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sudden onset?
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sudden onset?

Hi! I have a question about PVCs. I am 37 years old and have had an occasional PVC(2or3 a month) for years. Last May I was in a hurry so I was eating and drinking a soft drink on the road. I suddenly started having frequent PVCs (bigeminy and Trigeminy) along with a lot of stomach pressure. I thought I was having a heart attack and went to ER. In short, I was given mylanta. One betapace, potassium and sent home. All my labs were OK. Troponin was normal. This happened again later with another trip to the ER. I then had some testing, Including a holter(I had over 7000 PVCs in 24hrs)EKGs, and stress treadmill were normal. Echo just showed mild mitral staightening, not prolapsed. Well, I have been dealing with this almost daily ever since. I have tried lopressor and atenolol as well as stuff like paxil and celexa. Needless to say, nothing works. Some days I think I might be getting a grip on it and other days I feel like the physicians must have missed something. Can you give me any idea as to the sudden onset? Any suggestion of anything that might help? I was told that one day I would wake up and they would just be gone ( although they would likely return) Well, 8 months later I am still waiting. Please help.
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Avatar_n_tn
Pat,

Thanks for the question.

A quick calcualtion shows that you have about 4-5 PVC/minute.  Given the other information you have provided, the good news is that your prognosis is excellent.  The bad news is that therapy can be ineffective.  No one knows why these start as they do, or what trigers the initiation.  The one test that is frequently overlooked is a thyroid panel.

Depending on how much these PVCs bother you, you could always consider an ablation procedure.  This is a very aggressive approach, and should only be considered after a thorough diagnostic evaluation has been performed along with several medication trials.

Good luck in the new year.


28 Comments
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Avatar_f_tn
Hello, I too have pvc's and also pac's. They are very upseting and people who do not have them think that we are over reacting  and think that we are crazy. But I had a run of three pvc's in a row one night while sleeping, and I did have the 24 hour monitor on so it was caught. Well guess what! My cardiologist now tells me i have VT. If you have a run of more than one pvc's in a row that is vt.But she is not too concerned about this, but sorry, vt is very serious Im going nuts. How can they say its not serious, what do they do wait till you drop. anyway does anyone else have this? Ive been reading alot about pvc's and I read that alot people have alot in a 24 hour period, so if they are having alot do they also have vt. I saw the ekg strip and it was difently vt. Please let me know I would like to talk to you.
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Avatar_n_tn
Dear friends,
I also have PVC's and not hat you feel. It's uselless for our state of mind that everyone says they are inofensive. Our intelectual know that they are inofensive but our deep mind insist not to consider that. I don't know why - It just happens to me - For you guys, are the some?
Just another aspect about VT. Please, don't consider VT if there is more then one PVC in a row, neither duets or triples. Only more then 3 PVC in a row, and some cardiologists only consider if there are 5 or more PVC in a row, could mean VT. And, in a row, mean witout normal beats in the midle. So, don't be much upset about 2 or 3 PVC in a row.
Now, a questions : What are considered many PVC a day ? - What do Dr. ususally say to you?
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Avatar_n_tn
Just to apologyse some mistake. My first phrase should be "I also have PVC's and know what you feel"
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Avatar_n_tn
Hi! You were asking what is considered a lot of PVCs. My holter showed more than 7000 PVCs in 24hrs and the Drs were not concerned. All my other tests were what they considered normal. The Drs also told me that they have monitored other people for years who had many more than that(up to 40,000 a day) and they were doing fine. Personally 7000 PVCs can be quite uncomfortable so whatever I can do to be rid of these would be great!
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Avatar_n_tn
Dear friend,
Thanks a lot for your answer. I'm having, since 3 days ago, about 500-600 PVC/day and I was starting to be worried - Now, I see, I must be shamed. I also have Holter and Stress Test but they were fine (only 2 PVC in Holter and 1 PVC in stress test). But, before these 3 days, I only had sporadic PVC (m
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Avatar_f_tn
Thanks for helping me feel better. Do you get several pvc's
in a row?? Im very upset about the vt.I don't know what to do!
