tachycardia and pvc's

[blan3556]

I have posted before and the last answer confused me.  I have terrible PVC's and tachycardia.  I am 34, I excercise daily.  I had a 24 hour monitor and a echo a year ago.  My echo showed trace regurgitation other than that normal, the 24 hour monitor showed PVC's and sinus tach, low dose beta recommended.  On the last post the doctor answered saying that a 34 year old should not have tach and that I should investigate it furthur, that worried me.   1. I have had a echo and 24 hour monitor what more do I need to do?  My doctor don't want to run more tests.    2. Is this tachy dangerous to my health?    3. Should I worry about this more than the PVC's?  My doctor wants me on 25mg Atenenol and the cardiologist who ran just a ECG and read only the reports from the last test wants me to go off it,   4. so is it dangerous for me to go off atenenol with my PVC's and tach?     5. Should I stay on the atenenol or would that be more dangerous? I am so confused.     6. My PVC's are real bad right now how do I know if they are worse and I need more tests?     7.  Why did the last post doctors answer say I need more tests, when I have had tests already?     8. What are my chances of sudden cardiac death when I have PVC's and Tachy?        9.  Does when you have PVC's and how many in a row make them more dangerous?          10. What are the chances of all this becoming more sinister?            11.  My heart rate is always been fast between 90-110 is that dangerous?          12.  I am sorry I am scared please help me understand what is dangerous and what is not.  You are very appreciated

[CCF-M.D.-MJM]

Hi Blan,

I think you are pointing out one of the limitations of the forum.  Single statements do not apply to everyone.  For us to know exactly what should be done (and in some cases this is fairly subjective), we would need to see the studies.  Tachycardia is a broad word.  A heart rate of 100 is much different than a heart rate of 190 -- but both are considered tachycardia.  I know this is not what you meant, but I am using an extreme case to point out that there are nuances to every case that makes comment to one person potentially not applicable to all.

1. I have had a echo and 24 hour monitor what more do I need to do?
2. Is this tachy dangerous to my health?
3. Should I worry about this more than the PVC's?

I would have to see the EKGs and holter to determine if there is enough information to make this decision.

4. so is it dangerous for me to go off atenenol with my PVC's and tach?

probably not, but again, I would need to see all your information to make this judegment.

6. My PVC's are real bad right now how do I know if they are worse and I need more tests?  

PVC's come and go in cycles.  We don't know what causes them to start or stop, but we know some cases are related to stress, hormones, emotion, fatigue, caffeine, tea, etc.  Odds are they will go away as fast as they came, but again, I haven't seen your data.

7. Why did the last post doctors answer say I need more tests, when I have had tests already?

I do not know what you are referring to.

8. What are my chances of sudden cardiac death when I have PVC's and Tachy?

With a structurally normal heart, VERY low.  But again, this is not an assessment I can safely make over the internet.

9. Does when you have PVC's and how many in a row make them more dangerous?

With a structurally normal heart, no, it does not matter.

10. What are the chances of all this becoming more sinister?

With a structurally normal heart, the chances are very low.

11. My heart rate is always been fast between 90-110 is that dangerous?

No

My advice is to see another doctor.  Not because something is wroing but because I think you need reassurance.  I may be reading too much into your email, but you sound very concerned and I am afraid it is going to consume you.

One of our most respected electrophysiology attending will sometimes say to patients -- "you are not cursed because you have PVCs, you are a cursed because you can feel them."  Some people don't notice them and feel fine.

I hope this helps a little.

Good luck.

[tickertock]

Your situation sounds very similiar to mine though i dont have any regurgitation the valves. I have had a fast heartrate all my life, like you my heartrate was always in 90-110 range at rest, though it would be lower sometimes, I am now 40 , about 15-20 years ago I developed prolonged episodes of Pvcs, lasting from a day or two , then weeks to months, although I always had an occasional one even as young child.

I take 100mg of atenolol daily in divided doses thats completely controlls the tachycardia and probably helps with the PVCs also, I only have rare one now and then , i guess one day they'll soon flare again.

