Aa
Any PVC answers?
I have had so far benign pvcs throughout my entire life off and on. I was lucky when I had about a12 year time frame, where they disappeared completely. Now, they have returned again! I hate living with them! They constantly give me a reality check that life is fragile and when I have these pvc storms they give me a feeling that I could be snuffed out and ripped off the planet against my will, at any given moment. So you see it isn't just having episodes of continuing pvcs, it is the mind set and the fear it entails I live with. I use humor a lot, but deep down for years it has been worrisome and stunts my full potential and indeed robs me of happiness, that I never show or talk about. I have never gotten use to the pvcs, even as long as I have had them, especially the ones that take your breath away occasionally. I am back on the halter monitor as of today. Does anyone have any suggestions how to lift your spirits during episodes of disturbing flip flops and thumps as awell as breathtaking pvcs? You would think I would get use to it. Any info or humor is ppreciated. Thanks.
Thank you for your great explanation of PVCs - I think it will be helpful to many on this site.
This is a great thread. Everyone seems to touch on the same theme, where hypersensitivity to our own bodies makes us all acutely aware of any abnormalities. If it isn't PVCs, would it be something else? I am interested to see how many out there have, or have had, significant other health concerns or anxiety issues about illness in the past. My PVCs feed my anxiety, giving my mind the ammunition it needs to stress about something...and then the viscous cycle ensues...PVCs get worse with the adrenaline from worry and panic. My doctor claims to have PVCs all the time, and finds it hard to understand why I can't accept that they are benign. It's almost like a pilot talking to a nervous passenger who has a fear of flying. Being dismissive about an episode of PVCs means you have trained yourself to accept your doctor's diagnosis. Perhaps there are many other PVC sufferers out there who simply ignore the sensations because they aren't prone to worry about their health. Unfortunately, most of us on this site just aren't wired that way!
Someone up above me mentioned how PVCs can be thought of as the backup mechanism of the heart. Well, they are! They’re just firing when they aren’t supposed to.
Lookup something called an “Escape Beat”. You see, any cell in your heart can become the pacer of your heart beat. The reason the cells in the Sinoatrial node (SA node) pace the heart is because they *most of the time* are firing the contraction beat at the fastest interval.
It’s incredibly elegant the way it works and how it perfectly times the contractions of the upper and lower parts of the heart muscles. Try to envision this; I’ll do my best to narrate the story. The SA node which is located in the upper right atrium of the heart fires an electrical pulse. Now put this in slow motion, this electrical front spreads out across the right and left atria and as it does the atria (upper part of the heart) contracts. Because it’s spreading across the muscle the contraction across the atria is rather like a smooth wave. As it’s doing so it’s filling up the lower part of your heart with blood. This doesn’t require a lot of force, the atria only has to move this blood into the dedicate cavities of the ventricles.
Well, the ventricles have a much bigger job. It has to move this blood throughout the entire body. Into the lungs to exchange gasses, then back out to the rest of your body.
Nature did its job in designing the muscles appropriately for their work load, the ventricles have MUCH MORE MUSCLE MASS than the atria.
Back to the electrical signal, by the time it has spread across the atria and contraction is about complete the signal is hitting something called the atrioventricular node (AV node). The AV node is like an electrical wire; it takes this signal and delivers it to both the right and left ventricles at the same time (normally). This makes them contract almost at the same rate and same time, unlike the atria.
You could live with just your ventricles doing all the work. It wouldn’t be efficient but you’d survive.
But what would happen if the SA node didn’t fire or the AV node decided not to work for just one or two beats? You’d hit the floor or worse. So nature built in a backup into the ventricles. If there’s no beat from a normal source in a certain amount of time (usually 3 – 5 seconds), a group of cells in the ventricles will fire. This is called the “Escape beat”.
A PVC is not an escape beat but they come from the same source. A PVC is “premature” meaning that for some reason a ventricular cell(s) fired prematurely, well before it should as a normal backup. Now think of the model I just described during the heart beat and you get the picture why they give the feeling they give. The atria are in the middle of a contraction and the ventricles fire. Valves slam shut as muscles are not finished contracting. This in turn causes some hydraulic shock forces and this is what you are feeling. The timing is what controls the different feelings. Early in the cycle, late in the cycle, they can happen at point and all will have different feelings. Another factor is that the ventricles are now contracting at different timing instead both at the same time. This is because the electrical front is not traveling through the AV node, it’s spreading across the muscle. If it started in the right ventricle it will contract first then the left. Again, this will add to the sensations you feel.
Most benign PVCs originate in the Right Ventricular Outflow Tract (RVOT). The cause for benign PVCs is termed “enhanced automaticity”.
I’m explaining all this because this knowledge is what brought me the most comfort. I still get anxiety over them though, but rationally I know it won’t kill me. Hope this helps.
