Question about PVCs

[PAT65]

Hello! Thank-you for offering this service. I have a couple of general questions. First, In my last visit to the cardiologist he said my type of PVCs come from the right ventricular track which are benign and would be easy to ablate should the need arise. Are PVcs that come from one area more benign than from other areas? Also I read an article not to long ago (forgive me if this question is redundant) about PVCs during the rest cycle after exercise, such as the treadmill test, increases the mortality risk. Am I missing something like do you have to have a more significant heart history than PVCs? Also, I am taking cardizem 300mg qd.which seems to help a little but have gained weight since beginning the drug. Is this a normal side effect of the drug? I generally have thousands of PVCs a day and sometimes experience SOB while just talking but other times I can exercise vigorously and not have any problem. Could that be the cardizem or am I just really out of shape?(I am a 37y/o female)Lastly, My cholesterol and lipid profile have always been OK but my triglycerides have been as high as 300. What role if any does the triglyceride level play in heart disease? Thanks

[CCF-M.D.-KE]

Dear Pat 65,

Sorry to hear about the problems you are having with PVCs. Exercise induced PVCs can be associated with increased risk.
Cardizem is calcium channel blocker, have you tried a beta blocker for the treatment of your PVCs? If a person experiences PVCs which are 1/5 of their overall number of heart beats they are at risk for weakening of the heart muscle. Usually at this time we will consider performing an ablation for PVCs.

Cardizem does not usually cause shortness of breath, you may be deconditioned.

Elevated triglycerides are associated with an increased risk of coronary artery disease.

I would recommend trying a beta blocker in an effort to control your symptoms. Discuss the ablation further with your electrophysiologist.

Thanks for your question,

CCF-MD-KE

[CLM]

Hi!  I have thousands a day also and although was given the all clear from my EP, I still struggle at times when they are particulaly bad (like recently).  What has your dr. suggested?  I see you are on cardizem -- what kind of med is that specifically?  Have you tried others?  Feel free to email me at ***@**** -- I am a 37yo female also and we have a lot in common!  I'm thinking of getting an ablation for my 40th birthday!!!  For now I am waiting for the technique to be perfected (ventricle).

[PAT65]

Hello! Thank-you both for your insight. Chris, I think we have "talked" before. My cardiologist does not seem concerned about my PVCs. He says the location they are coming from is benign. I am taking cardizem, just increased to 300mg/day,. I have tried beta blockers. Neither helps all that much, but the cardizem seemed to have fewer side effects. My doc says our goal is to decrease the couplets by 90% and overall PVCs by 50 %. It is hard to tell how much if any they have decreased. I am scheduled for a repeat 24hr holter in June to see. I do think the couplets and runs have decreased.( I had over 9,000 PVCs in 24hrs). I do seem to have gotton use to having PVCs so they don't seem to stress me out as bad as they did a year ago. I have heard some people have decreased PVCs after menopause. I am hoping to go that route.
Dr. I have heard that exercised induced PVCs can increase your risk but I was concerned about the period FOLLOWING exercise. I seem to have them most during that time. A year ago I didn't have these problems, they just came on suddenly. Also. what about weight gain with cardizem? Have you heard anything? What is your opinion about my PVCs coming from the right ventricular track? Is that pretty benign in your opinion?

[Momto3]

Hi fellow "frequent fliers"! I think that you can find the recent CCF study (pvc's following excercise) on their main website (ccf.org).  I know I read it somewhere.  It is also in the NEJM March issue. If you can't locate it, let me know and I'll see if I can find it again.  Dr. Michael Lauer was involved in that study.  As for decreasing pvc's after menopause, that would be wonderful!

[Mel22]

Hi momto3,

Can you post a synopsis of what the article says about PVC's and exercise? A while ago a cardiologist told me that PVC's in the "warm up" phase and the "cool down" phase were not problematic, but PVC's during main exercise period may be more insidious. Of course later I had another cardiologist tell me that PVC's during exercise was no big deal either way. It would be nice to know one way or another.

Thanks!

[Momto3]

The article is probably too long to post here, so here is the link where you can find it.  http://www.cnn.com/2003/HEALTH/conditions/02/27/heart.stress.tests.ap/
If that doesn't work, go to CNN.com (Health) 2/27/03.
Please let me know if that doesn't work...

[Momto3]

Remember, although the information is valid, it is best to discuss your personal situation with your own doctor.  If you search "lauer, m and exercise stress test" you should get the study as one of your options.

