Trying to accept PVC's, and unexplained pain, medication questions

[Eddie 14]

I'm really trying to accept that I have palpitations and they are benign. This has been the most frustrating thing I have ever gone through. Exacerbating the situation is occassional chest pain and other various upper body pains that sound like heart related symptoms.

My paplitations are getting worse. Still no runs from what I can tell, but I am having a higher frequency.

I've tried calcium channel blockers and beta blockers. The beta blocker (inderal la 60) works better, but when I exercise my heart rate will not go above 80% of max, which makes it hard aerobic wise. The calcium channel blocker (cardizem la, 180mg) doesn't seem to do much.

Q's

1. Is there a beta blocker that seems to have a lesser effect on heart rate, or is this just what they do?

2. Should I take a long acting beta blocker?

3. Is it normal for PVC's to go away when I do exercise? (when my rate is above 120 they are very minimal if not non-existant. Is this above a "good sign"

4. Here is the toughy for me, particulaly when I have other problem. I'm only 35, 7 months ago I had none of these things.  I know they are supposidely benign, but for me, rationally something had to "change" for them to come on.  I have ecg's from my physical a year ago - NO PVC's.  Now, I can show anywhere from 5-20 in a 5 minute tracing. Something had to "Change" right? that is where I have to think there is a solution, or a cause... or a PROBLEM.

5. Are there blood tests that I could request that might show something? (hormonal, electrolytes, other?)

6. Other than a stress echo, other tests?

thank

[Cleveland Clinic]

Eddie,

1. Is there a beta blocker that seems to have a lesser effect on heart rate, or is this just what they do?

Beta blockers by definition effect heart rate, since the 'beta' that is blocked is a receptor in the heart that effects heart rate. That said, some people respond differently to each beta blcoker.

2. Should I take a long acting beta blocker?

This is person dependent. Some people get marked response to beta blockers with improvement of their symptoms, while some actually get worse.

3. Is it normal for PVC's to go away when I do exercise? (when my rate is above 120 they are very minimal if not non-existant. Is this above a "good sign"

There is no particular significance associated with this finding. Some people get more palpitations at higer heart rates, while others get more at lesser rates.

4. Here is the toughy for me, particulaly when I have other problem. I'm only 35, 7 months ago I had none of these things. I know they are supposidely benign, but for me, rationally something had to "change" for them to come on. I have ecg's from my physical a year ago - NO PVC's. Now, I can show anywhere from 5-20 in a 5 minute tracing. Something had to "Change" right? that is where I have to think there is a solution, or a cause... or a PROBLEM.

This is consistent with most people experience. PVCs can wax and wane over time.  The best thing for you to do is to try to figure out a better coping mechanism.

5. Are there blood tests that I could request that might show something? (hormonal, electrolytes, other?)

Other than routine thyroid tesing, not really.

6. Other than a stress echo, other tests?

None. People tend to get over tested for this. I dont know how to reassure you. Perhaps some of the others in the forum can help you with their tales of coping.

good luck

[Eddie 14]

Not sure if it causes confusion, but when I say palpiations, it's definitely a PVC, single foci, sometimes bigeminy, trigeminty has been the worst thus far.

one other question - IF they are getting worse - is that a bad sign?

[woodruff]

Eddie, type pvcs into the search box at this site.  Boy, will you get answers and ideas about the ways many of us have learned to cope with these things!

[oneil420]

yeah we are all in the same boat here but i just wanted to comment on your lower pvcs during exercise, thats me also!! I very very very very rarley get a pvc during higher heart rates from time to time one will jump in if im laying down or bending over but my palpitation occur more during rest or relaxation then any other time, yeah i question whats changed for me also im only 27m and had them going on 5 years....same days are harder then others but i just focus on enjoying my life day to day because like you said a few months ago you where fine, and lets me honest it could be alot worse then pvcs, hope you get your answers .

[oneil420]

sorry i missed you last ??? I have had my pvcs go up and down like a roller coaster for a few years i got one here or their then about 9 months ago i started getting episodes of 10 to over a few hundred a day and i thought it was never going to end but its been almost 2 months and i have a occasional one here and thre but  it always seems to go full circle for me, alright this time i done:)

[cmiller]

Hi Eddie...

You might find my posts on Magnesium of value.

http://www.medhelp.org/perl6/cardio/messages/36004.html

Good luck.

[gismatrix]

Hello all again.

