PVC and Stomach Connection?

[agray100]

I have been experiencing what I believe are PVCs for at least 25 years.  I first noticed them in my very early 20s.  They are typical as described in other parts of this message board: a beat that feels like a thump in my chest with the next beat slightly delayed.  I found I could actually force them to occur by laying down on my right side.  For some reason, that position caused them to occur every few beats or so.  Changing positions would stop them.

I have has alarming episodes every few years.  I have had an EKG done during an episode and was reassured they are harmless.  I have had a holter monitor which apparently indicated nothing serious.  I am a bike rider.  I have not had a problem during a ride (although I have felt them), and a good hard ride will actually reduce or eliminate them for a time period.

I celebrated the new year with a cold in January and then another one in February.  The PVCs have started up again with a frequency I have not experienced in the past.  Some things I have noticed is that I get them much more when I am in a sitting position.  I get many more after eating.  I seem to have what feels like a gas bubble on and off in an area just behind the bottom of the left side of my rib cage.  Taking Pepcid or Maalox seems to help reduce the PVCs.  Likewise, taking ibuprofren or Tylonol seems to help temporarily.  The frequency of the PVCs appear to be related with the quantity and type of food I eat.  I am six feet and weigh about 170 lbs.

I wonder if anyone has had experience with a connection between PVCs and the stomach.  If so, are there specific tests I can ask my doctor to order or advise him about?  (As an aside, a trip to Mexico several years ago gave me some sort of horrible bug that gave me the same symptoms as morning sickness without the vomiting.  Three rounds of Flagyl were needed over the course of a year.  During that entire time period, I had no problems with PVCs.  I also had an upper endoscopy and an upper GI, both finding no problems.)  Is a hernia a possibility?  I would appreciate your thoughts and other sufferers' experience to guide me in how to handle the PVCs.  Thanks.

[CCF-M.D.-CRC]

Dear agray,

There are other postings on this site of individuals who have noticed a connection between GI and PVCs.  It is possible that gastric reflux could trigger PVCs as the esophagus lies immediately next to the heart but I have not seen anything in the medical literature concerning this.

[Barbara]

I just read your comment about PVC's.  I too am bothered terribly by this things.  The last couple of months have been bad.  From emergency room, to upper GI (reflux) to Thalium stress test, to holter monitor.  I get them in a series, hardly ever just one.  They last about 5 minutes.  When I had the holter monitor on, they said I had 295 in 24 hours, which was not enough to do anything about.  They have actually ruined my life where my husband said, "I think I lost my wife."  Hows that?  I have quit smoking, joined a gym, gave up chocolate, went for massages, went to counseling, read everything available on the subject including all heart forums, and even made a novena in church.  Nothing helps.  I had them today so bad and afterwards I burp sour, yet they say they're not coming from the stomach.  Go figure.  Thanks for listening.  My email address is ***@**** if you can figure out something else for me.  By the way I just took a teaspoon of maalox.  Barbara

[arthur]

Many "pvcs" or atrial premature beats (not premature ventricular contractions) are caused by pulmonary vein foci...check out the literature and postings within this forum.  These PV foci are generally located at the entrance to the back of the heart or a bit further removed.  They are composed of cardiac tissue (acting as a sleeve to the vein) that contain cell types that simply fire off signals in a somewhat irregular pattern...some of which are picked up by the atria and end up causing the heart to "skip" a beat, or more accurately, undergo a premature atrial depolarization.  When they lead to persistent arrhythmia (like AF) they are treated (ablation)...when they only cause "skips" they are left undtreated...the reason being, that today's technology does not permit the ablation of these foci unless there is a benefit which outweighs the risk.

Given their location...back of the heart, it's entirely possible that any persistent irritation near that area will trigger their activity.

[Addie]

I just posted something to Arthur in an above e-mail when i saw this post.

AG,  YES..I truly feel there is a connection between the Espohagus and stomach and also the Respiratory area, i.e. phaynyx,larnyx, etc.

I had the upper EGD in November after having Reflux and heartburn for over a year.  (did not have PAC's during this time)

Biopsies showed no cancer or pre-cancer but they did see a small stricture in the espohagus caused by one year of reflux.  They balooned this stricture. (so they said) New GI Doc said she thinks it is still there.

