Re: PVC's

Posted By CCF Cardio MD-SGM on January 20, 1998 at 23:28:10:

In Reply to: PVC's posted by Cory W. on January 15, 1998 at 14:35:09:







: Hello, I've got a couple questions.  A few months ago I first started
experiencing premature ventricular contractions.  Now, I've been through
a stress test and a Holter monitor with an echo coming up in a month to tie
things up (it takes a month 'cause I live in Canada).  Now, my internist
told that these things are about as bad as the company they keep and since
there is no underlying heart disease they are really of no consequence.  
I'm not on any medication because they are not of sufficient numbers.  
However, I've recently went back to my weight training schedule (which is
pretty light) and I'm noticing a great increase in the number of PVC's
after a workout.  They usually last for about an hour and then I'm back to
normal (normal being a significantly reduced amount of PVC's).  Will
excersise put me in any danger?  Do I need to worry about this increased
amount?  There are no real side effects except for increased anxiety.
Thanks in advance for your help!



  _-
Dear Cory,
It sounds as if your internist is performing a thorough and appropriate evaluation of this problem.  Indeed, PVC's are for all purposes benign in the absence of structural heart disease.  For this reason, it would be helpful to ensure that you haven't experienced any heart damage for any reason, and an echocardiogram would answer this question.   It is quite likely that the heart structure and function will be normal on the echocardiogram, and therapy will be supportive for the PVC's.  That is to say that although some medications including beta-blockers might reduce the incidence of PVC's, there is no evidence that any medical treatment will improve upon an already good prognosis.  Also, many of the medications in the antiarrhythmic class have serious side effects, and should not be prescribed lightly.  
Regarding your question about exercise, it is typical to see an increase in the incidence of PVC's and other arrhythmias with activity, likely due to the increased activity of the sympathetic nervous system during these periods.  Again, if the heart function is normal, I wouldn't be concerned about this.  If you're experiencing lightheadedness, shortness of breath, or chest pain with activity (or at rest) I recommend that you undergo a stress test to see whether there is evidence of prolonged arrhythmia or ischemic heart disease (inadequate blood flow to the heart muscle usually due to coronary artery blockages).
Best of luck.