[Mel22]

Thanks for the article!

[PAT65]

Hi! I spent some time looking for the article you mentioned but I guess I must be too computer illiterate. Can you explain to me again how to find the article? Thanks a lot.

[Momto3]

Hi!! No problemo!! Go to ccf.org and scroll down on the opening page.  You will see an article about exercise stress tests.  Click on "more" and you will find more information on the study.  Also, you can access the "Press Releases" from the ccf.org website and scroll down to the bottom and click on "additional press releases" and there will be an article on the study.  Hope that helps....If you get stuck again, let me know where I can email the article and I will send it to you.  Good Luck : )

[valger]

Hi, yes, I would also like to know about the exercise induced PVC's, as Mel talks about.  I notice that if I lay around or sit around, I get very few if any, and then mine seem to come on as I get more active, even doing hardly anything.  I've been walking, and the cardiologist told me to keep walking even if I get them, so I do that, but it makes me very nervous.  I am a 43 year old female, and have been having these PVC's for a long time, but they went away for a while, and are now back.  It just seems like the pattern is a little different, where I get them while exercising.  The weird thing is, I find that when I'm done exercising, it seems to calm them down for a while.  The doctor didn't act like there was anything to worry about, so I was wondering if any of you had any other info about exercise induce PVC's.  I'm taking a treadmill test on Monday, I've had the holter done, and she said it was pretty benign.  Do any of you just exercise through your PVC's.  Scary.  Well, thanks!!  Val

[THBulk]

Has anyone had any issued with scuba diving and PVC's? I am an experienced diver, but went to new depths on my last dive (100 feet) and had incredible chest pressure. The sypmtoms were gone when I rose up to 60 feet. Any thoughts?

[jaz5802]

Your story sounds like mine!  I will be 44 next week and have had PVCs on and off since I was 17 (mostly off or at least not aware). Had treadmill test done in 2000; showed a "baby" murmur. Had a holter done in 2002 which showed irregular beats. Cardiologist suggested a Myoview (treadmill stress test with radioactive agent for pictures) because he thought I said I get dizzy (I don't).  Went through with the Myoview anyway; results were benign yet confirmed the PVCs. Doctor said I could exercise to my heart's content -- that I was perfectly normal.

I would only feel these PVCs and flutters usually when sitting or lying down (at my desk at work or if they were happening that day, then also when I would lay down to sleep).  What prompted me to see a cardiologist was my primary doc heard a murmur. I started to get nervous of his finding which I believe triggered the PVCs again.  However, once I knew I was ok, they went away which leads me to believe these were anxiety induced.

They returned last year while I was on a vegetarian diet (could have been anemic related I am told by my nutritionist). I also noticed them more around day 14 and the week before my period (I think I am at the starts of pre-menopause too). Went back to cardiologist.  Had myoview and holter done. Was told they probably were not hormonal related.  But in reading all these posts, many women would say the opposite.

Currently, they usually happen at the onset of exercise or any movement.  A few weeks ago, I was trying to get to the gate of a plane and quickend my pace.  They appeared.  They show up when I climb a flight or two of stairs; when I dance; when I walk.  Some weeks, they don't show up at all. Just the other day I ran almost down the hall at work and realized afterwards I did not have any PVCs.  Go figure!

I am told by the cardiologist that my heart "will do that."  But not to worry -- all is benign.  So, I work through them.  I may not exert myself 100% if they happen while I am dancing, but I don't stop dancing and I tell myself that this has happened before and I am okay.  I have no other symptoms associated with them (some folks get pain, shortness of breath, dizzyness, etc.) so I just work through them.  Very scary, but I don't want to give up living for fear of something that may or maynot happen.  Since I feel I was thoroughly checked out for the last 2 years, I just try to take it one day at a time.

How do you handle your episodes?  Do you notice PVCs more around the time of your cycle? Thanks for your input.

