PVC

[skippintime]

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!

[CCF-M.D.-RCJ]

Skipintime,

Thanks for the post.

I appreciate that you are scared and troubled by your PVCs, but your major risk for death is your poor exercise tolerance of 5.4 METS.  Any risk from the PVCs pales in comparison to the risk posed by the deconditioning.

However, the septal enlargement needs investigation.  Specifically, did the cardiologist that interpreted the echo evaluate for hypertrophic cardiomyopathy.  This condition can lead to increased PVC frequency, as well as a lower exercise tolerance.

Good luck.

[dartmouth03]

Dr. RCJ,
isn't it true that in order to tell if pvcs are multifocal or not, they have to be recorded on the exact same holter monitor or event recording with the electrodes in the same exact spot.  the lady who posted the question mentioned her pvcs being multifocal b/c they were recorded on separate occasions.  this could very well mean that her pvcs are actually unifocal and only appear multifocal b/c the electrodes were not in the EXACT same spot since they were on separate occasions.  is this accurate?
best,
alex

[netrox]

I don't know about the study saying that people having PVC after exercise; it said:

"Over an average follow-up of 5.3 years, 1,862 of the 29,244 patients died. The study included deaths from all causes."

Source: http://www.cnn.com/2003/HEALTH/conditions/02/27/heart.stress.tests.ap/

Exactly how many of them ACTUALLY died from heart disease - specifically that is believed to be caused by PVC's - not by other causes? Couldn't it be that their constant fear and worry actually increased the risk of death of all kinds?

Another question: is it possible to feel PVC's while exercising? I get PVC's a few times a day and I hardly feel it while I exercise.

-jeff

[skippintime]

Sorry but the multifocal pvc's were on the same recording, I said that:

"I suffer from occassional pvcs, but yet documented on event recorder multifocal pvc's and couplets, these were on two seperate recordings."

Multifocal on one, couplet on the other.

just for your fyi

[karie]

Pvc's L Treatement:
Waht do you think of Inderal as a drip in the hospital for a patient who had a increase in pvc's from 3 per minute ?
What about Rithmol does this only work on a racing heart ?
Ablation was mentione is that is laymen terms when then jump start the heart as the nurse said to calm in down or put back on track.
So scary We are talking about the engine to our body.
With an increase in pvc's ond over all health it is hard to handle.

[sheryl1945]

Anybody have this experience with pvc's?  When I bend over I get them; my heart actually goes into an irregular beat.  As soon as I straighten up, heart resumes normal beating.  I get no other symptoms, and have had heart tests and they call came back normal.    I wonder why position would affect my heartbeat?  Please someone, help me, I am very scared.  (I should mention I've had this condition for 8 years now.)  Either post a comment or email me at:  ***@****.  Thanks!

[sheryl1945]

Forgot to mention something...while I'm bending over, the irregular beats occur only when I inhale or hold my breath; I exhale and the beat returns to normal.  Anybody ever have this?

[dartmouth03]

yes, i've had this happen to me many times.  it's weird i know!  positional changes can set them off for me as well as a deep breath in or when i sniffle with my nose.  it's strange, but i've had all the tests come back normal except for pvcs and pacs.  i'm young and healthy too (23 years old).  i guess they happen to everyone, just some people don't notice them.  so don't be scared, if i bend over, sniffle, take a deep breath, etc. i can cause a few extra beats here and there.  take care.
best,
alex

[VikingColumbus]

Yep, that phenomenon bothers me as well. As one of the
Cardios mentioned not long ago, unusual things may occur
when the threads of our nervous systems go at odds with
one another (sympathetic versus parasympathetic). Consider
our internal organs are networked with the threads and
when you bunch them up when bending over, well, things may
happen (confused signaling )to further disturb an already irritable heart muscle.

That's my take from dealing with arrhythmia for 30 years
now. SVTs (Toprol XL) Afib (Digoxin) BP (Lisinopril)
PVCs, PACs, Couplets, Suspected nonsustained VTACH.

It's no fun. I sympathize.

