VERY frequent PVCs

[Momto3]

First, THANK YOU for the opportunity to post on this forum.  It is truly a benefit for all of us.

I am a 45 y/o female, avg.  BP 110-110/60-70, small frame, not overweight, no alcohol, non-smoker.  I have a longstanding history (20+ yrs) of MVP w/ moderate regurgitation and FREQUENT PVCS.  Over the years, I have learned to accept the PVCs as benign.  Holter in 2001 showed 92459 QRS complexes, 22531 Ventricular ectopics (4419 isolated, 2517 couplets, and few triplets, and many episodes of bigeminy). Subsequent reports were similar.  This past December, when I went for my annual echo my ejection fraction had decreased from 55% (one year ago) to 40%.  Interestingly, during the stress test, the EF increased.  The doctor said that was a good indication that the MVP was not the cause of the decline.  However, there is some concern as to whether or not the frequency of PVCs may be a contributing factor to the drop in EF.

In January, I was in the hospital to begin Flecainide and will go for a repeat echo in April. At that point, if the EF is still diminshed, the doctor mentioned an Ace Inhibitor.  If the EF is back up, I will have to decide (with my doctor) whether or not to continue to medicine or look at alternatives.  

Are you familiar with any study that supports the theory that a high frequency of PVCs could cause change in EF? Since beginning the RX, no significant side effects, but one episode of a "different" feeling." Now have event monitor to capture any new arrythmias.  Still PVCs, including runs (10 this am, but not as often. Your thoughts are most appreciated

[kahunadad]

just stumbled across this site while cruising through the net on a "busy" heart day. strange how almost everyone has similar complaints.  mostly how our problem is either puzzling or not important to the md's.  let'm try a day at work with that out of control coffee pot in their chest.  what is benign anyway?  something  between  b-8 and b-10?  gonna give that food enzym thing a whirl.  as for ef numbers mine are in the fortys (and so am i)  but i'm able to work out 3 hours a day,  hour and a half cardio in the am,  weight training in the pm.  asked the md how this was possible and his response,  well,  your heart works good enough for you.  it's really great to have a place to vent.   thanx

[Arielle]

Kimbee - thank you so much for that valuable information.  I am going to definitely look into this.  I'll try anything to rid myself of these dreaded PVCs.  ALSO - I WANTED TO LET YOU ALL KNOW THAT THE SUPPORT GROUP IS UP AND RUNNING!  IT IS CALLED Heart2Heart AND IS A PUBLIC GROUP. I thought I would get it started and if any of you don't like the name, we can always change it.  I believe you can join directly by going to http://groups.aol.com/heart2heart02903.
Or you can send me an email at ***@**** and I will send you an invite and you can join that way.  Whatever is easiest for all of you. I look forward to chatting with all of you soon and if there is every anything I can do to help, please let me know.  I am online most of the day and into the evening and would be happy to meet all of you! Marianne

[Kimbee]

This last week has been one of the best weeks I've had in years as far as PVC's, PAC's, and SVT are concerned.  (As a side note, I think I have been placed on just about every beta blocker at one time or another to no avail, and have had all the heart tests, which only indicated slight MVP.)  I did find that magnesium helped some, but I had to take mega doses every day. I also noticed a stomach connection, and am positive there is a correlation since eating certain foods will set my heart off, lying down after a big meal, as well as applying pressure to my stomach, bending over, etc.)  

A friend who is also a fellow sufferer started taking digestive enzymes, and they made all the difference in the world for her as far as her PVC's and SVT.  I was skeptical, so it took me a couple months to try them myself.  I started taking enzymes at meals a week ago, and my heart has been a whole, whole lot calmer! Interestingly enough, I also feel a lot calmer inside.  The difference has been amazing for me.  My friend was taking the Enzymatic Therapy brand, so that's what I also bought since it  worked for her.  However, I decided to try their vegetarian variety called CompleteGest since I am a vegetarian.  

My research found that enzymes are responsible for all bodily processes and the proper functioning of all vital organs and the healing and health restorative processes.  They are also responsible to properly digest food and absorb nutrients.  My cardiologist told me that the vagal nerve is next to the stomach, and can become irritated and cause PVC's.  Is it possible that PVC sufferers have a problem where they are not properly digesting their food and absorbing nutrients, thus causing heart symptoms?  

I am not a doctor, but I wanted to share this because lots of us have noticed the stomach correlation.  I have also been miserable for 19 years with PVC's, and this is the first week I've had some real relief, so I thought that maybe there really is some validity to this theory. Wouldn't it be great if something as simple as adding enzymes to our diet was the answer to our prayers?