Beth

[valger]

Yes, they are MUCH worse during hormonal episodes of any kind, I got them very bad during menopause.  I went through menopause kind of early, I am just 43, and the last few cycles that I had were terrible with my heart.  And, then they diminished greatly after that, so the connection was obvious.  I've had basically a break from them for about a year, just occasional ones here and there.  Suddenly, about three weeks ago, they are back, just as bad as before.  Your letter made me feel better when you said that your doctor didn't seem concerned that you got yours during some activity.  That seems to be the pattern with mine now.  I've been in bed sick with a bad chest cold for about 3 days, and I usually don't get any when I'm laying down, but when I get up, and just do busy work around the house, or try to get the kids off to school (not exactly exercise), they will start in.  I had a holter that showed PVC's and PAC's, but the doctor assured me to just exercise through them.  This is easier said than done!  I had been walking at the track, and would get them the whole time, but just kept trying to walk through it, but it's weird, it's like you have to be in a really strong mental state to do it, do you know what I mean?  Somedays I wake up, and just don't feel like dealing with it, and then I'm much worse, cause I can't mentally bring myself to deal with them.  I'm convinced that I have coronary artery disease since mine seem to only come around when I'm doing something active, and then go away when I sit or lay down.  I can't imagine that I could actually be doing this to myself with anxiety, it seems like I couldn't make these things happen.  I have a treadmill test on Monday, so I'm nervous about that.  In the meantime, I'm sure I'm making my health worse by laying around, but it's just so scary to get them, and feels so great not to have them, that it makes it easy to do that.  And, I have kids who need me, so these things really suck!  Thanks for the advice on here!!  Val

[jaz5802]

Val -- Living life with these PVCs is definately challenging; I agree.  I know I have this condition of PVCs -- I know I must have had it all my life.  Why they are choosing to surface now --who knows?  Maybe it is hormonally triggered for some of us.  I will tell you this though: 4 weeks ago, I had them constantly.  Moving, not moving -- it didn't matter.  They woke me up from a sleep (not hard thumping ones, just flutters). My nutritionist suggested magnesium orotate (I was told orotate was a "better" form of magnesium but very hard to find -- Atrium Labs distributes it from their website). I was reminded it could take 3 weeks to see any signs of improvement, if any at all.  First week, no change -- actually seemed worse -- got REALLY SCARED!  Second week -- decided, if I was going to die, I want to die not in fear but to be doing things I enjoyed, etc.  I know that sounds very extreme and almost desperate, but that is exactly how I felt! So I made a decision during my second week to focus on being calm.  Deep breathing.  Purposely took slow steps as if I had all the time in the world to get to where I was going. Remember the saying "stop and smell the roses"? Like that. Did calming self talk.  Do you know, that first day I noticed my self feeling better?  The tightness is my shoulders was going away.  And when I felt my shoulders creeping up to my earlobes again I literally FORCED my shoulders to drop and relax.  My PVCs lessened.  I was making a mind/body connection with these PVCs.  Next couple days I went back into the Oh My God world because I walked up the stairs at work and there they were again! My PVCs were back -- like they had never left!  Hmmm.. another mind/body connection noted.  Went back to calm, relaxing thoughts.  Slow movements.  Not hurried or rushed.  Got up earlier to take my time getting ready for work, etc.  PVCs diminished.  It's amazing!  Today, I climbed 2 flights of stairs to get to my office -- actually I ran half the way up because I was late.  Heart was pounding fiercly (for obvious reasons), but guess what?  No PVCs during or after.  No anxiety running through my veins. I remaind calm and did not ANTICIPATE them happening -- and they didn't.

So this was a long way for me to tell you that anticipatory anxiety does trigger PVCs. I think they will always be there -- don't get me wrong -- but I think there are coping skills we can apply to get us through them and keep them at bay.

I hope that helped you because you helped me so much!  Good luck with your stress test -- piece of cake.  If the PVCs happen during the test, don't worry.  They are there for the doctors to look at. And FYI -- when they stop the treadmill they will guide you back to the examining table to lay down and monitor your recovery period.  You will feel lightheaded and/or dizzy at first.  That's normal.  It freaked me out because no one told me that was going to happen.  Silly doctors -- don't they know I tend to be a nervous person?!?! Ha!

