Palpitations/PVC's Holter Monitor readings

I have had very minor PVC's on and off for a good 5 years only feeling the odd beat. I am 34, overweight and suffer from general anxiety.  Since having my baby 10 months ago they come hard and fast and leave me in a state of anxiety.  The last 3 months have been good..some days nothing some days 2 or 3 but not in a row.  The last week has been awful.  PMS is bad for me and last Saturday had pvc's in triples that sent me into full blown panic.  I saw my dr who did an EKG and it was normal now I am carrying a Holter monitor for 30 days to try and catch these runs.  Sent my first recordings in and dr says all is good and not to worry.  Had a good week with just one or 2 and yesterday evening had another run of 2 or 3 pvc's that sent me into panic.  Managed to get these on the holter monitor and waiting for results.  My questions are...should I be concerned that they have suddenly gotten worse? I have read somewhere that triple pvc's should be taken seriously?  I am taking 12.5mg of atenelol twice a day and it did seem to work for a while but this week nothing has helped.  I am also taking Doxepin for Post Partum depression which is under control....the pvc's are the only problem for me.  I worry more as my Dad had a triple heart bypass and defrib/pacemaker fitted and so naturally I worry.  What is the dr looking for on the holter monitor recordings?  If anything is dangerous would it show up on this?  I would point out that even when I am feeling calm and happy I get these beats too.  Is there a recommended beta blocker for the treatment of pvc's?

thank you

[Cleveland Clinic]

ali,

Im sure your going through a lot trying to deal with a 10 month old and deal with all this anxiety over your PVCs.

Im not sure that I can tell you too much other than what your physician told you. A holter monitor catches what your heart is doing during your episodes. If you have known PVCs then it probably will not provide too much other information.  Unfortunately, there is no magic pill or beta blocker for PVCs and palpitations. I do find that propranolol is a good beta blocker for those with anxiety as some report more of a calming effect than with atenolol.

I think you should focus more on your anxiety issues as the PVCs have become more of a concrete focus for your worries.  Look to the forum to see how others have dealt with their symptoms.  

good luck

[Sculpey5]

Can I ask which part of the county you live in?  I'm here in the East and our temperatures have been in the 20's.  My palpitations get much worse in cold weather.  Doc keeps telling me there's no connection between the palps and my breathing and I keep telling them they're full of beans.  I've got a log that shows when the temperature drops, my breathing is affected which in turn makes the palps worse.  Hope this helps.

[alistinker]

I am in Wisconsin and it has been soooooooooo cold as you can imagine!

I am so scared of these things.  I read in some places that i should not be worried and then I read in other places that I am in danger.

Thanks for replying

[Abeybaby]

in canada and when the cold comes its worse on the pvc

[footballmum]

Hi, in response to your question about more than 3 PVCs in a row - My cardio said that if I had thousands of these every day for months they would NOT damage my heart.  I, and many others have runs of 6, 7 or 8 in a row with no ill effect.  I had an echo, and Holter for 24hrs and, as long as your heart is structurally fine, PVcs will not damage your heart - that is the advice my Cardio gave me.  Anxiety will make them worse so often you find yourself in a vicious circle.  Try www.uncommonforum.com - many people with PVCs post there  - that site, as well as this one, have been my life-line over the past few months
Take care

[4paws4me]

For years Drs have been telling me that PVCs are benign.  I have idiopathic dilated cardiomyopathy with no known cause and upwards of 40,000 PVCs every day (triplets, couplets, salvos, etc).  Three years ago, an EP implanted an ICD because he was able to induce an NSVT during my EP study.  Now, six years after diagnosis with the cardiomyopathy with no explanation as to why my heart muscle is weakened, Drs tell me about a rare consequence of PVCs - arrythmia-induced cardiomyopathy.  Apparently, lots of PVCs over a long period of time can sometimes wear your heart out.  Bottom line is that now the Dr has decided to try to ablate the PVCs to see if my cardiac function improves.  I'm beginning to think that, however well intentioned, the Drs just don't know much about what causes them, what makes them go away, or how dangerous they are.

[upbeat63]

I have had thousands every day for nearly 22 years. Been as high as 24,000/day, recorded on a 48hr holter, but it could be higher some days, because I've had constant bigeminy (PVC every second beat) for days upon end.

Not that I'm trying to win any contests here, believe me, if anything I wish I could be the winner of the contest for the fewest. I just wanted to let you know that I had a stress/echo this Spring, and the PVCs haven't changed the structure of my "normal" heart after all these years. There is a remote chance that high frequency over long duration might cause a change, but it's something you would get monitored for occassionally.

Please trust your doctor if he/she tells you not to worry. I understand your concern because of your father's heart history, but both my mom and dad died of heart attacks in their 60's. This raises a concern for me too, but I am not them, and PVCs are not life threatening--just life changing if you let them be, and I let them take over every now and then also, you just can't help it sometimes. BUT if you have read somewhere that PVCs are life threatening, you may have read that arrthymias following heart attack increase your risk of a more serious heart attack in the future, or arrthymias in certain groups of people increase their risk. It is not in people who have "structurally normal hearts". If your doctor says you have a "structurally normal heart", but you still feel something is wrong, get a second opinion. I'm not trying to pat anyone on the head here, just offering an arm for comfort because I've been there, I AM there. I hope I've helped.

