Palpitations

I am really worried.  I have palpitations daily but nothing like I had last night.  I have been checked out by a cariologist and they say nothing is wrong with my heart other than skipped beats. I was feeling really anxious when this happened.  

I was watching TV feeling anxious thinking about my heart when it skipped a beat.  It then skipped again the next minute and then again.  This happened every minute for so for 5 minutes.

I have a stethascope and I went to get it and laid back down on the couch.  I listened to it skip every other beat for 10 minutes!  It would beat normal, then do a little skip then a hard one.  I counted it 30 times per minute.  This went on for 10 minutes until I stood up.

I started to calm down and just laid there and listed to it skip.  I was going to get my husband to take me to the hospital but it seemed to stop and go back to its normal beating after 10 minutes.  Needless to say I slept in my clothes because I was so worried it would do it during the night and I would have to go to emergency.

Could an anxiety or panic attack bring this on for it to continue skipping like that every other beat for 10 minutes even after I had calmed down?  I am just absolutely horrified!  Now I see the single skips are not big deal compared to what happened to me last night with this irregular rythum for 10 full minutes.

[Forum-M.D.-bkj]

crl,

thanks for the post.

Everything really depends on what has been discovered in your previous evaluation.  

Overall, from what you state, it really sounds like the familiar situation many of the other posters have suffered from with their PACs and PVCs. Many people see a wax and wane and even a frank change in the quality of their symptoms over time.

I realize it can be quite scary though. Sometimes, dealing with the underlying anxiety issues associated with palpitations can be more effective than actually treating the palipitations.

good luck

[tickertock]

When I had PVCs real bad this would happen several times a day all day long for weeks, a PVC every other beat(bigeminy)It's the nastiest feeling of all. I was checked while having them by cardiologist  and he told me not worry, they'd probably come and go like that all my life. Its been over 5 years since my last bad episode. I rarely have them anymore, maybe its the atenolol and cozaar I take to control hypertension.Hope you feel better soon. I know how distressing this can be.

[crl232]

I can't imagine this happening again!  It was the nastiest feeling I have ever had.  I thought for sure I was a goner!  I don't think I can go through another bout of those.

[sandrabel]

I'm a professional athlete and i know that my left ventricul is very little dilated (it disappears when i have one month rest). Do i still have a structurally normal heart with this?  And are my pvc's still benign?

[Momto3]

I've actually been in the doctor's office in bigeminy and her comment was, "it's only bigeminy."  Don't worry - you may never find a reason.  These pesky skips appear and disappear at the strangest times, often for no reason whatsoever.  

There was a time when I pretty much lived in bigeminy.  Seriously, with a structually normal heart, it's really no more significant than single skips.  Not to worry.

[Momto3]

Have you been checked out by a cardio?  If so, is he/she the one that told you about the slightly enlarged ventricle?  With a doctor's stamp of approval, I wouldn't let it worry you.  Just another of life's mysteries : )

[Rag123]

The best thing to do is go to a cardiologist and get a heart work up done.

Because the most frequent response you'll here on this forum and others is that with a structurally normal heart - PVC's/PAC's (skipped beats, including Bigeminy) are all harmless.

It's not that you will feel a total reflief right away, but it will be the facts that you will always be able to revert to, when in doubt...

There were some pretty good responses from another doctor in a recent post of mine:

http://www.medhelp.org/forums/cardio/messages/36251.html

[jerseygirl1987]

Hey everyone! I've been observing this forum for a long time, but I can't ever seem to get through to post a new question, so I thought I'd just ask the rest of you: do all of your palpitations feel like strong beats, or could they feel different as well? I get strange intermittent sensations in the center of my chest, but instead of feeling like my heart is pounding, they feel like my heart is contracting, or pushing inward, if that makes sense.
     I did have an echo, EKG and holter in August, but back then I was feeling just general chest tightness, not palpitations. I have been diagnosed with GAD, which mostly manifests itself in health anxiety. I am not currently taking meds, but I am planning on starting on Zoloft or Lexapro within the month. My cardio did say I might have MVP, but the tests weren't conclusive. The palpitations come most frequently when I am walking outside. They started during a week of extremely cold weather, but the last two days have been warmer and they are still happening. They occasionally happen inside or when I am at rest as well. I would say I get between 5-10 a day, and frequently a few of those will come shortly after the others, i.e I get three walking to one class, two walking back, and one randomly when I'm reading in my dorm ( I'm a female approaching my 20th birthday, by the way). Sometimes they come when I am not thinking about them, or worrying about anything at all, which makes me doubtful when people tell me it is probably anxiety.
     Any advice or reassurance would be greatly appreciated! Reading this forum has been very comforting to me so far!

[Rag123]

There are a lot of theories that we all have...

But, again, the general statement from the medical community seems to be that if your heart is otherwise healthy - the skipped beats are harmless...

Very frequent PVC's can lead to Cardio Myopathy in rare cases - we're talking like 20,000+ daily.

Most people have skipped beats and just don't notice or pay attention to it.

I have some health anxiety as well. And when this is the case, as soon as you notice one odd beat - your mind is in tune to most of them.

The possibility exists that you may have always had what you feel, just that your noticing them now because you happened to catch one and didn't mistake it for something else.

The medical community also states that anxiety can induce the skipped beats, but doesn't clearly indicate why. There are many possible triggers for them but anxiety is said to be one of the more popular ones, especially considering that most of us become anxious when we feel them.

Consider the fact that some skips feel mild while others feel forcful.  It's possible that this is due to the timing of the skipped beat and maybe even if your anxious or panicky at the time of the skipped beat.

Also, stress hormones may gather up, which may explain why some of these happen out of the blue...

Again, some of this is just theory.

But all the Dr.'s seem to say the same thing. If your heart is healthy, your really at no more risk for anything bad, than anyone else with a healthy heart.

Hope you found this helpful.

[Luciasbrown]

Palpitations or "premature ventricular contractions" occur in 100% of the population.
Why?
In easy to understand terms, it's because every cell of the heart wants to be a pacemaker. So every now and then, a cell depolarizes early and that spreads like a wave across the heart from cell to cell causing the ventricle to contract early.
Well since it's early, it hasnt had a chance to fill up much with blood so a person may not feel the beat or if its very faint.
Hence why people call it a skipped beat.

Now that the PVC has occured, it doesnt stop there. The regular pacemaker is still keeping time and it isnt going to change it's timing b/c of this. So what happens is that you have an 'extended' filling period of the heart (remember, blood is still coming into the left ventricle from the lungs). So now you have this left ventricle with more blood than it had b/c of this long filling period.
NOW, here is the key concept. There is a mechanism of the heart called the "Frank Starling Mechanism" where the 'more' the heart muscle is stretched, the 'more forceful' the contraction.
So what does a person feel. A so-called missed beat (it was there just very weak) and then a big 'thump' in their chest b/c of the Frank Starling Mechanism.

