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I have a question concerning the significance of PVC, mainly multifocal and couplets.  I am a 32 y old white female significantly overweigt, pretty sedintary, Stress test a year ago okay, excercised to 5.4 mets on a Modified Bruce.  Echo 2 years ago pretty normal except for some septal enlargement but on the larger size of normal, and mitral and tricupsid minimal leaking, and aortic calcification small amount. Cardiac Cath done in 1999 was essentially normal except for small PFO no treatment on that.  I am terrified of excercise after the study showing PVC's after excercise put the person at a higher risk of death within 5 years.  I suffer from occassional pvcs, but yet documented on event recorder multifocal pvc's and couplets, these were on two seperate recordings.  When this happens it scares the **** out of me and I worry about it.  I have PVC's daily but not this type daily is that of any more significant?  I may NOTICE a couplet every month, but not daily.  I have cronic hypotension as well, and I normally have a fast heartrate, 90-120 range.  I also get episodes of bradycardia which are very uncomfortable.  I am tired of just living with this as it is almost impossible.  I am worried about the PVC's, expecially the couplets.  I take Toprol XL 50 mg in am and 12.5 in the evening, this just a okay job keeping heartrate lower than it used to be 110+ all the time, but has caused more Bradycardia and I think more PVC's.  I have been on that for 3 years.  How significant is all this?  

Thanks for your time in answering my question!
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Avatar universal
I thought this may be useful for you all with PVC's. This is NOT a guarantee that it will stop your PVC's and we don't have much evidence for that. I am simply stating what I have learned and did everything to reduce my PVC's.

There are a lot of theories on why PVC occurs. I get eposides of PVC's lasting a few days. They aren't pleasant, indeed. There are two major factors that I think can trigger PVC's.

Number one factor is our dietery deficiencies:

Overwhelming evidence shows that omega-3 acids stablizes our heartbeats by calming the electrical cells down. The best sources of omega-3 is salmon, tuna, and fatty fish. Even eggs can be enriched with omega-3 acids (usually called "omega-3 eggs"). Flaxseed is rich in omega-3 but lacks DHA/EPA although our body can convert omega-3 acids to DHA/EPA. It is clear that eating fish is optimal for our heart. Just eating fatty fish like salmon will reduce heart disease by up to 60%. I recommend salmon because tuna can have high level of mercury. If you don't like fish, taking fish oil can be beneficial as well.

Here are a few sources:

"Men who ate about 3 to 5 ounces of fish one to three times a month were 43% less likely to have a stroke during 12 years of follow-up."

http://www.usatoday.com/news/health/2002-12-24-fish-strokes_x.htm

"Eating fish benefits those who are at high risk for ischemic heart disease (IHD), and sudden cardiac deaths occur less frequently in those who habitually eat ocean fish, a major source of omega-3 fatty acids."

http://www.intelihealth.com/IH/ihtIH/WSIHW000/333/28815/352901.html

"A daily fish oil supplement may help heart attack survivors reduce their risk of sudden death by as much as 42%, according to a new study. Previous studies have already shown that eating oily (fatty) fish such as tuna, salmon, and mackerel can reduce the risk of sudden death caused by a particular type of irregular heartbeat. But this study suggests that fish oil supplements -- rather than eating the fish itself -- may be an effective therapy for heart patients."

http://my.webmd.com/content/article/17/1671_53157

"It appears that omega-3s protect the heart in several ways. They may lower the risk of abnormal heart rhythms; reduce the "stickiness" of blood cells, which makes them less likely to form clots and block arteries; and lower high blood triglyceride levels."

http://www.healthandage.com/Home/gm=2!gid2=1691;jsessionid=PEjRAKuiMQFXQIVAna19fYiSb12cvpf1lDDVBl1fbX4T0JJdLQIJ!8876910089091682276!180357125!80!7002