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Avatar_n_tn
Hi everyone. I've had MVP for about 14 years now and was taking 50 mg. Atenolol per day up until last April.  I didn't feel that I needed it any longer so I took myself off of it.  The PVC's came back with a vengeance in late June and I ended up in the hospital for 3 days.  Doc put me back on 25 mg. Atenolol per day and I was fine until the beginning of October.  Now the PVC's are back even with an increase to 50 mg. of the Atenolol (per the cardiologist) and they haven't gone away since.  Do any of you ever get dizzy and/or lightheaded from these?  I've had three holter monitor studies (last one in October showed almost 8,000 PVC's per day), thalium stress test and echocardiogram, all of which were within "normal" limits.  I start to get a lot of PVC's about 3-4 hours after I take the Atenolol in the morning and I've tried until I'm blue in the face to get my doctor to switch me to something else, to no avail.  He said my PVC's are caused by anxiety and smoking.  This is my first day off of cigarettes and I am using the patch which contains nicotine.  I find that the PVC's seem just as bad being on the patch.  Any suggestions?
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Avatar_n_tn
Hi! I do have what I consider a lot of PVCs and when I do I feel weird in my chest, almost an aura(spelling?)or premonition feeling. I have had couplets(2 in a row) before that I know of but have not been worried. I had a friend in the hospital just recently with what they thought was a heart related problem because she had 2 0r 3 PVCs in a row with exercise. Needless to say she was determined to be fine and was sent home. She is 39yr and healthy although she doesn't feel her PVCs like I do which must be a blessing! I have read that PVC episodes come and go although for me these last 8 months have been much too long. I did have a few prior episodes that seemed like I had more than usual but they always went away. It just doesn't seem to want to go away this time. This past 8 months I have also had many more PVCs than what I had previously. I also seem to have them more laying on my left side, or during certain times in the day. It sure is a confusing matter. Good luck guys and keep me posted.
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Avatar_f_tn
my pvc's of three in a row were with no normal beats inbetween.very scarey, luckily i was sleeping.Ive been going trough this for almost six months straight. But I do have to say that since I quit smoking, drinking caffaine, and eating chocolate it has helped. My cardiologist said I could have chocolate and caffaine.I have read so much that it does effect you. Im scared to death to have it again. But do sometimes miss it.Thank God for decafe. any way if anyone would like to talk you can email me at ***@**** thanks everyone for being such a good support group this is very important to me.
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Avatar_f_tn
Im so confussed!! First off they tell me I have vt because I had a run of three pvc's in a row. Look at ekg strips, pvc's have the little drop down on the strip, vt has very large and wide drop downs. so how can it be pvc's. Second of all I posted a question and got three respones back and they said you have to have 10-15 of pvc's in a row or a run of them that lasted for 30 seconds or longer.(by the way it was three pvc's in a row with NO normal beats in between).Im just very confussed and upset at this point and im going crazy. some one have any answers??
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Avatar_n_tn
I sure do understand your worry, however on my limited experience They may call a 3 beat run VT or trigeminy (bigeminy is 2 beats in a row) but from what I have seen it is usually not a reason for concern. If you just have 3 beats you are not going to drop dead. I think the concerning ones are the runs of PVCs that do not convert back to the original normal rhythm and the person may have symptoms with that. I just posted a question about that myself because I had what I thought was 7-9 beats of VT. Maybe we will get more definate answers to this problem soon. Hope that helps a little.
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Avatar_n_tn
It figures! After I posted I realized I made an error. Three beats in a row are called a triplet not trigeminy which is a PVC every third normal beat.
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Avatar_f_tn
Thanks for your help. Its kinda funny how we are told that pvc's are not life threating, but every time we get them we freak.The only people who understand are the people who get them.But I am going to find a answer one or another.
