Problem Fear of PVC/PAC

[sallykin]

Hi, 3 years trying, 1st post, I am a 46 year old female, since 2000, I have been plagued by random bouts of PAC's & PVC's (both seen with event & holter), All other (Stress, Echo, Stress/Echo test normal), My arrythmia's come and go, 3 weeks with none, then several days with dozens, more pronounced with cold weather and exertion.  I have had some partial syncope with the PVC's. I am absolutely terrified whenever they come back, My MD says not to worry, learn to live with it.  I almost rather not live with it than to deal with the constant fear that I am going to drop dead at a moments notice somewhere or that I will be found dead in my home (I live alone).  Since these came on, my life has been horrible, I no longer excercise (I loved walking, skiing in the winter), I am failing at work (stressful job), and I am just losing the will to fight. I'd like to come to Cleveland to see if someone could figure this out (I had no problem before 2000), I know from the posts that its very common and most are far worse than I am, but its killing me every bit as much as if the Doctors did find a serious problem. I am afraid to drive or travle due to the partial syncope. I was hospitalized because of this in 2005 for 3 days in CCU, they observed no problems while I was there, same thing for my dozens of trips to the ER (I stopped going), PLEASE, PLEASE, HELP,
Thanks for this forum and advise, it has been of some comfort in easing my fears.

[Cleveland Clinic]

sallykin,

You've got to get a hold on your anxiety. I really don't think a trip to Cleveland is going to add that much to your treatment or diagnosis, besides....the weather is horrible this time of year.

You have a very common problem, however -- your adaptive mechanisms are truly out of proportion to your disease. If a trip to Cleveland and reassurance would help with your anxiety than any of the electrophysiologist here are outstanding. However, it might be good to see a psychiatrist that specializes in anxiety before making the trip.

good luck

[woodruff]

Well, Sally, you've quite specifically named your problem:  Fear.  Most of us who post here are very, very familiar with it.  In the early days of my own pvc experiences, I got faint, too, but there was no heart-based explanation for it.  The problem was my emotional response to the physical feelings, which were in turn worsened by panic.

Once I had had enough heart tests to demonstrate to a fairly intelligent person that the ticker was basically OK, what worked for me was to go to a psychiatrist.  Shrinks are docs; they can evaluate your medical history and relate it to your symptoms and complaints; and, most importantly, they can prescribe drugs.

My shrink explained to me that my autonomic nervous system, the alarm apparatus, was mis-set at about Level 9, and that it was now overly-sensitized and needed time to quiet down and forget the useless stuff that set it off in the first place.  Thereunto, he started me on the first of several SSRIs.  These are antidepressants which can also subdue panic.  It took a while to find the right one (there is no One Size Fits All with these things), but once I did, WITHIN DAYS, my awareness of the odd beats diminished.  More important, their actual frequency decreased!

I believe I took my zoloft for only maybe five months before I was able to start tapering off it.  Now, people who have panic or anxiety attacks tend to get repeat events, oh joy, and mine return (along with pvcs) every couple of years.  When it happens, I call my nice shrink, and we just start the procedure up again.  It really gives you your life back.   You can exercise, ski, and have fun once again.

[STUARTCBRANDT]

I went to the Cardiologist two weeks ago, and he had me do a 24 hour holter.
He said I have mild PAC'S, what are they, the doc said lots of people have them, he said yours are mild and he could maybe give me a med but you might feel worse.

The doc said my risk factors are very low for heart disease.
Never smoked.
Never drugs.
Never drink.

My blood pressure is most of the time 125 over 75.
No family history heart disease.
But I have been fat my whole life, I just lost 50 pounds.
I am so scared of having a Heart Attack that it is driving me nuts, if I feel a pain in my chest I think here it comes the big one.
Maybe its the Pac's thay make me get scared.

And here is the bad part my Cardiolosist is 48 and had a 5 way bypass with the same health profile, except he was never fat always trim, the only thing is he did was work 16 hours a day.