Lookup something called an “Escape Beat”. You see, any cell in your heart can become the pacer of your heart beat. The reason the cells in the Sinoatrial node (SA node) pace the heart is because they *most of the time* are firing the contraction beat at the fastest interval.
It’s incredibly elegant the way it works and how it perfectly times the contractions of the upper and lower parts of the heart muscles. Try to envision this; I’ll do my best to narrate the story. The SA node which is located in the upper right atrium of the heart fires an electrical pulse. Now put this in slow motion, this electrical front spreads out across the right and left atria and as it does the atria (upper part of the heart) contracts. Because it’s spreading across the muscle the contraction across the atria is rather like a smooth wave. As it’s doing so it’s filling up the lower part of your heart with blood. This doesn’t require a lot of force, the atria only has to move this blood into the dedicate cavities of the ventricles.
Well, the ventricles have a much bigger job. It has to move this blood throughout the entire body. Into the lungs to exchange gasses, then back out to the rest of your body.
Nature did its job in designing the muscles appropriately for their work load, the ventricles have MUCH MORE MUSCLE MASS than the atria.
Back to the electrical signal, by the time it has spread across the atria and contraction is about complete the signal is hitting something called the atrioventricular node (AV node). The AV node is like an electrical wire; it takes this signal and delivers it to both the right and left ventricles at the same time (normally). This makes them contract almost at the same rate and same time, unlike the atria.
You could live with just your ventricles doing all the work. It wouldn’t be efficient but you’d survive.
But what would happen if the SA node didn’t fire or the AV node decided not to work for just one or two beats? You’d hit the floor or worse. So nature built in a backup into the ventricles. If there’s no beat from a normal source in a certain amount of time (usually 3 – 5 seconds), a group of cells in the ventricles will fire. This is called the “Escape beat”.
A PVC is not an escape beat but they come from the same source. A PVC is “premature” meaning that for some reason a ventricular cell(s) fired prematurely, well before it should as a normal backup. Now think of the model I just described during the heart beat and you get the picture why they give the feeling they give. The atria are in the middle of a contraction and the ventricles fire. Valves slam shut as muscles are not finished contracting. This in turn causes some hydraulic shock forces and this is what you are feeling. The timing is what controls the different feelings. Early in the cycle, late in the cycle, they can happen at point and all will have different feelings. Another factor is that the ventricles are now contracting at different timing instead both at the same time. This is because the electrical front is not traveling through the AV node, it’s spreading across the muscle. If it started in the right ventricle it will contract first then the left. Again, this will add to the sensations you feel.
Most benign PVCs originate in the Right Ventricular Outflow Tract (RVOT). The cause for benign PVCs is termed “enhanced automaticity”.
I’m explaining all this because this knowledge is what brought me the most comfort. I still get anxiety over them though, but rationally I know it won’t kill me. Hope this helps.
A suggestion - ask for an event monitor. This allows you to take a three minute ECG reading whenever you are experiencing PVC's. With the one I had I could do three independent readings and then send the data by telephone to the cardio- lab at my local hospital. The one thing that surprised me is when I send my worst feeling recordings the tracings showed only minimal PVC activity. We must feel something more than what is recordable, at least I do.
Also, I think Yarrow said it, which is true for me. Sometimes when the hyper-awareness of the pvcs goes away, so do the pvcs - not always, but sometimes it will prevent a bad bout from becoming worse. I think my heart WANTS to get back to nsr, but can't because of the constant adrenaline from obsessive worry. Why ablation for me then? Well, I think I have a super irritable heart and the extra pacemaker cells are there and they want to join in the fun when adrenaline comes to the party. Very unscientific explanation, but this is what I think happens with me. High adrenaline levels don't irritate other hearts because they don't have an irritable heart that has pacemaker cells where they shouldn't be....
This is one of best threads I have read. I see myself in so many of the comments. It's true, but I didn't realize it till I read it that I also have personality changes when I am in the throes of pvcland. I become withdrawn, easily angered, sad, depressed, etc. It's so hard on my family, and that of itself is enough reason for an ablation. My pvcs have been increasing since July 09, but I have had them since 1996. I've been on rhythmol, verapamil, and now 50mg of metropolol (which I hate). The thing I hate most about these things is they make me feel like I am a "sick person" (we are talking physically here tee hee), when I have had all the tests and ticker is healthy. I curtail my exercising, which is part of who I am. I lift light weights, walk, bike at the gym, and when I am in pvcland, I don't want to do any of that because I have exercise-induced pvcs now, used to go away when exercising. I am seeing an eps in Boston end of April. I am going to discuss ablation, which I think for me would be easy (unifocal, rt ventricle). Haven't been able to capture them on a holter for a while. My cardiologist says to call in the am if they are bad and get "strapped on". But, mostly they start later in the day and go through the night when the office is closed. I'll get the little buggers sooner or later! Hopefully before my eps appointment. I do get a little chuckle though when I see my cardiologist. I just start seeing him (I left my long time eps recently because he didn't listen to me and always stood by with the ablation knife if you get my drift). He looks like a teenage kid (I think he's about 30 - I always have the urge to call him "son"!), he's nerdy, but REALLY smart and bright and very knowledgable. But he has pvcs too! He gets em real bad!!! But he's so adorable that I can't laugh too hard! But it is "nice" to have a doctor that suffers too and knows what I am dealing with!
