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Palpitations
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Palpitations

I suffer sensely with my obsessing about my palpitations. My question is:

1. If you were to take 100 people off the street and put holter monitors on them how many of them would have PVC's and PAC's?  Why do I feel every little thing my heart does and others can't feel a darn thing?

2. I had a holter last week and I got no palpitations but I did get palpitations three days later. I think the doctors think I am nuts worring about these things because they didn't see anything on the holter. I haven't been back to the doctor for my results but I am sure it will show nothing.

3. Doc says that if I had a serious arrythmia that is would not be coming and going as mine does.  She says a serious arrythmia is there all the time?

3. I have been for two EP studies (one in 1996 and one in 2000) because they caught something on the Holter (hospital said it was v-tach and the EP doc says it was probably just salvos). Would they have seen anything while they were doing the EP study if there was something wrong??

4. I think about my heart 24/7 and feel sort of high anxiety state waiting for the next palpitation to hit. It is all I think about. It is a vicious cycle, I get a palpitation and get really stressed and get really stressed thinking I am going to get another one. Doc says I have anticipatory anxiety.

I know the doctor is sick of seeing me about the same thing. What should a person do?? She already told me there is nothing wrong with my heart and every get palpitations but I can't accept that answer especially after getting the v-tach results years ago (1996).
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74076_tn?1189759432
Hi Carrie,

I am sorry to hear this is effecting your life so much.  

1. If you were to take 100 people off the street and put holter monitors on them how many of them would have PVC's and PAC's? Why do I feel every little thing my heart does and others can't feel a darn thing?

Just about everyone would have PVC,PACs, or both.  We do not know why some people feel them and other do not.


2. I had a holter last week and I got no palpitations but I did get palpitations three days later. I think the doctors think I am nuts worring about these things because they didn't see anything on the holter. I haven't been back to the doctor for my results but I am sure it will show nothing.

I assume you have previous holters showing PVC/PACs.  If you are having the same sensation and they haven't changed, I am not sure that it matters if the capture one now on holter.

3. Doc says that if I had a serious arrythmia that is would not be coming and going as mine does. She says a serious arrythmia is there all the time?

This isn't always true.  It is always important to try and capture on holter or event monitor symptomatic events to diagnose the arrhythmia.

4. I have been for two EP studies (one in 1996 and one in 2000) because they caught something on the Holter (hospital said it was v-tach and the EP doc says it was probably just salvos). Would they have seen anything while they were doing the EP study if there was something wrong??

The most important thing is that you have a structurally normal heart, normal EKG, and no family history of sudden cardiac death.  It is unlikely for you to have anything dangerous if these are all normal.  EP studies are very useful for narrow complex tachycardias, not as much for PVCs or assessing the risk of sudden death.  There are much better predictors for the risk of sudden death, EP studies only add incremental information.

5. I think about my heart 24/7 and feel sort of high anxiety state waiting for the next palpitation to hit. It is all I think about. It is a vicious cycle, I get a palpitation and get really stressed and get really stressed thinking I am going to get another one. Doc says I have anticipatory anxiety.

This sounds like the anxiety disorder and not your heart is the primary problem.  Have you tried any medications for anxiety?

I know the doctor is sick of seeing me about the same thing. What should a person do?? She already told me there is nothing wrong with my heart and every get palpitations but I can't accept that answer especially after getting the v-tach results years ago (1996).

I would prescribe a beta blocker to try and decrease the sensation of pvc's.  I also think an SSRI or other anxiety medication might be helpful.  Consider seeing an anxiety specialist.  They will probably more informed current treatment options for anxiety disorders.

