PVCs severe and continual - should I seek EP help or ablation?

[wal44]

51 years of age, male. Had minor PVCs about 6 years ago after big stress (work and kidney stone). Over time they got much better-basically only sporatic and of little concern. Those days, a little Magnesium and Potassium Citrate DID help. With stress-echo, cardiologist said I was "great."

Last October, I was given Lisinopril for marginal BP (140-90). Within a day or two I went to continuous strings of bigeminy - hours at a time. (I know ACE inh.s affect K) They said Holter confirmed PVCs. Cardiologist took me off Lisinopril put me on 25mg Atenolol. Better for 3 days then they returned even worse. They just will at times hardly ever stop, driving me crazy - can't sleep, affects work, etc. Sometimes, the "off" beat (premature? beat-THUNK-pause) is so strong it shakes my chest, makes me cough (part of the sleep problem).
New stress-echo showed no other abnormalities - EF 55-60%!

2 months later tried Toperol XL. No better. So far, Cardiologist  gives me impression I just have to live with this. He says drs. don't ablate PVCs only other problems.  (I'm not positively saying I require one, but I had a hard time believing what he said). Any comments? Do you have many patients that go into long periods of bigeminy until they are tired and breathless? They don't even want to refer me to an EP specialist. I would do anything to go back to the worst of my past - once every minute or two or so, but so continuously is driving me crazy!!

[CCF-M.D.-MJM]

Hi Wal,

Sorry to hear about the PVCs.  PVCs are a benign condition medically speaking, but for some people they cause significant symptoms.  I don't see people in clinic like yourself very often, but I certainly see some.

Some places do PVCs ablation.  You must have a significant number over a long period of time and be significantly symptomatic.  I am being vague because there are not set guidelines on when to do a PVC ablation, but I can tell you we don't do many.

The breathless feeling and fatigue are very common complaints.

It would hurt to see an EP doctor, but they will likely take a watch and wait approach to see if they get better before considering anything invasive.

I hope you feel better soon and good luck.

[Abeybaby]

Just curious are you located in Canada? I am and they dont even discuss the matter with PVC's. My cousin is a top cardiac surgeon up here at Sunnybrook in Toronto, and no one talks about PVC ablation. I have them too and yes they have crippled my life and I am only 39.  I feel for you. I have had them more with the increase of stress and anxiety seems to be the biggest trigger for me. I too was on Atenenol and it helped somewhat but when my heat rate got below 60, I would get strings of them together ... couplets etc ... not fun!  So now I take the meds only when needed and 12,5 mg so low it barely works but just enough to take the edge of things. You may want to ask the Dr. about a new meds called: Sectral (acebutolol) someone told me this meds is primarily made for PVC sufferers as it controls the heart rate within a range not too slow not too fast? Not sure but would be curious about what the DR says on this?

Yes, I have heard the same thing too - live with them "you are in good company" my cardio says given that I have a normal heart. Easy for him to say but I shouldnt complain because he gets them too and doesnt get phased.

Good luck you are not alone and although that is no solution its the facts - we all have to live with them one way or another.

Stay well.

[dafan]

Just to let you know I have almost the exact same thing going on. Mine are much worse in the morning tho. I forgot to take my Toprol with me the other day for two days and for some reason they got better after not taking it. But im afraid not to because of slightly high blood pressure ive got. They have ruined my life. Just had an EP dr appointment and he said everyone has them. All i know is I used to not have them. They came on all of a sudden. BTW all my tests are normal also. Ive heard of Ace butelol also. Oh well, they do seem to come and go but i sure wish they would go..

[Barbarella]

I've been having PVC's for the last 40 yrs.  Ten yrs ago at their very worst, almost every beat was skipping it was a nightmare, I hardly could sleep. I was afraid to eat because they came on big time after a meal. I found out that worrying about them makes them come on more frequently and they will stay longer.

The comments from doctors and Cardilogists i.e. "you've to live with it" and "everybody got them" I got similar answers.  Next time ask them if they would want their wife/husband and loved ones going through this or THEMSELVES.  Unless somebody goes through this exercise NOBODY has a clue what people like us are going through. Especially when they hit you while flying on an airplane and you can't get out that happened to me throughout the whole flight it was a nightmare.  Tranquelizers did NOT take care of the PVC's.  

They will finally decrease some be careful about mental stress, caffeine, alcohol and when going to the dentist tell him to give you a shot WITHOUT Epinephrine.

