Painful PVC's

[manatee-]

I began having, what I learned to be, PVC's in 1995. I became overly concerned about the skipped beats and in 1996 had my first panic attack. I was a State Highway Patrolman and was told by different doctors that stress was causing most of my problems. I was in pretty bad shape for a few years and was diagnosed with Post Traumatic stress disorder, due to some events that occured while on duty, and panic disorder. Over the last few years I have had an echocardigram,which was normal, Stress tests, worn Holter monitors and event monitors and other than having annoying skips my doctors have all said I was healthy and not to worry about the skips. The skips do seem more frequent when I am under stess. I take atenolol 25 mg twice a day and klonipin .5 twice a day. My question has to do with some recent symptoms. Sometimes while having a bowel movement or straining while exercising or while relly nervous I'll have a skip that feels painful or uncomfortable. I am guessing that if I have a skip while straining that the recovery beat is more forceful and causes some pain. Secondly lately when having sex sometimes I get very lightheaded. I have never passed out and it doesn't happen every time but it causes me to be a little nervous when having sex. I guess its a vicious cycle like worring about my skipped beats I began worrying about it happening which makes it worse. Any thoughts or advice would be greatly appreciated. I really want to overcome all this and have made great strides over the last few years. I guess I just worry what the years of worrying and stress have done to me

[arthur]

First off, I am not a doctor, but a scientist.  That means either you can ignore me, or think about what I am saying.

Ablations (rf) are now commonly used to treat a wide variety of arrhythmias, particularly those with identifiable foci (overactive cardiac tissue which send out signals interfering with the normal pacemaker system).  In the case of "benign" PACs and PVCs, the usual approach is to leave them alone, UNLESS, they really bother you (which translates to a question of risk vs benefit).  I would judge that as a rule of thumb, if skips only occur occassionally, then forget it...however, if there are many skips (let's say 6+/min as an example), then a case might be made.  Check carefully through the archives of this forum, and you will find at least several examples wherein the doctor has suggested an EP evaluation for ablation for people afflicted with "troublesome" PACs/PVCs...the reasons are probably that the Cleveland Clinic is one of many such clinics that simply has a lot of experience with the ablation procedure and can claim a better risk/benefit ratio.

Tambocor. It is an antiarrhythmic agent of the 1C class.  It's primary effect is to decrease the intracardiac conduction in all parts of the heart with the greatest effect on the His-Purkinje system.  It's primarily used to decrease the automaticity of cardiac tissue, and is applied mostly to cases of PSVT and PAF.  It is not recommended for patients with milder forms of ventricular arrhythmia, eg, PVCs.  Like other antiarrhythmics, it has some pro-arrhythmia activity as well...   The biggest no-no with this drug, is that it should never be used in people who have had a myocardiac infarction since it increases their mortality, or in people with chronic AF since it increases the incidence of ventricular tachycardia or ventricular fibrillation.
It has some side effects, typically including dizziness and vision disturbances.  It is not the cat's meow, nor is it the world's deadliest poison...it's just another antiarrhythmic drug.
I have used it with some success (at the lowest dose) to reduce the number of PACs (as recommended by my cardio).  I discontinued it's use, because I was uncomfortable about the dependence upon a drug for the rest of my life for a condition that's bascially benign.

[Jeac]

I have enjoyed reading this forum but wonder if I am in the right area, if not maybe someone can point me in the right direction.

My problem is that about every three weeks I get what can only be described as a 'flutter' in the throat and a bit of a 'jump' in the area just above my waist. It is not painful but causes me to stop for a minute. Sometimes I look around thinking what can I do if I have a heart attack. I am going to go to the doctors but came across this site so thought I would post this question. If I am in the wrong area could someone please advise. Thank you.

[czech]

Hi, Thank you for the comments. I just want to know one thning. Does anybody else suffering from PVC,s have severe dizzines like me or should I be concerned about something else causing it. Also, has anyone flat out had an ablation for these annoying PVC.s. Will they perform one for such a case? I don't want to live with them the rest of my life and I don't like taking Toprol either, it slows my heart rate down to much and I feel like a Zombie.

[paola37]

Just saw my cardiologist and posed the very question you had - can an ablation be done for these PVC since I don't want to live with them all my life? He said that any reputable interventional cardiologist would not perform such a procedures unless there is a underlying condition that would make the PVCs a more serious condition.  With an anatomycally healthy heart PVCs are considered a bening condition (easy for a doctor to say) with time as you get old - yes, your heart could anatomycally change and render the benign PVCs a more serious condition.  Only them, the procedure should be performed.  I wish there was another answer to this condition - I have seen a few (last count- 6 cardiologists - 2 of which a John Hopkins University) and they all say the same thing --- not to worry ---- I will not drop dead - basically learn to live with it --- I don't like to hear that but I am starting to think that it is the truth. Regards, Paola

[DSteinitz]

My name is Don Steinitz. I have enjoyed reading all the earlier posts which does afford some comfort knowing other people are in the same boat. This is my story: I have a history of panic attacks. A also had complained of PVC's as a bi-product of being nervous. My internest put me on Toprol which was given to me to calm my nerves and reduce the PVC's. It worked for several years. After awhile I noticed I was getting bad anxiety and thought it could be from the Toprol. I later saw cardiologist and he put a holter monitor on me a confirmed the PVC's. He put me on TAMBOCOR. It workeed GREAT for 6 years until I read HORRROR stories about TAMBOCOR. I saw another cardiologist for a swecond opinion and he said get off it now (It's toxic) and rarely used unless for serious heart problems with no serios hear disease. He said don't worry about the benign PVC's. The problem is that TAMBOCOR helps me with PVC's and calms me down so I don't become prone to anxiety attacks.
  What should I do folks. Now my cardiologists won't talk to me for seeking a second opinion. Is there something out there that will prevent PVC's and calm a person down. I have asthma and I believe Beta Blockers are out. I am taking Klonopin & Celexa which is not the best choice. Bottom line...........IS TAMBOCOR REALLY DANGEROUS?????????
Don

[paola37]

Toprol slows down your heart rate - hence it should make your pvc/pac less noticeable.  At first I could not understand the logic... if the heart rate is slower it would seem logical that for the pvc and pac to be more noticeable. My doc explained -in simple terms- that Toprol actually decreases the force of the "thump" that a pvc/pac sufferer feels whenever they occur. I have been taking toprol for 6 days now and the "thump" is less noticeable - I am not sure that I have a decreased number of pvc/pac - they are just a little less noticeable - by the time the day is over - however- I can feel each and every one of them... during the day is a little better. Good Luck I hope you feel better soon. Paola