pvc's on excertion

  I tend to get more PVC's on excertion then during rest. Is this something that I should be more concerned about?? I was told I get PVC's and PAC's how can one tell the difference? Sometimes the extra beats hurt and are more frightning while other times they don't seem to be as forceful. Do you think we can feel the difference between a PVC and PAC?? Is it normal to get more than 100 PVC's in an hour??? I get them frequently sometimes more than 100 an hour. Also I've been told that I panic during these episodes which increase the amount I get, but everywhere I read say's that when you are having a panic attack you have a rapid heart beat, where my heart seems to be misfiring. Is it common to throw lots of PVC's as opposed to a rapid heart beat duirng a panic attack or increased stress.  Thank you in advance for you answer...

[CCF Cardio MD - MTR]

Dear Diane, thank you for your question.  PAC's originate from the atria and PVC's originate from the ventricles.  It is difficult for someone to differentiate between the two when they're experiencing palpitations.   In most young patients who suffer from PAC's and PVC's,  the premature beats are benign and do not portend a bad prognosis.   If you are indeed having > 100 PVC's / hour, that would be abnormal but the only way to truly determine the frequency of PVC's would be to wear a continuous cardiac monitor.  Panic attacks certainly can increase the frequency and severity of PVC's so treatment of a panic disorder would help with the PVC's.   Again, it's difficult to determine whether you're having a rapid, normal heart rhythm during the panic attacks or just an increased number of PVC's without a cardiac rhythm strip.  Common precipitants to PVC's and PAC's are alcohol, caffeine, and tobacco so use of these substances should be restricted.  It may be a good idea for you to see your physician again to discuss treatment for panic disorder and to talk about other options to treat your PVC's.  
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