Stuart Brandt

[NBCT]

Your post with a two year age difference than myself, writes exactly as mine did six years ago. Let me start by saying your fear is real and crippling. Doctors and tests can try to convince you that nothing is wrong....but the feelings from the PVC/PAC's are overwhelming at times.
Now, after six years of dealing with the same and learning to accept and cope with the good days and bad days, I can honestly say my fear over the past few years has diminished ten fold. Finding this forum and being a newcomer back then, I thought posts from the regulars were just insane when they mentioned how well they were doing since realizing sudden death was not iminent from the extra beats. But now I have been living like the beats don't exist...still feeling them...many at a time all day, for many days...without the fear!!!
It will take some time to come to the point of acceptance and decrease fear, but use this site and find a cardiologist who understands how difficult it has been for you. Best of Luck to you...and yes, I know easier said than done!

[STUARTCBRANDT]

Hi All what are PAC's my cardiologist say I have mild PAC's.
He says they are not fatal in my case.
It still makes me nervous.

Stuart Brandt

Did I mention I have no insurance of any kind.

[woodruff]

Stuart, PACs are "Premature Atrial Contractions."  This means there are early beats in the atria, the smaller upper chambers of the heart.  Here is the google page for this type of beat:

http://www.google.com/search?hl=en&q=PACs&btnG=Google+Search

You can also type PACs into the search box of the home page here, and see the discussions that have already taken place on this subject.

[sallykin]

Again, I thank the Doctors and folks who post here, it does help with the fear.  Is what I have really a "disease", my MD and Cardiologist have not told me that.  Even if the anxiety is out of proportion, doesn't the "disease" that is causing it need treatment ?

[Cleveland Clinic]

Perhaps my referring to your PVCs as a disease was a mistake if you are going to use that term as a focus of generating increased anxiety. PVCs and PACs in structurally normal hearts carry no long term negative prognosis. You need to focus on that fact instead.

[sallykin]

Thanks;

I have been receiving counseling over the last year and that has helped (i.e no trips to the ER this year, 4 trips last year), anyway thanks again.  Like everyone else here, I just wish they would go away.

[Carrie41]

Oh my god.....I felt like I had written that post myself.  I too am 46 years old and suffer with pvc's and pac's, short runs of non-sustained v-tach.  I went to two EP studies because I was so sure that were something wrong years ago.  I have gone to countless cardiologists and everyone tell me not to worry I have a strucuturally normal heart and quit perservating about my heart.  I am on 10 mg celexa to try to subside my anxiety which I think worked for a couple of years but I am back to my severe stress level.

That is all I think about every waking hour - my heart.  I am so sure that something is wrong I just can't stand it.  It skipped on four different occasions today and I went into panic mode.  I hate living like this.  I am going back to my doctor next Wednesday to try to find something else for me to take because of my stress level about these things.  I have had them since I was 23 years old and you would think I would be better by now about them but I am not.  I can't imagine living like this for the rest of my life in constant fear.  I avoid social situations now, I have trouble a work because of my obession with these things, I am afraid to get my heart rate elevated at all because I think that there is something wrong with it.  I wake up during the night and feel a skip and go into panic mode and walk around the house the rest of the night and wonder if I should be phoning 911 or going to ER.  It is really silly.  I something sleep in my clothes because I think that it will be easier for me to get up in the middle of the night and jump in my car and go to ER.  I also will not leave the city because I am afraid of being somewhere where I cannot get to a hospital.  

I don't know how people can just live with these and not let them bother them.  I had a few years from about age 42 - 45 where the panic wasn't too bad and I just would talk myself down everytime I felt one but I am back to square one with my worry.

You are certainly not alone with this.  I have read thru numerous posts and everyone seems to have the same fear.  You can only imagine how many people actually have these darn things when you look at this website and just think these are only a handfull that have gone on here to post.  I have a freind that is a doctor and she has told me that I have had such a workup on my heart done by doctors that I really shouldn't worry, but I can't help it!

[woodruff]

For disabling fear--which is what you guys are describing--even after repeated testing has shown normal, healthy hearts, you have to see a psychiatrist and get really familiar with weekly therapy, and probably a trial of several drugs, including, most likely, more than one SSRI.  If one doesn't work, there's another.

Being confined to your house and concentrating on your symptoms is no way to live.    There is a way out, but you must take the step of getting yourselves into real psychiatric care.