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Avatar_f_tn
Is anyone here on beta blockers? If so can you let me know how you like them. They suggested metropapol 25 mg. to help the symptoms. I don't like meds. Im afraid of the side effects. let me know asap.
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Avatar_n_tn
I had a holter test and it showed less then 200 pac's and pvc's combined and all I can say is regardless if it is one or 7000 a day for the ones that you can feel they are distressing mentally and emotionally..
I can feel almost everyoneI have and sometimes I will be perfectly fine and I will get a strong one followed by several oters and boom I am in a full blown panic attack..and my head feels funny..
they are awful, truely...
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Avatar_n_tn
Yes, I am on Beta blockers. I take 12.5 mg of Propranolol [Inderal] twice a day and I LOVE it.  I have no side effects because I am on such a low dose and I would say that it's cut  down my arrhythmias by at least 85%.  It is a God-send, truly.  I hope you can find relief.
Love, Kristy
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Avatar_n_tn
I agree, no matter how many PVCs you have they are awful for those of us who feel them. I used to have one every few days or weeks so it was much easier to ignore, alas those days seem to be gone. To wmac, I have tried betapace(made me nervous to take it so I quit) and I have tried atenolol and lopressor. Right now I am trying Toprol xl and sure hope it helps. I really haven't noticed many symptoms myself unfortunately it doesn't really seem to help either. I'm going to keep trying until I get some sort of relief without increasing my risks as some drugs will do.
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Avatar_n_tn
TRY the beta-blocker!! I having been taking Toprol XL 25mg for two years now after suffering with frequent PAC's, many bouts of ventricular bigeminy and trigeminy daily for six months. I would refuse to try medication for fear of side effects, but after submitting recordings from an event monitor I wore for three weeks, my cardiologist called me and stated that the readings "warranted use of a beta-blocker". That caused me concern, but he followed it with "your not going to drop dead,so don't worry". I agreed to try the med and only wish I had done so when he first offered it. I can do activities without feeling my heart race and skip, I am much more relaxed when I do have some irregular beats because occasional is far better than freguent. I finally feel in control of something I have no control over! Good Luck and feel better soon!
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Avatar_f_tn
Thanks everyone for you comments back. Im so greatful for this forum and you all.
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Avatar_f_tn
I am getting conflicting info. can anyone help?
First off with what info you all have what is the defintion of vt?
Second i read that pvc are not generally associtated with vt!
my cardi told me that i had a run of three pvc in a row and that i have vt. she said if you have more than one pvc in row with normal beats then its vt. then i read  you have to have 10-15 in a row or lasting longer than 30 seconds. can anyone help me with this?
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Avatar_n_tn
WMAC, I'm  on metoprolol.  My doctor put me on that beta blocker because my resting pulse was always a little on the high side and also to help for my palpitations.  I must say, since I'm on this pill my palpitations just last minutes und I also have a nice, low resting pulse now.  He started me on 50 mg per day, when I complained about extreme tiredness he told me to just take 25 mg (the pills only come in 50 mg and up so I have to cut the pills in half)  When you first start out with a beta blocker you will be very tired, but I found that after a few months you will adjust to the pill and feel okay.  I'm taking the pills now about three years already.
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Avatar_n_tn
I read with interst your post. By your experience can a person have none or very few PVC (less than 5 a day) and then, without an apparent cause, you wake one days with lots of them - sometimes more then 1 in a minute (3 or 4 in a minute, fortunately don't seem runs of them but spaced by several normal beats), other times 1 in 3 or 5 min., other times an hour or more with none, 1 or 2 PVC - Let's say, ranging about 100-600/day, and this is lasting , now, about a week. Some days more, other days less, but always much more than it was use for me. This is happening to me, the first time, in a week.
2 years ago, because of a high BP (now is fine with some weight loose), I had a normal echocardiogram. About a month ago, because a tachycardia episode, the cardiologist ordered very detailed blood and urine tests (thyroid, adrenalines, endocrine parameters, elements concentrations, etc.) a Holter and a Stress Test. They all came ok. In Holter had only 2 PVC and in Stress Test 1 PVC (in the begining of recovery) Can this be enouth for me to relax ? - Do this mean normal heart and PVC are harmless? - This week episode is a thing that simple can happen to anyone and take time to go away (weeks, months)?
