PVC during recovery after tredmill increases suden death?

[juuliuuz]

Hello, I suffer from anxiety and panic disorder, MVP, I think my panic and anxiety are due to heart problems such as PVC's, PAC's etc.I have done lots of EKG, ECHO's, blood works. Doctors never sent me to do Stress test, or never monitored with Holter monitor. I know anxiety makes heart arythmias etc.But I have read one article which made me more anxious: Can someone explain this?Does it mean that if I have PVC during excercise or while resting and after excercise I m in increased mortality rate?PVCs during exercise were associated with increased mortality rates only if accompanied by PVCs after exercise. But "similar to previous
findings in clinical cohorts . . . recovery PVCs were robustly associated with adverse prognosis regardless of the presence of PVCs during exercise. My English is not the first the first language, so I didnt understod this artical. I do experience PVC's at rest time, they do increase when I excercise and as well when I finish the ecxcercise (recovery) . Hope somone can reply to me. Hoppe u understand, sorry for any mistakes.Thanks

[juuliuuz]

I think I ll just relax :) And ill try to forget about my PVC'S.I do suffer from panic disorder so ...  PVC'S are scary, I cant understand how other people cant feel them?Anyway thanks to your reply.Wish you best luck!

[Mom2four85]

There's alot of info in that article; the study had several important limitations that we would probably expect from the patients in this study; such as the study population was composed almost entirely of older men.  

As we age our bodies lose part of the normal functioning and some of the results can be attributed to normal aging. Also, they did not have the data on left ventricular systolic function, which could be an important factor.  According to this article - http://emedicine.medscape.com/article/761148-followup

"Left ventricular dysfunction has a stronger association with increased mortality rate than do PVCs. Many now believe that PVCs reflect the severity of heart disease rather than contribute to arrhythmogenesis."

One big thing I question is their exercise protocol did not include a cool-down walk; so I'm not sure what that would mean for testing this way.  

I would like to see a broader based patient study on this; because this does raise alot of questions about pvc's; exercise and recovery pvc's.  (I failed my stress test miserably and had pvc couplets during the test and a triplet in recovery phase)

[juuliuuz]

So I don't get this study, does it really increase or not? NP :)

[Mom2four85]

http://archinte.ama-assn.org/cgi/content/full/168/2/225?maxtoshow=&hits=10&RESULTFORMAT=&fulltext=Recovery+PVCs+During+Treadmill+Testing+Tied+to+Heart+Disease&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT

I think I found it =)  I skimmed but can't find the ages of the people in the study

[Mom2four85]

thanks for posting that from Medscape - very interesting and I found the link for the article - I wish I could find the study done I'd like to read about it.

http://www.medscape.com/viewarticle/571891

[juuliuuz]

Thanks for reply :)
Here is the actual video about it: http://www.youtube.com/watch?v=OiJSOy7Mjrg&feature=related

I went to my GP, he booked me for 24 hour monitor. Hope everything will be OK.

[sgately11]

I read that study. It basically says exercise induced PVC's how little prognostic value and or of little concern, and post recovery PVC's are more sinister. Who knows, it really does depend on the audience, I think these guys were vets or had suspected heart disease. Also you are young, and you are reading reports on folks that are probably middle aged, which is a huge difference.

If you have anticipatory panic, you will most likely get a pvc when exercising. Your expecting it to happen and it does, I get the same thing. Its hard not to worry when your body throws crazy physical feelings but at your age you should have very little to worry about. If your echo is normal no worries.

[juuliuuz]

Thanks, u mentioned LVH , one EKG showed me that I do have LVH, is it this serious?Doctors didnt mentioned anything about it.Thanks :)

[Mom2four85]

I didn't see you mention in your original post you had seen 2 cardiologists? I must have missed it...Have you gotten your test results from everything?

You should post on the heart rhythm forum also, there's tons of us who suffer pvc's and some are caused by anxiety and alot of info on how to deal and cope with them.  Dealing with anxiety and getting that under control may help with your other symtpoms; as it has with others.

I've suffered through 50,000 pvc's daily, and yes exercised with them, I've suffered pvc's for as long as I can remember and I'm 43 now; and pretty much always exercised.   Shortly before I had my surgery last year I was walking & running 3-5 times weekly WITH 50,000 pvc's - and I have malignant polymorphic VT.