AG, I did find a very good article a few months back on the connection but have lost this article.  It was written 10-15 years ago. BUT, a Baylor Doc told me once that Reflux can get into the airways and cause havoc and chain reactions. At that time, I was not having PAC's so I never asked about "heart related".

When, I asked the nurse (RN) at the Cardio's office the other day, she was unaware of the connection but she said that anything is possible being all so close together.

I mentioned this to the heart doc 3 weeks ago and he asked for the name of the GI doc for his files? or does he know something?

In the upper post to Arthur, I mentioned that these "monsters" started in March.  I also in March, tore the Meniscus Ligament in my right knee and developed a Horrible Upper respiratory Virus (GOT RSV from the baby) that has now landed in my chest. I got off the Prilosec and my Estrogen patch and Synthroid and Paxil, thinking one of these is causing the PAC's.  No luck.  I am back on everything except the Prilosec(been on this much too long)and decided enough is enough.  My PAC's are all day.  Some hours they are continuous with no relief and I fee very light headed.  

The doc who at first told me not to worry about them is now wanting me on Zebeta. Have yet to pick this up as I am also on an antibiotic and Advair Inhalers and a cough syrup and worry about mixing all these meds together.

Babara, I too am saying Novena's, etc. etc.  No such help yet :-)

I find that belching can trigger a few.  I find that coughing can trigger a few. But, it is the ones that do not stop that drive me crazy and occur right out of the blue.

Arthur, you seem to be very knowledgeable in this area.
What is AF, that you mentioned?  Do PAC's cause AF? I read where you mentioned that they do ablation for AF's and not PAC's. If a *pulmonary vein* is the cause of PAC's/PVC's, is there something wrong with the breathing aparatus, i.e bronchials, lungs?

My cardio doc said my PAC's are in the upper chamber of the heart and are benign.  There were numerous PAC's indicated in a 24 hour monitor.  

As, I am typing this, the "monsters" are really kicking..  Not funny anymore.

Perhaps, by more talking about these, we may come up with the answers that the docs do not have.

My Best too All suffering.

[arthur]

AF can be caused by PV foci and more evidence is accumulating that perhaps a majority of AF conditions are caused by these foci.  AF is a atrial arrhythmia which is completely irregular and can be quite frightening.  It is characterized by the atria beating rapidly, too rapidly for the ventrical to pick up the signal correctly, which results in the ventrical beating at it's own rhythm...this situation tends to have blood swirling around in the atria that is not pushed out often enough by the ventrical.  The end result is lightheadedness and an increased chance of forming clots in the atria.  

If you are having lots of premature beats, it may sometimes feel like AF is starting up...just check your pulse carefully to make sure that there is a background rhythym that's regular, even when every other beat is a "skip".  If so, then it's premature beats and not something worse.  If they feel rather irregular, typically with pronounced pauses, beating fast, beating slow, then it may be AF like.  

Although AF is not life-threatening in itself, it does need treatment...meds and ep evaluation.  I understand that a high frequency of PACs may be a sufficient reason to consider albation, especially if you are feeling lightheaded.  Doctors tend to treat a situation when the patient can point out a clear symptom (or presentation).

[Bruce]

Greetings to all:  I'm new to this Board, but have greatly enjoyed the comments by other PAC sufferers.  Briefly, I've been diagnosed since I was 11 with PAT.  It essentially controlled my life--decisions I made always considered my heart "problem."  Several years ago, beta blockers gave me a new lease.  Blocadren controlled my frequent episodes of PAT.  

Still, I had enough episodes that I was frightened of getting outside my comfort zone.  I travel a lot for my work, so it would be very frightening and unsettling at times.  

Last March, I underwent an EP study; the doc was certain I had a re-entry problem that he could ablate.  Going off the meds was the hardest thing I've ever done.  Ironically, when he tried to stimulate the arrythmia during the study, he couldn't do it.  So I was back to square one.

About 8 months ago, I started having episodes of PACs that the beta blockers seemed to have no effect on.  They seemed particularly severe a few hours after drinking wine.  Eventually, they went away, only to return a couple weeks later.  Now, they're present all the time, sometimes as many as 15-20 per minute.  They've robbed me of my concentration, my confidence, my happiness.  I'm a nervous wreck.  I've given up alcohol, caffeine, chocolate, but no noticeable improvement.

