PVCs turning into sudden death and Treatment

[AtlPaddler]

I've read through the archives and know that "in general" if there are no underlying conditions that PVCs are benign. I've had them since I was about 13 years old but only once or twice a year. Recentley they started coming (several a day)and some are quite painful,and sometimes I experience what feels like several in a row (10 or so). (I'm 39 now). I frequently experience chest tightness or discomfort before and/or after the PVCs, as well as a host of other symptoms. I had an Echo (15 years ago) which was normal. This year I've had a resting EKG, stress test, wore a Holter monitor and an event monitor. All showed PVCs but the cardiologist said I was fine. Since the "multiple attacks" I've been having a lot of trouble dealing with these. He said he thinks it does more harm than good to treat a benign condition with medications. I tend to agree, but even with a psycologist I can't seem to handle these things. The dang things are causing the stress, which causes more PVCs. I'm afraid to exercise and I have heard that PVCs can degrade into VF. I've asked my cardiologist, but he just tells me to see a pshycologist, so I hope that you all can answer these questions: 1.  What factors turn PVCs into VFib and do the tests I have had (Stress test, holter and event - echo (10 to 15 years ago)show if I am at risk for this happening to me?  2. Dr. won't give meds and I don't drink, smoke, eat caffine or chocolate, Tha Chi for stress etc. so are there any "natural" remedies to help ease these things? I'm desperate for relief if only to ease my fear.

[JDS]

I am writing this in hopes that it helps others understand they are not alone.

I am a 44 year old male.  I was on a swimming team for four years in high school.  I ran 5-10 miles a day all throughout college and then joined the military.  I was an Infantry Officer who spent most of my time in the field.  Needless to say, I worked my heart hard for many years without ANY problems.
In 1992 (35 years old) I had just completed a 5 mile run in which I was pushing the pace pretty hard, and my whole life changed.  My heart began to race and it would not stop for several minutes.  Shortly after that, I started to get PVCs and PACs.  I complained to one GP about my conditionand he told me no one lives for ever (rule #1) There is a doctor on every street corner - pick one that you like, is experienced in his field - and who genuinley cares about your problem.    
After three years of Holter and Event monitoring, experimentaion with drugs, tilt tests, stress tests, echos with and without color, heart sonograms, and countless EKGs, I experienced bouts of depression and anxiety attacks.  My cardiologist said live with it. So live with it I am.  Some days are very good and some bouts last for weeks and months. Recently the PVCs began two months ago and they are starting to dissapate a bit.  There are times when I can play full court BB ball without a problem, and there are times I walk upstairs and I get them.  I hate them - but I always figure it could be worse: I see worse all the time -kids with no legs, or arms, babies dying of cancer or Aids, people blind since birth ect...  My cardiologist wants me to get a thallium stress test to ensure there are no underlying problems.  I reccommend you get every test known to mankind (do them twice if it makes you feel better) and then deal with them after you find out its only PVCs.
I'll pray for you all because I know what you are going through -and I'll be here for you if you need to talk.  Thank God for this site - it has helped me tremendously - I used to think I was all alone !

[MarkM]

I have also had these God-forsaken PVCs on and off for about 20 years (I'm 41).  When they're gone it is euphoria, when they come back, it is often with a vengence.  I take fish oil, garlic, and magnesium (dissolved in orange juice), and this tends to 'soften' them a little.  I also drink only bottled water, as I think chlorinated water contributes to them.  Caffeine and alcohol are definitely factors.  One thing I do find, however, is that when I am having a big attack of PVCs (i.e several per minute), a little alcohol generally helps.  Perhaps it's the slight calming effect; I'm not sure, but it beats going to the emergency room...

[marian]

hello everyone, i just turned 40 a few weeks ago. I have been in the hospital twice in a week witht hese scary heart flutters. I was told i have pvc. Well thats nice for them to tell you that you have something but not what to do about it. In the past i was also told i had an anxiety disorder, but even in my worst panic attacks, i never had pvcs. I took paxil for 3 years and it did help me very much with my anxiety. I got off the paxil about 4 months ago cause it made me gain weight. well i have been felling anxious again so im on half the dose i was on in the past. I always remeber having these flutters once in a blue moon, but of course the docs always just said, ah, its probably part of your anxiey, so i would take an ativan and forget about it. Now they are happeneing every day almost all day long....i m frightened to death about it. I have had tests in the past for myto valve prolapse cause my dad has it, but nothing ever showed up. Im making my doctor test me for everything possible (thats part of my anxiety doing that) my white blood cell count came back hi, so if i understand correctly that could mean an infection in my body. I hope that is all it is give me the fix it pills and they will stop. Is that possible? please can someone give me any advice or help. I'm so scared of these things and they are ruining mine and my family's lifes. e-mail me if you can help at ***@**** you

