PVC's - Some Questions

[josemanuelcruz]

Dear Dr.,
I have for about 1 year PVC's.Did several heart,blood and urine tests last December(EKG,Stress Test,Physical examination,Holter,analysis)and a echo(3 y ago)and everything was fine-Had only a large recovery heart rate in stress test that my cardio said was out of fitness and some PVC's in HOLTER and stress test recovery period-Also of not concerned reporting him.
But lately my PVC's episodes frequency increased as well as their duration with several bigemini or trigeminy in a minute. For a day I stimate about 1500.Cardio,consulted this month, carried only detailed physical exam and ordered,only for begining of 2004,simple rotine tests like EKG and analysis,and said,since last tests(even the echo more time ago)were ok, no need for further testing and that the PVC's in my case are of no concern. My questions:
1-Cardio said only PVC's in exercise could be more problematic, since they are like "desobidient solders in battle field that's critical. When they are only desobidient when not in important situations it is harmless"-Do you agree with the harmless of these PVC's?
2-About trigger situations for PVC's-I note that they seem to be worse if I sleep less that 7/8 h or/and when the temperature is low (weather gets colder or in cold water) - Is this reasonable?
3-Can for some period-weeks,months-the frequency of PVC's raise, like from no one a day to about 1500,and then come to normal without major heart reason concern-Or being fine one day and in another much PVC's?
4-A <1min chest pain, could be from heart problem.Not related with exercise or stress.
Thanks

[CCF-M.D.-RCJ]

josemanuelcruz,

Questions:
1 "1-Cardio said only PVC's in exercise could be more problematic, since they are like "desobidient solders in battle field that's critical. When they are only desobidient when not in important situations it is harmless"-Do you agree with the harmless of these PVC's?"

Huh!?  What an analogy.  But yes, I agree.   In someone with an otherwise normal heart, we have no evidence for an increased risk of an adverse prognosis from the PVCs.

2 "About trigger situations for PVC's-I note that they seem to be worse if I sleep less that 7/8 h or/and when the temperature is low (weather gets colder or in cold water) - Is this reasonable?"

Yes, many people have increased frequency of PVCs from lack of sleep.  People will often describe triggers that may seem odd, but many of these triggers are things that affect the autonomic nervous system -- like lack of sleep, eating, and temperature changes.

3 "Can for some period-weeks,months-the frequency of PVC's raise, like from no one a day to about 1500,and then come to normal without major heart reason concern-Or being fine one day and in another much PVC's?"

Yes.

4 "A <1min chest pain, could be from heart problem.Not related with exercise or stress"

Yes.

Hope that helps.

[Fastdream]

Hi,
I felt disappointment when I read that you will not write again(to all my friends on the forum, I think this will be my last comment on the forum) but now I am glad to see your post again which help people who need it.If you do not mind I have a question for you.From long time(15 years) my doctor prescribed anderal 80mg LA for PVC(I had have more 11 thousand daily) I used to take it and feel comfort.this year i had been diagnsed with asthma so the doc. suggested to take lopresor 50mg which did not work with me like anderal.what you think abuot atenolol 50mg? any suggest i will be greatful.

Thanks,

[glassheart46]

I can't ever seem to get through to post a question so thought I pose the question to anyone out there who has had an ablation for AV node reentry.  Question:  Did any of you experience speed-ups of your heart rhythm.  I have experienced that twice now.  It only lasts for a minute or two but reminds me of the old problem and I wonder if my ablation was a success.  I am only 11 days post-ablation so maybe the above is to be expected.  I also experience what feels like a pause, then a rather hard beat, and then all is normal again.  My normal rhythm seems to be rather high as well.  It beats around 75-85 beats per minute and then sometime it gets closer to 70-75.  My EP dosn't do a follow-up for four months which I thought was unusual.  I was not told what to expect after the ablation and for how long.  I have no underlying heart problems and there were no problems durning the ablation itself.  Sure would appreciate some input.  Can't seem to get much info from my EP as he does not take phone calls so I only have his nurse to rely on and she seems rather insensitive to the whole thing.  I honestly believe that she feels it is all in my head and I am over-reacting.  I wouldn't over-react if I knew what the heck to expect!