Thanks
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Avatar_n_tn
Dear friend,
Thank you so much for your precious answer. I thnk you are absolutely right, and you are nor the first person to tell me about cardiac neurosis. What is the best way to deal with that?
Do you, I have attended to several seminaires about mind deveolpment and stress management, as well as about Raja Yoga, and maybe they are the way, but it's so difficult to apply them when we are feeling badly, specially when several PVC came in the same minute (I don't think in a roe, but with only a normal or two normal beats between them).
Thanks again my friend
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Avatar_f_tn
Welcome back !  I haven't seen you post in quite awhile.  Thank you for your comments, they are right on.  I am very intrigued by your seasonal observation:  I am going on week three now of marked increase in my pvcs (I get a lot anyway, and have had NSVT recorded, and do notice couplets regularly, but have a structurally normal heart, etc.).  I have noticed this is the past few years during the winter and assumed it was holiday stressors.  I live in SoCal so we don't have SAD here (it was blindingly sunny and warm today!) but I am fed up with the pvcs and am off to the cardiologist tomorrow.  I was going to ask about toprol XL since atenolol is clearly not doing it, but your case is interesting.  I think for me the betablockade does help to some extent and certainly isn't making them worse, so perhaps a different one could help me fight on.
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Avatar_f_tn
Thans for your input everyone! I spoke to my doc. last night and i told him i was going to wait on the beta blocker, everything i have read just kinda leads me leaning to the fact im going to wait before i rush to the drug store.I asked my doc, if i were his daughter or wife or even mother what would you recomend he said to try to survive with out the meds. kinda funny puts in differant propective when you say that to them. I guess my symptoms arent as bad as alot you, but i do have runs of pvc's in a row so its conciderd vt thats the scarey thing.
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Avatar_n_tn
I feel really ignorant, but I have NO idea what PVCs or PVAs or VTs or most of the acronyms are that you all use so freely. I'm in Australia, so maybe we speak a different language. Anyway, my question is also: HOW do you know which is which? Do you listen to yourself through a stethoscope? My cardiologist gave me no info like that. He called them "ectopic beats". Whatever it is that I'm getting, it is pretty well constant, all day. So I'm a bit worried when the post-it commenst say things like you should be worried if you get over 20,000 a day. How do you know??? I'm just conscious of it in the same way that you know your car needs a tune-up because the timing gets ragged. As I'm typing now, my heart is sort of tapdancing its way through the process. I've got the mild fluttering in the throat too. I'm trying to achieve positive attitudes and am endeavouring to think of it as my new friend, but it's a pretty irritating companion. I've been this way for about 7 months now.
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Avatar_n_tn
Dear friends,
I'm also a PVC surferer. Gnatty, ectopic beats or extrasystoles are the same as PAC's or PVC's.Both are permature contractions of the heart with origin in a part that is not the responsible for normal heart contactions - the sinus node. So, both type of permature contractions haven't origin in sinus node (as it should be), but, in the case of PAC - originated in the atrium, and in the case of PVC - orininated in ventricule. Dr.(s) say that, in person with normal hearts, they are benign, but, if an underlying heart disease is present, they can me a marker of any heart problem. So, PAC's or PVC's, by itselves, seem to be not malign, only what might cause them - That's why when PVC are shown in EKG, Dr. sent us for further testing, like echo, holter or/and stress test. If no underlying disease is detected, it seems, by what the present medicine knowledge (and I think the term "present" is very important) know, they appear to be benign, since people seem to don't dye from it and can pass  worse side effects form the meds used to deal with PVC. I also found a medical text about PVC in the Web that might be interesting to read -> http://heartdisease.about.com/library/weekly/aa011501a.htm.
Wich the best to us all and hope and faith to deal the best possible with this "benign" arrhythmia.
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