PV foci and internal (infernal) quivering

[arthur]

I have been diagnosed and successfully treated for PAF triggered by PV foci.  Ablation left several such foci behind which were deemed as only triggering occassional PACs.  In my case these PACs occur at 0-5/min (normal HR 40-50 bpm)...so at times, they can be quite annoying.  Associated with these PACs and felt much of the time, is an internal quivering sensation, not caused by PACs, at times, almost palpable.  It is located at or near the atria (judged by previous flutter feelings associated with AF).  These quiverings occur at a frequency greater than 200 bpm and their amplitude appears to be modulated by physical activity (eg, sudden movement begets a period of 5-15 min of obvious quivering) , vivid dreams, or full stomach after eating.  All these events are the same events that classically trigger PACs due to PV foci.

My EP (and others I have talked to, including world famous Dr. Haissaguerre, France) have suggested that the quivering sensation is due to the foci and that, for some reason, I can feel their microscopic movement...Dr. H suggested that the epicardial neural system may be picking this up.  Interestingly, some others afflicted with PACs have made similar observations.  

So, assuming they are real, and we can feel them because there is a nervous sytem near the focus which somehow "amplifies" the signal....what can be done about it?  I have learned to largely ignore the PACs, however, being awaken at night repeatedly with this internal vibration is quite another matter. Is there a drug that can be used to interfere with the signalling (anti-cholinergic)

[egret]

I found your post interesting because I've also experienced the same thing.   What is also interesting is that I've found this "quivering" has been felt by other people who experience PACs.  Since I'm not a doctor, I do not know what causes it.  With the support of my PCP I'm currently getting treatment with Japanese Acupuncture.  I'm very hopeful about the treatments and so far I think I've gotten some relief.  It's good to finally have a doctor who looks at the body as a whole and is able to help me heal myself.  Perhaps you can discuss alternative treatments with your current doctor?  Good luck.

[Goodgal]

gee Wilson-wilson--I think we all know why you suffer from palpatations. Perhaps a yoga class would do your aggrevation the world of good?? This forum is supposed to give you a sense of stress relief, but in your case I can imagine you getting of the computer in a lather of perspiration and suffering from adreniline overdose. Ease up buddy, for your hearts sake.

[wilson-wilson]

I didn't want my Yahoo Heart support group to become a "pity" party...

-OR

A support group where folks were saying, "My heart problems are worse than your heart problems!"

-AND

That's what it was becoming!  So I deleted it!

I'll tell you whose "heart problems" were worse than
-YOURS/OURS/THEIRS/HIS/HERS- all of ours put together!??

Those that -DIED- with "heart disease!"......

-REAL- Heart problems!

My Grandfather [that raised me] died on the operating table of a massive heart attack while having a "pace maker" inserted on November, 9th, 1974 at the age of 70.  My "biological" mother died of CHF at the age of 61 in 1990...Her last words were, "I can't breath"...and there was NOTHING anyone of us could do for her!

-THOSE,  were REAL heart problems!

-NOT, the arrythmias we experience!

I can not believe the ARROGANCE/NARCISSISM of people with nothing better to do than complain, "I may die because of ectopic beats!"

Then, "DO SOMTHING ABOUT THEM!"  -OR, quit the F--k complaing about them!

That's why I deleted it..........I didn't want NEGATIVES.........!  I wanted us to come together and "celebrate" our being "special"!

wilson-wilson

[arthur]

I agree with your sentiments completely...but there's always a "however"...

There are those who are new to the PAC/PVC family...and they don't know any better than to feel high anxiety.  It's just a natural human reaction to an unknown situation involving the center of the universe, their hearts.  So, I think you should forgive those "first-timers" (or should it be "first-mis-timers"?) as they can't help but be worried ... with time and information these things tend to iron themselves out.

Maybe you should start up a new Yahoo site devoted only to those with a sense of humor about the situation...maybe something like
"PACLAND", or maybe even "Frostbite Falls" (might have to watch for copyright infringement here).

Looking forward to more of your sardonic wit.

[wilson-wilson]

Arthur said:

"Hey...I tried to get on the Yahoo PAC_PVC group...I was told it does not exist...what gives?"
---------------------------------

I "deleted" it like I said I would in a couple of messages to the group, because:

I got tired of the "politically correct" B-ll S--t!  I'm surprised the Doc's here still answer question's from people that could look it up in the archives!  They are giving advise here for -FREE-!
Yes, I agree they want us to come to Cleveland Heart Clinic for "capital gains"...........BUT....What is wrong with -earning-money from what one knows the best!?

"Capitalism" is -NOT- a bad thing!  That's what FREEDOM and being an AMERICAN is all about!!!!!  How many people from the "UK" have found this site and said, "well ya know, we have "Hillary Clinton"<G> health care here and we are at the "whim" of that care!" [socialized medicine]

Tell me, when was the last time you ever heard of a person of -ANY- "means" [poor or otherwise] being turned down from hospital, or a Doctor's care??........[insert the theme to Jeopardy here] and the question is............"Alex, what is never!"

I tried to have a "group" that had a -sense of humor- about the serious nature of what we deal with daily.  Because if we -DO NOT- have a "sense of humor" about these things, then we will ALL die from "depression" over these things, and -NOT- the PVCs/PACs themselves!!