Doctors are not too worried about them since they occur in everyone unless they are right in a row. A good rule of thumb is that if they occur less than six per minute then they are usually benign.

Of course there are always exceptions to the rule.
Also, limit things that may get your little cardiac cells feeling independent and feisty and firing off early.

[Carrie41]

It sounds like you know a lot about hearts!  Are you a doctor by chance?

So you don't think a person should worry when they are feeling anxious and they get one skip after another for 5 minutes or so?  I will get one skip then get panicky and I think it sets it up for another and another.

[jeff 67]

Of course some people, like myself, are not so much bothered by the forceful compensatory beat as they are by the PVC itself.  In my case, even though it is pumping less blood, the PVC itself has a all sorts of sensations, ranging from an abrupt kick in the chest to a painful ripping feeling.

[finetilthree]

Can someone just explain why (how?) these won't kill me?  I had a rough week with these things.  Such hard and forceful ones.  They suck.  This is the worst week I've ever had, and I still probably only get about 20 per day.  They are so unnerving b/c they had almost gone away, I was feeling like 2 or 3 a day.  Now I am feeling 20 per day.  Why do they happen?  Why do they wax and wane?  I am only 35 and I am really afraid to get too active, if you know what I mean! I was a wild child before and now I am like an old person!

[Momto3]

Sorry the pvcs are still bugging you.  With a normal cardiac workup, I'd say go back to being a wild child (within healthy limits)....lol.

Don't worry about the pvcs - they are harmless in the setting of a structurally normal heart.

Think of them in the context of a migraine.  Surely, you think you will die b/c the headache is paralyzing.  But, it's found to be a migraine and nothing more.  I'm always thankful that pvcs got me instead of migraines.  Those of us who have one one will be happy to never experience another.

Have a great weekend!

[Luciasbrown]

Carrie, some people are more in tune with their body and when they have one PVC, they are likely to 'pay more attention' and worry when they get another. Some people have them all the time and do not notice them whatsoever. I have seen patients with every other beat is a pvc (bigemingy) or every third heartbeat is a pvc (trigeminy) and you ask them "do you feel that?" and they are like "feel what?"
They just dont notice. Usually that is with older people for some reason, maybe they are old enough that they just dont care. Younger people, many times women, tend to stress and worry and ruminate about these. So often times, just for peace of mind, an echocardiogram is performed to show them that their heart is 'structurally normal', although there is a cost to this test which may not be warranted. It may actually limit medical expenses such as ER visits and improve their peace of mind. It is not limited of course to just young women though, if someone can tell me how to not notice when I get them, even though I know what they are, Id appreciate it, they can still be startling ;)
As far as the older people not feeling PVCs, they are also dont alot of times feel atrial fibrillation unfortunately.
While young people who get it, notice their heartbeat is irregular, older folks commonly do not realize it until they get a regular ekg at their doctors. Not recognizing atrial fibrillation can lead to stretching out of the atrium making it more likely that the condition will be chronic, rather than treatable with cardioversion. So it cuts both ways.

Jeff, I have no clear idea why you would have a painful feeling from a PVC or even if it is coming from the heart. The heart does not have pain nerve endings. So when you get for example, ischemia from lack of blood flow, you dont feel it in your heart. You get 'referred pain' elsewhere. Like arm,neck, this that.
It's actually somewhat of an odd thing about the thoracic cavity in general. That if I was to take a hammer out, hit your toe. You could tell me exactly which one I hit. Not true with the thoracic cavity. I could take a pair of needle nose pliers, reach inside you and squeeze something. You probably would feel it in a different location in your chest area. Just the way it works.
As far as what you are describing, I dont know what mechanism is at work. Check with your physician if it continues to bother you.

Finetilthree: Why are they going to kill you? Well the vast majority of these are benign, in fact, they are a natural physiological occurence. You could just as easily ask why farting doesnt kill you, but I digress.
To understand this a bit. Lets look at the heart's pacemakers.
First there is the Sino-atrial node which is a group of cells on the top of the heart that fire in a rhythmic manner to initiate the heart depolarization which stimulates the muscle to contract.
That group of cells fires and like dropping a pebble in a pond the ripples spread out across the atria. The top chambers of the heart. That is the 'p-wave' on an ECG. Then there is a slight delay at the Atrio-ventricular node. This is a safety valve of sorts, you see, there is a non-conductive sheath of tissue separating the top (atria) and bottom (ventricles) of the heart. This safety mechanism prevents things like atrial fibrillation (more of an annoyance) from becoming ventricular fibrillation (sudden cardiac death).

From the AV node, it then shoots down to the apex of the heart where the muscle contracts and squeezes to eject blood from the ventricles out of the heart. Simplified, yes I know, but for the brevity purposes I have described three  pacemakers of the heart. Not clear about all three?

First there is the SA node, the 'primary' pacemaker.
Second, there is the AV node, the 'backup' pacemaker. If the SA node fails and does happen with sick people*, the AV node will fire when the heartbeat becomes too slow.
Finally, the trickiest to spot as a pacemaker in my explanation, is the muscle itself, now I am not going to go into ion channel physiological explanations of this. But, the heart muscle itself is a backup pacemaker. You dont often see this except in the final stages  of death where the muscle itself is trying to keep a person alive.

*Interesting factoid is that Alberto Salazar, a champion marathon runner in the Eighties was in such great shape (and the better shape you are in, the lower your pulse typically) that it was so low that his AV node tookover as his pacemaker, it had taken over because his heart was so slow at rest.

Also, as far as exercise. PVCs by and large go "away" with exercise, they are overridden by adrenaline. So lets say you went for a stress test and you had numerous PVCs to start. By the time you were a few minutes in, most likely they would go away. But, lets say you were normal to begin with, then as someone gets winded they start getting PVCs then that may be taken as to be more substantial.
You have to realize that PVCs in and of themselves occur in everyone.
Depending on the timing and occurence of them, they can also be a symptom. Diagnosing heart problems you have to look at a "constellation" of symptoms in order to ascertain whether or not they fall into a likely category requiring further followup with very expensive testing.

Short answer: If I were you, which I aint, but if I was, I wouldnt use PVCs as an excuse to not exercise, you would be doing more harm than good with that reasoning since exercise staves off many heart problems later on down the road. Nice try though :O)

[Carrie41]

I wish you were my doctor!  You have said a lot of things in here that no doctor has ever told me.  

Can you please tell me why then I had wicked palpitations on Tuesday night.  I was feeling really stressed laying on the couch and my heart skipped a beat every minute or so and I started getting more and more anxious and i went to get my stethascope and laid back down and it skipped every other beat for about 10 minutes.  I started calming down listening to it and it still skipped.  I was going to go to ER but I then when I stood up it stopped skipping.  Needless to say I am back in panic mode and can't stop thinking about it happening again.