Since I'm not a doctor, you might want to check with your doctor before trying enzymes, i.e., the bottle states that people with ulcers should check with their doctor first.  If you do decide to try enzymes, make sure you get a good brand that has all the necessary enzymes to digest protein, fat, and carbohydrates -- they all do something different.  All brands are not created equal!  A good multi-vitamin/mineral supplement wouldn't hurt as you begin the healing process.  May God bless and heal you.

[alexa's mom]

MARIANNE - That is a wonderful idea. There have been numerous times where I wished I could have actually talked to someone online when I was having a bad heart day!

JEFF - I totally understand where you're coming from. Just last week my doctor told me to ignore my skipping heart. Easy for him to say! I never get answers to any of my questions. He just looks at me with a puzzled look like he's thinking "don't ask me". I've been to the doctor 3 times in the last 3 weeks because I've been so scared and frustrated. That's why this forum is helpful because I actually get information. I think you will find this forum helpful as well. And with Marianne starting a support group I think we will all feel a little bit better. Take care.

Michelle

[jeffr]

Hi:  I am a 37 yr old male.  I was diagnosed with "benign" pacs a while back.  All I get from the cardiologist is that it's stress related and nothing to worry about.  Sometimes I can go a day or 2 without a problem, but other days it continues all day long.  It is to the point that the Doctor won't even talk to me anymore when I call!  I know he has told me I won't drop dead from this, but it sure doesn't feel like that when the irregular heart beats begin.  I am glad to see that I am not the only one who suffers from this.  Any comments from other members would be appreciated.

[Arielle]

I run a support group for depression/anxiety and it really helps with the "down" days. We have weekly chats and they benefit everyone just to be able to "talk it through".  We also post helpful websites that we've all found and share our experiences, as well as email and IM each other when we need support. I would be happy to start one up for people suffering with PVCs and other heart disorders.  It could really help if we were able to share our thoughts both in an open forum and in a chat.  Let me know what you all think.  Have a a great day!  Marianne

[dartmouth03]

i'm all for that idea.  i think getting together in a group setting and chatting about these pvcs will help.  last night i had a couple and they basically ruined my evening.  whenever i have a few in a minute i get really scared and then depressed.  these things are so annoying. urrrrrr.  hopefully, that idea will work.  lets hear from others.

[Ianna]

Hi Marianne,

I am all for it!
Come on folks, let Marianne know!
-
I'll be checking back...
Bey     ***Ianna***

[Arielle]

I can set the group up right away but need your input into an appropriate name for it.  I'll leave that up to the board.  Belive me, I know from my support group for anxiety that it really does help to get you through the day sometimes, just knowing that there are people out there who are going through exactly what you are.  The weekly chats we have in my other support group are wonderful - if you want to come, fine, if you don't there's no obligation.  You can do as much or as little with the group as you want.  We have members from both the US and UK - the time differences help because someone is always online to help someone if they just need to talk or are in crisis.  I'll check back later in day and see what names you all have come up with.  I'm looking forward to this! Lots of love, Marianne

[Arielle]

I suppose that all doctors look at the EF differently. Six months ago when I had the echo, mine was 60%. My cardiologist told me that he doesn't even begin to get concerned about EF in someone with a structurally normal heart unless it gets below 45%. I've read on the net that some doctors don't worry until it is below 40%. I'm sure that during the bouts of PVCs, it is only normal that the EF drops a bit  Anyone else with comments on EF?

[Risen]

I agree 100% with your reply to alexa's mom for I too have this as one of my many arrhthmia probs......  Gary M

[CCF-M.D.-RCJ]

Momto3,

Thank you for the question.

PVCs can lead to a real drop in EF if they are so frequent as to cause a fast heart rate, or they can cause a "pseudo-drop" in EF if the echo clips all contain PVC beats and not normal beats.

However, what is more concerning to me about your posting is the history of MVP with moderate regurgitation, and now a drop in EF.  If there is any chance at all that the EF dropped in the setting of moderate MR, then you need consultation with a cardiologist for consideration of mitral valve repair.  There is very good evidence that patients with MR do well when they undergo early repair of the mitral valve prior to the onset of a drop in EF.  Once the EF begins to decline, the prognosis begins to worsen.

Furthermore, an EF of 55% is not normal in someone with moderate MR (it should be higher, like >60%%), and suggests that the MR has been leading to a deterioration in the heart's function.

Seek a second opinion soon at a large medical center.  The Cleveland Clinic and Mayo clinic are two good options.

Hope that helps.  I will watch for follow-up posts.