[Tigger2]

In response to  feeling your palpitations more at night.  I can relate, and have been through the same thing.  I have several rhythm problems all of which seem to be worse when I go to bed or lay on my left side. I suffer from tons of PVC's, also PAC's, Superventricular tachycardia, and now Atrial Fibrillation.  Of all these, the most troubling and painful are the PVC's. As far as felling them more at night, it was explained to me that when you are at rest you tend to feel them more, even though you may have had just as many while active.  I too went through a lot of anxiety and hated to go to bed. I tried several beta blockers.  Toporol (made my blood pressure to low), lopressor (caused worse anxiety), Atenolol (also made things worse).  Then put on Digoxin (Horrible!! made them so strong and painful).  Was also told to see a psyciatrist! Went once, said I had generalized anxiety disorder.  Who wouldn't with all this activity in your heart.  Now am taking Propranalol (generic indural).  I highly suggest it.  It does make me very tired though.  But it has helped my PVC's soooo much.  I still have spells of my SVT and A-fib, but It has really helped with the anxiety and PVC's.  Hope this helped a little.

[TangerineDream]

It is very comforting to read that I am in the same boat as a lot of other people, but not comforting enough to help me sleep at night.  I've have been having these PVCs for almost 6 mos. now and the quality of my sleep has deteriorated rapidly.  After having numerous tests, trips to the ER, assurances by doctors, along with a prescription for valium for those high anxiety moments and being on Atenelol (25mg), my bed has become my enemy.  Can anyone explain to me why these premature beats, skipped beats, flip-flopping, palps, etc. always kick in when I lay down to sleep and why they seem to be worse when I lay on my right side?  My doctor says it is simply b/c I am more aware of them at that time, however, I can not accept this, b/c there are so many times that I am so exhausted from lack of sleep and even with the aid of a valium, that I should not be aware of anything. I would surely appreciate it if anyone could explain this to me and/or if they have the same problem when they lay down.  Thank you.

[Goodgal]

What happens if you have to have an operation under full anaesthetic for unrelated problems?? Can this put you at risk if you suffer from pvc's and palpatations and other weird symptoms that mimic heart problems(shortness of breath, numbness resembling bad circulation)Should the surgeon be informed? I realy dont feel comfortable about it.

[Laurmar]

Hi all.I am 42,and while visiting the hospital,for acute diarreah,it was brought to my attention that i had and echo...extra heartbeat.I often while lying in bed,would feel that my heart was going to pound out of my chest,but it brought no pain.After reading everyone elses stories,i realize i have nothing to complain about,but my concern,or question,should i say,is does this get worse.Will i eventually experience the pain associated with what others are experiencing with pvc and require meds?I am not going to let this stress me of course,as i am hearing that worsens it.But am curious to what i might be looking forward to.Thanks,and take care everyone.P.S.I think i am going to quit smoking,to celebrate i am alive and feeling not too bad.

[pistolpete]

You two sound identical to my experience, except fortunately I don't have any pains.  But, up 4-5 stairs or mowing the lawn almost always send a few thumpers.  I always trigger them on walks and in the past they would continue for 4-6 hours after that.  Lately though they almost subside when I stop the activities.  And afternoons are worse than any other time of the day.  I've thought a lot about all this (way more than I want to!) and have come to the conclusion that ultimately my biggest concern is them progressing to VT or worse.  But I guess after treadmills, echos, a 30 event monitor, and a 24 hour holter, if the cardiologist isn't worried, then I guess I shouldn't be either.  It is a little hard to concentrate when things are bad, however, and I'm not sure I can learn to block it all out 100% when its happening.

[squeala7]

Wayne I get them too when I mow or something, and they do hurt. I think its because were working our heart harder and its having to pump more and when it hits that extra beat after the pVC, its forcing all that blood out at once and its like WHAM! It scares the s--t out of me! ANyway I feel the same walking as you do. I really do think its the CONSTANT that keeps your heart working good - walking , your keeping up the same pace pretty much, so your probably keeping your heart rate at one rate. When you mow - its up and down, your muscles are requiring more here and less here...I notice too when I bend down in the yard to pikc somethign up - wham! I think some of us are 'wired' to have them and some worse than others. Unless of course there is something wrong - but if weve been checked out - I guess we'll continue to live and WITH THEM! UCK! BUT I must say that I did have the hard ones a LOT more before I got on Toprol XL. I know youve tried lots - but it did stop those hard ones I would get for absolutely no reason, like walking up 4 lousy stairs. I can mow now and really dont have any serious (what I can serious ) ones...good luck!