"Omega-3 fatty acids appear to protect against arrhythmia by enhancing the electrical stability of heart cells and increasing their resistance to becoming "hyperexcitable". In cultured cardiac myocytes of rats, for example, omega-3 fatty acids terminated toxin induced arrhythmias mainly by reducing the electrical excitability of the heart cell... Omega-3 fatty acids appear to enhance the mechanical performance and electrical stability of the heart and to protect against fatal arrhythmia in both humans and animal models. Their mechanism of action likely includes modifying the fatty acid composition of cell membrane phospholipids, affecting cell signaling and controlling ion transfers across the cell membrane."

http://www.flaxcouncil.ca/pdf/arr.pdf

What we really need is a better ratio of omega-3/omega-9. We have way too MUCH omega-9 and way too little omega-3 thus increasing our risk of sudden cardic death. Transfatty acids interferes with omega-3 metabolism so avoid anything that contains "partially hydrogenated oil" of any kinds, like cakes and margarines.

Be sure to get plenty of magnesium, calcium, and potassium in your diet.

There are studies showing that men who do strenous exercise is much more likely to die from abnormal arrythmia (atrail fib) than unfit people. It does NOT mean that it's not safe to exercise. You will be MORE likley to die of a heart disease (and other causes of mortality) when you're sedenary than when you're active!!! I think that many cases of "sudden cardic death" could have been prevented by getting enough omega-3 acids.

The second factor may sound unusual but I am firmly convinced can cause PVC's: lack of sunshine exposure.

People who work night shifts are known to have more PVC's. My theory is that the heart needs a dose of sunshine. It could be that when our body sythensize Vitamin D from sunshine, it binds well with calcium ions and helps maintain heartbeats better.  

Of course, there are always biological limits and no amount of changes in diet, medication, or behavior can stop PVC's or diseases.

Hope this helps.

-jeff
Helpful - 1
Avatar universal
Hi all, I was just wondering what an EP study is?  The doctors that I have seen have never suggested that.  I have documented PVC's and PAC's, and one short episode of atrial fib, and the docs still act like all of this is pretty much benign.  I worry sometimes because of the frequency of my heart palpitations.  I was taking my pulse today, and I didn't get beyond the 20's before I had a PVC.  So, I must be having several a minute, and I wonder if that is dangerous.  I don't usually feel more than one at a time, but I get them every few beats sometimes.  I walked again tonight, and feel good when I'm walking, I think maybe I'm just not feeling them then.  I know it must be hormonal, because I'm going through an early menopause, and having crazy cycles.  It really seems to be related to that, but since about a couple of months ago, they are very consistent, and I have them the same each day.  One day is not really better than the next, they are all pretty bad.  Sometimes in the middle of the day, I just have to take a cold, wet towel, put it on my forehead, and lay down for a while, just to calm them down a bit.  Well, thanks again for all of the help, this board has been so great!!  Val
Helpful - 0
Avatar universal
Hi
I have been getting these extra beats since my mid 20's.  Recently I have had a couple of them where it seemed like my heart was 'confused' after an extra beat and it 'fluttered' as you describe for a few seconds afterwards.  Made me very scared and I saw my cardiologist who has recommended I see an EP and have an EP Study done of the heart to determine the cause of the arrythmia.  Am going in 5 weeks time.  
Helpful - 0
Avatar universal
wow, i can't believe ur doctor just suddenly recommended an invasive ep study just b/c u had a fluttery sensation in your chest.  the only reason an ep study should be done is if u've documented an arrthymia, not just from a fluttery feeling u get now and then.  i hope that ur doctor can change his ways.
best
Helpful - 0
Avatar universal
Hello,
I just stumbled upon this site.  I have had PVC's since I was a teenager and I thought I was the only one with this annoying thing. It is so comforting to hear I am not the only person with a wacked heart.  

Anyway, my history is fairly normal with the PVC's, all tests come out good/normal.  I had a really bad episode of PVC's for about a month (before I was getting ready to get married and move to Europe-talk about stress) when the doctor put me on a betablocker.  Other than that, I live with the annoying thing.  I do notice when I get stressed or over tired I get them more.  