I posted this a few days ago:
I hate PVCs just as much as the rest of you do. Lately, when I get really anxious, I go into bigeminy and it takes a while for it to calm down and return to normal sinus rhythm. I had two avnrt ablations this year (the latest on July 25th with "knock on wood" no SVT yet. However, I get more pvcs than ever before and the bigeminy. Is is possible that this bigeminy will go away with time assuming I can get the anxiety under control? I also have peptic ulcers and GERD which exacerbates my pvcs. Does anyone know if it is safe for me to exercise with this bigeminy happening and if it will potentially help lessen or eliminate the episodes? Any insight is appreciated.

NOw my PVCs are so much worse after these ablations than they were before.  Has anyone had experienced the same thing?  Do the PVCs that come on after ablation eventually lessen in frequency?  

These are so terrible to have...sometimes I get more than 15 a minute...other times I might have/notice a couple an hour.  It is always worst after I eat, during some part of the digestion phase.  Any ideas would be really helpful.

[Fran71]

Hi Eddie,so many on this board have your same problem. We all can understand you!!! I hope what the doctor and others said is reassuring you. My fear of PVCs is decreasing with time, as I receive more reassurance and hear the experiences of others.

I would like to address the issue in your post’s title: accepting palpitations can be challenging. Sometimes I even felt self-pity for it! Like you I’m 35.
My aunt has been on an antiarrhythmic for 20 years because of AF. Then 4 years ago, she developed one type of cancer. Then another. 2 Weeks ago she was diagnosed with bone cancer...I guess that even if her palpitations once made her feel miserable, what she’s going through now is a million times worst. This is easier said than done, but whenever we feel bad about our palpitations, let’s try to keep in mind that it is nothing compared to having a deadly and painful disease.

What I just said may sound like a commonplace, but I’ve just found out about my aunt. I was shocked, and this has got me reconsidering a lot of things about my attitude to problems.

Hope it helped just a bit

Fran

[suzzie1]

Hi, Iv just been on the site you recommended and found it VERY interesting....im going out to buy some magnesium asap!! Thanks again B-)

[anacyde]

Watch supplementing magnesium.  You may get more palpitations instead of less.  Your doctor should be aware of any supplementation for your safety.

Anyhow, I can relate to the frustration of ectopic beats.  I'm the opposite, mine come with exercise.  It sometimes makes it difficult to stay active, but on my cardiologist's advice I have kept plugging along and keeping fit.  They come in patches for many of us, and a few months back I hit a horrid patch.  I was convinced something horrible must be wrong with me, but I checked out okay.  They are still there more than before, but they're easing up.  I'm looking forward to my next palpitation-free stretch, and hopefully yours will come soon too!  ;)  Hang in there.

[woodruff]

A few questions for you:

Have you asked your cardiologist the questions you ask here?

Have you typed "pvcs" into the search box up on the right of the page?  If you do, you will learn a lot about these strange beats, and how so many of us cope with them.

Myself, I have had pvcs for years.  At one point, I wore a Holter which showed that I was getting over 4800 pvcs and a fair number of couplets in 24 hours.  I also have mild aortic incompetence (my aortic valve doesn't shut all the way when it's supposed to).  

I go to the gym and exercise hard six days a week.  This routine seems to make no significant difference in the number of pvcs I get, but since I'm still alive, I figure I have nothing to lose, exept pounds I don't need.  The exercise is good for the space between my ears, and is good for the rest of my body as well, so I do it.

As for anxiety, in all seriousness, I suggest seeing a psychiatrist. I have done that, and, for a period of time, have taken the medication he recommended.  It's very, very difficult to get anxiety "under control" without help.  The way it works is that when you try to "control" it, it winds up controlling you.  

[dafan]

Hi all to make a long story short i was having them to the tune of about 10 a minute... Went to an electro and he dx me Toprol XL After about 1.5 yrs on the Toprol im relatively pvc free on MOST days... It took a long time to work.... (i guess it is helping) but ive had relief now for a bout 6 months... i had sudden onset of them like eddie at 49yrs old... im now almost 52 good luck all... these have changed my life too...but there is hope....

[RHYTHMRN]

Hi,
I've replied to you before.  I think our situation is a little defferent than most of the other posters as far as looking for a cause(both had 2 ablations for svt).  Like you, I did not have all of these skipped beats prior to ablation.  I am 3 months past my second ablation and am still having them constantly.  I get tired of hearing "everyone has them - you just notice them more".  The bottom line is yes, I did have them before ablation - maybe 5-6 on a bad day and many days none at all.  The ablation had to trigger something to be having several a minute 24/7.  I wasn't having anxiety until I started having these - they are causing my anxiety.  I don't know about you, but I cannot ignore or get use to these - sometimes they take my breath away. I see my EP and regular cardiologist this week.  I will let you know what I find out.  I also have GERD and do notice that when I feel full they are worse.  They also seem to get worse lying down. Take care and please reply................