[alexa's mom]

This board is very helpful in trying to understand what may trigger PVC's and what may help to eliminate them. Thanks to everyone who comments on this forum.
This might sound funny but I was just wondering if anyone has experienced PVC's while blowing their nose. It seems when I exert myself like when I blow my nose or if I'm talking and I run out of breath at the end of what I'm saying it seems to happen and also when I bend over sometimes. I just wish there were more information on this epidemic. Sometimes it makes me wonder if it is my heart or something else causing this......I mean blowing your nose!!! Told ya it sounds ridiculous :)

Michelle

[marc.m]

I experience the three things that you mentioned. PVC's while blowing my nose, running out of breath at the end of a sentence, and while bending forward. No, you're not crazy or we both are. I've seen three cardiologists about chronic PVC's and have not been given any answers. This is the only affliction I have ever had where doctors just don't seem to care. If it wasn't for this forum I probably would have lost it by now

[Alisande]

I've seen a lot of questions about PVCs on this forum, and wanted to add my own experience.  I developed PVCs in my 30s and they seemed to increase with pregnancy.  In my 40s they became more frequent, and I found them both irritating and alarming.  I had the Holter monitor, which revealed that they were the benign variety.  That was reassuring, but they still drove me nuts.

Today, in my 50s, I don't have them at all, unless I happen to have a fever, which is rare.  I eliminated them by doing several things:

1.  I gave up caffeine, sugar, aspartame (Nutra-Sweet), and other sugar substitutes.

2.  I became vigilant about keeping my blood sugar at an even level, and not letting it drop between meals.  (I have hypoglycemia.)  A low-carb diet helped a lot with this.

3.  Through trial and error, I learned which foods caused PVCs for me, and eliminated them from my diet.  In my case, they included dairy products, potatoes, and eggplant, among others.

4.  I include calcium, magnesium, vitamin E, and B vitamins in my daily supplements.

Hope this helps someone.

Alisande

[Arielle]

It is so comforting to know that others out there suffer from the PVC nightmare that I do.  I've only had a hard time with them since October of this year, but can relate to what everyone is saying.  My cardiologist put me on 100 mg. of Atenolol per day but I can only tolerate .50 mg. per day, as my b/p gets very low and I got extremely tired with the 100 mg.  I strongly feel that this medicine is actually causing more PVCs simply because prior to this last bout with them, I had been on Atenolol for almost 15 years for MVP, stopped taking it on my own (I know - big mistake!) back in April and by late July, started to feel the PVCs again so doc put me back on Atenolol. I had every test in the book run - thalium stress, echo, chest CT, EKG's, bloodwork, 3 holters - you name it.  Stress was normal, except that it showed that I do not exercise as much as I should; echo was normal except that it showed mild mitral regurg with an EF of 60% which doc said was just fine (he also said that being on the Atenolol may cause fluctuation in EF); EKGs clearly show the PVCs, bloodwork was fine. My last holter showed 8,000 PVCs but no VT and only a few instances of bigeminy. I suffer from anxiety and the doc told me that this, combined with my smoking, is what is causing the PVCs and to stay on the medicine.  I know he is partially correct about the anxiety and smoking causing the PVCs but about 4 hours after I take the Atenolol every day, I start to really feel them and I get lightheaded and tired.  My cardiologist is very old school and will not switch me to a different beta blocker (I've heard that sometimes your body can become resistant or sensitive to a med if you are on it for a long time like I have been on the Atenolol).  Instead, he gave me two choices.  Cut down on smoking and take the Ativan for the anxiety (which I do) OR be admitted into the hospital where he can try different anti-arrthymic meds.  I opted for the first choice simply because I have heard horror stories about the anti-arrthymics. There are days that I just sit here and cry because there seems to be no light at the end of the tunnel.  I just needed to get this off my chest and thank all of you for your great posts and understanding.  If anyone else has experienced this, please feel free to email me at ***@****.  Or if you just want to vent, my shoulders are always there.  God Bless.

[tgb]

Hello.  I'm a 40 year old woman who has been experiencing palpitations for the past year and a half.  My PCP told me it was anxiety (I was very anxious over a gynecological health problem).  After a year and a half of counseling, six months of Paxil, gynecological surgery, and a general feeling of less anxiety, my palpitations have increased to the point of making me feel uneasy while they are going on.  They often increase during the second half of my menstrual cycle and are usually more frequent in the morning.