[alistinker]

Thank you everyone.  I feel so reassured when I come here and read everyones comments.  Sometimes I feel addicte to this site!! LOL  My dr has suggested taking Clonazapam on an as needed basis when my anxiety gets high but I am scared on benzos.  He said it would be fine to take it though.  Does anyone else take anything for anxiety?  My dr is also now ordering an appointment for me to have a scan of my heart to reassure me that my heart is sound only because of my dads history.  I would give anything to get these under control.  I thought I was doing so well over the last few months and now this month has been hell. I suppose with 3 kids, christmas etc it is no wonder my heart gets sensitive.

Thank you so much everyone.  

Sharon

[tickertock]

From what I gather PVC induced cardiomyopathy is a very rare complication of frequent PVCs , as I understand PVCs has to occur at a rate of 15-20% of your total heartbeats daily for years or even decades, even then , the medically documented cases ain't that common or so I've been told my many cardiologists, including EP cardios.

However that's why an echo is recommended at least every 3-5 years if you have very frequent PVCs just to make certain no signs of cardiomyopathy is taking place.

In general in the absence of some cardiac anomaly, I think most case of PVCs are labelled as benign ,but defnitely an annoying and distressing problem for most that feel them.

They are definitely both frustrating to the doctor and patient. What the doctors do know now about them after monitoring persons with them for many years now is that they are not the big red flag that they were once considered to be.

[Momto3]

I did develop dilated cardiomyopathy in the setting of chronic, persistent pvcs.  I was having pvcs in the 20,000's daily for who knows how long.  In and themselves, the pvcs were still considered benign, just bothersome.  However, when I developed CM outta nowhere and no other cause could be linked to the CM, the doctors got to thinking....maybe it was the pvcs (since I had them for so long, and pretty much all the time).  Like Upbeat, I got used to them and they were just part of my "normal" rhythm.  Anyway, once the CM developed and all other causes were ruled out, I ended up with two very successful pvc ablations.  Today, I am nearly pvc-free and the CM has completely resolved.  It is indeed a very rare occurence, but worth mentioning since it can happen every now and again. While I think it is important to be educated and viligent about our own health, I think you have to balance the need to find answers with a healthy interest in accepting that some things just are....Periodic check ups can't hurt.

Are you going ahead with the ablation?  I was multimorphic, so it took two procedures, but they were well worth the time and effort.  It has been just over 2 years since the 2nd RFA and according to my most recent echo (11/2005), my EF is back up to 60% and the CM remains resolved.

[upbeat63]

I want to thank EVERYONE who posts on this forum because you've helped me so much. What a nice Christmas gift. And blessings to momto3 because you've given me so much guidance, our situations being so similar.

I understand that while PVCs are benign, they are still to be monitored especially if very high frequency. I've met three people now including momto3 and 4paws4me who have developed a rare complication of high frequency PVCs--cardiomyopathy.

All that being said, I also want to say that cardiomyopathy can develop in persons WITHOUT any PVCs. So please everyone, take good care of yourselves. And if any of you smoke would you consider quitting for New Years?!! Had to push that one. hee hee

And lastly to alistinker, I too have high anxiety and sometimes panic attacks. I've taken xanax on an as needed basis, which seems to work the very best for me, having tried other anti-anxiety meds without good results. Thankfully I've been able to ride out most of the anxiety, and even some long runs of PVCs and I find that I feel a little stronger after each episode. But the xanax (and Toperol XL) are still on hand as a security blanket. Hope your RX of clonazapam is helpful. Anxiety with PVCs is a double whammy, but I think anxiety is worse by far.

[Momto3]

To my cardiac "sib" - Have a fabulous holiday season!!  You have been equally supportive to me....I find your posts so uplifting.  I've no doubt you inspire many posters with your knowledge and kind words.

I just had to write to tell ya that some people never leave home without their AmEx card. For me, it's my Inderal and Xanax : )

I rarely use either, but the extra security they provide is worth a place in my purse : )

Merry Christmas!

connie

[madgeOwens]

Merry Christmas and Happy New Year! Thank you for all the great posts. My Inderol is my present this year.....so far its doing great.I wish pvc/pac free in 2006 !!!!!!

[Momto3]

Same to you...Wishing you and your family a wonderful holiday!!  

I'm happy to hear that your Inderal is still working for you...Here's to continued good health and happiness!!

[alistinker]

Thank you from the bottom of my hiccupy heart to everyone who takes the time to reassure others when themselves are suffering too.

Happy holidays to everyone.  Email me if anyone wants to keep in touch

***@****

sharonx

[madgeOwens]

Who ever told you you could use Inderol prn? Isnt that dangerous? I am concerned about this....but I am sure your physician had ok'd it.......around here they poopoo that...
the only downfall(no pun intended) with the inderol is that it makes me a bit dizzy...but not as bad as the pvc's did without the Inderol haha I fell over into presents the other night, rolled around the floor laughing.....it must have looked too funny....hurt my darn knee and back duh..but its better..I bounce real nice....looked like a drunk haha.oh well....have a happy!!