Beth

[valger]

Hi Jaz, and thank you so much for that letter, it has helped me so much!!  This morning when I took my daughter to school, I actually focused on my shoulders, and I noticed that I do keep them up a little, and tense.  So, I was trying to force them down, and it seemed like it helped a little.  It's really hard to imagine that these things could actually be caused by stress, but I am in a very stressful situation right now, so I guess I should see the connection.  But, it's just that it's so consistent, and usually I'll have some good days, and some bad, but they just all seem to be bad right now.  Anyway, your letter helped a lot, and thank you for that.  I don't see how I've helped anybody!!  I'll try by telling you what my doctor says, and hopefully he'll come up with some good information.  So far, he dosen't seem too concerned, even with the palps that occur during activity.  I guess that's pretty common.  It seems like once your heart is irritable, it goes off at anything.  I just hope that I gradually get better, and start to be able to do things with my kids again.  I'm tired of feeling this way, and feeling like there's not much you can do about it.  This sounds stupid, but I was watching a biography on Aerosmith the other night, and they were saying how they were on drugs, and then they got sick and tired of being sick and tired, and cleaned up their act, worked out, got healthy, and now they're doing great.  The frustrating thing is that is how I feel, except I don't do drugs, and can't just get off them and feel better, this is something that I feel like I don't have much control over, do you know what I mean?  
    Not to be depressing, I'm just getting sick of these.  My doctor did say that taking medication for these is usually not the answer, though, cause it can actually make it worse.  I guess the key is to make sure they are benign.  
     Well, thanks again, I'm going to read your letter over again!  Thanks, Val

[karie]

I too try to stay positive when dealing with these Pvc's,Pac's .
I have had a increase this past year and the Nutrionist did not see a connection with diet. I follow all the guide lines from my EP; Cardiologist. No sugar, caffeine, chocolate, alcohol : All can trigger events around the heart and nervous system. My obgyn noticed my hormone levels were very low and this and cysts on my ovaries effected my menstrual cycle. I started Progesterone cream and still hoping for improvement. I was scared 7 years ago when learning about MVP, Heart Murmurs since premature birth and these pvc's. But the increase is overwhelming and hope to learn why and help my body function better.

[jaz5802]

My nutritionist is an alternative nutrionist -- not someone you would find in your traditional hospital setting.  She knows so much about everything from asian medicine to herbal and homeopathic.  She appears on different AM radio stations and currently is helping medical doctors learn about alternate treatments -- to incorporate eastern and western medicine.  I'm very proud of her! I've read books on how food sensitivies can trigger palpitations and severe sensitivies (not full-blown allergies) can cause -- you got it, PVCs (book is titled Brain Allergies authored by Philpott). It's amazing what can affect your body.  Just in some of these posts alone, people have mentioned a magnesium connection.  I'm not saying magnesium is the magic pill, but I have found that it seems to help keep me even keeled; my muscles feel relaxed.

Thanks for your post,
Beth

[arcphoto]

HI,
I just want to thank everyone for being there. I Just turned 35 and spent my B'day doning a Thallium stress test due to the many multiple PVC's. I have had them occasionally throughout my life but this episode has lasted now for 5 weeks straight. Had the Arteriogram and echo and all other tests show that all is well mechanically with my heart. It was incredably frustrating to have the doc basically give me the brush off. He didn't even offer any meds. The pvc's are worse when reclining or trying to sleep and generally get in the way of normal life for me. Some of them are painful. I am not very well versed in the medical speak, but all my blood work was excellent according to the EP. Its just very nice to know that I am not alone or crazy. Thanks to all.
Steve

[twigs]

Here's something that my cardiologist told me about PVC's which might help reassure.  I was complaining of runs of pvcs and how bad they make me feel.  He told me that sometimes they are not probably not actually runs that i'm experiencing.  He said that some  may just be a single ectopic beat which is felt.  Apparently an ectopic beat then raises the heartbeat (makes it go faster) and so may be felt as a run when its actually just a single hard beat  followed by a quickened heart rate.  When i thought about it made sense because some pvcs are not as bad i.e. seem slower. He also said that he has experienced them himself when he's watching football matches (I live in the UK) and the exictment of the game and too much coffee causes them to happen.  He added that they didn't concern him as he knew there was a logical reason for them.

[twigs]

Here's something that my cardiologist told me about PVC's which might help reassure.  I was complaining of runs of pvcs and how bad they make me feel.  He told me that sometimes they are not probably not actually runs that i'm experiencing.  He said that some  may just be a single ectopic beat which is felt.  Apparently an ectopic beat then raises the heartbeat (makes it go faster) and so may be felt as a run when its actually just a single hard beat  followed by a quickened heart rate.  When i thought about it made sense because some pvcs are not as bad i.e. seem slower. He also said that he has experienced them himself when he's watching football matches (I live in the UK) and the exictment of the game and too much coffee causes them to happen.  He added that they didn't concern him as he knew there was a logical reason for them.

[Casper664]

A related discussion, Exercise and PVC's/PAC's was started.