I am not a doctor , but i think your heart would have to beat above 120 consistently for quite a number of years before any damage would occur, I guess like anyone else it might affect some earlier than others, others it might never affect.

I am made to understand with a normal cardiac evaluation its doesn't matter whether your pvcs occur at a lower or higher rate, the prognosis is the same.

If this can be of any comfort I know a man that is now in his 80s and has a resting heartrate rarely ever lower than 100 most of his life , he usually clocks in at 105-115,with pvcs occuring with that rate at that, though he tells me he has never been aware of his fast heartrate or the PVCs, only what hes been told by doctors from time he was young man, yet his heart is totally healthy even at his age.

I know how horrible it is suffer with this problem and the anxiety and worry it can cause. I think the bottomline is to try and learn to live with it and if the beta blockers help and your doctor prescribes them and the side effect are limited, i would take them.

In the long run , I think it probably easier on your heart to beat 70-80 at rest, but its one tough organ and made to take a hell of a pounding before it wears out.

[tickertock]

Sorry I meant to write blan3556, not 3536.

[fearfactor]

Hi - I could have written your post, too.  My HR has always been high, and I have PVCs.  I've had the same tests as you, with the same results as you.  I take 12.5 mg of Toprol XL a day, which helps.  I tried to go off it, but the PVCs came back with a vengeance.  I was told by my doc that I am ok, I've got NO increased risk of sudden cardiac death (but I do worry about it like you do), and that I should just ignore these stupid PVCs (yeah, right!).  I have had them all my life, even when I was a little kid.  I, too, exercise very frequently and am fit and in shape - so I don't understand why I have a high resting HR and PVCs.  I guess I'm just trying to say you're not alone, and there are lots of people with the same problem and we're all still here so chances are we will be OK in the long run.  My aunt who is 50 has had PVCs her whole life and my grandma who's 70 has them, too - she told me a couple days ago "I'm still here, and you will be, too when you're my age."
Take care,
Stacy

[blan3556]

Just wanted to say Thank you to the doctors and all that posted.  Believe me, you have helped me more than you know.  I am scared but am already feeling better.  Do any of you also have sinus tach?  They said mine went up to 150 at times.....

[astros18]

I just want to comment on how impressed I am with your thoughtful and caring attitude towards everyone in these posts.Your patients are very lucky to have you as a doctor. I go to other forums and the doctors who respond do not do so with the thoroughness or kindness that you do. A HUGE thanks to you!

[kwhite]

I recently started having PVC's that seem to occur only in the early morning when I first wake up. I am taking 371/2 mg of Toprol XL. I still have them in the morning sometimes. In the last 3 months I have had a nuclear stress test, echocardiagram, thyroid test. Everything fine in that regard. I am 49 years old in decent physical shape. I'm trying to find out if anyone has tried magnesium supplements along with the beta blocker for their PVC's. If one of the doctors could respond that would be great, but any input would be appreciated.

[jan]

I have inappropriate sinus tachy and before it was treated, even after, it was often caught on the ekg.  Mine has only been caught at the highest of 170 bpm.  I rarely felt palpitations from it.  I have felt palpitations from PAT's, PVC's, and PAC's.  I, also, have NCS and that with the tachy was causing me fatigue, brain fog, and dizziness, sometimes SOB.  Now I am on beta blockers and feel'g much better.  (I have mild valvular disease, too).  I am told I have nothing to worry about and don't.  

Since you have 2 different opinions, maybe you would benefit from another, although it can be a hassle.  Also, ask yourself did you feel better on the BB's?  What about the side effects?  

Good luck

[astros18]

I have taken a magnesium supplement called Natural Calm. It is in liquid form. It is extremely fast acting, you can tell a difference right away. I had to stop taking it because I have digestive issues and it upset my colon, no matter the amount I took. I now take a magnesium tablet that I chew up first. I can always tell the difference in my body when I take magnesium vs. not taking it.

[lolathechi]

Hi!

Does anyone ever get really odd feeling pvc's?? Kind of like you cant breathe for about 4 seconds.. almost like a hiccup?? but you know it is not a hiccup.. It is a pvc but a little longer and no thud.. I am so scared it is turning into the runs of pvc's, couplets and triplets... does anyone have those and what do they feel like?? thanks!