[tickertock]

I have heard several people that had a ablation for SVT mainly (AVNRT) one of the adverse effects of the ablation would be an increase in ectopic beats maily PVCs. I know a woman that refused an ablation during an EP study for AVNRT because her EP advised her an adverse effect would/could be a dramatic increase in PVCs. I think this is not the case with most ablations for AVNRT, but for for a small percentage of persons I think it depends on the area where the burns are made depending on the location from which the AVNRT is triggered.

[cmiller]

Eddie and everyone,

PLEASE work with your doctor if you decide to use Mg... you want to do this safely... it has effects like a Ca channel blocker, so you want to be careful if using it with Ca channel blockers.
Also, search this web site for my comments (cmiller) under another PVC post... there are a lot of things to consider in terms of cardiac health and they have to do with the delicate balance of K, Mg, Na (sodium), as well as antioxidents, etc.

Here is a review of Mg with a lot on cardiology.

http://bja.oxfordjournals.org/cgi/reprint/83/2/302

It does not have all the cool stuff I found on Mg in Pubmed, but it has a lot.

As for me, after 3 trips to the ER in the last month with weakness and palpitations, the last one a week ago Ssturday where I begged for Mg and K and they finally gave it to me, with continued supplmentation the palps have diminished each day.  I am sleeping much better at night.  today I went to the pool and swam 30 laps... It was wonderful.  Other side effects of not enough Mg/k- a week ago monday (1.5 days after ER) I tried to go to the pool and could not make 2 laps without being out of breath.  In this review you will find that Mg also impacts the muscles of the chest involved in breathing (thus part of its value in asthma).  My sense of calmness and well being is just so much better- and sure enough... Mg also influences (can reduce the impact of) catacholamines... the hormones of stress.  so if they are giving you the "you have anxiety' thing.... you might.... do meditation, and consider Mg supplementation... but find someone who can help you take it safely.  

Oh yes, in addition to what I wrote at another place on this site.... I think we are deficient in a lot of trace minerals, because over the years the soil has been stripped through overfarming and errosion.  This impacts your metabolism and ultimately your heart.   So if you are comfortable eating meat, find an source of organic grass fed beef- spring is better and now is ok because they've been in pasture in the summer.  Get yourself a nice sized soup bone, find a great recipe, and boil that baby down for a LONG LONG LONG time to get a great broth. Thow in whatever veggies you like and spices.  between the bone and the meat and the marrow and the veggies, you can get a nice dose of minerals for a few days.    Eat lots of fresh stuff too!
  
Mineral replacement takes TIME, particularly Mg, because very little as a percentage of total body Mg is found in plasma and it takes a long time for the transport mechanisms to get enough back into interstitial spaces and cells.

Cmiller

[gismatrix]

I would like to thank everyone for their replies (woodruff, tickertock and all).  I agree that the anxiety is starting to get the best of me and certainly makes these beats worse.  

RHYTHMRN -  Thanks again for your reply.  Our case is certainly similar.  I see we have met up on other pages as well.  Please feel free to email me at ***@**** so we can compare notes.  Maybe I wrote something in correctly, but I did not have all of these PVCS before ablation either.  I did have/notice only a few each day.  Now I have anxious episodes of 15/min or even bigeminy.  Still, these worst case episodes only happen after eating, and I feel alot of gas moving around near my breastbone and have an excess amount of belching, which at times relieves the pvcs for a few seconds at a time.  My EP doc is having me wear a holter for a day so he can see what is going on.  I do hope they at least let me try a beta-blocker or something for relief.  Of course I can't help but feel that something is happening that is worsening, but all tell me that those thoughts are in my head.  I am still having the gastro tests over the next three weeks and I will certainly let you know what is going on.  I do believe there is a connection with digestion as far as making them worse, but this may not be the root cause of the problem.  It could be like tickertock said...that the ablations created foci that allow pvcs to be worse.

Lets just pray these things get better or more tolerable over time.  Thanks to everyone for sharing their stories and how you cope.  