[Wayne Monaghan]

I see all types of letters with peeps having all types of PVC's.....I'm 42. Mine hit everytime I want to do something that requiers alot of physical effort. I work alot at night on my feet and I walk alot during that time. But after about 20 mins or so......here they come. I will have 20-50- a min. But if I sit down and wait a few mins they go away. Once back on my feet within about 5 mins they are back. Cutting grass......big time PVC's. But there have been times while walking with my wife they seem to over ride themselves. What's up with that? They are gone until of course my heart rate returns to a slower pace. And sometimes they hurt. The pit of my stomach and I swear I can feel em run all the way up the back of my neck and head. Is ablation an option? Sure I have runs of PAC's here and there but nothing like PVC's. I take 50mg of Tenormin twice a day and 150 mg of Rythmol twice a day. Nothing has any effect on them. I have even reworked my weekends around my PVC's....If I feel like I'm gonna have a "Bad Day" I won't go anywhere or do much. Like the lake or shopping or walking. It really wears on your mind big time. If I could just get them to stop. It's not easy living with these things and you sometimes wonder if it's worth living them at all.........Thanks for listening.......Wayne

[bluechevy]

Hello.  I am new to all of this.  I am a 32 year old woman that has just went to my gyn who sent me to get a EKG.  I have had a funny feeling since Sept with being able to feel my heart beating an extra time hard.  The only time I recognize this is when I become still (which isn't often with a full time job, a husband , and a 5 year old).  I mostly notice it when I lie down at night until I fall asleep.  I just received notice from my gyn about the results about my EKG and he has told me that I have normal sinus rhythms, abnormal PVC'S and my left atrial is enlarged.  I am in need of some answers as I wait for him to call me back with my appointment with a cardiologist.  I have has some extra stress in my life since September and think it could be the cause of some of it.  Any information would be greatly appreciated.

Thank You
Shannon

[nickwithit]

I can't believe how many people have PVC's!  I've been having them since I was 19 or so (now 34).  They come and go, and tend to be stress related with me.  I also have a lot of anxiety, and I don't think that helps.  The only time in the past 15 years that i haven't had them is for 8 months when i was seeing a therapist once a week.  Since then I've had children, and have moved or something else stressful fairly regularly.  I'm afraid of dying ultimately.  I'm afraid of leaving my kids alone in this crazy world.  oh well, i don't even have it that bad i guess.  I only get them a few times a week unless i'm really stressed out.  It's nice to know i'm not the only one, but at the same time, i wish none of you had to go through it at all.

[squeala7]

Nice to hear there are other people goin through this stuff too. My husband always tells me just because I dont know anyone who has it, doesnt mean there are millions of sufferers! I just wanted to pass along a treatment plan I came about for myself through research and mostly being a guinea pig. I am a 37 year old female, a lot of my PVC's are hormonal. I am convinced of that, and while I am only 37, perimenopause starts about now. SO for those of you who are female,  do not let drs tell you there is no correlation. Thats BS. Even for males hormones can throw the heart into abnormal behavior. Our bodies are built to work in a certain way, hormone regulate every bit of our being. When one is deficient or too abundant, it can cause all kinds of problems. Males can be lacking all sorts of hormones as females too. Its worth it to check it. There are saliva tests online you can purchase to check your hormones. Many times , for women, natural estrogen or progesterone can do the trick. Estrogen fluctutations cause major problems for women.  Some synthetic hormone replacement therapies and progesterone (synthetic) actually cases "vasospasms" which causes your heart and veins to constrict, thus causing PVC's and those painful afterbeats. I have experienced every type I think - they do get really wierd around ovulation and through the luteal phase. Then I have one great week then its all back again. Anyway - sorry this is so long, but for anyone who might want to try - I really think the CoQ10, 50mg in the am and 50mg in the pm helps considerably. It takes about 6 weeks to notice...Vit E is essential , and calcium and magnesium supplements.  I am also taking Toprol XL, which is like a betablocker, but is cardiac specific and doesnt cause the bronchospasms and asthma breathing problems that most betablockers do. I didnt like the side effects of the atenolol. Try Toprol!!! I think its great - most of the time insurance does not cover it right now - but its worth it if it gets rid of these danged things. Its about $30 for a month supply. I cut them in 1/2 and take 25ml instead of 50 and get 2 months out of it - it slows your heart rate, lowers blood pressure and I havent had any of those HARD PVC's that hurt real bad and the 'runs' have reall been cut down to almost nothing. I am still battling the hormonal ones, but working on that too! If  you are having some of the same problems, feel free to ask me in a month how it turned out! Or if anyone has any more suggestions let me know!