[Momto3]

When I get couplets, triplets or runs, they feel like hiccups or a long rumbling.  I can't quite catch my breath and it defintely feels different than an isolated pvc.  Fortunately, they are much rarer since my ablations.  Now, I only get them a couple of times/month...YEAH!!

[lolathechi]

Hi.. are having those any more dangerous than having regular pvcs?? I had a holter a year ago which just showed sinlge pvcs.. but these are freaking me out.. my cardiolgist upped my toprol a week andhalf ago to 125 mg.. and 3 days after uping it, i started being a little short of breath and felt these weird pvcs, the ones that feel like hiccups...  all of the sudden it feels like i cant breathe for a second.. like the begging of a pvc but no thud.. i always think i am going to pass out and die!!! i do have a structually normal heart.. thanks!

[Momto3]

Hi again : )

In the setting of a structurally normal heart and with a normal cardiac workup, they are benign.  Try not to let them get to you...I know they feel weird, but absent any cardiac anomolies, they really aren't harmful. When patients become uncomfortable b/c of ectopics, some doctors elect to treat the symptoms (beta blockers) to offer the patient some relief. However, I think that sometimes beta blockers can actually make them worse.  If your BB is not working for you, mention it to your doctor and perhaps he/she will try another RX.  Have you talked with your doctor about stopping the Toprol?  Or, about trying a different medication?

[momof6]

Hi to all,

I havent posted on this forum in so long.But like to check in once in a while to encourage or to be encouraged as we live with these arrythmias.Mine really havent bothered me to much for the last several months.One thing I think helps is to just let your body respond to the pvc ect. not get anxious over it once the feeling is gone.You've lived thru it before right.I do take Lorpressor 150mg.in the morning and 100mg at night,I do feel tired at times.Norvasc 5mg once daily for mild hbp.Then I do take two to three magnisuims a day of slowmag its with calcium.If you do take mag.make sure its with calcium.And then I do take Potassium 20mg. once daily. All these together make my heart run smoothly.But the number one thing is to make sure you drink plenty of water!!So important,and the next thing is to just focus on other things even if you have to force your self!!They will subside if you dont sit around and wait for the next episode.I used to do that,please dont waste presious time focused on these darn things.If I get one that scares me especially the ones that come in more then one at a time Ill start to fear and then remind myself oh yeah Ive had that feeling before and actually am able to blow them off now.I hope and pray you all can at least get to this point.I know pvc's are like a sleeping giant but just enjoy while he's sleeping and then kick butt when he is awake by ignoring him!!;)Have a wonderful un-noticed pvc day to all!~Momof6

[blan3556]

Everyone is great..Thanks alot...a little worried about the tachy though, no straight answers there...

[tier]

I am a 47 year old female and was very excited to find this website!  I have had PVC's off and on for the last 4 years, with bad runs usually lasting 6 months or so.  The one correlation I definately see is with my menstrual cycle.  7-10 days before my period they are crazy and so bad that I can't sleep some nights, a day or two after my period is over they go away just about completely.  I am secretly hoping that after menopause they will disappear all together.  I have had all the tests, blood, ECG, and stress tests.  I have been prescribed Toprol, 12.5 mg. which I plan on taking only on the very bad runs when I do not sleep at night.  I have been an avid exerciser pretty much all my life, 30 minutes running/30 minutes weights every other day.  I refuse to let PVC's run my life, especially after all the tests came back perfect.  I too believe more tests should be done to find out about the underlying cause.  I have a maternal grandmother, and two brothers who say they also have felt PVC's, and my grandmother lived well into her 80's. Don't let this beat you!