My, "I'm still not convinced of your existence" [sorry my agnostisism is coming out, I'd be a COMPLETE Atheist, but they don't have any holidays....-BUT, for those that believe in god...insert "god" between quotes]  do we all really want to live "forever?"  -AND, why should we go through life as "sour pusses?"

[Yada, Yada, Yada..[Oh did I just Yada, Yada, Yada god?]

wilson-wilson

PS. Doctor Dean Edell RULES!

"Eat, Drink and be Merry!"

[arthur]

wilson-wilson...
Hey...I tried to get on the Yahoo PAC_PVC group...I was told it does not exist...what gives?
fwilson...
After thinking about the "tone" thing, and the possibility of cross-talk, I am now unsure whether the internal vibes stem from the PV foci themselves or are some sensory nerves picking up vagal activity (due to the viral episode).  I do know that over these past 2.5 years, the perception of internal vibration has changed (from a slower rhythm ... 150-200 bpm, at times feeling like a second heart beating,  to a faster one...200-?).

I suppose the right people to engage are those in the nerve business, like the guys in the neurology forum.

[wilson-wilson]

egret {regret perhaps?}

I'm of the mind egret, if someone found a "REAL" cure for these PVCs/PACs, life as you know it would cease!
Because you -NEED- to have "drama" in your life to EXIST.....
I can hear you now to your friends, "oh poor pitiful me!"  My heart skips beats.....Boo, hoo hoo!"

I DO NOT say what I say to put the "spotlight" on -ME- as much as to say, "life is short, deal with it, and live it to the fullest till you die!!"  PVCs/PACs -WILL NOT- kill us......-AND- if they do.....oh well, something has too!

I do NOT care what you think I may be about.....but I do know where to find the REAL answers when I need them......-AND- those answers lie with the EXPERTS........-DOCTORS-!  -NOT- with those that -THINK- they know what is going on!!!!!!

Hence what I said to fwilson:  "just cause you have an illness DOES NOT make you an EXPERT!!!!!!!!!!!!!"  So put your "I'm all knowing god complex" up yer kazootie!

When fwilson, or anyone else can show me a "16-20" year academic degree.......I -MAY- listen......but til then, people like that should let other people know that what they are saying is "just there opinion" and NOTHING more!!!!!!!!

the person you like the least!
wilson-wilson!


wilson-wilson

[arthur]

Thanks for your advice and observation.  It indeed does seem that many suffer the same "mysterious" symptoms, perhaps many relegate the quivering feeling to "nerves" and anxiety.  But I think we know different.

Acupuncture has actually also been suggested to me by a cardiothoracic surgeon. I grant that the technique has the capacity to change nerve signal relationships throughout the body, and is basically an empirical approach that seems to work well for lots of folks.  Creating electrical noise in several junctions appears to re-route the way the mind perceives signals from other junctions.  Pretty cool stuff.  Please keep us posted on your progress.  You might want to check out the posts at groups.yahoo.com/group/PVC_PAC/ for other comments re. us skippers.

[egret]

Please just ignore the comment from wilson-wilson.  I've seen him do the same on other lists.  I'm not sure why he does it.

[wilson-wilson]

What a hypocrite you are!

LISTEN to the GOOD DOCTOR'S here on CCHF & Arthur....
and leave -YOUR- "god complex" at home!

wilson-wilson

That's all I wanted to say to you.

[arthur]

Of course, my first answer to my own post is gone...

Just to set the record straight (before this post disappears)...
the doctors here are doing a fine job.  It's just that some questions appear to be beyond their scope of experience and/or training...and that's just the way it is with leading edge observations/discoveries.  The reason my questions seem repetitive, is that I kept homing in on more precise detail in hopes that one of the staff would come to realize that my situation is somewhat unique and may require some research and discussion with peers before being answered.

[arthur]

I am located in NJ.  I am not sure that a differenct way of measuring the "quivering" will get us anywhere.  There are specialists (electromyographers?) who can use probes to measure a variety of muscular fasciculations, internal and external.  They likely would have equipment similar to the type you are proposing. Neurologists often quote the frequency of such presentations and correlate those frequencies to possible disease states. Their discussions would likely show up in the neurology forum.

It's true, I would like to know exactly what is quivering.  My pet thought at this moment is that it's actually the outer portion of the heart muscle (where the epicardial neural system lives) undergoing miniscule movement.  It's also possible that I (or we) are sensitive enough to notice the PV focus twitering away...and that would be much harder to pick up from the outside.
I have noticed that, in the past, when the quivering was more like 150-200 bpm, that when I pressed on my lower abdomen to provide pressure up into the diaphragm, the quivering would present itself as tiny deflections (puffs) in my exhalation.  This would suggest a location at or near the back of the heart where it presses up against the lungs.

You might review the web and the forum to see what it is that these EMs actually measure and how.

-Arthur

[CGTMHI]

I don't mean to tread on your thread here, but I think you missed something.  There already is a database of all the questions and answers from this board. It can be found by clicking on the ARCHIVE button near the top of the page.

As for the complaining that both Arthur & Fwilson are doing...
Please don't let them bother you, CCF doctors!  There are many of us "silent" types who have been helped immensely by your answers!!!  Don't let the few spoil it for the many!

I hope other "silent types" will speak up in support of this tremendous FREE service!!

Viera

[CCF-M.D.-CRC]

Dear Arthur,
Antiarrhythmic drugs that suppress ectopic foci or a repeat ablation procedure would be two options.  The next best step is up to you and your EP doctor. Best wishes.