I have started taking 10mg Ciprilex.  I have been on it for three weeks and am still stressing about my heart. Can you please get back to me with your comments?  I feel so much better when I read your comments.

[Rag123]

I enjoyed reading your explainations...
First off, I've had a normal echo and Thallium stress test with the past 6 months. EKG's were aslo normal. My 24 hour halter showed some PVC's and PAC's.
PVC's were mostly during sexual activity.

You mentioned that PVC's are overridden by Adrenaline?

I do experience PVC's during sexual activity - I think sometimes - bigeminy. More so if I feel fear set in if I feel a few... I thought my brief periods of seconds/minutes were long until I heard of people with days/weeks of it...

If Adrenaline overides them, can you explain why them might happen during sexual activity and worsen if I fear them at that time? Does this have to do with stress hormones and/or other hormones?

My cardiologist also mentioned that they are less likely to occur when your heart rate is higher.

I have felt thuds during exercise and especially if I had a panic attack while exercising, but they may have been PAC's.

I mostly get occaisional PAC's/PVC's. I think mine are primarily stress driven since I started having panic attacks 6 months ago...

You say that PVC's are a natural occurance and compare them to farting. I hope I can get to that point where I can compare them to that!

In layman's terms, why do they naturally occur? What's the purpose? My primary physician stated that skipped beats reset your heart/heart \rate?

As I've posted before, I always fear that if I'm in bigeminy and I continue doing what I'm doing, that it may turn into couplets, etc. and become dangerous.

I always get concerned about being sick and vomitting - that it will cause some sort of Electrolyte imbalance and I will get a harmful arythmia. Would this take a major amount of vomitting?

What are your thoughts on some of the idea's behind magnesium helping to eliminate bigeminy. And/or suppliments that may help a hypersensitive auto-immune system?

And lastly, would you agree with the other explainations I've gotten, that with my work up, there is no danger when they occur and simply continue doing what I'm doing?

Thanks!

[sandrabel]

You said "Doctors are not too worried about them since they occur in everyone unless they are right in a row. A good rule of thumb is that if they occur less than six per minute then they are usually benign."
Why are the doctors worried about them when they are right in a row????  Because the doctors on this forum are telling that pvc's in a row are benign!!!

[Luciasbrown]

Can you please tell me why then I had wicked palpitations on Tuesday night. I was feeling really stressed laying on the couch and my heart skipped a beat every minute or so and I started getting more and more anxious and i went to get my stethascope and laid back down and it skipped every other beat for about 10 minutes. I started calming down listening to it and it still skipped. I was going to go to ER but I then when I stood up it stopped skipping. Needless to say I am back in panic mode and can't stop thinking about it happening again.

Carrie, I could never tell you why or even if you had palpitations over the internet. I am glad to offer a little more than basic explanation to help you understand a PVC as I know the worry is the worst part of these. Not knowing what it is can lead to issues, from personal experience, I was convinced I had lymphoma when I was 16 because I found one of my lymph nodes. Then I talked myself out of it and thought I had Ebstein-Barr virus. Of course, it was normal.
The problem is that without 'knowing' what exactly is going on with some objective evidence, there would be know why to say whether you are experiencing another rhythm (although I do believe you that they are PVCs, just know way to know for sure over the internet)
That is why they have event recorders that you can wear to document when that happens, its alot cheaper than going to the ER.
I had to chuckle at the stethescope and listening to your PVCs, first time I heard that ;)
I would suggest that you go for a walk rather than sitting down waiting for the next PVC. That will help take your mind off the PVCs and will in all likelihood 'overide' the PVCs. Although, you may experience some PVCs after exercise as adrenaline is still high and your heartrate has fallen.
As you can see palpitations are difficult to explain and one can make it a very complex explanation. I used to have a professor and we would ask a question and he had a famous response that made us cross our eyes, his answer was for example if we were students asking a question about the heart he would say: "...always, sometimes and never"
As soon as you tell a patient 'always', it wont happen and as soon as you say it will 'never happen', it will happen.
Leading to the trap of people saying "...but you said..." So, the wisest course of action is say "in relative percentages, your risk stratification having a cardiac event yada yada yada".
Which in of itself gives the patient a  bit of annoyance b/c people like clearcut answers, yes or no.
And with the palpitations which can in some settings be used as an indicator but the vast majority are just normal, but because of things like LongQT syndrome where I have seen patients have brief runs of ventricular tachycardia (do not google that please, its just an example of one rare thing not specific to you) a person just cant say for certain without some sort of clinical evidence and again, cannot be done on the internet.

If it bothers you where it interferes with your quality of life and you just want to find out what it is. Talk your physician into an event monitor. Extra piece of mind may be an echo to see if your heart is structurally normal but probably not necessary b/c of the cost can be several hundred dollars for the echo.

Short answer: If I were you, which I aint, but if I was and it was bothering me. I'd eliminate things which may make the heart muscle 'jumpy' like caffeine or other stimulants, alcohol the byproducts of which can irritate the cardiac cells causing PVCs or other rhythms known as 'Holiday Heart', limit stress, eat a healthy diet with some potassium rich foods such as a banana or even better; canteloupe which has twice the amount of a banana per amount.
If all dietary and exercise changes do not work AND you find yourself still stressing, then you might consider a low dose beta-blocker to see if that can ease your mind* and help reduce the occurence of palpitations. Although I wouldnt do that.
*interesting factoid: Many concert pianists before important performances take a beta-blocker to help reduce their nerves and performance anxiety.

I have started taking 10mg Ciprilex. I have been on it for three weeks and am still stressing about my heart. Can you please get back to me with your comments? I feel so much better when I read your comments.

If you are having problems with anxiety, the cipralex may help with your worries and ruminating about health or any other issues.



Rag123
2/23/2007
C16 Luciasbrown I enjoyed reading your explainations...
First off, I've had a normal echo and Thallium stress test with the past 6 months. EKG's were aslo normal. My 24 hour halter showed some PVC's and PAC's.
PVC's were mostly during sexual activity.

You mentioned that PVC's are overridden by Adrenaline?

Well, I simplified it to a large extent. The SA node stimulated by exercise and adrenaline actually overrides with a higher rate. Adrenaline can actually cause PVCs at low heart rates b/c it is a stimulant to the muscle cells. I dont mean to confuse you.



I do experience PVC's during sexual activity - I think sometimes - bigeminy. More so if I feel fear set in if I feel a few... I thought my brief periods of seconds/minutes were long until I heard of people with days/weeks of it...

If Adrenaline overides them, can you explain why them might happen during sexual activity and worsen if I fear them at that time? Does this have to do with stress hormones and/or other hormones?