[RHYTHMRN]

HI,
Thanks for replying.  I was wondering what your EP is telling you about the PVCs you are having now - does he/she think they will subside?? I can't seem to get a direct answer from my EP.  He did tell me that I may "feel like mt heart is going to go into SVT for a few weeks after ablation but it won't" That is what he told me before ablation. Nobody ever mentioned having skipped beats 24/7 three months after ablation.  Just curious - did you have cryo or radiofrequency for yours?  My first was cryo, second was RF.  Also I had a cardionet monitor for 2 weeks.  Mine showed many Premature junctional contractions, PACs and a few PVCs.  Are you sure yours are true PVCs?  Are you having any trouble with shortness of breath or activity ontolerance?? This has been bad for me. I hopefully will get some answers this week when I see EP and cardio. Keep posting and let me know if you have anything new.  Take care and thanks again for responding.......

[Fran71]

I've tried magnesium supplements. I didn't feel any effect on my PVCs, good or bad. I guess it's just like with beta blockers. For some they work wonders - so far they do for me most of the time - others don't get any real benefit from them.

[gismatrix]

My EP doc did not warn me that the additional PVCs were a potential consequence of ablation.  Also, I have not heard the docs thoughts about the potential of them diminishing over time.

I go to get my Holter monitor in the morning.  I will try ask about the PVCs and whether they should lessen in frequency at that time.  

Do your PVCs get worse with exercise or exertion, or immediately afterwards?  Perhaps only when your heart is slow?  

For me, when I put a load on my heart (exertion) like walking up a large flight of stairs, I get terrible PVCs afterward that sometimes puts me in bigeminy for a few minutes.  I hate this feeling, and if I could get to the point where I only had a few pvcs here and there I could probably learn to live with it (especially if I felt it was not getting worse).  

One thing that concerns me is that I was evaluated for ARVD after my second ablation via a MRI.  The MRI found that I did not have dysplasia (ARVD), but my LV ejection fraction was 50% and my right was 35%.  I understand this is lower than normal.  An echo I had in Feb of this year listed my LVEF as 55%.  I am worried about the 5% drop.... I don't know if this is due to the PVCs making the muscles weaker or if the ablation actually lowered the ejection fraction.  I realize the interpretation of the echo can be off a couple of points too.  

Maybe the beta blocker will work for me as it has for others.  I am ready to try almost anything to find some relief.  

Please email me if anyone would like to talk more.

Good luck and God Bless

[momof6]

Ive had the palps. in many different forms too! pvc,pac, tachy, erratic beats for the past 10yrs. I agree with cmiller give the mg a try. I take slow-mag with calcium and a K M20 tablet everyday! Makes the heart run so smoothly! I still get pvc's or pac's BUT nothing like before and not erratic any more. Even if you have blood work done ask to see the results. Sometime they will tell you all is normal but some levels like potassuim or mag. can be on the low side of normal and cause problems. I know these darn beats can be scary at times but we get thru them one episode at a time. Soon you realize thats just how I am and they get a little easier to handle. Still sometimes I will get a corky beat but I try not to let it control me. But since the K tablet and slow-mag with calcium its soooo much better. I take 2 of the slow-mag a day doc said I could take up to three but seem to do fine on just the 2.

Try to focus on something you love! and let that consume your thoughts and soon you'll forget the palps;) at least for a while, every possitive thought helps! I know its hard! hang in there.

God Bless!
Debbie

[upbeat63]

I can't agree with your advice on the home-made broth more!!! Loved it. Trace minerals are terribly lacking. Who knew.  and synethic vitamins and minerals may not help at all.

Go natural if you can. It does take time. I can't figure out why people would risk potentially dangerous procedures or Rx but turn up their noses at good old ox-tail soup. Yum. Really, oh and don't forget liver and onions just like mom used to make (if you are old enough to remember that it's not common now-a-days).

[gismatrix]

I finished the Holter monitor and the nurse reviewing/downloading the data said there was not at many PVCs as she expected, but did not have stats available yet.  I go to see my EP tomorrow morning and should get the report from him.  I'll ask him some of the questions we have and certainly let you know how things went.  It would help if I could have your email address.  Mine is ***@****

There definately is a connection between my digestion/GERD and the frequency of the beats.  I kept a diary with the Holter so the doc should be able to see this.

