PVCs/High resting heartrate with ankylosing spondylitis

[hankstar]

  Dear Doctor,

       Are you aware of any connection of increased heartrate and PVCs from ankylosing spondylitis?
       I suffer from ankylosing spondylitis and have been told that persons with these connective tissue diseases are more prone to high heartrates and palpitations.
       I used to suffer from a fairly high resting heartrate in the daytime say 90-105 bpm , but is well controlled with atenolol 25mg twice daily, now my resting heartrate is around 54-66 bpm .
       I was taking atenolol 50mg twice daily 2 years ago when I developed very frequent PVCs, stopped the atenolol and the PVC disappeared. I started to get PVCs , but not that frequent, that triggered a sinus tachycardia about 3 months ago and was put back on the atenolol 25mg twice daily. I was reluctant to give it a try again, but did, now this is the less frequent palpitations I had in my life. I must say that from time I can remember I was always aware of my heart beating most of the time whether fast or slow, had most test besides a cardiac cath, everything within the normal limits.
       Anymore theories on why some persons are so aware of their heartbeat and others not?
       I also notice since taking the atenolol that my pain has not been as severe from the AS as before, Are beta blockers been shown to have any anti inflammatory effects?
       I am also asking one last question on behalf of a worrying mom. How common are PVCs in a 17 year old and if other test are normal , Is there any cause for concern? I know I had them all my life , I'm 39 and still around.

   Thanks,

[Cleveland Clinic]

Hank,

There is not alot in the literature that specifically addresses your heart rate question in relation to AS.

You may want to see:
Abnormal autonomic cardiovascular control in ankylosing spondylitis
in the Annals of Rheumatic Diseases. August 1999 pp 481-7

They did find some relationship with role of autonomic system responses with AS and disease activity. This is a small study, so I wouldn't put alot of faith in the results.  However, inflammation and autonomic activity could certainly explain some heart rate variability form those seen without AS.

There are not specific therories on body awareness. Some people have better hearing then others and we dont know why.  A non-cardiac disease analogy might be fibromyalgia, which certainly exist and may be some relation to a persons sense of pain.

Beta blockers have been shown to have both anti-inflammatory and antiplatelet effects in vitro.

In the absence of structural heart disease the same would go for PVCs in a 17 year old.

Good luck

[steveswife]

Why would you say that about you not posting anymore questions regarding yourself .... if it weren't for you being here, I don't think alot of the regulars seen here would be here much either. Not to mention people who don't even bother to post, or just can't, who might have the same symptoms as you, get the answers they are looking for from yours or somebody else's posted questions. I know I wouldn't be returning here daily if it weren't for you. You help a great deal of people around this site. You just keep doing what you're doing :)

Tammy

[njrob]

Hank,
  I remember getting premature beats when I was a young teen.  I went to our family physician who never found anything.  I did experience these on and off for years, sometimes they were followed by some period of high hr. Since then I had always had normal ekg tests during yearly phys.exams.  It had seemed that the PVCs had gone away, but this year I started feeling them again.  I am now 40.  In August one evening I was awakened by an uncomfortable tingling feeling in my hands and a chill, followed by a period of very high hr (approx 150) that lasted for approx 45 min.  I had been pretty fit at the time with a normal resting rate of 60-65.  I went to a cardiologist and all of the tests (stess/echo/ekg), I wore a holter and it captured another episode (145 bpm) for 30 minutes. The doctor diagnosed sinus tachycardia.  
Since then I have been ultra sensitive to every beat, every variance, and now have been feeling the PVCs again.   I now have developed anxiety over the concern of my cardiac health, developed other uncomfortable anxiety symptoms, and was prescribed an SSRI.  
With your history of PVCs did you have any bouts with anxiety (if you don't mind my asking)?  Do you think the recurring PVCs/ ST could be caused by anxiety?
I went to an electrophysiologist and he thought I was overreacting and he told me to live my life and "don't wear my hr monitor- that I'm only driving myself crazy".
  
Thanks for your comments.
Rob

[pandora9049]

Hey Hank,
ur really on a roll here getting ur questions posted:)  good for u!
Konopka,
What were your symptoms with SVT and VT?  I have a rapid heartbeat (sometimes up to 130 bpm) and wore an event recorder, doc said it was sinus tach.  I know the difference is where the beat otiginates from or something, but i was just wondering now fast ur heart would go and how they differentiated between vt and sinus tach?.

