PVC's PAC's and ???

[NurseKagome]

Hi there!I am a 23 year old woman who has been having pvc's pac's and bouts of tachycardia since I was 16 years old. Normal ekg, holter, stress test, echo, x-ray and blood results.I had a holter done a couple weeks ago where I had only one pvc/8 pac's show up but the part that has me baffled is that everytime I recorded on the holter as feeling a palp sensation the doctor said it actually matched up to a regular sinus rhythum??? What is going on here? It is soooo strange to me that I felt a flip-flop beat and it was a normal heart beat? I have never heard of this. I have been documented previously as feeling the pvc's(holter). So, my questions are:

-any idea or theory as to what is going on when I feel the palp that "isn't there"??
-how can I tell this normal rhythm beat from a pvc to know when I should seek help (i.e. if I get a bunch of these in a row or I get them during an intense workout...?)
-the doctor is getting me to do another stress test this monday to see if he can see the beat I have been feeling during exercise.I feel a little anxious about it since getting those beats on exertion scare me. Why are pvc's above 150 bpm dangerous? I am a nurse so please explain this all in a physiological way so I can really understand whats happening:)
-my pvcs(or whatever these things are.Can't tell the difference) have been torturing me over the last four weeks.I really feel like my heart won't return to normal during couplets and bad spurts.Can you explain to me why I should not fear SCD? I feel so sick when having palps.
-what is different in athelete with SCD?Thanks

[Cleveland Clinic]

Nurse,

There is no way to tell what is causing the sensation outside of electrical monitoring of the heart. I have to say, if it doesnt show up on the monitor, the sensation you are having may very well be non-cardiac. Sometimes reflux, or muscle pains can mask as heart symptoms.

There is no reason in particular a PVC at higher heart rates is any different than those at slower rates in patients with normal hearts.   Your physcician is trying to replicate your symptoms at higher rates to see if there is an underlying arrythmia to explain them.

If your symptoms have been evaluated, I wouldnt concern yourself with trying to tell a normal beat from a PVC beat, unless your symptoms change from what youve had before.

I patients with a normal cardiac evalution, there is no increased risk of SCD associated with PVCs. Althletes predisposed to SCD generally have undiagnosed structural heart disease such as HOCM, or an inherited predisposition for SCD such as LQTS. Youve had an ECG and an Echo with none of these findings. In the absence of a family history of SCD these conditions would be unlikely.

good luck and relax.

[tickertock]

I had isolated PVCs at a heartrate of 170-180 bpm , documented on ECG and both treadmill testing with the cardiologist present monitoring the test, he did not tell me that the PVCs I was having was dangerous at this rate.I asked and he said no it was not dangerous, at least not the ones I was having.

I for one think you have to be careful of the conflicting articles one may read on the net or otherwise, some of the medical professionals have very conflicting views themselves, I would trust someone who has a vast amount and knowledge in a specialized dealing with these aggravating arrhytmias, Its a good question though, I hope the answer puts your mind at ease.

[NurseKagome]

I just wanted to say before the chat starts that this is my second post within 6 mths and that the last post I made I pressed the stop button on my browser to change my topic title and then posted it to only find the 2 of them there. It was a mistake :)Happy posting.

Nurse Kagome

[NurseKagome]

I always thought pvc's at a rate higher then 150bpm were more troublesome. I mentioned it to my cardiologist, he has been one for over 40 years and is well acknowledged in this province as the best cardiologist around, and he said that there are usually more concerned about pvc's occuring at a higher rate like 150 + bpm. On the other hand my GP says not to be concerned since all of the previous tests came out great. So, tickertock...who knows whats right. I hope your right...though like you said, your particular ones are ok. Maybe there are some pvc's that occur at the higher rates with more widened QT intervals or something...who knows! ahha :)

I hope the doctor answers all the questions in a very informative way...I'm curious about the human body and enjoy to learn new things.

Nurse Kagome

[tickertock]

First I want to say I have a lot of respect for the older well experienced doctors who have seen it all, but they are a few of them from the old school thought(no disrespect intended) who still think simple pvcs are a harbinger of worse things to come.I know a few of the older cardiologists  who have changed their way of thinking regarding pvcs and is updated on all the latest studies regarding arrhythmias , PVCs and such, of course they are some old guys(docs) who never regarded them as anything significant either after seeing many patients with them for over 40-50 years that are still going strong.

In the past 20-25 years there is a much better understanding and general agreement of PVCs and arrhythmias among the medical professionals and the vast amount of people with them have nothing to fear but the fear of them and they feeling of dread they bring, I'm going 42 and had them all my life, though I rarely have them anymore, though this morning I had a few good thumps but I'm amazed at able I'm able to almost ignore them and just keep going before I would have been vigilant waiting on the next ones for days to come. I know how they can scare you, but you can also learned to overcome your fear of them also, it has taken me nearly all my 41 years to comes to terms with my anxiety over these PVCs and rapid heartbeats and not let them get the upper hand. Good luck.