I'm exercising now with a wigged out heart, pacemaker/icd that's messed up; pvc's - pac's galore (Dec 2009 pvc's were back to 10,000+), all of my valves are messed up to some degree, cardiomyopathy, LVH, NCS/OI where I pass out at a drop of a hat, but I do it because I want to live till I'm 90 and I don't believe dr's are right that I shouldn't exercise.

[juuliuuz]

well you know its hard, when you get all the symptoms

[juuliuuz]

Was there a reason your Dr didn't have you do a stress test or holter monitor?
The doctors think, that everything is in my head.

Yes as I said I went to 2 different cardiologists.

Now by taking omega, magnesium, q10 etc I m doing better, than it was before. Before straight after a panic attack , I had thousands of them.

By the way tomorrow I m going to my GP and I will ask that she would send me to the electrophysiologist or to the cardiologist and I will ask to do those 2 tests.

Thanks :)

[juuliuuz]

Thanks for reply, I feel a bit better, well my PVC started after I had a huge panic attack while I was doing exercise on treed mill, I thought that time was really a heart attack, because it happened while I was exercising, so from now I m really afraid to do that, I m afraid to think about my heart. I get lots of rapid beats, sometimes after I wake up I that strange fast, but light heart beat , which I can only feel by checking my pulse.Is that could be a Atrial Fibrillation or something serious?Like when I get a fast heart beat I usually feel it in my chest, but this nothing compared to it. It could be felt in the neck by placing fingers and its very light, but very fast. Well I went to the two cardiologists, they did only echo's and eko, I don't know why they didn't gave me those tests, maybe because they think that everything is in my head. I m taking the SSRI's for my anxiety this helps sometimes. They said my MVP is not very big, other thing they said, that my heart wants to enlarge, which I think could be the cause from MVP and anxiety. Its really, really hard for me, afraid to exercise etc.But I know there are people for who life is really difficult.By the way, I m male, only 19 year old.Thanks again

[Mom2four85]

was there a reason your dr didn't have you do a stress test or holter monitor? was that a cardiologist or a pcp/gp?  holter monitor was the first thing I had done, then stress test to see how my heart performed (horribly lol) and then echo

with any research or articles, there's probably 10 other ones that are a bit different or conclude different things depending on what was the target was and who paid for the research - I've read a few different articles where the topic was recovery pvc's and similar to what this one says

If you haven't had a stress test or holter, it would be beneficial to have those and find out what your hearts doing - sometimes drs do overlook things or graze reports and may miss something.  

If all is normal get control of your anxiety and pvc's - pvc's and pac's really aren't a problem with your heart unless they're frequent in number or where they originate is somewhere that shows may dangerous.  Many of us have MVP and as long as it's not severe they really don't do anything about it, just keep a watchful eye - if all else is normal with the heart.

[lvhguy]

BTW, if you indeed do have mitral valve prolapse where the valve closes slightly behind where in normally does. In women, it is strongly associated with anxiety and panic attacks and the like.
For many years, physicians did not know this and just blew patients off and many patients got jaded (cynical) with the medical profession.
Now we know there is this mitral valve prolapse syndrome with increased anxiety and people particularly women having this anxiety syndrome. So you arent crazy, and no one really knows why, the interface between the heart and nervous system is fascinating.
Regardless, the valve has little chords that attach the leafltes to the inside of the left ventricle, when it "buckles" back as it closes, it tugs slightly on chord which tug on the muscle of the left ventricle causing a PVC.
Betablocker therapy is definitely a good choice for you as it blocks adrenaline which helps both with the PVCs and iwith the anxiety (MVP syndrome)

[lvhguy]

Yeah, that studied is not accepted as useful in the cardiology world. And if my memory serves me correctly, that study was for post-heart attack patients, I could be wrong on that.
If you have PVCs after exercise it is considered in the normal realm as you have excess adrenaline from the exercise, in recovery this excess adrenaline can boost PVCs.
So in other words,
Before exercise, PVCs are normal
With exercise, PVCs go away which are normal
Post exercise, PVCs can return due to excess adrenaline floating around.

When is it considered a bit suspicious? When you a normal rhythm and then when the patient reaches maximal exercise, the heart gets irritable and has PVCs.

This can be two things, lack of blood supply, but FAR more likely is that the heart is deconditioned and not used to that level of exertion because the patient is a couch potato.

So are you a couch potato? One could definitely argue that increases mortality. So if you want to decrease your chance of mortality, Assuming you passed your stress test and dont smoke, then walking an hour a day will greatly increase your chance of living to an old age and also your heart will become less irritable with exercise like you describe.