I had a holter monitor over a year ago which only picked up a couple of PACs.  A few months ago I saw a cardiologist who prescribed Toprol XL.  Instead of taking the prescription I asked for a 24 hour event monitor.  I am glad I did not take the Toprol because based on the results of the event monitor EKG's he said medication could make the condition worse.  The event monitor showed events of both sinus tachycardia and sinus bradycardia with PVC's and a couple PAC's.  The doctor said my condition is not life threatening and probably anxiety related, but sent me for a stress echocardiogram.

I had the stress echo two weeks ago.  For the last month, my palpitations have decreased to one or two every day or two, except immediately after my stress test (but after the monitors were removed)when I had a string of them.  I received a letter today from the doctor saying my test results are satisfactory and please continue the same medications (I'm not on anything) and see the doctor as scheduled (nothing is scheduled).  This is obviously a form letter.  The report shows two things that concern me:  a trace of mitral and tricuspid regurgitation, and the resting ECG shows sinus rhythm with non specific ST and T wave abnormalities.  Does the mitral and tricuspid regurgitation mean I have MVP?  Do I need to investigate this further?  My mother, a nurse, said I need to see the doctor and demand an explanation of this.  I'm feeling better and I don't want to get unnecessarily worried by pushing the issue.  The doctor had told me earlier that if my test results came back OK that I should just let it go.

[nadia]

I have to disagree that a prolonged resting heartrate of 115 or over can be a sign of something more serious.

[Momto3]

HI again!  I can't believe I got the chance to post a question.  I am anxiously awaiting the doctor's response.  When my EP first prescribed flecainide about 2 years ago, I also refrained from taking it. Since the PVCs are benign absent any other underlying problems, I figured I could get along fine.  HOWEVER, this time the technicians couldn't even get quality images because of the persistent bigeminy, etc. On top of that when the reading did come back the EF had dropped to 40%.  Long story short...the doctor suggested I try the flecainide to get the rhythm under control and redo the echo in the hospital.  I was on the medicine when the second echo came back 45%. Now, I will go back in April and see IF the medicine shows any improvement....It seems as though a few of us belong to the "frequent flyer" club for PVCers. I would love to keep in touch with others in the same boat.

As for the use of flecainide, it is my understanding that it is not used in patients with structural heart problems.  Also, my doctor elected to hospitalize me because I live about 30 miles away and she was more comfortable keeping me monitored....

I still get the pvcs, but they are not as frequent....Last night a run of 10 was a little weird.  I am told I do go into VT, but I think because of the # of pvcs as opposed to a "racing" heart.  

Any other frequent flyers out there?

[Cathy12]

I don't think anyone at least in USA treats PVCs with flecanide, it increases the chance of a person having ventricular arrhythmia and sudden death, there are better medications around now adays that eventhough might not decrease PVCs significantly but at least have some protective effect on the heart.

[nadia]

My elevated heartrate began at 11:30 pm.  I didn't have it checked out till 9:30 the next morning due to advice given me from the local hospital.  They told me to wait and have it checked out the next day.  I should have had it checked out right away but trusted what they were telling me. By then you know something is very wrong.  My BP was 150/110 which was another danger sign which wasn't checked till the next day.  These are both things that could very well go unchecked because I didn't feel that my BP was out of normal range.  I am otherwise a very fit person, don't drink,don't smoke, and am of a healthy weight.  Good cholesterol and no history of heart disease in family. Previous BP was always 110/80.  Took Panteloc and elavil for a very short time prior to this episode and haven't been the same since.  Any medication taken should be checked for serious side effects.

[hbp702]

A heart rate of 115 shouldn't cause damage unless sustained for many hours or even days or weeks unless there is something very wrong with one's heart to begin with.

A lot of people who exercise hold their heart rate well above that for quite a while, sometimes (significantly) in excess of an hour.

[nadia]

Have either of you had any blood tests to check for protiens released from the heart muscle that could indicate damage done to the heart?  This damage may only show up on an ultrasound of the heart.  I had an elevated heartrate of 115 for over an hour and my troponin levels were elevated indicating damage to the heart.  This level usually drops back to normal but does not mean that everything is okay.  I would recommend that if you have an increase in blood pressure and heartrate for an extended period of time to have blood work done to ensure everything is alright.

[dande4]

Hi:

I also am a mother of 3!. I too have mvp w/trace regurgitation and suffer with pac as well as pvc's and a probable svt. I have had the event monitor on and off for a while. It has caught the pac's and pvc's, a few bigemy and one episode where a palpitation caused my heart to race up to 140 for about an hour. That was a few years back. For as much as they say there is nothing to worry about, I too worry what these palpitations may do in the long run. I may not have them every day, but there are several times where they will be daily for months at a time.

Hope this new medicine does the trick for you and that all turns out well!