[NurseKagome]

I agree with the older doc thing but this cardiologist feels that pvcs are a highly researched thing and he feels absolutely no worries in my regard. He said he has had countless 1000's of pt.s over the years with them and they are all older people now, he said he gets alot of young ppl too in their 20's like me who have them alot and are all frightened about them. He isn't one of those old foogies haha. He said that pvc's are not dangerous but the ones at the higher rates do concern them more for some reason. I plan on asking him more about these on monday as to why, I will surely come here then to tell what he has to say. He is doing the stress test more for my sake I believe since he knows they bother me so much at higher rates...It may not even be pvc's that I am having since I have been documented as having a NSR during feelings of flip flop too! That has me so weirded out.

Your 42 and had these your whole life? Wow...did you honestly truley feel like you were gonna die like forsure? at times? I do. It's a struggle all of the time. Sometimes I feel just so gross and sick and others times so good. Do you drink? I used to but now I don't, it causes too many pvc's. I want to cause a sociable was always fun, I feel at my age I am like an old person...pretty crapy huh? Other friends view me as athletic, strong, healthiest person they know...but I see myself differently. I think I'm sick cause of these stupid things bothering me so much. I wonder how can something so "harmless" make me feel so bad and like I'm in such danger?? I dunno. What do you feel about it all?

Nurse Kagome

[oneil420]

YEah ive been there, at the age of 23 i started getting palpa and YES i honoslty thought i was gone,,,I ended up in the ER a few times just to get sent away with normal results. MAny tests later i still havnt got a palp caught on a ecg, even with event and holter monitors i didnt experience the symptoms during tests, however they did find marked sinus arrythmia during a "episode" and said that althoght rare, the variant between my inhale/exhale is so exegerated that it prob is causing my palps, im still waiting to ask the DR about that. BUt like ticker said four years later and i can all but ignore them now , although there are those rare moments where my mind runs with the anxiety.  Im curious what the doc will say, me i dont get many palps during exercise or a increased heart rate it usually at rest or hours after a strenous day but i think thats the norm? I know my papls arnt caused by anxiety but the anxiety does increase them and besides that i cant find any enviromental triggers, caffiene , no caffiene, alchol, no alcohol, exercice, no exercise they show up when they want and leave just as fast but i hpe you find the answers you looking for, just remember your just as responsible as the DR's to get to the bottom of this, its your body, later oneil

[tickertock]

Yes I had PVCs from time I can remember though when younger(childhood to teens) my main problem was a heartrate on the high side of normal or little higher of which I was very aware of. I never had episodes of frequent PVCs til around 26/27, then they would come in episodes every few months to years and last in 1000s daily from weeks to months , longest was 5-6 months from Oct. 2001 to April 2002, since then no prolonged attacks.

I used get them when I drank alcohol, I laid off it for about 2 years sometime ago , but up to last night I had 3 glasses of rum & gingerale(probably what caused a few thumps this morning :-), but to be honest not even drinking alcohol sames to trigger them much anymore though I could pinpoint that as being a trigger for PVC & tachycardia combined. I drink in moderation though, though sometime I don't have a drink for weeks.Maybe its because of the atenolol & cozaar for palpitation HTN that the palps are controlled.

Many  a day when I would wake with them, I thought I would never outlive the day that's how bad they made me feel sometime, but I always made it through, I tried never to let them cripple me.

I worked in the healthcare profession( I'd rather not say what my job was)) myself for nearly 20 years so I know a bit about that side of it. I have seen both doctors & nurses that also had PVCs, as the matter of fact a lot of nurses  I knew seemed to be bothered by palpitations( I wonder why?)!

[Applehorse]

PVCs sometimes can mean something bad - I'm living proof.  I have had them only since Oct 95 - never had em before.  Started out at high frequecny bi, tri, quad and remained that way for 5 mths - saw many docs including cardiologist - had evey test backwards and forwards except MRI - told by all docs unamiously and unambiguously (including cardiologist and the doc on this forum) "...there is nothing wrong with you and you have nothing to worry about..." some suggested I might have an anxiety problem
Well I almost bought this reassurance - but not quite - I pushed hard to see an EP who agreed to do MRI - what did they find you ask?...ARVD/C

I don't wanna scare you PVC'ers but remember your gut instinct can be more accurate than normal ECG/halters and echos.  Note that PVCs greater than 1000/day on 24 halter is one of the dx criteria for ARVD/C so PVC'ers with more that that (I was 32,000) should be concerned until MRI rules out ARVD - especially if you PVC onset is relatively abrupt with no explanation - Echos are useless unless you are an advanced case!!!! (I had 3 negative echos).  I have no family hx of ARVD or SD - I was a case out of the blue - I could be you.