[weston89]

I read your story, and you have to know that you are not alone.  I have had an increased heart rate for many months now.  Initially my heart would race up to 120, 130 and even 140 on occasion (that was with a major panic attack).  I had every test (nuclear stress, echocardiogram, holter monitor and 3 ecg's).  My cardiologist told me everything came back normal and that functually and structually there is nothing wrong with my heart, but I still get tachy all the time.  I cannot take beta blockers because, stangely enough, I am allergic to them, also I cannot take calcium channel blockers.  I have been told there is nothing wrong with me and that my normal resting heart rate which ranges from 84-100 is normal for me.  You sound, from what I have read, to be ok.  It is not easy to have this, you have to learn it will not kill you, it will just be annoying.  People live normal productive lives with PVC, etc.  Keep exercising.  This is the best you can do for yourself.  I was deconditioned and I am getting back into the swing of things.  Do not let this hold you back.  I initially forgot to live my life when I was diagnosed with this...you cannot do this. Good Luck, you are ok.

[Duchess47]

I just started having a very fast heart beat about 6 months ago.  I went to my primary care physician and he "caught it" in his office when he took my pulse.  I was put on atenelol and scheduled for an echo stress test.  The result of the stress test was that my h.r. went up too fast too soon.  I am 47 never smoke or drink and weigh 118 lbs.  But as luck would have it, I still have high  cholesteral for which I am on Lipitor and I also have Graves disease for which I am on Methimazole for hyperthyroid. One cardiologist says I may have a hyperkinetic heart whereby my heart rate just goes up.  another says maybe I just produce more adrenalin than others and that is where the atenenlol comes in.  I must admit though, since starting the beta blocker I have also felt the "skipped" heart beats. With an otherwise noirmal heart, the beta blockers just make you feel better like taking an aspirin for a headache.  You can live with it or without, but if it makes you feel better than there is no harm in taking them. At least thisis what my doc says.

[Taheri]

Hello!
This is samim...iam 18 years old.i have hearbeat(sinus arrhythmia(RR int.change over 20%) this is the result of (ECG)from me..i wish to see and check this problem of mine and writte the treatment and the name of drug for me...i wish to consider this once and reply for me.thanks samim

[actoreddie]

Hello,

I am a male, oh not that it matters, and yes I am a "not yet famous" actor here in the NY\NJ area in his late 40's that has worked on popular shows like "Law & Order", "Rescue Me" on the FX channel, amoung other shows, At any rate, I too have been suffering from recurring episodes of "multi-form" PVC's and "occasional" bouts of "IST and PSVT since 1992. Although my Cardiologist here in NJ has reassured me that although they are frightening and but definitely interfering, in my opinion,  with the quality of my life as they become more frequent, despite the 50mg. of the Beta Blocker (tenormin) I've been taking to suppress the SVT, which it has for the most part, it isn't "as effective" for the re-occurring out of the blue PVC's that come and go but when they come, make me highly anxious, unable to sleep, work, function to well (when they are occurring) yet my doctor continues to reassure me that they are benign and won't kill me! I know about RF ablation "and" it's risks as well as it's likelihood to make an arrhythmia "worse" or more dangerous than it was to begin with as well as NOT even successfully stopping certain arrhythmias, e.g., PVC's, and even if they "found" a bypass tract(s) for the PSVT and ablated\cured that abnormal rhythm, I'd still be left with the PVC's that are much more frequent and could be the result of "many" foci, which I understand RF ablation is UNLIKELY to successfully cure PVC'S leaving me back to square one and "still" having to take the Meds for the PVC's!!. Therefore, since Cryo-Ablation "claims" to "reversible" and pose less risk to a patient as well as eliminating or decreasing the need for an ICD\Pacemaker in the event the Electrophysiologist "unintentionally?" damages the sinus or AV node while attempting to ablate the "offending" tissue causing this arrhythmia. I appreciate any info. regarding this procedure and how it "may" help me and when any of the "local" Hospitals in my area NJ\NY will be using the cryo-ablation technique. I am also, interested in a clinical trial, if necessary. Anything, that will offer HOPE to end this 13 years of "extreme" anxiety over these, seem to be, progressing episodes, despite "anxiety" meds as well as a supposed safe alternative to Anti -Arrhythmias (Beta-Blockers) that sometimes don't work and the side-effects are sometimes "worse" than the arrhythmia but if I discontinue them I leave myself susceptible to the PSVT\Tachycardia returning and PVC's occurring even more! What does one do after 13 years of agony and worry,of course despite what my cardiologist is telling me!