To your questions on the potential stomach connection, I too notice that they are sometimes worse when I eat (especially if I overeat).  I also notice that they sometimes dissipate when I take a Pepcid, or, sometimes, even just a couple ibuprofen.

I'm seeing my EP doc on June 1, and pray that he can prescribe something to help me get my life and my sanity back.  I would appreciate any responses.

Bruce

[Addie]

Bruce, go to the gatroenterology site and there is various posts about this connection.  You may have to scroll a ways back but there was one fellow posting a lot on this.  

The vagus nerve travels from the heart to the tummy.  I firmly believe this may be my culprit....I am NOT a doctor... just a sufferer.  You may want to consult with a GOOD Gastroenterologist who may be able to shed some light on this.  Often times, I was told, that people have reflux and are not aware of this.  

I also want to share a story that I recently heard.  A lady who for 20 years had PAC's/PVC's and went from heart doc to heart doc.  She also though, had some throat pain, that at times was worse when she ate and drank liquids.  A neurologist figured she had a condition called Glossophyngeal Neuralgia and this is, I believe, the 9th Cranial nerve (Glosso Nerve) and sits right by the Vagus nerve, which is the 10th cranial nerve. Everytime the 9th nerve would act up, it would set off the 10th nerve (vagus nerve) causing these irractic heart beats.  Once she had surgery, (MVD with a Very good Neurosurgeon) her heart PAC's/Palpitations left.

One never knows until you hear different stories.

Good Luck.

[Bruce]

Macy:  Thanks for responding to my message.  As I had been reading over many posts on this site, I came across one (which I haven't been able to locate since)that talked about the PAC/PVC acid reflux connection.  The poster suggested that a radical reduction in acidic foods, and a general change of diet, would eradicate the beats.  He also said to take a Pepcid in the a.m. and one in the p.m.  As I mentioned in an earlier post,I was having PACs/PVCs to the tune of 7 or 8 per minute, off and on for weeks on end.

I looked seriously at my diet and cut out any acids, including my daily cup of decaf.  I cut out all alcohol intake.  I followed any acid-reduction path I could think of.  Within 24 hours, the beats subsided, and within 72 hours, they were almost completely gone.  That was a week ago.  I'm maintaining my new diet and, thus far, I'm cautiously optimistic that I can be free of these, at least most of the time.

I feel like I have a new lease, however premature it might seem to say so.  I'm just thankful to be rid of these for the meantime.  

If any of you sufferers haven't tried this approach, it might be worthwhile.  Give it a shot!

Bruce

[SGC]

I finally found a site that seems to connect with what I have been experiencing.  I am 35 and was diagnosed with an irregular atrial premature beat when I was about 22.  I am a complete ski bum (winter of course) and now ride my bike 3 times a week -at least 10 miles each trip.  My arrythmias have only burdened me once while exercising.  The doctors said it was harmless and brought on by stress. Occassionally over the years (usually about 1 time a year) my heart will just take off - tachycardia - supposedly in my case harmless.  It begins beating so fast that I can hardly catch my breath, can't even take one step and have to stay/sit in the position I am in for approximately 15 minutes until it just mysteriously vanishes.  My mother who is 62 has had this for years and was diagnosed with PAT years and years ago and also told it was harmless but annoying.  It is, however, terrifying when it happens and I feel like I am having a heart attack.  I haven't had one of these episodes in over a year but have had some "other" annoying arrythmias that seem to always accompany indigestion, heartburn and the reflux of acid in my stomach.  In fact, on many occassions I have given my chest a little pat thinking I just need to burp. I too, try to keep Pepsid on hand at all times.  When my cardiology originally gave me a work up years ago, he too, said the vagus nerve was the culprit.  Since some of these gastrointestinal nerves lay so closely to the vagus - I am convinced their is a connection.  I had a completely different feeling episode that awoke we several nights ago and lasted about an hour.  It was slower than my normal tachycardia take-offs and felt as those someone was plucking a nerve in my heart area.  It scared me to death!  I have felt my heart "try to take off" since but it only lasts a second or two.  I keep dreading another occurance though.  I FINALLY made an appointment with a Cardiologist on May 17th and will bring all of this up (since it's not just me - ha).  I will post whatever information I find out asap.  Maybe he can help all of us - cross your fingers!  Hang in there.