##### Well if we compare sex to a stress test using the bruce protocol where first three minutes are the easiest and PVCs are usually still present. I was taught, although I dont have a scientific study to back this up, that Stage One is equivalent to having sex with your wife. Stage three is equivalent to having sex with someone other than your wife.
I have no gauge really to know how much your heart rate is and how much adrenaline you have released during sex.



My cardiologist also mentioned that they are less likely to occur when your heart rate is higher.
I have felt thuds during exercise and especially if I had a panic attack while exercising, but they may have been PAC's.
I mostly get occaisional PAC's/PVC's. I think mine are primarily stress driven since I started having panic attacks 6 months ago...
You say that PVC's are a natural occurance and compare them to farting. I hope I can get to that point where I can compare them to that!



##### Well with increasing knowledge of what they are and the length of time you have them, you will probably eventually tire of worrying about them. Like I said before, if someone can tell me how to not get startled now and again by them myself, then I'd appreciate it. The release of methane gas is natural biological process, so is a PVC, that was the parallel I was trying to draw.


In layman's terms, why do they naturally occur? What's the purpose? My primary physician stated that skipped beats reset your heart/heart \rate?

##### My best answer for why is; 'because they can'
The purpose of them is as I mentioned that your cardiac muscle is actually the third pacemaker of the heart. Sometimes, a cell just depolarizes. When that happens, it spreads from cell to cell causing a PVC. Same in the atria causing PACs.
*Interesting factiod: Before pacemakers became common, people used to hit the chest to break a lethal ventricular rhythm b/c the force would cause ventricular cells to depolarize. This was called a 'precordial thump'. People may have seen it on the TV show MASH and wondering why they are hitting the chest trying to restart the heart. Not that it is restarting. Its trying to depolarize ALL of the ventricle cells at once. Then while all the cells are repolarizing, the pacemaker can take over and maintain a normal rhythm, fibrillation rhythms in atria or ventricle is like an electrical dragon chasing its tail preventing proper contraction. Also, getting hit in the chest during the T-wave can cause v-fib, we've heard stories of kids getting hit in the chest with soccer balls going into v-tac or v-fib. There is some truth to that, although very very rare, not enough to stop playing soccer.


As I've posted before, I always fear that if I'm in bigeminy and I continue doing what I'm doing, that it may turn into couplets, etc. and become dangerous.

I always get concerned about being sick and vomitting - that it will cause some sort of Electrolyte imbalance and I will get a harmful arythmia. Would this take a major amount of vomitting?

What are your thoughts on some of the idea's behind magnesium helping to eliminate bigeminy. And/or supplements that may help a hypersensitive auto-immune system?

##### Since I believe in evidence-based medicine, I rarely believe marketing hype of so many supplements and the companies who profit from them. It's hard enough to believe the claims of some of the pharmaceutical reps, let alone someone who bottles an herb and promises to alleviate an ailment at a profit.
Magnesium however is a mineral and if you are deficient can cause PVCs and is used as an antiarrhythmic when there are no contraindications.
You may speak with your physician on testing if you have low levels of magnesium especially if you also have low potassium levels.
The vomiting question is hard to answer b/c it just depends. An otherwise normal healthy adult who eats a nutritious balanced healthy diet, it would not be something to worry about.


And lastly, would you agree with the other explanations I've gotten, that with my work up, there is no danger when they occur and simply continue doing what I'm doing?



##### I would be very pleased if I had a normal echocardiogram coupled with a normal thallium stress test. If you think of your heart as a house. You know that the structure of your heart is normal (echo shows the foundation is good and doors open and close and all rooms are the right size) and the plumbing is good with no plugs(stress thallium). Your ekg was normal with no evidence of long QT I take it. And if all you have is PVC's and PACs. You can be confident that the wiring is good as well. I think all the bases have been pretty well covered. Again, if you have continued anxiety AND after you have eliminated alcohol, stimulants and certain foods like chocolate which can contain caffeine, ate a well balanced diet and all of your bloodwork is normal. Then I would consider a beta-blocker and perhaps something to help turn your brain off for a bit such as an anti-anxiety med.

Thanks!

Your welcome and stop worrying

[Carrie41]

Wow do you ever know a lot!  Are you a heart doctor?  You make total sense about what you are saying.  I am really going to take some of your comments "to heart".  

My only other question to you is that when a person has a panic attack could my heart still be skipping 10 minutes after I had calmed down?  I have never had a run of them for so long like I did on Tuesday.  I am still freaked at it.

I just started counselling with a therapist becuase of my anxiety about my PVC's.  She is trying to get me to focus on other things than my heart and told me to get rid of my stethoscope.  I know I should but I just don't think I can!  

So Lucasbrown if you could just tell me if that is a bad thing to have my heart going into the funky rhythum every second beat for 10 minutes after just having a panic attack what?

I have had an EP study as well becuase of my cronic (chronic) complaining about my heart.  They caught something called salvos or something like that and it really freaked me out.  They do say that I have a structurally normal heart though and don't worry about the skips but I really do.

[Luciasbrown]

You said "Doctors are not too worried about them since they occur in everyone unless they are right in a row. A good rule of thumb is that if they occur less than six per minute then they are usually benign."
Why are the doctors worried about them when they are right in a row???? Because the doctors on this forum are telling that pvc's in a row are benign!!!

Well without reading what they may have said, I guess it all depends on how you define "...right in a row" and also how you define "worried"
I do not know what they are saying with different words, but I am trying to say is if they are runs of non-sustained vtac. Which what I meant by saying 'right in a row' or R on T phenomenon.
I just had a patient yesterday who had a non-sustained vtac on the treadmill but he reported no symptoms and was on the proper medication already and it occured only twice.
So, yes we pay more attention to non-sustained vtac b/c a patient may be at higher risk of developing sustained vtac which can lead to ventricular fibrillation.
Without symptoms it does raise an eyebrow when you see it.
Far more than seeing a PVC or bigeminy or several PVCs in a short period of time.
When I say 'right in a row' it means no normal beats in between.
Hope that makes it more clear.
PVCs are for the most part benign and no treatment except reassurance is needed. But what I also touched on is that they can be an indicator as well but a poor one.
So what I am saying is that PVCs are benign if they occur in a normal heart :P

[Rag123]

Your responses are outstanding!!!

I will inquire about the long QT thing. I was simply told that it was normal by more than one cardiologist...
(I would hope it would have been pointed out if it was an issue?)

I assume it's only necessary to measure the QT time during a normal rythem?

I'm still a little confused about the adrenaline thing though.

Sometimes, I have panic attacks and don't experience any noticeable skips...  And other times I may feel stressed s or have anxiety and I get a couple.

Adrenaline is what kicks in to make your heart race isn't it? Or does it have to be a lot? Does it depend on how much is released at a time or something?

In regards to the sex/adrenaline issue. If I understand, if I'm having sex with my wife - I may have a moderate amount of adrenaline being released. And if I were to have sex with someone new, I would likely have more of a rush of adrenaline.