Thank you for your help!
actoreddie

[upbeat63]

I haven't heard of the procedure you mentioned but just wanted to give you some reassurance. I have had a 22 year history (and counting!)of "only" (ha ha) single PVCs but with such frequency 24,000+ per day, that it is nearly driving me crazy.

But I'm still alive. And unless I let the anxiety and/or the thumping sensations get to me, I try to go on to lead a "normal" life. Some days are better than others. I hope you can get the assurance you need either from the information you seek about the procedure, or from a compassionate doctor. That may help to lessen your anxiety.

Since we don't know what tomorrow holds, try to enjoy what you have today. Sometimes I just have to write it, to help myself believe it too. You are not alone.

[actoreddie]

Thanks for the reassurance as it definately helps when you know so "many" others out there are experiencing the same horrible sensations, whether it's ioslated\multiform PVC's or PSVT\Tachycardia etc.. I am told by my cardiologist of "13 years" here in NJ , like many others are in this forum, that they "still" are benign in the setting of structurally normal heart,however,that doesn't give much comfort when they come out of hibernation, so to speak, or "increase" in frequency since they first started in 1992. In my case, which is similar to others in this forum as I read, my episodes started with a true onset of PSVT that would come out of the blue following my "1st" distressing episode. I was advised by my relative physicians here in NJ to consult with a heart doctor, I did and I have been seeing him ever since the first episode began. Of course, like many of us, I went through a trial and error of different BB's and even for a "short time" tried CC blockers(Verapamil)which seem to make my tachycardia worse! I also learned one certain trigger,"on my own" mind you, that several hours "after" the ingestion of ANY "alcoholic beverages" I would develop this rapid rate (140-180bpm) and sometimes even higher, as noted on the rhythm strip either from a holter or in the ER. The rate wouldn't subside or break until several hours later on it's own. I suspect this was a result of the alcohol in my system and because I've been abstinant from alcohol since approx. 1994. There would still be an "occasional" SVT or Inappropriate Sinus Tach episode but it never would last for hours like when I ingested alcohol. In any event, the SVT\PSVT became infrequent and "isolated" PVC's started, also scarry and NOT fun but just when I started to "tolerate" them In 2000 I had my 1st episode of Bigeminy, Trigeminy, Fusion beats, Escape rhythm, and one episode of 5 beats of IVR, All in a 2 week period while wearing an event monitor. Since 2000 I have had a few bouts of these same rhythms but not as frequent as what I've started getting the last few years. Interpolated PVC's and Ventricular Couplets are the newest rhythm I am enduring. What next?? What I don't understand is how Doctors can say this is ALL benign to "us" the ones that suffer, when these rhythms are changing in form and frequency? Something physiological has to be ocurring or changing within the hearts electrical system for changes like this to ocurr, (the rhythm) going from one form to a more complex form! I appreciate ALL the sites like this and "the Doc's" that take their "valuable" time to answer our questions about this on-going problem many of us are having to deal with but we NEED more than just reassurance! What about intervention that will "cure" many of us and NOT make us worse than we were, which seems to be the likely senerio with RF ablation, especially with PVC's. Is there ANY hope beyond words!

[upbeat63]

Well it seems like you have a very solid relationship with your cardiologist if you've been seeing (him/her?) for 13 years. Does the cardiologist have any answers to your VERY good questions--there should--must be a better answer to getting rid of these terrible irregular rhythms.

It's very interesting to me that the doctor's only answer, first line of treatment is a beta-blocker. Why do they prescribe a beta-blocker to an individual with a normal heart "rate", or normal blood pressure, when the BB "is intended to decrease the sensation" of the palpitation. In what I've read, and been told,  it does nothing for the frequency and could make it worse! Then second line are very dangerous anti-arrhytmic drugs, which could help but gee, the risk. And of course ablation. None of them seem very appealing.

Could you tell me, what does interpolated PVCs, fusion beats, escape rhythm and IVR mean? I've been told my PVCs are single and unifocal for the most part. But since that holter I've had hours of bigeminy, then it stopped, then it returned, and now I have runs of PVCs at every beat. I really can't keep up with all the change.