[pistolpete]

I am a 46 yr. old male with some family cardiovascular risk factors, and have been treating hypertension and cholesterol with medications for some time.  I have a long history of PACs. This past January out of the clear blue it suddenly changed to very pronounced and what I consider debilitating PVCs.   I had a normal treadmill prior to that in October 2001 which showed none at all.  I just had an echocardiogram and a 24 hr. holter. Echo was normal. The holter recorded 1500.  I get anywhere from 10 to 15,000 a day.  My cardiologist believes the focus is in a treatable spot on the right ventricle if he were to try to ablate it, and he has offered either that or medication to calm it down.  I had decided to try ablation, but am now agonizing over going ahead with it given the risks if this is really benign.  Exercise triggers them every time and I can't even walk around the block (7 or 8 minutes) without getting them to a pace of every third or fourth beat, which is driving me insane and why I have to do something.  My question is, since they've been performing ablations for several years now, does anyone know what the relative risks of stroke, death, etc. are for someone like myself that seems to have no structural damage or prior heart attack, and for those that have had it done, would you recommend it for someone in my situation?

[oma2]

I am 50 and have bigeminy pvc's all day long. It gets very uncomfortable, hard to breathe, headaches, etc. but my cardiologist's comment was "it won't kill you, live with it". I wish he could feel this for just one hour and then see how he would feel. I was on Atenolol for 6 years and then it stopped working. right  now I am not taking any medication but I would like to see an electrophysiologist and have an assessment for possible ablation procedure. Have any of you had this procedure done and if so what was the criteria neccessary. How bad does it have to get before doctors will consider it and how dangerous is it?

Skipping along life's merry way,
Oma2

[Tresee]

I too have had a history of PVC's and I'm 45 so I've lived with them for about 28 years.I will go days and not feel anything and always about the time I think they're gone, guess what.....there they are! The last couple of weeks they have been really bad, lasting for maybe 2 or 3 minutes at a time. It's like my heartbeat is completely erratic. I've heard people say that magnesium helps a lot. All I can say is God bless us all!

[AtlPaddler]

Thank you so much for the information. I am indeed relieved by it, especially the part about the V-fib. I really feel guilty for asking because so many of you who responded have them so much worse than I. I have been taking steps like counceling and Tai Chi and the like. I've really had these most my life and been fairly unbothered by them. It just seems that since I had my baby I worry so much about them. I guess cause people feel the need to tell me about the poor widowed father of two little babies whose wife just died in her sleep at 31 and such. I've become so afraid I will leave my babby. Sounds silly, I know, but there it is. It was so nice of you all to respond. And yes, my do to some extent seem posture related, when I slouch or sit funny, but then I have gotten them while out walking and such so who knows. Thanks for the web links and the support!!!
Nancy

[Michael Varga]

I am sitting here going through more skip beats then I can count.  I stopped smoking a week ago.  Could the increase in PVCs be caused from that.  I am chewing the nicotine gum, generic brand.  Anyone have any insight?

[jjill]

SO NICE TO KNOW THAT i AM NOT CRAZY, AND NOT THE ONLY ONE.  i TOO WAS SCARED TO GO ON MEDS.  i HAVE THE "TONS OF BENIGN PVC'S" TOO AND i WAS STARTED ON ATENOLOL AND i FELT GREAT!  rIGHT NOW IT HAS STOPPED WORKING SO WELL, SO I HAVE TO GO BACK, BUT I WOULD ENCOURAGE YOU TO TRY IT.  IT IS A HARMLESS MED THAT FOLKS WITH HIGH BLOOD PRESSURE TAKE FOR 30 YEARS SOMETIMES! I FEEL SO MUCH BETTER TAKING THE DRUG. HOPE IT HELPS YOU

[CLM]