So, Adrenaline can scramble the electrical signals or something?

It just struck me as strange, since I only niced this happening after I started having panic attacks...

Could my body be releasing excessive adrenaline. For example: sexual arrousal + fear/anxiety of getting the PVC's?

And as you explained about the house example, as long as my structure, flow, and general wiring is ok - it shouldn't go beyond bigeminy. I should at least have a good beat in between each PVC...

Here's an interesting question that I've gotten various answers on. I asked one of my Cardiologists, how long does someone need to be in Bigeminy before going to the ER? He said if it lasted longer than a half hour.

But then again, I hear of people on this forum that have had it for days and weeks?

What are your thoughts on that?

[Rag123]

Sorry to keep bombarding you with questions...

I just read your reply to someone else...

In regards to the vtach thing, my fear as I tried to explain in my prior reply is that bigeminy may turn into couplets or salvo's (back to back with no normal beats in between).

Could this happen withing a normal heart? And if so, would it still be harmless?

And lastly, can you explain what vtach is and if back to back PVC's could lead to it in a normal heart?

As you can see I'm always worried about things progressing, especially if I have skipped beats and I become terrified, panic, etc.

Or am sexually active while having them and continue...

Thank you very much!

[Luciasbrown]

No Carrie, not a heart doctor














BUT, I DID stay at a Holiday Inn last night :P



I still am hesitant to say your rhythm on tuesday is ok. If you had a PVC every other beat, that is bigeminy and is of little concern more than just PVCs are in a 'normal' healthy heart. I.e. someone without a diagnosis of heart disease. I dont want to open another can of worms by saying anymore about that.
As far as your EP study, I would trust the EP doctor as that is a sub-speciality in the specialy of cardiology. So when a cardiologist needs an electrophysiology specialist, they send them to a EP doctor.
As far as them maybe using the word salvo, I would tend to lean towards a misunderstanding or a bit of confusion.
In my previous post, I mentioned PVCs that occur right in a row, a salvo is one of the things I was referring to, I believe you have PVCs, maybe bigeminy, but they might be a bit more aggressive with salvos with medication. And panic attacks can release adrenaline and can cause PVCs in a low heartrate who is not exercising. (I know, I said adrenaline overrides but I was referring to exercise and a bit confusing my choice of words)
If they told you it was normal. Believe them over me. I have not looked at your ecg tracings, I can comment very generally on subject matters but there is no such thing as a doctor on the internet. A proper history and physical with your medications as well as a review of all of your tests is why you go to a cardiologist in person.

[Luciasbrown]

I'll have to come back to you on your questions a little bit later.

The sex and the stress test levels was a bit of cardiac humor.

I think I am going to stop saying 'its overridden by adrenaline' from here on out. It's making it too confusing b/c adrenaline can 'stimulate' cardiac cells, just like caffeine or the byproducts of alcohol can stimulate a cardiac cell to depolarize and cause the PVC.

I am just going to say that it is 'overridden by exercise' from now on because adrenaline after exercise can cause PVCs while the heart is slowing. So forget I said adrenaline.

[Carrie41]

Very interesting Lucasbrown.  I feel so much better reading your posts.  I actually was sent to the EP specialist because of the runs of PVC's.  My cardio didn't think it was a big deal because they gave me numerous other holters and they never caught anything more than a couple of PVC's together so they just said "don't worry about it and that it was a short run of non-sustained v-tach", although the EP doctor says it was probably salvos and not nonsustained v-tach (is that possible?)  

Needless to say I looked up v-tach on the computer and have been scared ever since after I found out what it was.  I have had echo's, and EP study and you name it and they say there is nothing wrong with my heart.  The funny thing is that I never felt the PVC's when they caught them on the holter when it was non-sustained v-tach.  This happened back in 1990 when I had just had my first child and I was having a lot of thumping around and they got me on a holter.  My other question is that if I would have a heart condition wouldn't I be dead by now since this has been going on for so long??

I remember in the EP study the doctor said I had "a slick sinus node".  He said it was the sinus node of a 25 year old and that was good.

Would the EP doctors have found something if I did have something serious?  Am I wasting my life worrying about something maybe never occured?  Thank you!!!!

[sandrabel]

I had a run of 10 pvc's without one normal beat between (=nsvt).  My cardio told me that this is benign in a normal heart.  The doctors on this forum are also telling that nsvt is benign in a normal heart and that nsvt does not go into Vtach or Vfib (in a normal heart).  Why are you telling the opposite? (maybe i did not understand you well?)

[Luciasbrown]

I am not telling you opposite, I am 'nuancing' my answer as to not give a direct answer. Dont worry, my fiance who is a lawyer hates it too since she speaks in black and white where as my profession you deal in percentages and probabilities.
The probability that if you have a structurally normal heart with that nsvt then it is benign. What I am referring to, is nsvt will catch a physician's attention whereas, a PVC half the patients who come into a cardiology office says I get these palpitations, why are almost always normal and once a complete history and physical is taken~in person. Then one can confidently say that it is benign.
What I am saying is that I cant say its benign to a person on the internet b/c there is not enough information.
I could say its benign and 99 times out of 100 be correct. Leaving a 1 out of 100 risk of being wrong and giving improper advice.
That seems low and I should just not be so anal and say they are benign to everyone. But if you take a chance with that risk factor of 1% every day for a year. That means statistically, I will give incorrect, possibly harmful advice to 3-4 patients a year.

If your doctor whom examined you and looked at your tests says they are benign, please believe them over me. This is a very complicated subject matter where I posted about my professor who answered questions with "always, sometimes, never"
Someone saying its benign is offering reassurance and that actually helps b/c alot of this is a psychological issue rather than a cardiac issue.
I was taught to 'nuance' answers in a way that answers the question and doesnt mislead. Other doctors may simply be more comfortable saying it's benign until they are wrong and say they were wrong at that point. Now which is best for that patient, arguments on both sides. 99 patients get their yes or no answer they want and it is correct but one patient gets the wrong answer but was not worrying about it until something messed up.

To answer your question, I will simply open this huge book called Hurst: The Heart and give you their answer and you can decide for yourself.

Nonsustained Ventricular Tachycardia:
Nonsustained runs of VT (salvos of three to five consecutive impulses or nonsustained VT of six impulses to 30 s; are considered indicators of high risk for potentially fatal arrhythmias (sustained VT or VF) in most clinical settings. There are important exceptions, however. Patients who have no organic disease or limited cardiac abnormalities do not appear to have increased risk, although some patients who have very rapid polymorphic VT may be at increased risk. Even in the absence of an increased mortality risk, symptoms such as transient light-headedness, near-syncope, or syncope require therapy.
At the other extreme, cardiomyopathy patients and those who have advanced coronary artery disease with a very low EF (ejection fraction) are a;mong the highest risk groups. Conceptually, nonsustained VT may be viewed as self-terminating VT or as an intense triggering even in a susceptible myocardium.