[sallykin]

Hi, I feel your pain as well as that of many others with this fear, yup I've done the walk around the house in the middle of the night thing, sometimes I unlock the doors and turn off the alarm system so that the paramedics can get in if I have to make that call, it is pretty far out there, my MD lives 1 street over from me and he tells me I have absolutlely nothing to worry about whenever I pay a neighborly visit.  Like I said I went into counseling for this problem late last year and it helps me motor through the bad days, but the fear is always there.  For 2 years, I kept a chart of every possible trigger and I could find no real correlation.  The closest trigger I could find is products containing artificial sweetner which I now avoid.  I am also back on HRT (hysterectomy at age 32) after I went off about the time the arrythmia's started, and this has also decreased the occurences but sadly not eliminated them.  I also got into a monitored excercise program which really helped a lot until my insurance co. pulled the plug.  Best of luck, I pray for everyone similarly afflicted that some day these can be cured.

Good Luck and take care,

Sally

[arnieK]

It is reassuring when I read through all the comments on PVCs.  It decreases my anxiety knowing that there are more of us out there and we are all still alive.  I am a 49 y.o. female (nurse) that was in an inhalation accident (building imploded) at work that threw me into PVCs.  Was living in trigeminy the first year after the accident.  Tried every med out there and attempted 3 ablations.  PVCs are stemming from the left ventricle and the docs at Riverside Hospital (where Cleveland Clinic sends some of there EP patients)that an ablation for me is a shot in the dark because of the location of the PVCs.  Currently in Bi and Trigemiy.  Tough to sleep, I feel like my thought process is changed when it gets bad, tired and sometimes collapse.  Have found that year 2 since the accident that the PVCs come for 6-12 weeks and then hardly at all for 4-6 weeks.  Weird! Had a hysterectomy 3 years before the accident so I am not quite sure where the hormones play in all of this.  

What has helped is:  Sleeping slightly upright at night with relaxation exercises, making sure potassium level is good, decrease stress, good hydration, whiffs of oxygen, enough sleep and a wonderful husband.

Is there anyone out there who has had a similar situation, would love the input. What do you do when you are running 5800 PVCs a day and the cardiologist says its benign?  Suggestions?

[LaRae]

I have also been diagnosed with PVCs. I was told it's not life-threatening. What I don't know is what frequency of PVCs is the norm. I have them every day and have them about every 7 beats or so. Is that OK?

[Beanzz]

My cardiologist at CCF said when they hit about 10% or 15,000-20,000 a day then they seriously consider medication. My 24 hr showed 1450 pvc's with 117,000 total beats- so I was running about 1.2%.  It is very difficult to live with these.  I have only had them for 6 weeks (45 y o feamle) and it is driving me nuts.  But some days I feel 100's and some days very few.  Strange, but having dealt with anxiety many years ago and knowing how it can eat up your life- I am determined not to let it consume me again.  I too am heading off to a psych who specialized in heart patients and their families(my husband had bypass in Feb 2006) before the anxiety takes over.  I think I have undealt  stress and anxiey from Feb that may be causing these things.  Funny though how many women in the mid-upper 40's have these- hormones??

[Carrie41]

I honestly believe obsessing about these things is making them worse as well.  I constantly feel on edge and I know I have got to deal with that.  What sort of SSRI's out there have people taken that take away their anxiety?  I take 10 mg celexa but I think I want to try something else.

I too have unlocked doors etc so that help can get in the house right away.  I have gone out in my front yard when I get every third or fourth beat missing just so someone will find me when I fall dead on the lawn.  What a pathetic existence huh!  I know it is crazy and I wish I could just stop thinking about these.

I feel sometimes 1 to 10 missed beats per day and I am in panic mode.  I sometimes get a lot of them - let's say maybe up to 100 and I really am in bad shape when I feel those.  When people get them like they say (1,450) do you feel every skip??  I honestly don't think I could take that.  I just wish they would find something to totally get rid of these things or something that would totally make me stop thinking about them.

[woodruff]

Carrie, I've worn a Holter and have run a documented 4800 of these per day, sometimes feeling what seems like every one (while awake, anyhow).  But I'm healthy and active, even after years and years of this.  Sometimes I do experience panic, though, and to see how I handle it, you might want to scroll back up the page to my first post there.