[Pollywogge]

I have suffered with PVC's for many years.  I have realized that stress is a MAJOR contributing factor for me.  However, ironically, I also ALWAYS have them every time that I initially lie down in bed after being up and walking around.  This is majorly annoying since I suffer from overactive bladder and am up a lot during the night.  

Is there any guidance to offer whether or not the resting PVC's indicate any condition particularly?  I have worn a halter a few times and had a stress test a few years ago and my doctor said they were benign - I still am very concerned however since heart disease is very prevelant in my family.

Any advice would be appreciated.  

Thanks.

[arthur]

That annoying feeling at the back of your heart, which seems to be a twitter or nervous sensation, that seems to be related to the onset of PACs and other atrial arrhythmias, that seems to be triggered by sudden physical activity or maybe even after eating too much, perhaps even felt upon waking from a particularly vivid dream... and sometimes even feeling like a quick and erratic pulsation while the heart beats normally...

That feeling, which most cardios are surprised that some of us can feel, is very likely a pulmonary vein focus or foci actively engaged in firing off electrical signals, some of which reach the atria of the heart and cause a premature beat.  Often, these foci, which are located at the connection of the PVs to the back of the heart, can be treated using ablation technology.  Not all cardiologists are familiar with this presentation or its treatment.  I would strongly recommend seeing an electrophysiologist (cardiologist with a specialty in arrhythmias), since a PV focus-generated atrial arrhythmia is one of the few that has a very good chance of being completely curable.

Good Luck.

[boq2]

I too have sensed the connection between gas and other GI symptoms and my palpitations.  I am 46 years old and mine started about 1 year ago.  I noticed them really increasing when I started taking Sam-e, which is a natural mood elevator, but in thinking back, these pills upset my stomach and caused gas, which may have had more to do with it.  After I quit the pills, I still would get them and some nights (they are much worse at night) I would feel gas moving in my stomach and the palpitations would start, sometimes trigeminy or bigeminy (every 2nd or 3rd beat, very regular)  I have been taking Mylanta anti gas every night and this seems to help some.  

I have also reduced most caffeine and alcohol.  There are occasions in the middle of the night in which I will get up to go to the bathroom and after standing and walking to the bathroom, my heart beats very hard (not fast, just hard), it subsides when I get back to bed, but the palpitations start during these periods and keep me awake for awhile.  I have also noticed that sitting after eating and having a tight belt or pants seems to increase them.  There really must be a connection with the vagus nerve, and with all of the people who have this type of complaint, you would think there would be more information out there that would prove this connection.

I would be very interested in hearing from others who have this similar problem.

[arthur]

The gas thing...triggering skips, and the tight belt thing...triggering skips...these are definitely being triggered by pressure on the PV foci.  Although the mechanism is not clear, it is supposed that the change in local pressure and geometry around the PVs seems to change the degree of signal transmission between those PV foci and the atria of the heart....thus, there is this loose relationship between odd physical states and the observation of "skips".  The vagus nerve system is often pointed to as the culprit since it runs near everything else...however, the vagus nerve system really doesn't do much beyond a general control of heart rate.  Nervous "irritation" brought about by GI problems probably irritates the PVs more than the vagus.  Check out the anatomy...those PVs sit behind the heart and on top of the stomach.

If the bigeminies and trigeminies are a real problem, ie, they are really persistent, check out your situation with an electrophysiologist (cardiologist specializing in arrhythmias).
There may be sufficient symptomology to go in and toast the source of those skips.  In addition, there are drugs available which make the atria less sensitive to outside noise (like the PV foci).

Good Luck!

[boq2]

Arthur, thank you for your comments.  I had not been familiar with the PV foci, so I went back and read some of the posts on the subject.  Do the foci trigger PVC's also or just PAC's, since they stimulate the atria?  I believe that my episodes of "regular irregularity" that occur with Trigeminy are PVC's and not PAC's.  I did have a 24hr holter monitor and the Cardiologist said that I was having predominantly PVC's. (This is the only diagnostic test I have had).   Either way, now that I think about it, they seem to always be triggered by the same types of physical mechanism, whether it is pressure, gas, heartburn, etc.  