I hope this helps and hope you feel better soon.
26 Comments
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Avatar_f_tn
I just wanted to tell you that I have been suffering from PVC's since I was 17 years old.  I am now 42.  I have lived so many years with this "vicious cycle" that you describe.  I also went to the doctor constantly and had numerous EKG's and echo tests.  It was very hard for me to accept their reassurance because I felt these darn PVC's constantly and I also felt every single one.  Sometimes I would get like 8 to 10 per minutes for hours.  Especially when trying to fall asleep.  I started having anxiety attacks because of  the palpitations and really stopped living my life.  However, one day about 6 years ago I decided that enough was enough and I started really LISTENING to the doctors and just not worry about them.  I mean when I would get a bad run of them, instead of stopping in my tracks and putting my finger to my pulse to see how often they were coming, I would just keep on doing whatever it was that I was doing.  If it happened at night, I would get out of bed, run a nice warm bath and sit there and read a book or just practice some deep breathing exercises.  SOmetimes it helped and sometime not, but the main thing is that I was losing my fear of them, slowly but surely.  Once you lose that fear and just start accepting them and living  your life, no matter how bad they get, you will start to relax and that vicious cycle we lose its grip on you.  Still to this day I get the occasional skipped beat and heart fluttering and yes sometimes I pause for a second and get a little scared, but I have learned to  not pause for to long and to just keep doing whatever it was I was doing.  If im in my car and I feel a few palpitations I turn up the radio and start to sing along to a song..lol..seriously it does help.  YOU MUST stop worrying and start living.  Doctors have reassured you.  Go with this reassurance and start gaining back your life.  Take care and God Bless..
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Avatar_n_tn
Do you get palpitations everyday Annako?  I get between I would say three and 10 a day and hate them.  They are all I think about.  I know I have to stop my obsessing.  I can have a really bad bout of them and then I know my anxiety brings them on more and more.
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170935_tn?1225374676
I was under the impression you were having loads and loads of PVCs!!lol I get between 20-70 a day!! and i now know that is not much either. I don't know about you but mine have just recently started i don't know why i have started to get them so sudenly. i have had tons of tests and i've been told they're benign.
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Avatar_m_tn
Carrie,  I think you're mixing PVC's with palpitations.  Both are very annoying and can cause stress but they are not the same thing.
If you are talking about PVC's the amount you are getting is very low indeed.
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Avatar_n_tn
Hi Carrie- I asked my sister (a nurse) today if she ever got palpitations and she said 'Oh no- I never get them' however on persisting asking her AND PROBING EVERY DETAIL (I have cardiac neurosis!) she then said 'oh yes actually i did get some the other day, my heart seemed to go out of control, race and beat funny up into my neck' I asked her how long this went on for and she told me 'oooh... about half a minute' HALF A MINUTE!!!!  If that was me I would have been straight down the ER!  She told me that she took a deep breath and thought  'it'll stop in minute' and carried on with what she was doing and forgot about it.  My son  also gets flutters and again he thinks nothing of it.  So I guess the difference is how much people focus on normal bodily functions. I had a boyfriend who when I rested my head on his chest could feel his heart skipping and flopping- and he never felt a thing. I also have the theory that a lot of our fears are not about what they appear to be about, and the bottom line is that the base fear is fear of life and especially death,  the feeling of being unsafe in our place in the universe, and this is the fear we need to address.  We are all in the same boat in that respect (no- one gets out alive) and worrying about it will not prevent the inevitable end at some piont in our mortal existence, so we need to come to terms with life and death and accept that it happens to all of us and so therefore MUST be normal. We need to learn to have faith that all is as it should be. More easily said than done I know.  This is just my opinion
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Avatar_n_tn
So what is the difference between PVC's and palpitations?  I was under the impression they were the same thing?  Whatever the #*(&*($# they are I hate them!  I get a feeling of a double of triple beat and then nothing and then a huge thump.  I also get runs of rapid beats sometimes and then sometimes I will get misfires every third beat or so.  I just cannot come to grips there is nothing wrong.
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97628_tn?1204465633
Counting them yourself seems like a very bad idea psychologically. Especially since it's diagnostically meaningless.

A palpitation is anytime you notice your heartbeat, racing, pounding or pausing. It is not always an arrhythmia and even if it is, it's likely a benign one.

Yes, it's true people get ectopic beats and don't feel them. My son got over a thousand PVC/PACs on his Holter and never feels anything out of the ordinary. He got the Holter because a routine exam had a murmur and ectopics.  The docs (regular and cardio et al) can hear them the minute they put a stethoscope to his chest, but he doesn't feel them.

Watching them like a hawk is probably part of why you feel them.
You are fixated and trying really hard. Like a person having a hearing test listening for every isolated beep, instead of to the cacophony of real life sound that drowns out, or blends in those little tones.

If you have a rhythm of concern on your Holter they will let you know.

It can't hurt to see someone for anxiety/obsessiveness. Cardiologists don't generally handle inappropriate "high anxiety"  very well, it's not their specialty.  If you had something the cardiologist could help you with, she would.
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Avatar_n_tn
Hello,

A few months ago i went to a doctor because i had a lot of pvc's. After a lot of tests he told me that a have a normal heart and that my pvc's are benign. But he also told me that ten pvc's in a row could be dangerous. Why is that?  On the forum i have read that more then 3 pvc's in a row = NSVT =benign.  Is this correct?
I'm also concerned about my brother. He is having pvc's in a row (7-8) at a low heart rate (50-60bpm). What is this? NSVT?
Please help us to answer my questions.  Thx.
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Avatar_f_tn
Here we go again "ten PVC's in the row can be dangerous", or 6-7 in the row can be dangerous" as it was stated before. If this was the case I'd have died a long time ago.  Did a Cardiologist tell you that 10 PVC's in the row are dangerous??  Because the Cardiologist I saw told me the total opposite.

