PVC - abnormality

[Dukvader]

Hello

I see many posts by people looking for reassurance when it comes to dealing with PVC's - Palps etc...... and the usual response from the Docs is these are benign and are nothing to worry about. I suppose most people feel the odd flutter however if you do experience regular occurences say 20,000 a day then this is most certainly abnormal.

I'm a 35 year old IT consultant and have done some research on the subject of PVC's and not all are harmless, I know from my own experiences!!

I was extremley fit in my 20s and was a member of the Royal Marines UK - unfortunatley an Arrhythmia ended my career - the rhythm started with the dreaded PVC's and resulted in my heart reaching between 250 - 300 bpm almost certainly kick started by a well timed PVC during excercise.

I've had numerous trips to the hospital to terminate my arrythmia by IV bolus or external defibrilation.
I decided to reluctantly go for the ICD option which has fired about 6 times so far in the space of a year to take me back to sinus.

All of my VT have been preceeded with PVCs during excercise. The docs reckon I have ARVC which is very strange as there is no familial history whatsoever.

Test have shown my right ventricle to be mildly dilated & systolic motion of the right ventricle is mildly abnormal.

Cardiologists seem to use the term ARVC very loosley when they know there's an arrhythmia that appears to originate from the RV - since there is no familial history -  is it therefore possible that my condition has been a result of stretching of the right ventricle during a high level of CV training? Could I have trained during a cold or flu virus that maybe attacked the myocardium causing the scarring thats casuing the electrical abnormality in my heart?
You thoughts would be appreciated.
Thanks!!!

[finetilthree]

You are a brilliant man.  Love your posts.

[arthur]

The connection between eating, digestion, stress, sudden movement, and other forms of physical stimulation, and arrhythmias (most notably, PACs and PVCs) is actually well understood.  The body relies on two types of ion-based signalling, namely, neuronal (your nervous system, which utilizes messenger molecules to relay a charge between neurons) and cardiac (which relies on building up an ionic charge along a series of cells, followed by a discharge, or depolarization, which results in muscle contraction).  One generally has nothing to do with the other, except that, the depolarization event occurs much more easily when there's neuronal activity in the neighborhood.

So, assuming focal signalling is the cause of a PAC or PVC (premature depolarizations within the cardiac tissue), the frequency of such depolarizations depends on the ease with which ions can find their way through cardiac tissue.  As far as I understand it, two things provide that ease...(1) sufficient space between muscle cells (the sort of thing that occurs with age, amount of use, disease) and (2) a heightened neuronal activity around the heart (which includes the vagus nerve, and a multitude of interconnected systems running around the cardiac sack).  The activities mentioned above all contribute to a heightened nervous system (translate as: lots of ionic charges moving between neurons), and will inevitably increase PAC and PVC production.

I hope this illuminates more than obfuscates.

-Arthur

[mitcheam44]

Thank you, for your information, and the reassurance.

[tickertock]

I had about 20-25 isolated PVCs during a stress test(BRUCE) in 2001,I was 36 at the time , I had the PVCs in all stages of the test resting, starting, maximum, cool down , I exercised for about 10 and a half minutes achieving 11METs. I had the test specifically for the PVCs at the time. The test was reported as completely normal with good exercise tolerance. The PVCs lasted in 1000s daily for about 5-6 months. I rarely have them anymore, unless I overeat, drink one too many beers, or lack sleep , even then I don't consider them that frequent though I can 10-20 in hour or sporadically throughout the day, then dont have anymore for a few days, I try to ignore them these days.

Another thought you might still be recovering from what you describe as a host medical problems, this can sometime trigger PVCs, especially when trying get back in shape. Good luck, hope you feel better soon & take it easy, go slow.

[mitcheam44]

I'm 26 years old 125 pounds female, (on a good day) and a clean medical history prior to a deployment to IRAQ in 2005.

Since I've been back, I had to get my tonsils removed, because they were  inflamed and scared, reasons unknown, migraines, sleep apnea, then, necrosis of my gallbladder (no stones), followed by a diagnosis of sphincter of oddi dysfunction, in return  giving me a episode of acute  pancreatitis, which was a risk of seeing whether or not I had that disorder.  Followed by another scope showing that I had acute gastritis. As you can imagine I was heavily medicated, until march of 07, I decided to get off all the drugs. Except one for anxiety. Now I have hard lumps in my veins, that feel like rocks, for the past two months, That only, I seem to be concerned with.

Anyway, back to the subject of PVC's I have recently started back up a work out routine, despite some lingering pain in my abdomen, that no military Doctors have an answer for.  

I am slowly getting back into it, mind you, nothing crazy, a couple of minutes
walking then a couple running, my rt. side of my chest begins to feel like there's a spear through it, and my heartbeats jumping back and forth.

I go to the Dr. on call, he sais it's normal during exercise for your heart rate to increase then decrease during exercise (I'm a med tech) not ignorant about how my body feels while I exercise, and knowing what my heart rate should and should not be doing. In other words I'm not retarded.