I too have been and am very active physically (running, basketball, softball, golf etc) and was afraid that if this was all cardiac related, my sports days were over.  Thankfully this does not seem to be the case.  Mine really seem to be relieved by watching what and when I eat and drink.  If I can control them this way, then I'll hold off looking into ablation for now.

Thanks.

[arthur]

PV foci are generally responsible for atrial arrhythmias, since the PVs are attached to the atria, and the foci tend to show up anywhere between the inside of the atria to some distance along the PV.  I was under the impression that bigeminies and trigeminies were atrial premature beats and not PVCs...did your Holter monitor actual record these more complex arrhythmias as PVCs?  Everyone gets some of both PACs and PVCs, and it might be that you caught some PVCs on the Holter that have nothing to do with the bi- and tri- stuff.

[boq2]

The terms Ventricular Bigeminy, V-Trigeminy and V-Quadrigeminy all refer to dysrhythmias that originate in the Ventricles.  I am not aware of Atrial versions of the same that are actually in the form of a "regular irregularity" such as these.  Some of the atrial varieties as I understand them are; PAC's, atrial tachycardia, paroxysmal atrial tachycardia (PAT), etc.  

To be honest, the holter did not show any of the bi's, tri's or quad's, because I had the holter during a very "light" 24 hr period, but I have felt these at times since, and have just assumed they are PVC's due to their distinctive pattern and my history of PVC's on the holter.  I have read of others who have thousands of PVC's in a day and I assume that these types of rhythm disturbances must be occuring in them to amount to that quantity.  If my heart rate were 60 and I was in Ventricular Trigeminy, I would be having 28,800 PVC's a day. (My episodes have only been for 5-10 minutes, so I have had nowhere near that many, but some folks may have episodes of these dysrhythmias for longer periods throughout the day, and thus their total PVC's in the thousands).  

Either way, whether my "skipped beats" are Ventricular or Atrial, I still see the association with the GI symptoms, now whether that is the PV foci or not, I am not sure.  If I see my Cardiologist again, I'll have to ask him about that.

[Curley]

I am a 45 year old female who has been dealing with palpitations for many years now. Have had every test known to mankind as far as cardiac is concerned. I, over a few years, have had....READY FOR THIS......numerous ekg's, holter monitor, dobutamine stress echo, echocardiogram, blood work-up, treadmill test, and thallium stress test. Went to a well known cardiologist...he taught cardiology at a famous hospital for 27 years...so the man knows what he's talking about. All of these tests are normal and I still am worried about having something wrong with my heart. I have also been told that what I suffer from are panic attacks. Numerous docs have told me that. These are docs from different hospitals, not the same hospital.

I also suffer from GERD, which I've noticed at times, when my stomach pit is upset I seem to have palpitations or a feeling that my heart is flopping around. Does anyone out there suffer from what I experience?????????????? I would absolutely love to hear from anyone that does. Am I just worrying toooooo much or what?????????????

Please email me with some honesty. Am anxiously awaiting to hear from you.

My email is ***@****

Thanks sooooooooo much and have a great day!!!!!!

[Rambo]

I am a well educated male over 50  who has had palpitations since age 15 and later in life some arrythmias.   I went though boot camp, vietnam, skydiving, scuba diving, flying with little problem.   I had a lot of confidence in myself in those days.    Since I started working in corporate america with layoffs and treatment by the corporate human resource departments as though I am just a nobody number, my stress level has increased and my confidence in myself has been beat to death.   When I get stressed like this I get in the fight or flight mood.  My stomach tightens up and I get palpitations and some arrythmia instead of getting a migraine headaches like some [Yes I am a type A]    The few times when I had a migraine headache, my stomach/esophogus palpitation problem disappeared because one stress substitues for the other but again the headaches was a killer.  

Read my lips:  When I get anxious and my stomach or esophogus tightens up gerd or otherwise, I get irregular hear beats. Prolonged stress such as bad bosses, job insecurity, long work days, 4 hours of sleeps will build up nerveous energy that can lead to irritation of the stomach and resulting area.   This irritates the atrium, increase  adrenaline and changes the hypersensitivity of the hearts electrical system, vagus nerves, foci surronding the heart.   Call it a heart migraine.  Coffee and chocolate can do the same thing for the same reason in some people.  They change the eletrical conduction of the heart.  

Most doctors have no clue to what is happening even though hundreds of people on this site and 30 percent in a hospitals cardiac wards are complaining of similar palpitations and arrythmias.  