Treatment is generally simlar to that outlined for other patterns of PVCs, although patients with prior myocardial infarction who have nonssustained VT and low EFs and are inducible into VT in the clinical electrophysiology laboratory are thought to be at higher risk than those with nonsustained VT who have better EFs and are noninducible. In MADIT, ICD therapy demonstrated lower mortality rates than with the best conventional therapy in a randomized study design of such patients (nonsustained VT, EF 35 percent or less, inducible sustained VT, and failed supression of inducibility of VT during programmed stimulation-guided therapy with intravenous procainamide).  In Multicenter Unsustained Tachcardia Trial (MUSTT), a similar group of patients appeared to benefit from ICDs, as opposed to electrophysiologically guided drug therapy.

[Rag123]

Ok, I was feeling reassured until you posted some technical/medical jargon...

I think that stuff freaks us all out! :)

It seems puzzling that 10 pvc's in a row would not be a concern? Is this something that happens rapidly or is it literaly 10 beats over the course of 5-10 seconds?

I've heard of people with other issues mention that their heart stopped for 5-8 seconds, then started again.

In either case - 10 PVC's in a row or a heart stopping for several seconds - wouldn't a person pass out or at least feel light headed?

I feel like I'm in a catch 22 sometimes. If I were to be in bigeminy and feel it - I would like to say to myself (as suggested) - "It's just Bigeminy", but at the same time if I were to ignore it, can it turn into something else like several back to back PVC's/nsvt? And then I wouldn't be aware of it and know to get help - and just croak!

Dramatic... I know! :)

As far as been recorded on a 24 hour halter, my PVC's are unifocal - I don't know if that makes a difference with regards to possible nsvt or not?

Which brings me to another interesting question - you mentioned Adrenaline having stimulating effects on the heart cells, like caffeine and alcohol biproducts.

Eight months ago I was drinking 4-5 cups of coffee daily, 2 glasses of wine 3-4 times a week prior to having panic attacks.

I stopped drinking coffee, stopped eating chocolate, and stopped all alcohol. Now I'm aware of these PVC's. That's not to say that I didn't have any, but I definately didn't notice/care...

So, now I feel that my anxiety about them brings them on more. Whenever I approach a situation or activity that I feel they may occur - I do so with hesitation.

Another puzzling aspect is the discussion of foci - I believe it's called. Are these focal points that fire off when stimulated? And do we all have these? Or is the adrenaline capable of causing just about any arythmia?

[Rag123]

Sorry, I forgot to mention this...

I have seen two cardiologists over the past several months. And after all the normal results, I asked both of them why this may be occuring now.

One said you may have a sensitive electrolyte system/cells within the heart. He said this could happen with age - I'm currently 36.

I mentioned this to the other Dr. and he chuckled and looked at me and said - "No, you don't have a sensitive electrolyte system..." He said, everyone gets PVC's - avoid certain situations and/or deal with them when they occur... They're harmless... Your heart won't stop, you won't have a heart attack, etc.

So, is there a such thing as a sensitive electrolyte system/heart cells? Or possibly a hyperactive adrenal system.

Perhaps since the panic attacks started, my parasympathetic nervous system just hasn't relaxed completetly - if that's possible.

I'm kind of anti-med, but am considering taking Xanax or something again to try and come back down from this worry cloud! I don't like SSRI's though - they seem to have some weird side effects...

[Carrie41]

I'm with ya Rag!  I was feeling better as well until I looked at the medical jargon and got freaked out again.  I am 45 (soon to be 46).  They also caught non-sustained v-tach on a holter when I was 29 and I have never been the same since.  I have been horrified with every little skip I feel.

I have started an anti-anxiety med becuase I just can't stand this worrying about my heart anymore but I don't see a difference yet.  I still freak out and ***** foot around when I feel anything.  It is a crazy way to live.

I love the posting from Luciasbrown.  He is the only one that has made sense to me yet.  The doctors just don't have time for a blubbering fool in their office when they tell you "don't sweat it - it is just PVC's".  I sweat it like crazy.  I have had these things for years and years and just within the last six months or so I have started freaking out again because at one point they were coming one after another for a couple of hours and since that day I have been worried again!

How may PVC's do you get a day Rag?  I average around 10 except the other night when they were one after another when I was having one of my god forsaken panic attacks thinking about them.  The last couple of days I have had around 10 a day but that is MORE than enough for me.

[Luciasbrown]

Please, the reason why I wanted to stay away from posting that jargon is because it does not apply to youse folks as far as I can tell.
But, it is true nonetheless.
I just do not have time to answer it right now. Listen, if I can't just not state the truth, but I can also assure Rag, from everything you have said, that the heart is the best part of you, so stay away from cardiologists.
Carrie, I dont what is going on with you and cant diagnose you given this is the internet.
BUT, if you read what I posted. That UNLESS you have organic heart disease, then you fall into the important exception of it being meaningless.

To the both of you, in the limited time I have in the next three days to respond.
I do not believe that I would categorize you as a significant problem.
There are times when I get patients the truth with both barrels to try and change their wreckless behavior with nicotine, drugs, alcohol, diet.
I do not think I need to do that to you.
So please, enjoy the weekend and have a couple of glasses of champagne and dont worry.
Your problem is anxiety, not cardiac. You both seem to have been diagnosed with normal cardiac structures rendering ANY thing I posted completely exceptional to your cases. Meaning, you have 'internist's disease'
Which is characterized by reading too many medical books.

I have alot of people who hug me or shake my hand b/c I tell it like it is in a way people can understand.
I am telling you right now and going out on limb. That you have done the right thing and your persistance means you have had many doctors tell you are ok.
So, relax, you are ok.
I just dont have time in the day to completely convince you, but if I was you, which I aint, but if I was, I would no longer worry about your heart for the next five years. Fair enough?
Just take a five year break and then start worrying again, in the meantime, eat right and limit cardiac risks.
Otherwise, you risk getting treatments that may actually put you at more risk than just leaving it alone.
Have a good weekend and two glasses of champagne. Doctor's orders!!

[sandrabel]

I have a technical question.  I've read that an exercise induced nsvt is dangerous.  Why is that?  Is it also dangerous in a normal heart?  Is there a treatment?

[Rag123]

Two glasses of Champane? I thought you said alcohol biproducts can stimulate the heart???

I'll admit I'm intimidated by trying alcohol again. I would like to drink red wine again... But just knowing it could cause PVC's and elevate my blood pressure has kept me away from it...

[Rag123]

Hi.

In terms of what I notice - I can get zero to less than 10 single ones throughout a given day.

However, there are those occaisions where I might get 3 or 4 within an hour or so.