Hi, I am a fellow sufferer and as I sit here (with my trusty event monitor on!) I am getting PVCs every other beat.  I get tons!  The reason I'm doing the event monitor is that the frequency of PVCs can get so high I was beginning to suspect bouts of a-fib, but now that I have heard the recordings for myself, I can hear that it is a massive quantity of PVCs, sometimes lasting 40 minutes at that frequency.  So, I certainly understand your fears and have them myself.  What I am doing is taking action:  I take 25mg atenolol each day to get a little adrenaline relief, I'm doing this event recorder just to make sure that these are "just" pvcs, and I just started counseling, and I walk 20-30 every other day.  I have made up my mind to "get a grip" because they are crazy-making and stress DOES make them worse or the "attacks" longer.  I find that easy movements, like walking around the house a bit can relieve the intensity.  But you know what?  They are going to happen to us:  that is just how we are "wired."  Kind of like the way some people get headaches.  As to them degrading into v-fib, I think if that could happen it would have happened to me already!  Really, I should get some kind of award for getting the most.  ha ha.

[stevebu]

I use to worry about PVC's, and was convinced they would kill me. Then I woke up one day and said so what is the worst that can happen?  If I die, then the PVC's will never bother me again.  Some people live with thousands and thousands of PVC's every day. Some people have terrible diseases that they would trade any day for a few PVC's.  You have to put things in perspective and realize you don't have it so bad.  If you spend 1 hour a day for 20 years worrying about PVC's, you will have wasted almost one year of your life.  Just try and let it go and move on.

[Mommyplus6]

well, I just wanted to say it is hard to understand...if you look back at my last question you will see alot of wonderful responses from the people who frequent the boards..
My opnion is this..I think it is all entwined with the stomach,posture,stress ect..and like alot of people think even is your not feeling stressed your internal thoughts/thinking pattern have a real effect...
I wish I had the answers..I have had chest pains,rapid pulse of 150..160 during a panic attack..pretty scary stuff..and yet I am still here..nothing ever recorded ther then pac's pvc's//I too get edgy just thinking about exercise..
it has changed the way I do things...
I am taking slow steps...
I just wanted to say your not alone in your questions...
and there does seem to be a good support system here...
I do not drink,smoke,caffeine,drugs..
check out these links

http://users.chariot.net.au/~posture/index.html#anchor65513

http://www.energybalancing.com/stomup.html

[crystalrocks]

I'm with you here. I have severe pain,shortness of breath and dizziness.  My holter shows PVCs (what the EP described as "alot") and even ended up in the hospital w/bi,tri and quadjimmny heatbeats. My EP wants to prescribe a beta-blocker (w/side effects) and a Xanax like pill to keep my anxiety down. But i'm more angry than anything.  Perhaps the majority of people can cope w/pvs, but some of us have them ALL THE TIME!!! And how do you cope w/crushing pressure every two-three hours. I describe my sypmtoms and they are exactly the same for a pre-cursor for a heart attack. At what point, are these not ok.

[CCF-M.D.-CRC]

Dear AtlPaddler,
This is a very common and potentially confusing area that I'm sure many people have the same questions.  Premature ventricular contractions (PVCs) are caused by a small "focus" of cells in the ventricle firing and causing the heart to contract earlier than the next normal beat.  There is usually a pause following the PVC which allows the heart to fill with more blood and the subsequent beat is therefore more forceful.  It is usually this following beat that people feel.  In some people this beat may be painful and cause a great deal of discomfort.  

The good news is that in normal hearts PVCs are not in any way, shape or form dangerous.  The confusion starts when we talk about persons with "sick" hearts in whom PVCs may indicate the potential for a worse outcome.  Now to your questions.

1. What factors turn PVCs into VFib and do the tests I have had (Stress test, holter and event - echo (10 to 15 years ago)show if I am at risk for this happening to me?
A: Persons with a history of heart attack, scaring of the heart, and a low ejection fraction (<30%) are at increased risk for having ventricular tachycardia which can degenerate into ventricular fibrillation.  Increased PVCs may be a marker for those individuals in this group at higher risk.  "In general" implantable cardioverter defibrillators (ICDs) are recommended for these individuals.  PVCs in persons without these risk factors are not predictive of outcome. So if your tests were normal than the PVCs do not have any significance.

2. Dr. won't give meds and I don't drink, smoke, eat caffine or chocolate, Tha Chi for stress etc. so are there any "natural" remedies to help ease these things?
A: There are many things that individuals have reported to help but no studies which I am aware of natural therapies.  You can read many suggestions here in this forum.  I am not opposed to giving medications to those who are severely affected by their PVCs and in some cases would even recommend ablation.