Sorry for rambling.
Debbie
Sorry for rambling.
Debbie
Amen to that...Let the doctors walk a mile in our shoes or should I say and hour of our life in the middle of an episode...
With arrhythmia's there are no easy answers. I really didn't let them bother me until my heart functioning came into play but by then I had so many other things wrong I was really sick.
I was told from the age of 9 until 42 that they were nothing and blamed on wanting attention stress anxiety and then overworking etc until I really believed it and stuck my head in the sand never believing I was as sick as the dr said I was in 2009.
It may be helpful to find out what's wrong and understand what's going on and how to treat them. If it's really benign pvc's and you're not symptomatic, then you should try and find what triggers you have, foods, drinks, caffeine or are there things such as potassium, magnesium etc that you're low in by getting blood work done. You may need a low dose beta blocker at some point so discuss this with your doctor when you can.
Another good thing to do is keep a journal of dates, times, symptoms and what you were doing/feeling at the time to see if you can find a pattern or trigger. Talking with others such as this support forum or even a therapist do help and to know others are going through what you are can be a big help.
As curmudgen says, I'd like to give all my dr's who told me not to worry about them, oh they're nothing you're just anxious about them my symptoms for awhile and let them see how "well" they deal with them :P
I was told from the age of 9 until 42 that they were nothing and blamed on wanting attention stress anxiety and then overworking etc until I really believed it and stuck my head in the sand never believing I was as sick as the dr said I was in 2009.
It may be helpful to find out what's wrong and understand what's going on and how to treat them. If it's really benign pvc's and you're not symptomatic, then you should try and find what triggers you have, foods, drinks, caffeine or are there things such as potassium, magnesium etc that you're low in by getting blood work done. You may need a low dose beta blocker at some point so discuss this with your doctor when you can.
Another good thing to do is keep a journal of dates, times, symptoms and what you were doing/feeling at the time to see if you can find a pattern or trigger. Talking with others such as this support forum or even a therapist do help and to know others are going through what you are can be a big help.
As curmudgen says, I'd like to give all my dr's who told me not to worry about them, oh they're nothing you're just anxious about them my symptoms for awhile and let them see how "well" they deal with them :P
I guess I have to take the scientific approach. What changed to bring these on? Are you dehydrated? Overly hydrated? Emotional changes? Have you changed any medication? Usually none of us can pin point anything in particular that brings them on. The evidence for supplements having a positive or negative effect is anecdotal at best.
As for uplifting of ones spirit - boy thats a hard one. I know that my personality seems to change during episodes...become grumpy, impatient and feel lousy. More than just plain ordinary anxiety. No matter what one does it is hard to ignore the feeling you get in the chest....but considering that we are still posting on this forum must mean we are somehow surviving. I stated this before - I wish the doctors that tell us "don't worry they are benign" could get my symptoms while I am in their office.
Hi,
I'm curious to see if stopping the fish oil helps. I started having PVC/PACs during my pregnancy 9 years ago - they were at their worst during the first year following the birth of my daughter. However, I have gone the last several years with only infrequent PVCs - that is - until I started on the daily fish oil. After I had been on the fish oil for six weeks, I was up to having several PVCs per minute. Since I stopped the fish oil, I only notice the skipped beats several times per day and they don't bother me at all.
Here are a few thoughts that help me:
1.My MD once told me that younger, healthy hearts are often more variable and flexible in their rhythm, and PVCs can be thought of as a "back up system" ie if there was a problem that took you out of normal sinus rhythm, other ectopic cells (origin of PVCs) would keep your heart beating. I'm not entirely sure how accurate that statement is - but I try to think of my ectopic beats as a redundant system rather than a problem.
2. I have a little mantra that I tell myself "My heart is strong and healthy, God is always with me" and/or (this one doesn't rhyme) "My heart's electrophysiology is healthy and normal - I can handle intense exercise and stress" The second affirmation helped with my fear that a panic attack would heart my heart.
3. If you have had all the tests done by a cardiologist (I went so far as to have a CT angiogram) and you have been told that your heart is fine, then what are you choices? Well, you can continue to worry and focus on your heart and make yourself miserable or you can do your best to be healthy, eat well, exercise, follow your doctors recomendations for screening teast,etc. and then know you have done everything in your control to be healthy and live each day to the fullest. After many years of making myself miserable with worry, I now choose to live my life and trust that my heart will keep going strong.