[Carrie41]

Man alive I don't know how you could stand that 4800 beats!!!  Do you sort of feel like an elevator dropping in your heart and also like your heart stops and then goes into a fast rythum for a few beats and then a hard beat??  

Can I ask how old you are Woodruff?  I am 45 going to be 46 in a few months.  I started having these god forsaken things when I was 23 as far I can remember.

Does the Zoloft help you with the panic/anxiety/obsession about these things??

[woodruff]

Man alive I don't know how you could stand that 4800 beats!!!  

And 4800 is below the threshold when doctors even consider them serious, if your cardiac tests are normal.  How about them apples?

Do you sort of feel like an elevator dropping in your heart and also like your heart stops and then goes into a fast rythum for a few beats and then a hard beat??

Sure.  That's how it feels a lot of times.  If you understand what's happening, it's a little less scary:  With ordinary pvcs, all that's usually going on is that you get one early contraction of the ventricles for some unknown reason, and then there's a natural delay, due to the way the heart's pacer works.  During that slight delay, your ventricle, which is elastic, has a chance to fill up a bit more than usual.  Now, the heart is required to try to expel all the blood that comes into the ventricle, and it's muscular, so it gives an extra hard contraction so as to do its job.  That "Ka-Boom" is the hard contraction you feel.

Can I ask how old you are Woodruff? I am 45 going to be 46 in a few months. I started having these god forsaken things when I was 23 as far I can remember.

I'm over fifty, kid, and this has been going on for easily twenty years.

Does the Zoloft help you with the panic/anxiety/obsession about these things??

Indeed.  That is exactly why I take it.  I don't always have panic or pvcs; they come in bursts or spells, lasting months if untreated, and they arrive together, so closely that I can't tell which is the cause and which is the effect.  The end result, though, is extremely uncomfortable.  Working with a good shrink, one who really knows his pharmacology, I've tried about four SSRIs and found that zoloft very quickly (within a couple of days for me) knocks out the panic, and as that goes away, my awareness of the odd beats diminishes amazingly.  With more time, the actual number of ectopics also decreases, because they're more frequent when I'm wound up.  Still, I understand that I have a tendency towards pvcs, and they will probably always return from time to time.  But I'm ready for them.

[Lecah]

I am glad for this thread and I cannot believe that I am not alone in leaving the door unlocked so the paramedics could come in and have the alarm off etc. I truly thought I was the only one! I was just telling a friend about this wonderful website and you guys and the Dr's are truly a Godsend,for me and many others. I do not respond a lot but in times of anxiety because of my PVC's and constantly taking my pulse,(something I have been trying for a decade to stop) I can come here and be relieved that I am not alone and there are people who have been suffering for 10, 20, 30+ years and are still kicking! I really needed to read this post today because I have been having noticeable PVC's this week and they have been driving me crazy! I wish I could be like some people who suffer from PVC's and they stop for months ad then come back. I have them every day and all night but I am still here and have others to share the aggravation and happy times with.

[Carrie41]

Well Woodruff I am going to ask for the Zoloft when I go see the doc this week.  I actually feel better today even reading this thread and know that I am not nuts with the pulse taking and stopping in my tracks with every odd sensation I get.  

I can't speak that the doctors don't think that 4,800 is not too many.  That seems like a ton to me.  I feel like people are probably looking at this thread and thinking what in the (*&*( is she worried about with the amount she gets.  I am beginning to think my obsession is making them ten times worse.  As I say I went for a couple of years after starting the celexa and thinking oh well when they would hit.  Now I am back in panic mode and hate it.  I see from the post above mine that someone else went into the panic mode as well!  I can relate.  

I just had a skip while I was making the kids supper a few minutes ago and starting my panic again.

Do you also get the strings of them where every minute or so you can feel it skip and then give a big bang?  I think that I am get all freaked out as well becuase they did catch an episode of non-sustained v-tach on an event monitor years ago and I have done WAY TOO much reading on it.  I went for two EP studies and they couldn't get my heart to go into any sort of irregularies so they sent me on my merry way.  I just cannot believe that I don't have something wrong!  I almost wish they would find something so that I could actually say I have something and my worry was necessary!

[woodruff]

Well Woodruff I am going to ask for the Zoloft when I go see the doc this week.  