[Momto3]

I know it's hard to manage sometimes, but in the setting of a structurally normal heart, the ectopics are benign.  That being said, dealing with them is a different story.  Although I was never afraid of the pvcs, they seemed to lead to panic-like attacks, like some sort of systemic reaction. It was the panicky feeling that I grew to despise.  The pvcs didn't really bother me.

There are successful ablation stories out there. In 2003, I had two ablations for multi-focal pvcs. Prior to the ablations, I had pvcs all the time.  I used beta blockers some of the time.  I had tons of bigeminal episodes & couplets everyday --to the tune of 22000/day.  I had pvcs for about 25 years so I really do understand your frustration.  Good luck.  Hope you are feeling better.

[actoreddie]

Thanks for your "postive" feedback & advice, it's appreciated and comforting to know that in spite of MANY negative articles\stories I hear about "UNSUCCESSFUL" RF-ablation, it's nice to know it work for someone in the same boat! Still, and not to be a total skeptic, you know as well as I do that the outcome of a successful "SINGLE" rf-ablation, specifically for PVC's, all depends on a HIGHLY "experienced" electrophysiologist and operator performing it or should I say precisely mapping it out and burning the "right" culprit tissue(s). This is why I hesitate for the ablation procedure. I believe you happen to be one of the few lucky ones and I am happy for you. I talk to many people in the medical field about this very distressing problem I have and "most" of them advise against an ablation. They also discourage me from an EP study since there is NO guarantee that they will find any foci or bypass tract for various reasons and if they do, what if it's too close to the sinus or AV node or concealed or on the surface of the heart where it's more difficult to get to?? I'm still worried\concerned that I will come out with a more life threatning arrhythmia than before I went in for an RF-ablation? Or, even if they find anything and are able to induce V-tach when they just to a study, what does that mean? Let's say I did the study, signed the consent for them to ablate hopefully just a "single"? bypass tract or accessory pathway that is responsible for my "now" infrequent PSVT and they cure me of the PSVT\IST, I am still left with the so-called benign "Ventricular Arrhythmias" and "still" would have to take the Tenormin so I am back where I started. How do "I" win? My life would still be miserable and I would have to endure the side effects of the BB's or any other meds. I realize The study "might" possibly confirm that I have a conduction defect but an ablation "may" only cure the Tachycardia and not the PVC's as well. See, I have a two-fold problem which I would think makes my situation a little different, and I assume, more complicated. I have been back and forth with this EP study\ablation issue and am unfortunately at a stand-still after many years, although the last 5 years have been the worst as far as strings and runs of multiform PVC's and an occassional episode of tachycardia, which when it occurrs, triggers high states of anxiety\nervousness, GI problems, etc.. and the return of the former panic attacks I got when this first started only to be shuffled from a cardiologist back to a SHRINK who tells me it's ALL in my head and puts me back on SSRI's that in my oppinion,seem to exacerbate my arrhythmias and I've tried them All. When does it end, only when I die? Something has to be done for people like us, even if I have to devulge this embarrassing problem to my friends in the entertainment business that know many people in New York, where there are some great Doctors and hospitals. I just don't know where to go with this anymore!

[Momto3]

It is so important for you to find a doctor that you can speak candidly to, as well as a doctor you trust. Over the past 25 years, I've been to a number of internists, cardiologists and EP's.  It makes all the difference in the world when the doctor takes whatever time is necessary to ensure your health, safety and emotional well-being (no small order for us arrythmia patients).  

You are absolutely right that an EP study and RFA for ectopics MUST be performed by only the most skilled physicians.  Although my ablations (2) were successful for ablating several foci (RVOT and LVOT), my doctor did not even consider ablating until I developed a cardiomyopathy.  In my case, frequent pvcs led to a dignificant drop in my EF so it became very important to eliminate, or signicantly reduce, the number of ectopic beats.  Absent the ablations, I would have been on anti-arrythmics for the rest of my life.

Good luck finding some relief for your ectopics.

[aman777]

A related discussion, sudden thump very hard one was started.