PVC's, exercise, and Atenolol

  I suddenly started having PVC's in April. I had a EKG, a 24 hr. halter, and an ultrasound on my heart, all normal. My dr. percribed Atenolol @ 25mg per day, we upped the dose to 50mg per day and I did not experience any PVC's until two weeks ago when they reappeared in full force. One night before bed I was having at least 20+ PVC's per hour at which time I visited the ER. Once in the ER my PVC's calmed down, they monitored me for 1 hr. plus did EKG. They said all was well. Since then I have had almost constant PVC's up to 20 times an hour. Since this all started I have begun and exercise program of riding a bicycle everyday for over an hour at which time the PVC's quit until about an hour after exercise, and I have no problrms during my rides. My question is this. What effect does atenolol have on the body during exercise? I take Atenolol at bedtime and exercise at 4PM. What is the best time to take Atenolol in relation to increased activity? Are there any additional steps I can take to avoid PVC's? Thanks for your advice, I enjoy reading all the questions and answers. Kevin Griggs

[CCF Cardio MD - MTR]

Dear Kevin, thank you for your question.  You have a common problem as you can see by the heart forum user who answered your question.   Your dose of Atenolol could certainly be increased to 100 mg/day to deal with your increased frequency of PVC's.  It doesn't matter when you take the Atenolol in relation to when you exercise, but you should take it at the same time each day.  Atenolol may slow down the maximum heart rate that you can achieve by a slight amount, but it shouldn't really affect your exercise.  All of the tests that you mention indicate that you have a normal heart, so the PVC's will be a nuisance but will not portend a bad prognosis for you.  Common precipitants of PVC's are alcohol, caffeine, and tobacco so you should avoid these agents.  Exercise, however, is good so it will be important that you keep exercising - the PVC's should not prevent you from exercising.  Good luck!
I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies. Please feel free to write back with additional questions.
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