It would be better to see a psychiatrist, because he/she would more familiar with which SSRIs would be best for you.  Some people do better on one drug than another.  But a trial of zoloft (at least two weeks) is better than fretting and not asking for help.

I can't speak that the doctors don't think that 4,800 is not too many. That seems like a ton to me.

The criterion for medical concern, Carrie, is roughly 10K of them per day, if there's nothing else wrong with your ticker.

I am beginning to think my obsession is making them ten times worse.

It is.  What with fear of dying suddenly, leaving the doors unlocked so that neighbors can find you if you collapse, you are flirting with the full agoraphobic experience,   What happens with that is that not only do you fear the physical sensations, but you become a prisoner of the fear of them, as well.   It's not fun, and it ruins your present, as well as your future.  There's a cool little old book about it by Claire Weeks, called "Hope and Help For Your Nerves."  I heartily recommend it--along with therapy.  

Do you also get the strings of them where every minute or so you can feel it skip and then give a big bang?

Heck, when I'm having a bout of them, I have no countable pulse at all, what with a dozen or more per minute!  One excellent thing about good treatment is that you stop checking your pulse.  Think about how nice that would be.

I just cannot believe that I don't have something wrong!

This is the usual feeling, believe me.  However, consider this (and I know how hard it is to slow down and consider anything when you're panicking):  Docs really are smart.  They go to medical school and you and I don't.  Why?  Because we know we couldn't get into medical school.  They study this stuff, and what's more important, they have ego invested in solving medical mysteries, and they hate, hate, hate to miss diagnoses.  At some point, you have to concede that they do know more than you, and that you are not physically ill.  However, there is an element of mental illness--namely anxiety disorder--that must be addressed if you want to live happily again, and denial is a huuuge factor in staying panicky.

I almost wish they would find something so that I could actually say I have something and my worry was necessary!

Yeah, that would be nice for our egos, but it ain't going to happen.  From my own experience, I'd say that pvcs, once started, are part of your person.   Things are not going back to the way they were before you ever felt a pvc.  It's not wonderful, but it is also not dangerous, and it is manageable, if you are willing to see a shrink and get treated.  Everyone has pvcs, really, but only those of us with hyperactive alarm systems are aware of them.  It is a part of our nature, and our nature is something we are born with.

[Carrie41]

You know something?  I just got back from my son's soccer game and I was thinking about everything you said.  I was trying to put my fear into perspective and it really made me feel better.  You seem very wise and I really feel better after reading your emails.

It seems that you don't let these things rule your life and I wish that I could be like that as well.  I just have to think everytime one hits that some people get a hell of a lot more than this.  I just can't imagine getting 4,800 of them.  

I am going to try to get on Zoloft by the end of the week and see if my fear subsides as all.

I still find it hard to believe that everyone gets these things but I have been told that 100's of times.  I ask all of my friends, my sisters, my husband and nobody can feel anything like it at all.  They just don't get why I am so obsessed about it.  I guess it because they have never felt one and they don't know how horribly uncomfortable and scarey they are.

Everytime I go into panic mode I get to this website as soon as I can and try to talk myself down when I read the posts from others.

You make a lot of sense Woodruff.  I am definately going to take your comments to heart (no pun intended)......

[kitcurious]

I am glad to hear that Woodruff's comments have made you feel better. My son is a laid back kid and gets 1500+ a day and he doesn't feel any of them and was unaware he had them. PVCs are very common, human body isn't perfect, and how aware of them one is seems to be related to how anxious a nature one has to begin with.

[Beanzz]

Yes- when I get 1450 a day I feel everyone of them. About 1 a minute.  The past 2 days I have felt about a total of 10.  What a thrill and joy, but I have no idea why.  Every day is different.

[dafan]

Hi all... just wanted to sympathize about the pvc's. My answer.. i suppose.. has been Toprol XL.. not sure if that is what made them diminish.. but i dont have nearly as many as i did before taking that med... Like all of you... strucurally normal.. they just popped out of the blue at age 49. Stress, a factor... lack of sleep, a factor... Do i have days that are worse than others... yes... but.. after almost 3 yrs of living with this demon... it has become easier... peace to all..and pvc free days.