5 mg) for the anxiety this is causing me. I have been told to 'just take another b/blocker or more diazepam if it gets bad'!!
I am constantly tired - I think from the beta blocker - and am probably pretty well addicted to the diazepam now. I am so unhappy and confused because I have a wonderful family who are supportive but just cannot begin to comprehend how frightening this is for me. I don't like to travel as I get panicky when I am away from home - this from a woman who used to fly as an International Air stewardess!!!
Please can someone tell me what AFs PACs and PAFs are? Also AFIB? We are not really encouraged here in England to ask too many questions of our Consultants/Specialists and also I find when I am with them I am quite intimidated and feel like a fraud! (They can be quite patronising - ther there dear try not to worry' etc!! I have just had another overnight attack with my heart 'bumping about' and missing/putting in extra beats all the time. I get chest pains sometimes too and I am so so scared i am going to die. Sorry this is so long a post - but I am at the end of my tether and need to take this into my own hands now to try to come to terms and cope with this problem. I am not a wimp but feel like I have lost myself and my confidence over these years. Thank you so much if you have had patience to read this - I hope maybe someone could give me some suggestions/support/explanations/ANYTHING!!!!
much love to you all over the pond xx
I had PACs/PAF erupt about seven years ago (I am now 59). At that time, not knowing a thing about these critters, I was in fear for my life. I had checked into a hospital emergency room, and had the misfortune of having a cardiologist eager to plant pacemakers diagnose me. The experience started an anxiety binge which lasted roughly a year...I was even fearful of getting out of bed!
About 6 doctors later, which eventually brought me in contact with an experienced EP (electrophysiologist), I was diagnosed accurately with a PAF whose origins were clearly understood. An RF ablation procedure took care of the problem.
I still get PACs once in a while, and even an occassional PAF...but now I understand their origins and their prognosis. There's simply nothing to fear.
A premature atrial contraction (PAC) is an early beat of the heart which comes from a prematurely triggered signal from the atria (upper chambers of the heart). A PAC is often felt as a skipped beat, since the premature beat is hard to notice and the ensuing normal beat is extra heavy as it carries with it some extra blood volume. It is thought these are caused by isolated "islands" of hyper-active cardiac tissue...we all have these, it's just that some of us have these located near areas within the heart that can ellicit the premature beat. Then there is PAF...paroxysmal atrial fibrillation...which can be triggered by PACs. Atrial fibrillation is a condition wherein the atria continuously fire at a rapid pace, with only some of the firing being picked up by the lower chamber of the heart (ventricle) completing the beat..ergo, an irregular heart beat. This condition persists for as long as the atria keep firing ... for a paroxysmal case, they'll stop doing that on their own after a while. PACs and PAFs are of themselves not life-threatening. Fibrillation, if continued for too long, can result in blood clotting in the atria (since it pools there for a bit)...so, care should be taken during such an episode to take blood thinners, where even aspirin can help (here you need the advice of a cardiologist).
If all you have is basically PACs, then my advice is to get over the anxiety, as anxiety itself will precipitate further PACs by stimulating your nervous system. The single best trick I found to cure myself of this type of anxiety was to avoid measuring my pulse. The action of checking your pulse has a subtle but strong feedback effect on you nervous system, training it to worry about skipped beats. If you've got the courage to avoid checking, you'll see a remarkable change in just a few weeks (yes, weeks, as you have already trained yourself to remain in high anxiety, it will take time to break the habit).
Good luck.
-Arthur
I have suffered PVC's and PACs for almost 8 months - holter monitored at 1 per minute - but I know there were 2 - 3 per minute a lot of the time.
One week ago I went to see a naturopath who prescribed COQ10 plus other natural products to reduce toxins in the blood - the toxins cause the PVCs and PACs as they irritate the heart. Makes sense to me.
Within 6 days of taking what the Dr prescribed - all of the PVCs and PACs are totally gone and this is the first time they've let up since they started.
I was fed up enough to try anything and everything so that I could feel "normal" again. If you've been to your medical doctor to rule out heart disease, then try seeing a good doctor of naturopathic medicine. Mine spent 1 1/2 hrs testing me on my initial visit and I've never had a medical doctor give me more than 5 minutes!
Just thought I'd share this in case it helps another sufferer.