[Gaspipe]

I think you will find many docs will avoid PVC ablations if at all possible. Remember ablations can given the very nature of the procedure fix one arrthymia and cause another. It may be worth exploring the use of anti arrthymic meds . this class of drugs certaintly are not  w/o side effects.but can help. I suffer from the same problems you do and you will likely find the PVC's come and go . I to take a beta blocker and find it used to help some but now mostly reduces the force of a PVC.Frankly I would avoid abalation unless you start to see signs of heart issues as per periodic testing.What you need to try and do is stop obcessing about the palps do not and I repeat do not sit there and take your pulse all day! Get on with your day excercise stay active . I have good days and not so good days but you are not alone and you can do it.... I have for 20 years.I am no cardio just a long time battler in the war on PVC's!  keep your chin up.Good luck Gaspipe

[~*CaMeO*~]

I sympathize with you, as does everyone else on this board.  We all are dealing with this most uncomfortable condition .....and that's why we visit here (for understanding, information and to read the stories from fellow sufferers).  As one who has dealt with this for many, many years I have to agree wholeheartedly with gaspipe as to the best way to handle things.  Some days are good and some days are horrible, but we somehow manage to get through them.  What helps me is thinking of all the other things that could be wrong (and aren't) and to TRY to not dwell on the pvc's. Easier said than done ------- I know!  Good luck, God Bless and see your Doctor regularly for the reassurance that he/she can give you.  I take a low dose Valium tab when the pvc's are REALLY messing with my head, and although it certainly doesn't stop them, it allows me to deal with them a little easier.

[MightyLovelyMan]

PVC's have really bothered me as well.  I never had one (or at least one that I noticed) until I was 39 years old after being placed on atenolol for mild anxiety by my regular doc.  They scared me silly.  My doc said "don't worry" they are harmless!!  Then in Sept of 2000 I had an episode of atrial fib.  I realy felt like that was the end.  At that point I'd never even heard of atrial fib.  Anyway, I educated myself and had several tests run that were all normal.  Then I was taking off the atenolol and put on a small dose of Norpace for the a-fib.  Thankfully, I have not had any more afib, but I have days when the pvc's/pac's/eieio's run me nuts.  My wife is in the medical field and she is not very understanding.  The doctor has told you that there is nothing wrong with your heart!!!  You've got to learn to deal with it.  But I'm afraid that I have let the worry etc. take control of my life to a degree.  I must admit that I haven't felt the same strength/energy wise since I had the episode of lone atrial fib.  I do take Xanax as needed and it seems to help some.  But as many people have previously stated, folks don't understand if they've never had them!!  God bless.

[MightyLovelyMan]

I forgot to mention...many times I experience an increase and/or occurrence of pvc's with a sudden movement, hearty laugh, etc.
I also had surgery this past April for GERD.  I has helped the GERD a great deal, but stomach rumbling persits with gas and bloating.  This will as well set off a run of ectopics as well.

[hapecamper]

I get Pvc's and Pac's really bad to, had them for 20+ years but they are getting alot worse. I had all the test done and they came back normal. Dr said the same thing either put up with them or try Atenolol which I did, only took 12.5mg. HR slowed down to 40 so I never took it again, gave me some Lopressor to try if I wanted but never did. I get them real bad when my heart slows down which it does without medication in the 40-50's, then they last for hours getting them every beat to every couple beats. Sometimes my HR gets up to 120bpm but I think that it's because I get anxiety from them. I wish the Dr's could get them for one day just to see what they felt like and how it messes with your quality of life. I just started acupuncture to see if it will help they say it's should but might take a few times because I had them for so long, suppose to help with anxiety to. They also started me on Chinese Medicine, I am keeping my fingers crossed. I could go on and on about these. Good luck to everyone who get these terrible palps.

[pms_barbie]

I am the exception for the pvc ablation.  I had one done last Aug at the Cleveland Clinic.  I had dealt with constant bigeminy for almost a year.  It took 9 and a half hours.  It did not compltetely stop the pvcs.  However it did stop the bigeminy.  The pvcs that do remain are on most days far and few in between.  When I went back in December for a follow up my ep said for what pvcs I was still having it wasnt worth doing an ablation.  Because there are some risk that go along with the procedure.  Unless you have tons of pvcs most drs wont even fool with an ablation.  I hope you find some relief soon.  Good luck .

[Gaspipe]

Being realistic if someone is telling you accupunture will help PVC's you're being sold the cardiac equilvalant of the Brooklyn Bridge.

[Paule]

may want to try paxil 20 mg/day...probably will lower the bp that was elevated due to stress over the pvcs

[hapecamper]

Right now I will try anything because they are so bad. I go to the school were they teach it so it's not that expensive at all. Doctors don't seem to listen. So far every time I went they spent a couple hours with me and didn't try rushing me out of there.You never know something might help.

[MightyLovelyMan]

I have thought about trying Paxil or some other SSRI drug, but I have been told/read that they cause weight gain in many people.  Not sure about the exact reason.  It could be that the person is feeling better and just eats more.  I also agree with the previous post about Chinese medicine.  I don't believe that you can cure ectopic heart beats with needles.  Just my opinion. :-)

blessings,

[pms_barbie]

Gaspipe I understand your statement about the Brooklyn Bridge.  I have read somewhere that accupuncture could help with pvcs and I balked out it myself.  However I can relate to hapecamper wanting to try anything to get rid of those nasty pvcs.  I think gaspipe is just wanting you to realize there is a lot of things out there that are just money wasters.  You also need to be careful what you do try because they could make the pvcs worse.  My opinon is I dont think accupuncture would do any harm or any good as far as pvcs go.  However if you want to try accupuncture and it does help you then I wish you all the best.  Just be careful there are a lot of things out there that claim one thing or another , that might actually make the pvcs worse.