[njrob]

Thank you for sharing your experience and for the advice.  It certainly is easier to deal with the uncomfortable symptoms knowing that the condition is not that uncommon.
Have a Great Holiday,
Rob

[raildown]

not that the practice of mindfullness trainng as described by Jon Kabat Zinn in his books may be of some utility for any/all anxiety based syndromes...this practice was rooted in Buddhist meditation practices...at a Worcester, mass hospital and pain clinic,Jon formulated a well known program for chronic pain relief whereby folks learn to become familiar with the sensations without judging them etc...the program has had some success in the arena of chronic refractory pain...it's a slippery concept at first and one that takes pretty intense practice but it's intriguing and seems to work for some...;

//

[Kimma]

sorry i cant ever post on here because it has always reached its limit for the day. i started atenolol and i am doing really well on it no more sinus tach , always feeling my heart beat and pounding heart. i have a few questions about it though and cant find much info on the internet: is it ok to have a couple drinks while on atenolol? in a year or so my husband wants another baby and on the insert it says atenolol can cause fetal deformities!very scary. is there a safer beta blocker to take while pregnant? i would only take a low dose but i know there is no way i could have another baby without one. my doctor said it was safe but that doesnt explain why the insert says its not. anyone know of any web sites with good info on this subject? i would really appreciate it. sorry im off topic. Kim

[glassheart46]

Has your Sinus Tachycardia been diagnoised as Innappropriate Sinus Tachycardia?  What is your history with the above?  I am sure there are people on this board who can give you more info but we need more info on your history and symptoms.  As for the drug you are questioning, I think Hank here on this board could address that but would need more info as well.  Post more and let us know what is all going on now and in the past.

[steveswife]

Hi Hank,

Thanks, I appreciate it :)

Some of my questions I'm sure others think are nutty.

See you in your mail box.

Tammy

[Kimma]

yeah i have IST..my heart rate is always over 100. 90 at rest. doctor told me i have the ist because of an electrical problem brought on by irritation to the electrical system of my heart from the ablation. its all confusing to me and i was never told that was a possibility before i got the ablation. i would do anything to go back, but i try my hardest not to think about that. i guess im just going to have to take beta blockers for the rest of my life. kim

[glassheart46]

I would like to know when you had your ablation and what it was for.  I had an ablation 7 weeks ago for AVNRT and atrial tachycardia.  I now have sinus tachycardia from irratation from the ablation.  At this point I do not know if it is temporary or permanent.  I really would like to talk to you and look forward to your post.  I do not know how long ago your ablation was but I was told by my EP that it could last for some time but eventually could go away too.  So don't despair, this may be the case for you as well.  Please post soon.

[Kimma]

i have had sinus tach for about 5 monthes now. bad pvc's for about 8 monthes. i had my ablation last november, over a year ago. i was cured for about 3 monthes then i felt my first pvc. as the monthes went by i got more and more pvc;s and then developed sinus tach, now if it wasnt for the atenolol my heart never beats regulary, i get pvc's all day long with a pounding fast heart. everyone is different so maybe your heart will get better. since it is from the ablation why didnt i get it right after the ablation? i did have a couple pvc's here and there but nothing bad. i really dont want to take beta blockers the rest of my life but my doctor scared me and told me tachycardia induced cardiomyopathy could result somewhere down the line if i didnt take them. kim

[glassheart46]

What were you ablated for? What area of your heart? Did you have any post-ablation symptoms during those first three months?   Have you thought about getting another opinion?  What you are experiencing could be hormonal related or thyroid related. I have read in many places that IST usually has an underlying cause.  I agree with you that it should have showed up right after your ablation but I'm not a doctor either.  But still, I would get tested for the above and seek another opinion as well. I await your response.

[Kimma]

im going to have my thyroid tested next week. since i have had my ablation i have not had any symptoms i had before the ablation, all my symptoms are new. my only problem before the ablation was psvt that i would be in for 5 or more hours. i went to the er one time because it wouldnt go away and they gave me adenosine but it put me in afib for 12 hours. i almost had to be cardioverted but i converted on my own right as they were about to give me the drugs to put me out. i was ablated for 3 extra pathways 2 in one side, 1 in the riskier part of the heart. the doctor said it was successful. having psvt every two weeks doesnt seem that bad compared to what i  have to live with everyday now. i am going to seek another opinion, the doctor im seeing now is a cardiologist, i want to go see an EP doctor. Kim

[grapes270]

A related discussion, PVC was started.