I used describe my symptoms to doctors in great detail and nobody listened.   They all tried to downplay the effect of stomach/esophous/gerd issues. If I analyzed problems like that on my job they would fire me in a week. Some things do not have med school textbook answers but with HMOs, who is going take the time to loo?   I am presently doing my own research into this area on my own and not relying on the medical profession.

If you are slightly depressed sometimes symptoms are taken out on you bodilly organs to prevent your mind from taking the brunt of the stress.   For istance a death in the family or other troubles in life.   In this case the solution may be an anti-depressant medication, watch your eating, lose some weight, get more sleep change your attitude on life issues.

[Desert paddler]

Yikes, hearing all these stories was like hearing my self talk to my doctor. I too have had a very stressfull last 4 years, multiple deaths in family, hight stress, had chest pains and constant heart burn all  the time. I finally found a great clinic in santa barbara california, the sansum clinic, and found that almost all the problems that I was complaining about, that were being responded to by numerous doctors with the advice, calm down cut out caffeine, deal with your stress, etc.
After extensive tests I found out I had a hiatal hernia, umbelical hernia, and had both shoulders operated on for torn rotator cuffs.(I'm in commercial electrical construction, I  killed my body with over lifting and very heavy carrying)
Since the shoulder surgeries were done,  the chest pains went away,  now with the prilosec, the burning sensations are gone, but now, the only thing left is the constant frightening pvc's.
Im changing my life style, how and when I eat,(used to always eat just before bed due to busy schedual's.
Im  working on the pvcs, with thalium tests and echocardio gram.
the acid relux and pvc's are definitlyy connected for me, though never thought to mention to doc, will mention it next visit.
thanx for the great info, I thought I was the only one, with those damn pvcs, they scare the day lights out of me. Tired of hearing the phrase, "the pvc's are normal , their harmless, lower your stress level"
thanx for all the info folks.

[MrWest]

Hi to everybody,

I am also one of the few who believed to be the only one with sensations to do with the relationship of heart and stomach ... and no doctor believing me.
Well, I have been suffering with reflux oesophagitis for about 14 years (I am 38 years old). I had experienced PVCs first time 12 years ago. I definitely believe in a relationship. Everytime I get PVCs I also realise a substantial amount of stomach gas leaving in a natural way directly after the "attack".
Symptoms are less when I am rather stressed and get stronger when  I relax.
My conclusion is that the PVCs have to do with physical irritation combined with stress factors.
Physical irritation is caused by gas in the stomach, gas in the bowels, reflux acid and actually bending or folding of the body area just below the ribs (My symptoms actually started when I developed a "beer belly". This causes a folding of the "critical area" especially in a sitting postition. When I get up the are gets irritated once again. I also realized that my chest area is rather narrow in comparison to the belly. This increases the physical tension on the "critical area". Please give me input if anyone can support this theory. I started exercising now to get rid of the belly. Symptoms are slightly getting worse now but I think that this is the way it should be as I increase the irritation on the area by exercising.) Of course these physical irritations cause some neuroelectrical effects on vagus etc. but as I am not a doctor I could not identify these in detail. However, a lot has been said about this already at this place.
The second factor is stress. Due to a higher adrenaline somehow the sensitivity of the area is decreased. For example I am a musician and I also did skydiving. I never had symptoms on stage or in the air. Even drinking coffee and increasing the adrenaline by this can decrease the symptoms for me (but only for a while. They will come back stronger later.).

Once again thanks to everybody contributing to this as it helps to know not to be alone.

MrWest

[Panic Man]

YES!!! It's such a relief to know that I'm not crazy on this matter.  My heart goes into a funny rythm from time to time--only when I am hungry or am having gas and bloating in my stomach for some other reason.  It is never at any other time.  I can even press firmly just below my left ribs during these times and feel little "pops", which I suppose are gas bubbles bursting.  I had a cardiologist tell me that my stomach can in no way be affecting my heartbeat.  But after living with this for ten years, I felt sure that there must be a connection.  Thanks to this site, I am relieved to know that I am correct.

[DSTEPHENS]

has anyone heard of a same connection and palpitations?

[brownbomber]

A related discussion, g.i. symptoms triggering hbp and arrhythmias was started.