Bigeminy PVCs When Exercising

I am 52 year old male and have been exercising my entire life (biking, walking, kayaking, weights, etc.) and in good shape, avoid caffiene, dont smoke, dont drink, etc. But a year ago I started getting PVCs (mostly trigeminy or bigeminy) during my regular 5 mile walks and biking. NO other symptoms other than the PVCs and anxiety about every other beat a PVC. They usually start 15 to 20 minutes after I start walking and sometimes settle down the longer I walk but sometimes I go back home becasue they become so unpleasant and I have a hard time believing bigeminies are benign. But my cardiologist says they won't kill me since every other beat is a good one. But I also think about how my dad (age 65) and his dad (age 57) both dropped dead while walking. This REALLY freaks me out that I get this when walking but the cardiologist looks at the holter results and says the PVCs, even bigeminy runs, are benign and "dont worry about them." When I stop walking or biking, they go away within a few minutes and back to a more random, occasional PVC. I have had the holter a few times and echo stress test and all they showed were the PVCs. All blood tests have been OK. I have been taking 50 mg atenolol since age 25 when I developed a tachycardia and panic attacks for no reason and everytime I have tried to get off the atenolol over the years the tachycardia came back. So now my cardiologist suggested I try 75 mg atenolol. I did this and the PVCs (bigeminy, trigeminy) became even worse). Then I tried 100 mg atenolol (50 mg twice a day) and just doing a few chores around the house or in the garage brought on the bigenimy or trigeminy runs. So I figured out that the higher the dosage of atenolol I take the WORSE my PVCs get and I think because my pulse gets so slow at 45 to 50 bpm. Now I have tapered off to 25 mg atenolol at bedtime and my PVCs are better and not quite as bad when walking or biking. But PVCs definately fewer then when I take 50 mg. Now I am thinking that maybe the reason causing my tachycardia many years ago---and that the atenolol has been preventing---has gone a way and now by taking atenolol it is maybe causing me these dreadful PVCs during exercise. I have done some research and apparently sometimes beta blockers make PVCs WORSE instead of better for some people. I think I may be one of those hapless people and no doctor has ever suggested that the beta blockers may be making my PVCs worse. But I have been experimenting with the atenolol dosage myself and keeping a log of my symptoms. I intend to cut down to 12.5 or 18 mg of atenolol next and then try getting off it completely to see what happens. But I am tapering off very slowly because the last time I did this about 10 years ago the tachycardia came back. But I would prefer the occasional tachycardia to the bigeminy PVCs during exercise. But who knows, maybe if I get off the atenolol my PVCs will go away. Are there any studies that suggest beta blockers can actually make PVCs and other irregular heart beats worse?? Or is this just wishful thinking on my part?

[itdood]

I completely believe that two types of antiarrhythmics make benign PVCs worse.  Class II (beta blockers) and class iv (calcium channel blockers) for some.

The thing is, doctors like to prescribe them for benign PVCs.  I've seen enough anecdotal evidence in myself and others to believe they can worsen PVC frequency in some people.  What that % is I'm not sure.

My own half-baked idea is that some benign PVCs are triggered by some sort of low grade inflammation.  BBs can enhance low grade inflammation by lessening blood flow.

I went on a statin back in October of 2009 for different reasons, but my PVCs mysteriously lessened GREATLY.  I don't know if there's a relationship.  Statins have anti-inflammatory properties.  There is a recent study that shows a relationship between statins and eliminating or lowering exercise - recovery phase PVCs.  Exercise-recovery PVCs are the only category thus far been shown to have predictive value in mortality.

I haven't had enough PVCs to test this idea on myself since I came up with it.  I was going to take 800 mg of ibuprofen during a bad episode to see what happens.  Ibu (a.k.a. Motrin, Advil,...) is a really good anti-inflammatory.  DO you think you'd be up for taking some 30-60 minutes before a walk to see what the result is?  If you do, please drop me a note on what you learn.  If you don't know how you react to ibu, please do not try or start out on a really small dose.

Thanks.