Thanks

[RHYTHMRN]

Hi,
I saw my EP yesterday. I asked if the PACs could still be from the ablation, I got a definite "maybe".  I am getting another monitor for 2 weeks,  He kept my inderal dose the same,  He is also referring me to a cardiologist for women to follow up on why I am still short of breath with exertion.  He wants to check for microvascular disease or endothelial dysfunction.  I had an appt. with regular cardio. the day before and had a VQ scan of my lungs.  I told the EP if he would tell me that this is normal for some people after ablation and it will go away within 6 months I could deal with it better. I just can't get any definite answers.  He did mention sending me to Cleveland Clinic for another opinion and I may consider it.  Good luck with your appt. I hope you get more definitive answers than I got.  Keep in touch.....

[gismatrix]

I guess you do not want to email me directly?  It would be much easier.  

Anyway, I had two appointments on Friday.  One with my regular EP and one with an EP and Cleveland Clinic.  The first EP had the results of my Holter monitor...said I had about 2% PVCs (2% or total beats).  He said this is not concerning to him, but if they are too concerning to me (quality of life) he can give me medication for them.  He would rather me "tough it out".  He claims that the PVCs are not from the ablation since they originate in the ventricles.  He could not tell me at that point if they are multifocal or unifocal.  

The EP doctor at Cleveland Clinic looked over my chart and all the data that I had sent him and brought with me.  He wanted more data with tracings (could not get that in time) but said that everything looked pretty good except for the pvcs.  He was slightly concerned about the lower than ideal EF, but said from what he could tell my heart is structurally normal.  He did say that sometimes it takes a few months for everything to even out after an ablation.  He also said that beta blockers might be a good drug to try to see if that offers any relief in the meantime.  He recommended a follow up holter in six months and an echo at some point just to make sure things are ok.  In the meantime I am going to get some tracings and the raw data from the holter for him to review.  

Talk to you soon.

[cmiller]

I found some awesome material on what things influence palps for those of you intractable to Mg.  In some cases Mg has increased palps, however while I have found antedotal evidence that this may be true, I have never seen a study that shows it... and Mg and K supplmentation has been shown to reduce palps.  Also, it really takes TIME for the Mg to work...like a few days minimum, and maybe weeks for some, and make sure you take Mg in the right form.  I would make darned sure that it is the Mg that is increasing the palps and not something else before you give up on Mg.   If you took Mg Aspartate or Mg glutamate you were definately going to have more palps because of problems generated with aspartic and glutamic acids and the heart.   The emotional wellbeing benefits of Mg are hard to beat anywhere and considering it is important in more than 300 processes in teh human body, you are bound to benefit in some way.  Also, if you take Mg with too much Calcium, it may not work.

Also... diet is EVERYTHING.  That means fresh fruits and veggies, minimum processed carbs fats sugars, etc.   eat tons of food high in mineral content.    I'm not sure a lot of people are willing to make this change.  I was and I think it has paid off.

Avoid MSG- and glutamate additives- most restaurants add it to food.   glutamate will cause palps. and so will aspartame.  sodas HAVE to go, as they will make you acidic and mobilize Calcium, Calcium will cause problems with Mg.

sorry to say for some sex will cause palps.

Taurine supplementation and possible arginine can be helpful.  Taurine stabilizes membranes. Also CoQ 10 may be essential as well.

My guess is, that if you want to stop palps, you MUST try and do it early on BEFORE your heart gets used to running that physiological pattern. once a physiological pattern is "entrained" by the body, it will be like a train on a track... a familiar route for the body to take under stress.  by the way, stress depletes Mg.

http://mdheal.org/magnesiu1.htm
http://george-eby-research.com/html/taurine-l-arginine-arrhythmias.html

I have read extensively on this subject and am fairly convinced that most people could find benefit from considering these alternatives.  And I feel that quite a number of people are being harmed by beta blockers and anti anxiety meds because these do not address the underlying cause.  For instance in my case my Doctor said my PACs were no problem..no worries, would have given me pain killers or B blockers at the drop of a hat..I declined because I know there is a reason our body talks.  And ultimately I found out that I was really having small TIAs (strokes) for lack of Mg and that was also setting off a cascade effect with my heart etc. My body was waking me up for a good damn reason.  If I had gone on my usually 2 hour bike ride, I could have had heat stroke or worse.  At any rate, this would not have been good over the long term.  So if you are not feeling things are right, please don't feel you have to buy into them telling you "it's ok" or drugging you out of finding out what is really happening. Or doing surgical proceedures like ablation until there are no more options.  This is irreversable and as you are reading on this forum for many it simply does not help. If you aren't willing to change your diet and you think pills are easier, then go ahead and do what they suggest.   I do admire the people who continue to live their lives for a long time with heart palps, and ultimately many may have to... and what if they really don't?  

Good luck.