[Applehorse]

I have had PVCs only since Oct 2005

[sandro]

i'm sorry...how old are you? where you always in bigem, trigem, or quad? i had an MRI done to which was negative (same as all the other basic tests). i would look in the internet for different tests they could perform on me (non invasive) to make sure nothing was over looked...i guess when it comes down to your life source (the heart), im not takeing any chances...

[Heart3]

Hi:  Just wanted to put my 2 cents in..

I have had PVC's and PAC's since 1996.  They came on during my 3 pregnancy. It is common during pregnancy. But I think once a pathway is created it is always there.  At first (after the baby and postpartum) they were very speratic.  Sometimes months or years went by and I hardly noticed them.  Then suddenly they came on like wild fire.  Which brought me to the holter monitor and to the cardiologist frequently.  Both showed normal and only a few PVC's.  

But early in 2001 they came on continuously for 2 months.  I was definetly in the 1000's or more per day.  I went to the ER and they documented them.  Pretty much every other beat.   It was a point when I could not deal with them and I was sure I would die.  But as the weeks went by I managed without medication.  And one day just a suddenly as they started they dissappeared and then they were like they were before.  Occassionly.....So it is weird how they  start.  I never had an MRI during that time, but I would suspect that I did not have anything serious.  Now they seem to be here and there per month.  I feel them probably every month several times.  

They seem to have a mind of their own.  I sometimes feel anxious and that definetly brings them on, but other times I feel perfectly normal and they are there.  I do get runs of NSAT which I have had checked out and they say that is nothing to worry about.  So I just take it one day at a time and try to stay calm always, and I never get upset about stupid things as I just think they will effect my health more than anything.  I do now just recently take 12.5 mg of Atenol as they say that will help the Tachyardia.  I think it has or at least it feel as if it has helped.  

Just wanted to post.  That was more like a $1.00 then  2cents.  :)

[Gaspipe]

If it was a mistake the first time and you shut down the posts for the day  you should not have posted again now. No excuse in my book for posting again today

[NurseKagome]

I'm sorry you feel that way...though on the day I posted twice they allowed three different topics so 2 daily topics still went in and no one was at a loss.

Thanks.

[CollegeGirl143]

irreguardless of how many posts are allowed in a 6 month period, i urge everyone who is wanting to ask another questions about pvc's or pac's to check the archives and see if your question has already been answered., because this is the most common subject on this forum, and also the most benign complaint.. the doctors answers are not going to change.( you arent gonna die from SCD! ;-)  This forum allows very few questions daily.i myself have been a member for nine months and have yet been able to ask a single question..  I fully understand That it helps people with health anxiety (and this IS what you have) to talk about their issues with someone else, but i think anyone here can tell you, a million people can tell you that your ok, but you will NEVER believe it until you accept it, and to accept it you need to stop questioning it. Period. You have been dealing with this for seven years, and you havent dropped dead yet. VERY few people die of arrythmia's, even people with more serious arryhtmia's like VT. IF your pvc's continue to be bothersom, continue to see your doctor, he will prescribe tests as they are needed. this is what they train for 12+ years to do. Put your trust in him and your faith in god and modern medicine and you will be perfectly fine.

Applehorse. ide just like to express to you that i personally found your post to be kinda irresponsible. People in this forum are suffering. Many from health related anxiety, And i think you might have really scared some people.... AVRD is difficult to diagnose just because it sometimes doesnt show up on an echo, but if your pvc's are persistant enough (as yours where 32000 is a HUGE number) a doctor will prescribe an MRI test. If your doctor didnt think you needed the test, you wouldnt have gotten one.Your intuition didnt diagnose you.  You got excellent quality care,as im sure everyone in this forum has :)  and your doctor treated you exactly by the book and that is why he found your true condition

Ide just really like to continue to see people on here helping other people. Sharing experiences is a part of what this forum is for :) ide personally just like to see it be a little more helpful than hurtful, but then again im only one person :)

[tickertock]

Just want to say I completely agree with everything you wrote in your comment. I fully understand the anxiety and torture these PVCs and ectopic beats cause though, after many years I myself is just learning hope to cope with them and finally ignoring them, but like an alcoholic, I'm well aware I could "fall off the wagon" again :-).In the maintime I'll just try and share my personal experience with PVCs and hope its helps in some way. Have a nice day.

[Applehorse]

Sandro - age 42, mostly bi, tri and quad but sometimes as few as a few PVCs in one minute.