[pms_barbie]

My experience with the ssris was awful.  I lost weight.  I was down to 117lbs.  It seemed to make my ectopics worse.  I dont think it was the drug itself.  I think it was the fact that I quit eating and the lack of nutrients made the pvcs worse.  All of us handle drugs differently.  So what helps one wont help another.  In my case getting off the ssris helped with my pvcs.  Just for the fact that I could eat again.

[MightyLovelyMan]

I'm sure that is true.  They affect people in different ways.  I must admit that I have had a decrease in the number of PVC's since I've been taking an "extended release" Xanax every day.  I saw an earlier comment about beta-blockers lowering the heart rate and causing an increase in the number of PVC's.  I have done a bit of research on that subject and found that to be true.  Many people are more succeptable to irregular beats when there rate gets too low.  That is what I believe happened to me initially.  I didn't even know what a PVC was until I started taking atenolol.  I have a friend who had a pacemaker installed a few years ago (had nothing to do with pvc's) but his cardio told him they were setting the rate on his pacemaker at 80.  The reason was they had data to support the idea that fewer disturbances occur at a slightly higher heart rate.  Makes sense to me.
MLM

[Barbarella]

Oh man do I understand when family and friends say "there is nothing wrong with you why worry, or get used to it".  To these folks I say "I do not expect for you to understand these PVC's all I do expect of you is to understand that this is a problem for ME".  But most of these very people who critcize us about our PVC's have their own hang ups, lots of them freak out thinking about going to the dentist, freak out of getting a shot at the dentist or at the doctor's, are scared to death of a little pain.  I NEVER criticize these people because I understand that it is a problem for THEM.

This is why I stopped going to therapy about anxiety conditions, unless these therapists experienced it themselves most of them look at you like you're nuts and you can just read their mind what they are thinking. But if somebody suffers from depression there is all the understanding and compassion from these therapists.  Don't get me wrong I do NOT mean that these people should not get help, and I do count my blessings that I do not suffer from depression but unfortunately this is the only condition understood by most therapists.  Yeah I know they pretend like they understand about panic attacks/anxiety disorders etc, but trust me they have NO clue.  I been to several of them and wasted my time and money.

[MightyLovelyMan]

Yes Ma'am, I made two visits to a psycologist my self.  He seemed to understand my situation, but didn't really offer any help.  He said it's obvious that your not crazy!!  But you need to work through this yourself!  Okay.  I agree with your perception.

[Barbarella]

I saw one Therapist one time he immediately sent me to a shrink so I could get meds (he didn't know how to deal with my situation so he took the short cut and sent me to the shrink for meds).  The shrink would hardly listen to me I thought I'd have maybe 15 minutes at least with him to talk about my condition.  He had the inkpen in his hand and was staring down on the prescription pad the whole time and in less than 5 minutes I was out of the door with a prescription of Xanax.  I could not function at all on these pills, totally drained out.  I went back to the shrink and told him and he said "keep taking the Xanax and I have this wonderful drug for you named Zoloft you will feel so good and not drained anymore".  I said "yeah right you will get me hooked on this stuff and then hang me out to dry and I have to figure out myself how to get off of this stuff" and I walked out and never went back.  They do NOT want to listen to you but want to give you "band aids" instead as in drugs.

[hapecamper]

That's one reason I went to the accupuncture they sit and listen to you and don't try to push herbs on you they ask if you want to take them. I have been taking Xanax for over 10 yrs and the DR. I go to for the meds don't really listen to what you say. So I agree with what you said about the DR.

[dreamboat]

I too have pvc's that drive me crazy. I feel sometimes like I am bound with them like a rope.For the last couple of nights I have noticed when I wake up in the night my heart is beating slow and normally then if I turn over the pvc's start.Anyone ever do that?I hope all of you find peace with this awful thing.

[Jeff67]

Yep, I get that at night.  Not sure if they are PAC's or PVC's though.  Sometimes I get I short burst of whatever they are (SVT or NSVT).  You ever get short bursts? I always wonder whether those people that get many PVC's also get short bursts - I do not get many PVC's or PAC's (eliminated every trigger know to man), but I do get short bursts every now and then.

[Barbarella]

Yes, when turning over but not always.  When carrying heavy grocery bags in the house.  Sometimes during exercise and sometimes not. But then I have times when I do all the above and don't feel any PVC's.  Have been having this for the last 40 yrs.  Heart was checked out all is o.k. except for a leaking heart valve and the Cardiologist told me "it was nothing to worry about" and had nothing to do with my PVC's.

[Mantels]

What are PVCs?

[dafan]

Yes Jeff, periodically i will get short bursts of something. Not sure if it is nsvt or svt. I think it might... be svt because the beats really feel almost regular just a little faster, and they really dont end with a big thump just my pulse goes back to normal with no symptoms at all. Of course i guess it could be nsvt for there is no way of telling really i dont think without a holter. I hadnt had any of these since November but the last week ive had three bouts of these and all in the middle of the night when ive awoken already.