Lately though, I have been feeling these wierd flutters, it's like suddenly my heart kinda does these tiny fast flutters together- instead of the regular, "extra beat" feeling that I usually have. I don't know what it is but it scares me so bad!  Now my doctor wants me to wear the event monitor again.

I am hearing about some unfamiliar terms, what is a PAC?  or a Couplet?  I wonder if that is what I am having now.  I tell you, I don't need this worry when I am only 28 years old.  Then I hear that PVC's and other heart things can give you strokes!  Not another thing to worry about.  Please help!
Helpful - 0
Avatar universal
Bending over is not what it seems to be. If you will do this test you will see that other movements will exacerbate the situation, like putting your elbows above your heart out in front of your chest. Leaning on a parts counter with your elbows on the counter, say below your breast. Seeping on your left side can provoke an episode, your right side take it away. Take a very deep breath and let it out fairly fast and then resume your normal respiration. If your wondering how I have come up with all this lour it's because I'm 51 years old and have had this cruel joke of a disease from the age of 17
Helpful - 0
Avatar universal
re Arthur's info on PAC's...it was VERY reassuring because that's EXACTLY what I have.  This forum is such a comfort.  I learned today to be careful who I talk to; I was at a picnic and an in-law of mine who is a nurse was there.  I mentioned my irregular postural heartbeat to her and she suggested a pacemaker...scared me so much I came home and have been crying ever since!  Then I looked up pacemakers...they're for SLOWLY beating hearts; I don't have that.  My whole day was ruined!  My heart is skipping more than ever when I bend over now and it's been doing it all day; could my nervousness about it be making it worse?  My email is:  ***@**** (or answer here, thanks in advance).
Helpful - 0
Avatar universal
I thank the lord i have found this site,I know that I am not alone with this irratating skipped heartbeats,It seems sometimes I have control over them and other times I dont,I really dont know the reason for that,I am 51 years old female and I got my first one whenI was 15,at that time it was discovered that I had a heart murmer, I have noticed over the years they have come at the most hardest times in my life and mostly disapeared as quick as they came,but this time I have reduced the stress that I have been going through, but they just seem to stick around this time,I dont know if getting older is a factor, I do know once I get the first one of the day, it scares me and they seem to be there for the rest of the day,I am convinced anxiety is a major factor and being over tired,its hard to think other thoughts once they are there,please does anyone have any idea,, how to control these things once they have started, thank you
Helpful - 0
Avatar universal
Hi Sheryl,
-
About postural arrythmias and posture and inhaling.
-
Did you read the thread on this Forum named SKIPPED HEARTBEATS?
I believe at the bottom of the page right now.
Arthur explaines about the phenomena.
The date nov-02.
He did lots of research about PVC's etc.
He's not a Med.Dr. but a serious intelligent guy.
-
Have a nice weekend!
-
Bye - *Ianna* -


Helpful - 0
Avatar universal
FYI : I found this question and answer on another website.

My heart sometimes palpitates when I am startled or sometimes when I bend forward. Should I worry? Also, I sometimes have panic attacks, and my heart will race--is it logical to assume that I am experiencing palpitations?

Both of the questions relate to a similar underlying mechanism, and that is the effect of substances in the body such as adrenaline which cause the heart rate to increase and the heart to beat more vigorously, creating a sensation of panic, heart pounding and heart racing. This is the experience of becoming aware of a natural or normal functioning of the nervous system. Anxiety, panic, and startling cause the adrenaline level to rise and create the sensation of palpitation. These in and of themselves are normal and natural and don't require any specific treatment in the vast majority of cases.


http://www.vh.org/adult/patient/internalmedicine/faq/heartpalpitations.html
Helpful - 0
Avatar universal
Whenever I had one cigarette (just ONE) my heart would palpitate off and on for a day afterwards.  Taking potassium helped me - it seems that the nicotine upset the body's electrolyte balance, which is essential in proper heart functioning!