[LynnSB]

Hi, I don't think it's time to worry yet -- apparently lots of people have some weird beats for a while after their ablation and yours is quite recent. ON THE OTHER HAND I had mine on September 15th and I am soooooo *(#&^@% depressed that I'm not only having skipped beats (as if my heart "stops" or sometimes quivers for an instant) but have a had a few episodes that feel like fast heartbeats. I'm so afraid my AV reentry node tachycardia wasn't "fixed". although i went to a famous heart center, no one mentioned any kind of follow up ep study.The ep doc said just follow up with my cardiologist which I did 4 weeks about the ablation. He said my EKG was "perfect " and "go exercise" and maybe improving my conditioning would help with the irregular beats. I go back to him in Jan. NOt a word about going back to the EP doc for anything. I have those palps that make you feel like the breath has been knocked out of you for a few seconds(does that make sense?). I am not having as many irregular or fast beats but, yes, I'm BUMMED that things are not better. My resting heart rate, oddly enough, is lower after the ablation.

[Dr. Erik]

You beter not stop posting! Your input is greatly appreciated. I read your comments every day. You are a great supplement to what the doctor says. By the way, I have raised my HDL from 30 to 40 through exercse, weight loss and Zocor. My total cholesterol is 129 LDL-53. Blood pressure 100/50. I am a 35 year old healthy male with pvc's and one episode of A-fib two years ago. What do you think my risk of CAD is? Thanks for the good information!

[pandora9049]

Hi Hank,
Just wondering something, if u know.  is there a difference between SVT, NSVT and sinus tachycardia?

[pandora9049]

Sorry I spelled ur name wrong on the above post, and sorry to keep bothering u. it is just impossible for me to get a post to the doctor on this forum.  thanks
Pan

[jobob52 ford]

Hi, I had my third ablation on Sep. 12,03. The first(Jan. 01) was flat unsuccessful, back on meds. immediatly. The second( a year later)I was off meds. for about three weeks, felt a few flutters and all of a sudden locked into full tachy(250 bpm), back on meds. in increased doses. Kept increasing throughout the year(both events and meds were increased)which led up to third ablation. The first 3/4 weeks, there were short flutters sometimes several a day, sometimes several an hour. By short I mean 1 or 2 seconds. During that same time I had 3 or 4 events that lasted 3-5 minutes, didn't seem like a-fib or tachy, just weird. Once it even woke me up at night and I thought I was hearing kind of a clicking sound. To be honest, I thought maybe I had been reading this forum too much and that my mind was playing tricks on me. I made a sincere effort that as soon as I'd feel something, I'd put it out of my mind and not dwell on it. I still feel an occasional flutter, maybe once every other week, again in honesty, usually when I'm at this forum and thinking about it. It does lead me to believe that now a lot of it is in my head especially when I consider that I've been off meds since Sept. 6. I was on meds since '86.
  If I ever have to take another trip to er for 12 mg. of adenacin I'll be crushed, but whats working now is putting it out of my head so I'm not so sensitive to what I'm feeling ....and  It seems to be working.
I hope this helps some and that I don't come across sounding too simple.
  Hank, Thanks for sharing with us. I (and I,m sure, We) wondered how you could be so knowledgeable and communicate in this forum without the restrictions that the Doctors have. You are truly a blessing to this forum and Thank You for sharing your time and gift.   Bob

[glassheart46]

Thanks so much for your input.  I am a very nervous person by nature.  I have suffered from anxiety disorder since I was in my teens( my first panic attack was shortly after I experienced my first episode of tachycarida.)  Since then lots of palps, skips, bumps and speed-ups.  I know that my anxiety originates with my first episode of tachy so I suppose that is why I am not handling this very well.  And it does not help to be so uninformed by my EP.  Today I am going to get an appointment to have all of the after effects explained to me.  My first follow-up isn't scheduled for four months and when I had my ablation I had gotten extremely sick on the pain med they gave me(pain med was unrelated to the ablation) so each time my EP came in I was too sick to ask my questions and was discharged without any of my questions answered.  I am so sick and tired of being a slave to my emotions.  It is so hard for me to know if It is adreanlin causing my problems or if it is something concrete.  I am truly afraid that my av node reentry will return after all of the posts I have read of which very few are positive.  My husband says that people whose ablations are successful probably would not be posting on a forum.  I disagree with that to some extent.  Thanks again for your input.

[LynnSB]

I asked the ep doc what were the odd of an ablated AV reentry tachy returning and he said " one in many, many, many hundreds.."

it is successful, in the right hands over 90% of the time.

I, too, know what you mean about being a slave to your emotional response to the arrhythmias. It is as if someone pressed a button on my body for "anxiety/depression" when I have heart palps.on the other hand, i lived for 20 something years being told this was "anxiety" and all in my head much of the time, even having the phone disconnected from the wall and being screamed at " YOU ARE A HYPOCHONDRIAC!" while my heart was 200 plus for hours on end and I was so weak and begged to be taken to the ER. I've been through it all.My original internist even refused to give me a heart monitor and when i called her during an tachy episode said "the ER is not where neurotic young women go for panic attacks". I always knew this wasn't panic and i wasn't making it up in any way, shape or form. but the anxiety of having NO ONE HELP ME for so long was real and has remained.now , when my heart 'acts up' it is hard to think, well, we finally know these are real, i've had an ablation,i've had an ep study, it's not life threatening. but is so hard to give up the worry after being treated the way i was for so long,discounted and belittled.