Then, sometimes when I'm sexually active I may get a few or I may get bigeminy. Depends on the event and duration, etc... Sometimes it's really unpredictable, but as I've said before I think anxiety plays a major role, because sometimes I approach it with more confidence, knowing for almost a fact, that it will not harm me. And then there are times when I feel very uncertain of what I believe - those times seem to be when I have a lot more...

The sex part feels like a curse! :D

What's also awkward is going to work and feeling stressed that you may get these away from home, away from where you feel comfortable... It's tough to remain confident about yourself when your heart starts doing those back flips...

My wife has no problem taking med.'s - she's Bipolar, so she really has to... But I don't like to take them. I was on Xanax back in the day for panic attacks, then just a few years ago I was on SSRI's(had some strange sexual side effects and felt like just sitting and doing nothing most of the time, although it did stop the worrying).

I know it's not good to stay on Xanax for too long, but I know it will have an immediate effect, without the odd side effects... I just want to try a low dose to start...

Unfortunately, I had taken my daughter(6 years old) to a father daughter dance and we got strep throat, so we had to take antibiotics. There was a post about certain antibiotics causing long QT times, so I was really freaking... And asked the doctor, he said some do and prescribed one that doesn't.

Fortunately, my common sense kicks in every now and again and says something like - everyone gets PVC's, I've had a normal workup, I wouldn't be any more at risk than anyone, else. But then it leaves and I hear something like - but what if I get bigeminy and the medication has some impact...

It's like a never ending series of questions that come to mind and feels like noone with ever be able to reassure us enough to just move on... I've had days/moments where I forcce my self to get involved in what I'm doing/not check my heart rate/etc. and have done well. Then when I find myself checking my pulse or something, I try to reference those times and say to myself thay, hey, I survived and actually felt good doing so. So, don't pay no mind to my fears...

My psychologist keeps telling me just to get on the treadmill and run as fast as I can to see that I won't croak. But it's not that simple - I know myself and I know just that one time won't do it - I might consider myself lucky that time. And in the state of mind I'm in - I might have a panic attack.

Sorry, I know you simply asked how many skips I got daily. :D

[Rag123]

I'm going to try and make this my last question to you...

To sum things up a bit. Adrenaline may be causing the brunt of my PVC's/Bigeminy.

So, my question is since adrenaline can cause various forms of arythmia, PAC's, PVC's, etc. - Can adrenaline cause harmful arythmia's?

Which was kind of my question earlier, can it push the arythmia beyond bigeminy - into a harmful arythmia?

Please, no excerpts from the technical medical manual! :D

I think you've already answered by stating that arythmia's that occur in a structurally normal heart are typically benign - but please humor me with a somewhat straight answer - since this seems to really be the biggest road block for me... Either sudden death from one of these or the arythmia's progressing into harmful one's with more adrenaline being dumped from fear, etc.

[Carrie41]

Okay now I am freaked again because you said you don't know what is gonig on with me.  Do you think the caridoligist or EP docs missed something?  Is it possible that I didn't have v-tach in 1990 and they thought I did and made a big deal out of nothing??  I mean is it possible that a holter could ge mixed up with someone elses?  They have never seen v-tach on a holter again after that one time.  They saw a couple of PVC's together and said don't worry about it.

Can you give me the black and white of it?  I mean all I ever get now if about 10 skips per day where it goes beat..beat..quick beat....thud.  Somedays I only get around three of them.  There was just that one time on Tuesday when I was totally anxious about them laying on the couch that it went totally irregular for about 10 minutes.  Can a panic attack do that?  Make it go irregular for 10 minutes or so??

I really value your opinion.  I wish you were in Canada and I would come and see you as my doctor.  No other doctor I have ever seen has said any of the stuff you stated above but it all makes sense.  

[tickertock]

I have suffered with PVCs Off and on just as much as anyone that I know, 10-20 Thousand on a very bad day, then in 1000s from weeks to as long as 6 months, had all the tests possible (besides an heart cath or EP study) which both cardiologists and electrophysiologists told me would be bordering on malpreactice , at least in my case.My holter in 1987 showed a 5 beat run of NSVT or salvo of PVCs, was reassured from then that I was fine and would not drop dead,also my PVCs are more adrenaline triggered and exercise can induce them which I was reassured via a stress test that I was not at increased risks , apparently some PVCs kick in at higher heartrates and others at lower rate, though generally more at lower rates from understanding, the prognostic significance depends on whether any structural abnormality or CAD is present, other than that is really doesn't have significant prognostic importance at this is what I've been told. I'm male 42 and rarely have PVCs anymore, take atenolol , cozaar and htcz to controlled HTN which is very controlled, drink a few beers when I care to, dont smoke at all(never did), exercise as much as possible though I'm limited because over exercising in my cases can agggravate the symptoms or relieve them because of a connective tissue disease that i have, other than that Ive told that I'm otherwise healthy. Bottomline trust your doctors and cardios, listen to others experience and symptoms , realise you are not alone, watch what others write on the net regradless of their qualifications, be careful of the article you read (most don't apply to the everyday PVC sufferer) and try to to enjoy life, it's too short not to even if you live to be 90 or 100. I know PVCs can be disruptive, disheartening and scary, but try and harness the anxiety and move on. LIVE!!!!

[Rag123]

Thanks for your post. I usually find your explainations along with your history comforting...

I actually posted a question to you in the Patient-to-Patient forum - but I've never seen you respond in there, so here it is:

I know I had asked you before about bigeminy and what your Cardio said - which was in the presence of a normal heart structure, they are harmless.

Did he ever explain why the bigeminy wouldn't progress into another harmful arythmia if you simply continued your activities while havig it? Like having back to back PVC's such as a couplet or Salvos(3 or more in a row) without the normal beat in between?

This is my fear when I do get bigeminy or trigeminy...
That it will just keep progressing to less and less normal beats... Then a harmful arythmia.

I thought I read in one of the posts that one of the doctors replied to someone regarding a protective mechanism of the heart... (in a normal heart)

And was hoping that couplets and Salvos were due to heart disease or something.

But, then again, I also recall someone posting that they had couplets and their doctor said not to worry? I've read so much, sometimes it becomes a blur...

And now just reading your recent post - you did mention that you had back to back PVC's and your Dr. said it's ok. Is NVST and Salvo's the same thing?
Thanks.

[Luciasbrown]

you are all hypochondriacs.

REMEDY: Get a life!!

Whatsamatta with you?  I have no idea, but if you sit there all day wondering about your heart, then you are a selfish person. You COULD be doing something better!
You people, to be honest, make me wanna puke b/c you chew up valuable  healthcare dollars that can really help someone. But you pukes rather take advantage of the system and screw everyone else over so you get an "ok"
YOU dipshits have gotten the "OK" and STILL Persist
Go away you boils, you are the ones that screw things up for everyone else.
REality check

[Carrie41]

If anyone should get a life it should be you.  If you have nothing better to do than look over the postings and say mean things then you are a very self person!

