25,000+ PVC

[PVC_runner]

I just clocked in with 25,000+ PVC's on a 24 hr Holter.  I'm 58 and run about 5 miles a day. In fact the running slows the PVCs and normalizes my blood pressure. The PVC's don't bother me at all, but over 25,000/day is a lot of Premature Ventricular Contractions. I'm just glad they are not the other "Premature"!  What is considered an extremely high number of PVC's? Are high #'s of PVC's usually benign? Can high # of PVC's develop into something like V-Tach?

[RVVq]

Having 25000+ PVCs a day puts you at risk of developing "PVCs-induced cardiomyopathy."  Frequent PVCs with LBBB morphology may be potentially harmful for the myocardium analogous to the asynchronous contraction in long term right ventricular apical pacing. This has been shown to result in remodelling and subsequent LV diastolic and systolic dysfunction in previously normal hearts. Stroke volume is decreased as a consequence of prolonged duration of mitral regurgitation flow and diastolic dysfunction. LBBB also causes a reversal of the normal squeezing effect  of LV contraction resulting in reduced cardiac function.

You should get an ECHO to assess your LV dimensions and ejection fraction. Even if they are normal now, you should consider undergoing an ablation,  as they can rapidly deteriorate as a result of your extremely frequent ectopy.

Good luck!

[itdood]

That's a pretty high load of PVCs.

It varies from doc to doc.  Anywhere from 6-20% of total beats measured daily will throw a red flag for more tests.  Since a typical heart beats 100,000 x per day, you are at about 25%.

It's not as simple as the number of them though.  It has to be evaluated in light of your general overall health, heart function measured through other tests like echo and stress tests, what part of the heart the PVCs are coming from, are they coming from different parts (polymorphic) or a single part (unifocal), the efficiency of the ventricles, the muscle wall health and motion, are they of known cause or idiotpathic (don't know why they are occurring) cause.  There are others I'm forgetting.    

As you can see, simply taking the number of them is a futile way of assessing the overall picture, but it does help.

There is a recent study in a particular sub group of people with a high load of PVCs.  These people didn't have any other health issues, their heat was OK overall, and PVC of unknown cause.  These people however were showing some dysfunction with their left ventricle.  In particular a lower ejection fraction if I recall correctly.  It was shown that for folks where they could reduce the number of PVCs significantly (through ablation), their heart started to work better and most measures returned to normal.  What this showed is that 1.  A high load of PVCs in an of itself and reduce heart function and 2.  removing the PVCs can improve muscle function.

[MichelleP_3811]

Has your heart been deemed structurally normal by your cardiologist?  If your heart is structurally normal and the pvcs are not causing you a lot of disruption in your daily routine or bothersome symptoms like shortness of breath or passing out then you likely have nothing to worry about.  That said, 25,000 is a lot of pvcs.  Are you under a lot of stress or anxiety?  Do you have underlying stomach issues?  They are the two biggest triggers but you should definitely consult with your cardiologist to make sure there isn't some structural issue causing the pvcs that needs to be addressed.  If you are given the all clear it is very possible your pvcs will diminish and settle down with time.  As for whether or not it can develop into vtach it is possible but from what I have read in a structurally normal heart it is rare.  That said, again your cardiologist is the best person to evaluate your risk level since he has a better picture of your overall health.  You say in your post that running normalizes your BP.  What is your bp otherwise?  It is possible if there aren't any lifestyle contributors like stress or stomach ailments to work through getting your heart rate and blood pressure regulated through meds may help alleviate your pvcs.  But your cardiologist will evaluate if this is the right path for you.  But definitely keep on top of this.  I can imagine that 25000 is a bit annoying.  Take care and keep us posted on how you are doing.    

[achillea]

If you wore a 24 hour Holter, you almost certainly were seeing a cardiologist.  What did he say about your 25,000 PVCs?