So stop smoking :)
Helpful - 0
Avatar universal
Hi, again, thanks for all the valuable info, I don't know what I would do if I didn't have this board to reassure me all the time.  It looks like I've had all the tests I can have concerning my heart, I've had the holter moniter, and the nuclear stress test, EKG's, echos, all to say that my PVC's are benign, and to try to live with it, or I could go on medication.  I recently had some blood work done also, and my cholesterol was a little high, so I guess I should work on that.  I also had a high Sed Rate test, it was 38 in a range of 0-20.  I had a negative ANA and RH factor, and I feel fine other than the palpitations, does anyone know what that could mean?  They didn't seem too concerned at the doctor's office about the sed rate, but in looking it up, it seems like it can mean something serious.  I had a bad cold a couple of weeks ago, do you know if that could elevate it?  Also, I am going through menopause, but I don't think that would have anything to do with it. Also, I've been living in a highter altitude for about 5 months, coming from Houston, so I also heard that could contribute.  Well, thanks, I was just wondering if anyone knew anything about this.  Thanks again for everything!!  Val
Helpful - 0
Avatar universal
Hi, Sheryl

You probably know this already but you ought to drop
the nicotine habit.

You might also try watching a syndicated sitcom (daily
episodes) on TV where the actors will grow on you
and help take your mind off things, at least for a
while. Laughter is supposed to be of benefit to one's
well-being, or so I hear.

Best,
Helpful - 0
Avatar universal
Thanks so much for answering me.  No, I've never had an ekg while in the bending over position...and here's what happens.  When I go for the ekg, I'm always scared and my heart rate is, naturally, elevated.  My heart won't skip in the bending over position when it's going fast; it only happens when it's beating slowly (I take tenormin for rapid heartbeat.)  As I think about it, this whole thing started when I began the tenormin; maybe the med is causing it?  In any event, I have decided to face my fear and just let it happen.  I am tired of it controlling my life.  I've had it for 8 years and it hasn't killed me yet.  The last ekg I had done just a few days ago did show some pac's, but they told me it was probably my anxiety that was doing that and that my ekg was perfectly normal.  I even went to a cardiologist and when I told him of this condition he literally just shrugged his shoulders.  Thanks for your advice, but I'm too scared to go for more testing.  My family doesn't understand my fear and I only have this forum to talk about it.  I feel so alone.
Helpful - 0
Avatar universal
Sheryl, have you had an EKG where after they pasted the wiring to your chest the Cardio/tech asked you to demonstrate the posture
you take which induces your arrhythmia?

If not, ask to have it done that way. The EKG should pick up
the beginning of your arrhythmia and trace it's signaling.
Perhaps the Cardios can then zero in on the orgin of your
problems.

Just a thought.
Helpful - 0
Avatar universal
Hi...Just saw my doctor and she says I don't need any further testing; that all the tests have come back fine.  Thanks though for your suggestion.  She says what my heart is doing is normal for me; that nobody has a perfect heartbeat.  Went walking, even uphill, and only got slightly out of breath (I'm a smoker).  I try to walk every day.  It calms me down somewhat.  Hope you're doing okay.
Helpful - 0
Avatar universal
"I feel I am in hell because of my fear. I cannot relax, can't concentrate on anything because I'm so scared of this irregular postural heartbeat."

I really hate when that kind of fear takes control of a perosn's life.

It is clear that fear is controlling you. Don't panic when you have a skipped heartbeat. Just think about it, you've had it for 8 years and you're still alive!

Fear only makes your body get worse because fear thrives on hormones and chemicals that worsen your heart health (high blood pressure and increased pulse as a result).

Xanax is NOT always effective. You can try other antidepressants. I had panic disorder for a while and I know how crippling panic attacks can be.

-jeff
Helpful - 0
Avatar universal
Concering my earlier post of 5/28, if anyone can help me, please email me at ***@****.  I feel I am in hell because of my fear.  I cannot relax, can't concentrate on anything because I'm so scared of this irregular postural heartbeat.  All heart tests have come back normal.  Perhaps anxiety can be causing this, but why only when I bend over?  Sounds more like a physical thing to me.  I keep having panic attacks.  I am so unhappy because of my fear.  Please, somebody, help me!
Helpful - 0
Avatar universal
"what do u think about the fact that tuna, mackerel, sardines, etc. contain mercury which is toxic to the body? i love sushi, but at the same time am worried about the mercury."