I'be been there with the worries and know how all of you feel UNTILL a Cardiologist set my mind of ease i.e. telling me "the more I worry about it, the more frequent they come and the longer they stay".  That "your mind is very powerful" and most of all THAT IT WILL NOT KILL ME.  

Before I saw this Cardiologist I was put on beta blockers by a doctor, it slowed my heart rate to 30 bpm, I felt like **** but the PVC's were still there.  I was put on Xanax and the PVC's got even worst.  The Cardiologist took me off the beta blockers and Xanax immediately.  Gave me all kind of tests for the heart and THEN sat down and explained to me what my mind is doing to me.

Untill I saw this Cardiologist my life was a living hell because of these PVC's and the worrying about it.

Get yourself checked out, if your heart is healthy (most of the time it is) TRUST WHAT THE CARDIOLOGIST TELLS YOU, and you will get better concerning the PVC's

What also helped me a lot was when a relative of mine who had 2 heart attacks by the age of 42 told me "to stop obsessing about my PVC's that he would gladly trade with me, he gladly would take my PBC's no matter how severe and I could have his 2 heart attacks which done damage to his heart and his life has never been the same since.

Good luck!
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21064_tn?1309312333
"Here we go again "ten PVC's in the row can be dangerous", or 6-7 in the row can be dangerous" as it was stated before. If this was the case I'd have died a long time ago."

Me too : )

Still here and hope to be for a very long time : 0

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Avatar_f_tn
i wanna know where that rumor started! VERY curious.. As for the statement about pvc's and palps... a pvc is a premature beat, if you feel it,its a palp.  A palpitation is any heartbeat that you feel. Even when you have a rush of adrenaline, and you feel your heart pounding, thats a palp, even if its not premature..
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Avatar_f_tn
I think its not very considerate to post what somebody read or what some of their doctors said i.e. "so and so many PVC's in the row can be dangerous/fatal".  People don't realize that it can upset a person very much to read this.  Especially if this person has not seen a Cardiologist yet or is afraid of the outcome.  No wonder doctors tell their patients to stay away from message boards.  I've yet to see a Cardiologst on this board posting "how many PVC's in the row can be fatal", or "go to the ER ASAP because your life is in danger".

I know how frightening they are and what they can do to peoples every day life, but to tell these people who are already going through hell that 10 PVC's or whatever can be very dangerous or fatal is very inconsiderate.  These boards are to comfort each other, share what helped us, not to scare the hell out of people who already are very scared of these PVC's.  
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Avatar_n_tn
Very interesting Collegegirl.  I didn't know the difference.  I just always tell everyone I have palpitations.  I honestly didn't know there was a difference.  I don't worry when my heart goes fast if I get jolted (like someone scares you) or the ones when I am walking fast and the way your heart rate goes up.  It is the darn skipping and pausing that I panic about.
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Avatar_f_tn
I dont get those attacks of PVC's anymore Carrie as I really try to keep calm and have lost my fear of them.  I am telling you that if you lose your fear, then they will subside.  However, when I was suffering from bad PVC's I would get like 8 a minute for hours on end.. That is thousands of PVC's per day.  So relax Carrie, get your life back.   Your heart is normal, it just likes to fire off with a few extra beats once in awhile.  Good luck!
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Avatar_n_tn
I think someone read online (in their obsessive search for info to calm them) that many PVC's in a row can kill you.  But it was taken out of context and referred to someone who has had an MI (heart attack).  They can be dangerous then, but I'm talking someone in the CCU who is unstable, not someone with a normal heart!  And I do know the answer to where PVC's come from in someone with a normal heart...ANXIETY!  They have had them all along but didn't know it, and when they found out, their anxiety rose and rose and thus fueled more *palps*.  This is why insurance is so expensive, folks!  It just kills me to read where people go to 2 or 3 or more cardiologists and have multiple very expensive tests, which are all normal, and still don't believe the doctors.  And YES, I have been there and do in fact know how unsettling PVC's can be, and I do NOT have a normal heart.  I am sorry if this offends anyone but it is the truth.
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Avatar_n_tn
I have a question I'd like to put to the DR some day. We all know that PVCs can be dangerous in someone who has had a heart attack. I assume this is because PVCs in these patients indicate the heart has been badly damaged. I wonder this: if someone with a normal heart has PVCs like many of us, and then develops a heart attack when he/she gets older (I have a strong family history of CAD so in my case this is not very unlikely), will the PVCs become dangerous after the heart attack, though they were previously defined benign?

