Palpitations

[Ocean1961]

I'm a 47 year-old female with normal blood pressure and good cholesterol. I've had an echo, which was normal, and a 24-hour holter monitor that showed 165 PVCs and 28 PACs. Everything else about the holter was normal. I've had a normal chest x-ray, normal blood work, as well as three separate EKGs, all which were normal. Sometimes my PVCs seem to come one right after another, and this scares me because I've read about ventricular tachycardia. Can PVCs ever turn into something worse? My cardiologist says that this is unlikely, especially given all of my normal tests. I get very worried, though. I worry about sudden cardiac death from these things. Is this even possible? I don't have any other symptoms besides the anxiety these skips cause. What are the chances of getting v-tach with a normal heart?  Also I was told that I shouldn't worry about any skips, bumps, flutters etc. in a normal heart and everyone get these daily and people just don't notice?  TRUE????

[tickertock]

When I was saying rare exceptions , i was talking about about people collapsing!  I think anything below 1000s PVCs daily would be considered occasional, anything 10,000 and above PVCs daily would be frequent 15, 000 to 20, 000 PVcs daily can be associated or cause PVCs induced cardiomyopathy  occasionally.

[Ocean1961]

Hey Tickertock.....so what do you consider rarely?  Do you mean one a day or once a week or what?  I just want to find out what rarely, occasional and frequent is.  I can't find any info on this.

[tickertock]

I've dealt with similiar problems all my life, though I rarely have PVCs anymore, of course when I get them I sometime still get very uneasy, I'm 46 years old and suffered from PVCs and Tachycardia most of my life. I would say in the setting of a normal heart work up you can truly trust your doctor when he declares them as "benign" , Don't think of those rare exceptions, it can happen to anyone, Fact is you're "cardiac problem" is considered normal though very abnormal to those aware of the PVCs. take care and don't stress over it!

[CCFCardio MD2]

I'm sorry to hear you're having some difficulty.  Premature ventricular beats/complexes (PVB/PVCs) are extremely common and do happen in people with normal hearts.  Their etiology and significance is not always clear.  In a patient with a truly structurally normal heart with no history of cardiomyopathy (weakened heart), coronary disease/heart attack, or valvular disease, PVCs tend to go unnoticed and don't increase mortality or adverse outcomes.  PVCs can on occasion lead to a more sinister heart rhythm such as ventricular tachycardia IF the patient has a history of some type of heart disease which causes structural changes in the heart (such has heart failure, heart attack, etc.).  It doesn't appear that you have any of these.  However, if you have PVCs frequently enough there is a small chance these could weaken your heart muscle over time.  If you are having symptoms (palpitations, lightheadedness, etc) it is appropriate to treat the PVCs with something like a beta blocker or calcium channel blocker.  However, it sounds as if you are symptom free.  I'm not sure why you had the Holter done in the first place.  One thing you could discuss with your physician is a cardiac MRI to look for structural heart disease that may not show up on an echocardiogram.  This may not be warranted however, but it is worth discussing with your cardiologist.  In general though, if you have a normal heart PVCs are benign and should not lead to ventricular tachycardia or any other dangerous arrhythmia.

Best of luck.

[Hiker in Hawaii]

I have some similar concerns as you...I'm 40, and have had palpitations for years....Had all the tests (tons of bloodwork, Holter Monitor, event monitor, EKG's, chest X ray, echocardiogram), all were good/normal....Once i even went to ER...The ER doctor did tell me they "don't see V-Fib in people with normal hearts"..I assume she meant structurally normal hearts..I've seen a cardiologist 4x, and he's (tried to) assure me most palpitations are harmless in a structurally normal heart....He did NOT recommend a stress test, nor did my primary care physician..

They (palpitations) are extremely annoying and frustrating, seeing a cardiologist has helped give me a piece of mind, though sometimes i drift into doomsday thoughts about palpitations...So i know what you're going thru..Take care