He told me he would order me a stress test for my own peace of mine, assuring me it would be 100% normal.

I got the results back, and they were like he said normal, at the top of the page,
but it showed that I had 8 PVC's.  Here's where I'm ignorant.  I have had no other testing of my heart done.  My primary care Dr. gave me the results after I asked for a copy, not explaining me the PVC's, she just told me that the bottom line is that my stress test was rated normal.

Any advice????

[wildcat27]

I'd also like to hear from you all about exercise inducing VT or other bad stuff.

Exercise, if anything, seems to really help get rid of my PACs/PVCs...almost like its helping my heart get rid of the bad electric impulses or whatever (no science behind that obviously).

I was a college football player...so I used to really get pushed to and beyond physical exersion limits. I NEVER had a cardiac issue back then at all.

Now, I very closely monitor my exercise. I keep my HR around 120-160 the whole time...I don't try to push it too hard...

But docs always say exercise is the best thing...so I am curious to hear others responses

[SillyHeart]

Dukvader, MANY people have reported the eating/PVC connection.  I've seen this reported again and again over my years on heart boards.  You for sure are not alone there.

[nikgirl28]

Yes this is interesting...I hear of people exercising quite abit and then go into cardia arrest...because the extreme strain it puts on the heart...I heard of a healthy 50 year old man jogging a mile every day and then just one day after a run he died because he was pushing himself too hard....
you hear of people that have eating disorders and exercising constantly and dying because their heart can't take it...
I was wondering though that if you exercise too much does that send your heart into VT...and possibly causing cardiac arrest...
VT really scares me because i get random run of my heart going fast...like for a minute and palps all the time...i'm sooo afraid of VT...because it is life threatening...
I don't know if age determines whether u have VT or not...like would u find out early in age if you have VT... like from exercising...

[Dukvader]

Cheers for your comments & good luck!!

[Carey01]

It would be great if you could post that same post over on the Dr's forum.  You can usually et through early in the mornings.  I woudl love to hear their response.  Good questions.

[wildcat27]

I agree 100% with the vagus nerve thing...all of my worst episodes have followed eating.

[tickertock]

Thanks for sharing your story and thanks for serving your country. I think it's like 1 in 33,000 that have frequent PVCs that is diagnosed with ARVC/D. There are minor criteria and major criteria for the Diagnosis, though its mostly found in the Italian Ethnic groups of persons, it can occur in anyone, its mostly genetic but can be idiopathic, I for one always believe moderation is the key when exercising and training and one should never overdo it.Good luck and best wishes.

[Dukvader]

Thanks for your response,

I beleive the PVC's i was experiencing all those years ago were only minor, I was becoming aware of my heart beating slightly irregular but nothing major - when I started getting periodic breathlessness during exercise i got suspicious that something wasn't quite right.

At first I experienced only short periods of non-sustained arrythmia, for example I would go for a 15 mile run - 1 mile in I would take a dizzy/breathless spell then it would pass, allowing me to complete the run!!!

Now if I even attempt any form of exercise without taking Sotalol I'm at risk from sustained dangerously fast VT. I've cut out all CV and mainly do upper body exercise to limit my bad experiences.
I also get round this by carefully timing my medication before exercise - 80mg sotalol two hours before is the optimum time. Not 80mg in the morning then 80mg as recommended by my doc although this would suffice for normal actvity without exercise.

I don't beleive PVC's can lead to CM, if you think about it, the heart is very robust - look how hard it works during intense exercise! Even continued thuding in the chest caused by PVC surely can't damage the heart can it?
In my  case I think a scarr or lack of myocardial heart cells on the RV block the normal conduction path causing the premature beat which then gets re-routed during exercise casuing re-entry.

I get PVC,s every minute of every day - I just try and soldier on although it does get you down from time to time.
Also regardless of what people think, i'm 200% convinced there is a real connection between Vagus nerve stimulation / eating and increased levels of PVC. I will not have anyone disagree because I know my own body, plain and simple!
Example - I will be on the road all day working and don't eat much until I get home, as soon as I eat an adequate meal the PVC's increase ten fold !!!!

I mentioned this to my EP and he agreed there is a connection but they can't explain this other than the Vagus is linked to heart ryhthm etc..... I have tried all the acid reducing pills for acid reflux etc.... to no avail. Also had my H. Pylori erradicated.

Also, i have read articles from Italian studies that beleive, some people for one reason or another have an inherent weakness of the heart tissue which will make you more prone to PVC / arrhythmia, especially if you have pushed your CV to the limits - which is what I did during commando training in the Royal Marines!!!
You never know!!!

[wildcat27]

Thanks for sharing your story. Can you offer any more info any how or why you think your "benign" PVCs eventually turned into something much more serious?

Others on this board have shared that it would take 20-30K PVCs a day, without let up for a very long period to create any type of CM.

Do the docs think your PVCs caused your ARVC? Or do they think that your PVC symptoms were simply much worse because you already had ARVC?

How often were you/are you having PVCs and does it/did it typically turn into VT?

Thanks...I am just curious about some of the details of your situation.

God Bless.