4. I have a very strong family history of anxiety disorders and have personally suffered with panic attacks, GAD, and OCD since my late twentys (more than 15 years now). For me, cognitive behavior therapy was somewhat helpful, but the only thing that has really made a big difference in my mental health is Paxil - it is a miracle drug for me. In fact, it has only been the last couple years that I have felt truly happy and not abnormally anxious .
I'm curious to see if stopping the fish oil helps. I started having PVC/PACs during my pregnancy 9 years ago - they were at their worst during the first year following the birth of my daughter. However, I have gone the last several years with only infrequent PVCs - that is - until I started on the daily fish oil. After I had been on the fish oil for six weeks, I was up to having several PVCs per minute. Since I stopped the fish oil, I only notice the skipped beats several times per day and they don't bother me at all.
Here are a few thoughts that help me:
1.My MD once told me that younger, healthy hearts are often more variable and flexible in their rhythm, and PVCs can be thought of as a "back up system" ie if there was a problem that took you out of normal sinus rhythm, other ectopic cells (origin of PVCs) would keep your heart beating. I'm not entirely sure how accurate that statement is - but I try to think of my ectopic beats as a redundant system rather than a problem.
2. I have a little mantra that I tell myself "My heart is strong and healthy, God is always with me" and/or (this one doesn't rhyme) "My heart's electrophysiology is healthy and normal - I can handle intense exercise and stress" The second affirmation helped with my fear that a panic attack would heart my heart.
3. If you have had all the tests done by a cardiologist (I went so far as to have a CT angiogram) and you have been told that your heart is fine, then what are you choices? Well, you can continue to worry and focus on your heart and make yourself miserable or you can do your best to be healthy, eat well, exercise, follow your doctors recomendations for screening teast,etc. and then know you have done everything in your control to be healthy and live each day to the fullest. After many years of making myself miserable with worry, I now choose to live my life and trust that my heart will keep going strong.
4. I have a very strong family history of anxiety disorders and have personally suffered with panic attacks, GAD, and OCD since my late twentys (more than 15 years now). For me, cognitive behavior therapy was somewhat helpful, but the only thing that has really made a big difference in my mental health is Paxil - it is a miracle drug for me. In fact, it has only been the last couple years that I have felt truly happy and not abnormally anxious .
I completely understand how you feel. Even though I've been checked and reassured that these things are "only a nuisance," deep down inside I'm always wondering if they're missing something. I just have to keep reminding myself that God is in control and I'm not and that I'm doing all that I can to make sure my heart is o-kay. It is harder when you go through a period of time when you don't have hardly any and then they come back for no apparent reason. It's just devastating! I do believe that worrying about them makes them worse. It's hard for someone who doesn't have these things to understand why you can't just stop worrying when that's what's making you worry in the first place! Just know that you're not alone. : )
Skip, you say:
"it is the mind set and the fear it entails I live with."
If you've had all your medical workups and your heart has been shown to be healthy, then the mind is indeed the problem. Myself, I've had bouts of PVCs for several decades, always accompanied by panic attacks. Never found out which was the chicken and which the egg, but I have learned ways to deal with the fear--or rather, the 'fear of the fear,' as the author Claire Weekes put it.
For people with similar problems, I always recommend seeing a psychiatrist to discuss ways to handle the anxiety these weird heartbeats can cause in those who are sensitive to them.
Shrinks are MDs and can thus prescribe, and personally, I have found that small amounts of the right medication are an invaluable adjunct to counseling. Ironically, for me, once the hyper-awareness of the PVCs is reduced--so is their frequency!
"it is the mind set and the fear it entails I live with."
If you've had all your medical workups and your heart has been shown to be healthy, then the mind is indeed the problem. Myself, I've had bouts of PVCs for several decades, always accompanied by panic attacks. Never found out which was the chicken and which the egg, but I have learned ways to deal with the fear--or rather, the 'fear of the fear,' as the author Claire Weekes put it.
For people with similar problems, I always recommend seeing a psychiatrist to discuss ways to handle the anxiety these weird heartbeats can cause in those who are sensitive to them.
Shrinks are MDs and can thus prescribe, and personally, I have found that small amounts of the right medication are an invaluable adjunct to counseling. Ironically, for me, once the hyper-awareness of the PVCs is reduced--so is their frequency!
Have an Answer?
You are reading content posted in the Heart Rhythm Community
Are there grounds to recommend coffee consumption? Recent studies perk interest.
Salt in food can hurt your heart.
Get answers to your top questions about this common — but scary — symptom
How to know when chest pain may be a sign of something else
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