Good question. Actually, I was going to post about the mercury problem but forgot about it.

From what I read, salmon has extremely low level of mercury and there's no reason to be concerned. Tuna has slightly more mercury. Predator fish have more mercury than fish that eats algae or plants.

Just today, I went to Todai and ate a lot of salmon but little tuna.

If you want maximumn health benefits from fish, fish oil supplement itself is good enough as long as there is no toxic metals in it. Some fish oil are "molecule distilled" claiming that it removes residues and toxins but I don't know how it works. ConsumerLab.com has tested on different fish oil supplements and lists supplements that don't have toxic metals and does meet the label claims. Thank goodness we have an independent lab to verify the label's claims!

-jeff
Helpful - 0
Avatar universal
Nobody's really answered my question the way I need it answered; perhaps I haven't been clear enough.  Please help me; I'm terrified.  Had an ekg done just the other day (I've had so many of them in the last six months because I'm so worried) and it was normal.  BUT...when I bend over, my heart goes into an irregular rhythm when I inhale, then goes back to normal when I exhale.  If I stay in this bent over position, the irregularity doesn's stop!  It only stops when I straighten up.  Does anyone else have this?  I'm not talking about one skipped beat...I'm talking steadily skipped beats on inhale while I'm bent over.  I am so frightened.  I suffer from deep bouts of depression and panic attacks.  Am on antidepressants and xanax, but I can't stop the compulsion to bend over and take my pulse.  It is ruining my life!  Please someone, help me.  If these irregular beats are harmless, I'll so happy.  By the way, this has been going on for EIGHT YEARS and no heart damage yet from it.  Please, somebody, help me!  I'm crying nearly all the time.  Thanks.
Helpful - 0
Avatar universal
what do u think about the fact that tuna, mackerel, sardines, etc. contain mercury which is toxic to the body?  i love sushi, but at the same time am worried about the mercury.  i understand that some of the oils have been tested and extracted the mercury, but you never really know according to my doctor.  it seems like all good things have some other kind of side effect unfortunately.
Helpful - 0
Avatar universal
"I take fish-oil capsules 214 mg, containing 34 mg EPA and 22 mg DHA,(and evening primrose oil GLA 68 mg)."

That is too low. One capsule should have at least 100 mg of DHA and EPA.

From what I read, Super Omega 3 from Carlson Lab is reliable and contains what the label says. Just one capsule contains 200mg of DHA and 300mg of EPA. Two capsules a day everyday is enough to confer cardioprotection.

I don't know of a study that shows that GLA is beneficial for heart.

-jeff
Helpful - 0
Avatar universal
Hi Jeff,
-
What is the dosage one can take and be on the safe side?
Did you check that out?
I take fish-oil capsules 214 mg, containing 34 mg EPA and 22 mg DHA,(and evening primrose oil GLA 68 mg).
I take Vit E caps. too - 400 mg.
-
Your comment?
-
Bye -*Ianna*
Helpful - 0
Avatar universal
I just found a new link regarding omega-3 (fish oil) and arrythmia!

http://my.webmd.com/content/article/65/72744.htm

"May 27, 2003 -- There's nothing fishy about fish oil's ability to protect your heart, according to a new study. Researchers say the omega-3 fatty acids found in fatty fish such as tuna, salmon, and bluefish can prevent sudden cardiac death by blocking fatal heart rhythms...

In a new study, published in the May 27 issue of Circulation: Journal of the American Heart Association, researchers found that omega-3 fatty acids from fish oils are stored in the cell membranes of heart cells and can prevent sudden cardiac death by blocking potentially fatal heart rhythms."

Yea! :-)

-jeff
Helpful - 0
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