[Ianna]

Hi,
-
Yes, I too am sure that the nervous system is the culprit.
Like VikingC. said:-'confused signalling, and thus disturb an already irritable heart'- That's just it.....
-
I cannot eat a large meal cause then the party begins!
Or bowel-problems can set them off...
Bending over is a well-known booster for PVC's too.
-
If your Dr. says your heart is ok then THIS will not kill you, but it is VERY ANNOYING I know!
Good luck!  ;-)
-*Ianna*-

[sheryl1945]

Thanks Viking and Ianna for your input.  I live in such fear!  I can't seem to break the compulsion to bend over and "test" my heart and it's driving me nuts.  When I feel the irregular beat I panic.   Nothing really happens...just the irregular beating, no other symptoms.  This has been going on for 8 years now...you think I'd be used to it by now.  Sometimes I actually dread waking up in the morning because of this.  How can I get over my fear?

[jaz5802]

Fear -- I don't think we ever actually overcome it.  We learn ways to cope with our condition.  The hard part for me was accepting my condition because I wasn't in control of it!

I've had these things forever so you would think by now they'd just be like getting up and getting dressed in the morning. Not! Some days are better than others though and it's not all gloom and doom.  I don't fear them anymore -- they just annoy me mostly.

What has worked for me is taking everything very slowly.  That gets my heart out of it's sensitivity.  Slow, deliberate walks.  Breathing deeply.  Being peaceful. Telling myself that I'm okay and I've been through this a million times before.  Eventually, my nervous system calms down which also calms my PVCs down.

Yoga, dancing, meditation, eating healthy, plenty of water and RELAXING and not over racting to things all help me.  Plus knowing I can come to this website and listen/talk to other people who are just like me or very similar.

Try sitting still and relaxing for awhile.  Or take a slow walk and notice the trees, the birds, etc.  Maybe that will help you too.

Beth

[Anjakarena]

Hi everybody,

I just wanted to share something. I am 33 yr old female and have PAC's and PVC's since I was 18 yrs old. And like everyone else these really bother me and some days are better than others.
We are getting ready to move and about 3 weeks ago my heart starting skipping like crazy. Of course I freaked out once again and made an appointment with my doc.
Finally after always refusing to take anything for the irregular heartbeat I caved and the doctor prescribed me Metoprolol (Lopressor)25mg a day, its a Betablocker. Now I am so amazed how well this works and I feel like 100% better. I can deal with the moving stress and am so relieved not to feel the skipped beats every few minutes.
I will probably take the medication until our move is over and then see if it will be fine without it.
I was just so happy that there is actually something out there that helps me and I don't feel any side effects.
Somehow I always felt like a failure considering medication, I thought that I should be strong enough to just deal with it. But now I am so relieved.
So for all of you out there, if you can't take it anymore and this drives you nuts like it does me, don't be silly and wait 16 years to even try to see if medication works. :)
Anja

[dartmouth03]

i'm really glad you've found some relief!  so are you still having the exta beats/skips or is it that you're just not feeling them b/c of the beta blocker?  what's your resting heartrate and has the beta blocker caused it to go down?  thanks.  take care.
best,
alex

[sheryl1945]

I feel some comfort by reading your input, but I'm still having a hard time getting past the fear.  Why is it that when I bend over my heartbeat changes?  When I inhale, my heart beats irregularly; if I hold my breath is STAYS in this irregular mode...when I exhale it goes back to normal.  I get very few PVC's while sitting or standing; only when bending over.  I've been to the emergency room at least four times for this and no doctor has ever explained it to me.  I live in fear; sometimes I don't even want to get out of bed in the morning to face the day because I know I'll get the irregular heartbeat which depresses me.  I might add I've had depression problems all my life and severe anxiety.  Think anxiety could have anything to do with the irregular heartbeat?  Anyone -- please answer me, or if you want, contact me at:  ***@****.  Thank you!

[Anjakarena]

Hi Alex,

to answer you questions:
I have been on the Betablocker since Thursday and as soon as I started taking it I noticed my heart calming down and it stopped beating irregular.
The doctor told me to come back and see him this week and let him know how it is going since this is a trial time with the dosage etc.
I take the medicine in the morning and I do notice at evening, night time that my heart skipps a little bit, so I am thinking that the  medicine might wear off after so many hours. The doctor might have to increase the dosage, I don't know yet.
But overall my heartrate isn't much lower than usual, my heart just seems to be really calm and I love it.
I am so thrilled that its actually working and if I can take it longterm without any problems I might just do that for my peace of mind. Will have to see since we do want another baby and I don't know if I could take it being pregnant.
If you want to know anything else you can email me at:
***@****

Anja

[netrox]

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

[Anjakarena]

Hi,

thanks for you info. Are there Omega 3 supplements or can you only find them in food?
Anja

[netrox]

Anja asked: "thanks for you info. Are there Omega 3 supplements or can you only find them in food?"