Everone - to those of you who feel my post (based on reality) is irrisponsible - I do not understand why you just want to get cuddles from this forum - just warm fuzzies.  If so you should start a new forum called "Suppot Forum for Benign PVCs Only" What is it? you can't handle when someone with a real problem posts.  Irrisponsible my post is not, it is real and the reassuarnce I get from Docs now (changed from the fuzzy type) is that they are not mistaken about my illness. As for intuition it WAS my intuition that pushed my heath care and finally after much self advocacy and Dr shopping I and nobody else ensured that a MRI would be done - my own cardiologist did not see the need for it so I would not call that excellent health care.  Yes I was treated by the book - the book says in most cases - PVCs, normal echo, normal ECG, normal stress = no problem.  Now you see the book can be wrong.  Personally if I had read a post like mine pre-diagnosis I would have fould it alot more infomrative that the endless reams of "PVCs are lovely" - I could have arranged my personal life more strategically if I had considered a maligniant possibility - but unfortunately I was 90% brainwashed that I had no problem.  the 10% led me to PUSH the drs to find the Dx (which of course they would find by the book eventually sometine in the future when I develop ECG abnormalities).  I hope this post helps to inspire people who have the courage to stare down the naysayers and advocate from themselves to get quality medical investigations when they instintictively know (as we all know our own bodies better that any dr ever will) that there must be someting that they are overlooking.  I wish you all the best.

[tickertock]

I just want to clarify that even though I wrote I agreed with everything collegegirl wrote , I should have said basically everything. I don't think your post was irresponsible and you're obviously a case that falls in to a very minute in which case PVCs do point to serious condition.

It is my understanding that ARVD/C is actually underdiagnosed and can be very difficult to do at times.Good luck and the Best to you.

[kitcurious]

I completely agree with everything college girl has to say. With a structurally healthy heart, these are simply not dangerous palps and the docs are going to say it over and over and over again. Most doctors seem almost overly cautious in my eyes and are certainly not leaving their patients to walk around with dangerous arrhythmias.

What is at the root of health anxiety?  If it is not personally controllable, then outside counseling would seem to be the only thing that might help because the reassurance given here is never actually accepted. A counselor may be able to help people train themselves to interrupt, or stop the negative thinking.

There are very many people trying to access this forum everyday. Many of them have been diagnosed with substantial conditions and, for one reason or another, need medical advice. It would be good if they could post once in a while.  
Maybe they should declare a PVC free week :-D

[Applehorse]

Thank you for your understanding - that I find truly supporting.  I do not post often but do read often. I have long noted that you are a frequent poster and one of the most knowledgeable on the forum.  Although you often disclaim that you are not a doctor I would wager that you know more than most of them out there whan it comes to matters of the heart.  I also am not a doctor but I am a healthcare professional.  Good luck to you and your heart.

[NurseKagome]

I do not come to this forum for "fuzzy lovey" whatever was said posts. I am digging down to find out the truth, as as applehorse has clearly shown, we should not accept things blindly and continue to seek care if we feel that we are not well. I'm truly happy that applehorse posted the comment because everyone needs to know the ups and downs to pvc's. They are not all benign and they are not all bad either. People just need to help one another and stop being so overbearing to others. Whats important to someone else, whether trivial in my OPINION or not, is still important to me, especially as a member of the healthcare team. I could never address a person in need so coldly or dismiss them for being worriers or whatever. I think everyone's feelings matter and sometimes those who have the anxiety problems can be worse off and have a lower quality of life than those with more dangerous health problems. So, that being said, lets just all show respect to one another and act like adults and not disregard the feelings and lives of others. We are not here to judge others but to support one another.

Kind Regards,
:)Nurse Kagome

[NurseKagome]

Well said.

Nurse Kagome

[ihatepvc's]

I think you make a very important point and that is to trust your own instincts. In the past when I had a benign tumor that ended up costing me my ovary - doctors kept telling me my back pain was just muscular - I never stopped looking for an answer because I knew something was wrong, and when I had Lyme disease I had to push to have testing done and be given antibiotics - despite my doctor repeatedly telling me "you do NOT have Lyme disease Pauline"! With my pvc's, I don't feel like there is something more serious going on, so I accept the reassurances by my cardiologist and electrophysiologist. You on the otherhand, knew instinctively there was more to it and good for you for being strong and demanding that mri. Now you can take the medication and precautions you need to avoid any serious problems. As for the person who felt you were irresponsible in posting "bad news"... irresponsible would be posting an abstract of a study and omitting some very important data - you know who you are :)

[NurseKagome]

Thanks for your time and answer, it's well apreciated :)

Nurse Kagome