Thanks

Fran
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Avatar_f_tn
You're right on target and I could not agree with you more.  The Cardiologist I saw who put my mind at ease told me "if you cannot believe what I tell you and you still will be frightened and obsessed about your PVC's THEN YOU NEED TO SEE A THERAPIST TO DEAL WITH YOUR ANXIETY ABOUT THESE PVC'S, there is nothing else I can do for you since you've a healthy heart, and I only saw him once, but I guess he could tell by my questions that I was still very worried.

About Insurance.  Our Insurance doesn't even allow us to get a second opinion.  Unfortunately that is the only Insurance we can afford, but I trust what a Cardiologist tells me before I pay out of my own pocket to get a second opinion.  Yes, some doctors make mistakes, but I trust a Cardiologist who studied the heart for yrs, I trust him with something so simple as benign PVC's.
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Avatar_n_tn
Well, I'm floored. I thought I had read and read and talked to enough docs ( and gone through an ablation and countless event monitors) that I had an understanding of what electrophysiology was useful for ( in addition to mapping for ablations). Now the doc says an EP study is NOT useful to test for risk of sudden death?
I thought it was and was so relieved that no risky rhythm ( just my psvt, reentry  -- for which i was ablated)  could be precipitated on my EP study.  

I also had a microvolt alternans study -- not that i needed it, i volunteered to help train a cardiologist to get the test free.. I was totally negative.

I am finally getting over much of my anxiety about my remaining flips and flops but, again, I didn't know an EP study isn't a strong predictor or not that you might be at risk for a dangerous arrhythmia. I realize no test is 100 percent. again, I'm floored.
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Avatar_n_tn
re: EP studies predictive value from: http://www.hrspatients.org/patients/heart_tests/electrophysiology_study.asp

THE VALUE OF AN EP STUDY

An electrophysiologic, or EP, study provides information that is key to diagnosing and treating arrhythmias. Although it is more invasive than an electrocardiogram (ECG) or echocardiogram, and involves provoking arrhythmias, the test produces data that makes it possible to:

Diagnose the source of arrhythmia symptoms
Evaluate the effectiveness of certain medications in controlling the heart rhythm disorder
*************Predict the risk of a future cardiac event, such as Sudden Cardiac Death *****************
Assess the need for an implantable device (a pacemaker or ICD) or treatment procedure (radio frequency catheter ablation)

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84483_tn?1289941537
I fully understand where you're coming from!! I guess they are making new discoveries everyday that's all I can think of.
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Avatar_n_tn
Hi there, I will try to answer your question...as far as I understand yes pvcs are harmless in the setting of a "normal" heart, one with normal structure and no scar-tissue that could possibly send the electrical pathway of the heart off it's normal beaten track (so to say). And again, I am no doctor, but if you have suffered from a heart attack, you have a certian degree of scar-tissue, depending on the amount of damage done during the MI it could be a small amount to alot. This scar-tissue then acts as a type of "obsticle" on the conduction path of the heart, and this may send the electrical pulse down a different path or etc. ( a pvc is from a different area of the heart and not the "regular" firing point), so when our healthy normal hearts have a pvc occur it resets itself and starts beating normal again, on the other hand,in a MI pt. the pvc can happen and the heart may not beable to reset itself normally again (becuase of the "obsticle" scar-tissue) and instead goes into a cascade of pvcs that may potentially lead to VT (sorry I didn't explain all that better!)So to answer your question, I believe it's a known fact that just about 100% of the population gets pvcs for starters and also if you had a healthy heart with pvcs as aposed to later if you have an MI, yes your pvcs would not be considered totally benign anymore, or in other words you would be at a higher risk simply becuase you would have accumulated scar-tissue from the MI.

I hope this may give you a little more insight? Anyway, again, I am not a doctor, just a pvc sufferer. Take care!

Nurse Kagome :)
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Avatar_f_tn
You say you are not a doctor then where did you get all that info?
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Avatar_n_tn
haha! well...i suppose i should say i am graduating with a BN RN in april and considering med school...just debating whether i wanna be a nurse practioner or a doctor. i study and read up for school as well as pathophysiology is of great interest to me, so i guess that answers your question? take care!


Nurse Kagome
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Avatar_n_tn
Thanks for your reply! What you say makes lots of sense and that was what I thought too. I'll put the question to the doc with other questions I'd like to ask about AMI prevention, but I'm sure he/she will basically say the same thing.

Fran
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Avatar_n_tn
No prob! ^.^


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