Yes, fish oil supplement is a good source of omega-3. I read that Super Omega-3 Fish Oil by Carlson Laboratories is believed to be the best due to high concentration of EPA/DHA and being free of toxic metals. That's what "ConsumerLab.com" said. It's an independent lab that tests to see if the supplement delivers what it promises. (http://www.consumerlab.com/results/omega3.asp)

I make a delicious shake of milk, apple, banana, a dash of cimmanon, and a tablespoon of flaxseed. I put them in a blender and flaxseed "thickens" the shake. It is good. Flaxseed is one of the richest sources of omega-3 acids although it lacks EPA and DHA. Your body converts some of omega-3 acids into EPA/DHA but it is beleived that it's best to get them directly from fish or fish oil.

-jeff

[Hey_Its_Me]

Hello everyone.  I am new to this.  I started having symptoms that sound like this - fluttering sensation in my chest and my heart skips a beat.  This has been going on for one week now.  I have some minor heart problems (Sick Sinus).  In the last month I have had 2 Echocardiograms, abdominal ultrasound, stress test, and cardi catherization.  All tests were good with the exception of the Holter monitor which showed the Sick Sinus Syndrome.  I have been on Toprol for a month now to control the tachycardia and it has been terrific for that however I have noticed some abdominal swelling (minor) and now this new symptom.  I went to see my cardiologist and mentioned these things to him, butI really didnt get a response.  Any possibility of this being caused by the Toprol?

[valger]

Hi everyone, I just wanted to thank you for all the valuable info again, everytime I come on here, I learn something new!!  I am still getting lots of PVC's each day, and just trying to learn to cope.  I think it might be hormonally (sp?) induced, but that wouldn't really explain why so many men get them too.  I have had the holter moniter, the nuclear stress test, and just got the results of bloodwork back.  I was wondering if anyone knew the significance of the sed rate test?  I think it was called the Westergren Sed Rate Test, and mine was a little high at 38, I think the range is 0-20.  I looked the test up, but it's a little confusing as to what it means.  All my other blood work came out ok, with the exception of a little bit high cholesterol, and LDL type of stuff.  My white cell count was ok, and my red cell count was just one point over (high).  Anyway, thanks again for all the help about PVC's, we went camping this weekend, and I know that I wouldn't have been able to go, if I didn't have the support and information from this site!!  Thanks again, Val

[valger]

Hi, and thanks for that info!  I hate to sound stupid, I usually know alot about medical conditions, but what is a connective tissue disease?  Is having an elevated sed rate test a pretty serious thing?  I don't have any other symptoms besides the PVC's, and I really think those are hormonal because I am going through this menopause thing, and the palps got really bad again right before my last cycle, and it just is like clockwork.  Sometimes I hate taking blood tests cause I feel like you have to worry until you re-check it, and then it can be nothing.  Months ago, I had elevated liver enzymes, and worried about that for the longest time, and in this latest test, they were normal.  Along with my glucose, which in an earlier test, was abnormal also.  Now, I'm happy that those are down, and now I have this one elevated, it seems like it's always something.  Well, anyway, thanks so much again for taking the time to answer me!  I really appreciate all the help on here!!  Val

[valger]

Hi, sorry, one more thing...........on the Omega 3 capsules, is there a certain dosage that is good?  I never am sure how much I should take.  Thanks!!  Val

[netrox]

Omega-3 is known to reduce inflammation as well.

Hank, glad there was news about fish oil! I believe fish oil is often ignored too many times on this forum. Fish oil is one of the most effective drugs for stablizing heartbeats. Just be sure you get enough of EPA/DHA in omega-3 capsules. Most fish oil list how much EPA/DHA it has.

A note of caution though: too much omega-3 on a daily basis can thin your blood too much and increase the risk of brain hemmorage (mispel).

-jeff