I don't believe for a minute it was LuciousBrown posting that last comment.  You should be reported to the medhelp org for using someone else name!

There are people on here that value opinions of people such as LuciousBrown so maybe start purusing other forums where you can batter and cut people down.  THIS IS NOT THE PLACE.

[wmac]

Wow if Luciasbrown is a doctor, I wouldnt give him one penny after speaking like that. If he is a good doctor why would he sit on this forum does he not have real patients or what? That just blew me away very immature also. I just cant believe what I read from him very shocking. Also if you are a doctor and there werent people like you wouldnt be making a living we are your meal ticket so I hope you dont treat all your patients like that if you are a doctor.

[Rag123]

Yeah, I would definately say that it's someone else posting using his name or he is Bipolar or Schitophrenic(got the spelling wrong on that one...)

Or his lady got really irritated that he was spending time comforting us and lashed out! :)

But, if it's truly some shmo... That person will have a time in their lives where they feel vulnerable, also...

I got a laugh out the post!!! We all have issues behind closed doors. If yours isn't what we have here - it's something else.

We are simply not masking our concerns with alcohol and drug abuse - but are trying to be as certain as possible that we do not have anything life threatening - because we truly want to go on with our lives...

[tickertock]

Unless someone else has access to the persons email to get the password then I would assume it's the same person, if you read all his/her comments carefully and know anything or even a little about psychology you should been able to see into this person's psychological profile and know that they would eventually turn on the persons they were commenting to , a comment must have hit them the wrong way and they took it out on all, that is why I warned in my last comment to watch out for those posting comments on the net no matter how qualified they might appear to be, these persons can't stand facts that hit home as long as they are in control its fine but when something no matter how insignificant it might appear to others hit them,they lose total control, not that they ever were in control to begin with. This world is full of dangerous individuals who play some very dangerous games you have be able to pick up on them very fast or you'll find yourself on the bad end of stick. Be careful.

[Carrie41]

Yeah I never thought about that one that the person has to have the name and password.  You are probably right.  Oh well, I guess that is what I get for being nieve.  I actually believed in this guy!  Sounds like a nut case to me.  I will be more careful from now on who I do and don't talk to.  I will just stick to the people that I know are regulars on the board......

[Rag123]

TickerTock,

I had a post/question to you above... Not sure if you missed it or not. It's ok if you chose not to answer. I've seen what happens to some if you bombard them with questions...

I did notice that he was jumping around a bit in his posts. But I think we were all just hopeful that we were tapping into some knowledge.

Carrie,

Just be glad that you found out about Dr. Jeckel and Mr. Hide on the web and not in his office...

[tickertock]

3 PVCs in a row without any normal beats in between is arbitrarily defined as NSVT once its above 120 bpm, anything below as i understand it is defined as AIVR(accelerated idioventricular rhythm , aslo known as slow Vt). It really doesn't matter with a normal cardiac work up. Some cardios and EPs regard 3 PVCs as a triplet, 4-6 PVCs as a salvo, and 7 more and  above a run of NSVT depending on the rate usually above 110-120 bpm, everyone( cardio & EP) usually has their own interpretation, other than that it's just basically semantics. With every test coming back normal the prognostic significance is of little importance if any at all( meaning you have nothing to fear but fear itself). Take care and Good luck.

[sandrabel]

Thank you so much for this explanation.  Have you any idea of an exercise induced NSVT in a normal heart is also benign?

[tickertock]

From what I gather and understand, please note I'm not a MD, exercise induced NSVT in a normal heart pose very little risk, I can't say that it doesn't pose none because I really don't know , if you have exercise induced nsvt then a consultation with a good EP might able to put your fears at rest or he/she might even discuss a possible cure with ablation if the cause is that easy identifiable.

[Brittany M]

Hello all.
I am a 20 (almost 21) year old female and started feeling paplitations alot about four months ago. I have them pretty much everyday and don't see any correlation between getting them and something I'm doing. I have had an EKG, blood work, echo and holter monitor. I'm still waiting on the results form the monitor, but everything else came back normal. I have a feeling the monitor will too, because, of course, the one day I only had one palpitation was the day I had the monitor on. I also have had really bad chest pain for the same amount of time. My doc had me take large doses of pain reliever, but that didn't do anything. I can't stand not knowing what is causing this. I don't feel like myself and I can't do most of the things I used to be able to do, because I get exhausted very quickly. I can't even go up one flight of stairs without getting a really fast heart beat and tired. I'm only 20 and this shouldn't be happening!  I worry,  because I know my mom's biological dad died in his early forties from either heart disease or a heart attack.
Thanks for listening to me rant on and on. I'm sure others out there have more problems than me, I just want to know what's going on.

[beezle]

I have been having PVC's for the last 10 years and I am 43.  I have seen a cardiologist, had an echo-stress-ech done, EKG's obviously, and have been told that this is nothing to worry about.  I take Tenanol 25mg when they get really bad, other times when they get less frequent, I will wean myself off of them.  I make myself not worry or stress over them...but it is not always easy. Now I have them back, worse than ever, I have then one after another, non-stop, for hours at a time. I wonder if this means anything, or if I should see my cardiologist again, or just assume that all is well and this, too, will pass?  I have been really tired lately and more that the usual amount of stress, that is, historiaclly been my recipe for getting these things back.  I have never had then like this before, however. Any comments?

[NurseKagome]

Hi there,

Your so intelligent! I have a question. I have spurts of very fast heart beats that feel "not normal" but maintain a steady pace, they are not all over the place. (not irregular) its something I can't seem to time with a holter....should i be concerned?

Also, I have noticed that the pause I feel before my next beat after a PVC is lengthening. I counted 3 secs on the last ones today. Should that concern me? It feels like my heart stops for so long during those 3 secs. I am scared again by all of this after a while of peace. I had an echo done about 2yrs ago, all normal, ekgs normal, bw normal, stress test normal. Is there still room for issues? Or with these tests should I forget about this funny run of fast beats and my longer pauses?

I look forward to hearing what you have to say. Talk to you soon!

Nurse Kagome

[NurseKagome]

Hi there,

Your so intelligent! I have a question. I have spurts of very fast heart beats that feel "not normal" but maintain a steady pace, they are not all over the place. (not irregular) its something I can't seem to time with a holter....should i be concerned?

Also, I have noticed that the pause I feel before my next beat after a PVC is lengthening. I counted 3 secs on the last ones today. Should that concern me? It feels like my heart stops for so long during those 3 secs. I am scared again by all of this after a while of peace. I had an echo done about 2yrs ago, all normal, ekgs normal, bw normal, stress test normal. Is there still room for issues? Or with these tests should I forget about this funny run of fast beats and my longer pauses?

I look forward to hearing what you have to say. Talk to you soon!

Nurse Kagome