[Momto3]

It is so great to see that you maintain your sense of humor even with all that you've been dealing with : )

Your posts make me smile : )

As for the Inderal and taking it prn....Yup, the doctor said it was fine.  After taking a daily dose for many years, I eventually noticed that it didn't seem to be as effective. With the doctor's permission, I went off of it.  I was on/off of it a few times after that.  I had always been told that I was taking it for symptomatic relief.  Anyway, back in the 80's, one of the doctors had me on Inderal LA80's (those had just come out...before that I had to take 20mg/4x day).  He also gave me either 10 or 20mg tablets to supplement me for any "break-through" episodes.  When I needed the extra RX, I found that the supplement usually worked with 20 minutes...So, fast forward....Years later, I asked about taking it prn, and was told if it worked for me, not a problem.  To this day, I can take a 20mg tablet as needed (which is not too often these days).  I think I've taken it 4-5 times this year.  For me, it seems to work best that way.

BTW...Thanks for helping the soldiers back in Vietnam.

[madgeOwens]

My lord that was forever ago......the soldiers were great back then too! It was an honor to care for them.
Didnt you have to be weaned off the Inderol at all?
I wish I could take them like that.....I have the anti anxiety for break thru prn....I dont seem to need it now......figures haha.only needed it wneh I didnt have it.......I have a sense of humor now, because I feel good now......I was feeling bad for so long its like being reborn to have relief. Have a wonderful Christmas........I so enjoy our chats.....talk soon....:)
nanna madge

[tickertock]

Sorry if I was misunderstood about the 5 beat nsvt that i had, the doctor was mainly referring to pvcs when he said everyone had them, but he was no more concerned about the run of nsvt than he was of the PVCs.

With a normal cardiac evaluation persons with occasional runs of nsvt are no more at risk than the general population from what I have been made to understand.

I personally know someone that has runs of nsvt and bigeminal and trigeminal PVCs all day long everyday for the last 15 years , but he isn't aware of one, lucky him, he can't go 6 normal beats without a pvc.

check out http://www.americanheart.org/presenter.jhtml?identifier=562   this might help put your mind at ease. Merry Christmas.

[rdf6218]

Hi.

I know what you're saying about being scared.  Until last week when I stumbled on this website, I was still scared all time because all the doctor would say is that I am okay and not to worry. He never sat me down and scientifically in a dumb person way tell me WHY I SHOULDN'T worry.  So, after reading all of these posts, I have finally been able to take a big, good sigh of relief.  Then, I cried.

The triggers of these palps are different for everyone.  I had to cut out all caffeine and different foods for a while.  But, mine is from stress, I can tell.  But, I have noticed when I bend over and my jeans dig into my stomache just above the belly button, I get heart palpitations.  But, it is only a certain spot.  Very strange, but true.

I suggest going to your doctor and telling him how you feel and tell him you need him to be more open and explain things more.  I love my regular doctor and he could only do so much, which was send me to a heart specialist.  I believe he did it because I wouldn't believe him when he said I was okay!!!!  I really liked my heart specialist, but he could have done more as far as explaining things to me.  I will tell him this when I go for my year check up next month.  I have lived in fear for the past 2 years because they did not explain things very well.  I see that most people here have the same problem.  That is too sad!!!
Good luck to all.

[windowgirl]

Has anyone had episodes where pvcs are daily(About 1000 by holter) for about 4 monnths then disappear? I just don't get it. I don't do anything different.

[tickertock]

That how I get pvcs in episodes every 3-4 years anywhere from 1000-10,000 daily lasting for weeks to 5-6 months, then gone til next time. Of couse I will always get a few some days , but nothing worth mentioning. They occur for no rhyme or reason whatsoever, then disappear.Who knows?? Like one cardio told me almost jokingly , just the nature of the beast. Merry Christmas.

[windowgirl]

And all your test come back normal? It's so hard for me to believe when my cardio says its "benign"  or its just a variant of normal. They absolutely impact my life(pychologically). It's like I'm always awaiting for the other shoe to drop. On the last holter, I had some couplets(pairs), a few(14 to be exact). He said that is normal findings also. Not to worry.

[tickertock]

All test essentially normal, I'm 41 had this practically all my life. Over 18 years ago I had one 5 beat run of PVCs also called nsvt on a 18 hour monitor, back then they usually only did an holter monitor for 12-24 hours . was told from then by one the best electrophysiologist at that time, my heart was basically perfect, nearly everyone had these at sometime in their life, just too bad i was that i was aware of them as most people are not. told never to take any anti arrhythmic drugs , only beta blockers and try my best to ignore them.

As you see can by the many that post here on the forum that suffer with these PVCs for 20-40 years, they must be benign in the majority of persons or no one would be here to chat about them if they were not.

[fearfactor]

Hi, Tickertock - did your doctor say that having a run of NSVT was something most people had at some point?  That would be really reassuring!  I have never had it as I know if but always fear it!