[fpd3hm]

I was under the impression that pvc's during exercise (or, at least, during the first few minutes of exercise) were of no consequence.  I realize there is a study which says that post-exercise pvc's are potentially problematic, but I'm wondering if I should be concerned with exercise-induced pvc's.  

If I am understanding the doctor's reply to the "disobedient soldiers" analogy, it sounds like exercise-induced pvc's are dangerous.  

Any thoughts?  Thanks.

[glassheart46]

Thank you so much for the positive input.  And Lynn, I got treated the same way.  "It's in your head," "go home," "get a life," "you're over-reacting."  I am to the point now were I feel I have no one to talk to and then the anxiety just goes up from there.  But, you guys made me feel much better.  I did not know the success rate for AVNRT was that high.  I am hopeful.  It's just that when these hit, even though I tell myself it is nothing, my body's adrenal system just reacts different.  I must be causing these problems sub-consciously.  I think that is why my heart rate has been on the high side since the ablation (75 - 90)  I just can't beleive that after 30+ years my problems are solved.  I think if an EP doctor or any doctor for that matter had these problems he or she would be much more receptive.  I think my EP at the very least could have told me what to expect in the way of what is normal and what is not post-ablation.  I was told nothing so had to rely solely on this board for answers.  I tried to input a question to the doc but could never get in.  So, thanks again.  I really, really appreciate it.  In my EP doctor's defense, before the ablation he stated that he was very confident he could get rid of the tachycardia.  I'm thinking now that maybe he is that good.  Apparently he is one of the pioneers in the EP field of ablation.  He came highly recommended and has been doing ablation for many years.  I beleive the figure mentioned was 20+.

[Kimma]

i can never post any questions on the site because its always full. i had an ablation in November 2002 all was perfect until about March when i started to get a few pvcs. now i'm sure i get thoasands, im waiting for my new insurance so i can go see a doctor. i always feel so weak when ever im standing up, i cant take care of my son like i used to, my pulse always stays around 90 and my blood pressure stays around 90/60. since march i havent been able to drink a sip of alcohol, i get a feeling as if im going to faint, i get even weaker, i was never a heavy drinker but a drink or two a month at get togethers with the family would be nice. i try to tell myself this is all in my head but i know its not and im scared to find out what it might actually be. i dont complain to anyone i love because i know they all think im a hypochondriac. i had an event monitor and all was fine except for the pvc's but the monitor is all i can get until i have my new insurance in a few weeks. im very anxiety ridden and i just want to feel like i did right after my ablation or before i had my son, befor i had problems with my heart. i needed to vent. if my symptoms sound like anything PLEASE let me know.

[glassheart46]

What were you ablated for?  Have you mentioned your low blood pressure and high pulse to your doctor?  Be sure to do that when you get your new insurance.  No, it is not in your head.  You are anxious about your symptoms just like the rest of us and that just makes how you feel worse.  The more anxious I get, the worse my symptoms become even to the point of feeling faint and it raises my pulse to over 90bpm.  My blood pressure is low as well.  You need to talk to the EP that ablated you as well if you havn't already.  Keep posting and let us know.

[Kimma]

i had my ablation for PSVT, when they went in they noticed pathways in both sides of the heart so im not sure if that means i also had an atrial arrythmia. it was done in cali and i now live in NY with no insurance yet(its in the process, at the end of this week it should go through). i have talked to my ep doctor from cali and she sent me an event monitor she got the results back and said yes you are having pvc's but they benign(that was 2 monthes ago, before i started feeling so weak), she said that she wants me to go on lopressor but she's not licensed to give it to someone in ny, she can only send the results from the monitor to a doctor i see here in ny and get them to prescribe the meds. taking the meds worries me becuase i already feel very weak and ive heard the meds make your tired, and they lower your bp, mine cant go any lower 90/60. but then again maybe i feel weak because my heart rate never goes below 90. im not living, my life is filled with anxiety. im so young and i feel so hopeless. i thought the ablation would be my cure. it was for a few monthes then it all just came back worse in a different way. i have palpatations and weakness everyday, before the ablation i had psvt(250bpm) once a month, i also went into afib in the er for 7 hours a month before the ablation. about my low blood pressure, my doc isnt worried about it becuase i have a small frame, im only 100lbs and my fast heart rate she says is fine as long as its not over 100 at rest, she told me this over the phone.