Exercise Induced PVCs - Dangerous or Not??

I am almost afraid to discuss this issue.  When I asked my cardio and my EP, neither seem worried about exercise induced pvcs.  I have suffered with these things for nearly 18 years (as a kid would "note" a few here and there but never brought it to anyone's attention).  I have had 2 or 3 major "bouts" of them where I would have up to a month of around 12 - 17K per month.  One bout landed me in the hospital with a prescription for Rythmol, which worked like a charm for a few years.  Now I control them with 50mg Toprol once per day, relaxation, and maybe a klonopin.  About 2 years ago the pvcs started with a vengeance in a different way, with exercise.  For years I only had pvcs when my heart was at rest and exercise made them go away.  Well, back to the cardio and EP for all the testing - everything was perfect, ticker is in tip top shape.  So now I have exercise induced pvcs and every doctor says, "don't worry!".  But I can't stop worrying...  Do exercise induced pvcs indicate death from HD???

Debbie

[is_something_wrong]

It's correct that PVCs are supposed to go away with exercise. PVCs during exercise is not necessarily dangerous but they more often indicate heart disease than PVCs during rest (which almost never indicate heart disease).

Two conditions are known to cause PVCs during exercise. One is coronary artery disease and the other is myocarditis. I assume you have ruled out CAD, but infections may at some point in your life (maybe after a common cold) affect a small part of your heart, which may fire lots of PVCs. If your echo is clean, your heart isn't damaged, but a clean echo can't rule out microscopic infections (and remember, just a few cardiac cells may cause LOTS of PVCs).

That said, it should be kept in mind that most PVCs/PACs during exercise are caused by excess adrenaline and poor exercise condition. Did your doctor tell you to keep exercising or stop?

[is_something_wrong]

It's correct that PVCs are supposed to go away with exercise. PVCs during exercise is not necessarily dangerous but they more often indicate heart disease than PVCs during rest (which almost never indicate heart disease).

Two conditions are known to cause PVCs during exercise. One is coronary artery disease and the other is myocarditis. I assume you have ruled out CAD, but infections may at some point in your life (maybe after a common cold) affect a small part of your heart, which may fire lots of PVCs. If your echo is clean, your heart isn't damaged, but a clean echo can't rule out microscopic infections (and remember, just a few cardiac cells may cause LOTS of PVCs).

That said, it should be kept in mind that most PVCs/PACs during exercise are caused by excess adrenaline and poor exercise condition. Did your doctor tell you to keep exercising or stop?

[dmacd74]

Thank you for responding...I meant to say that I can get 12 - 17K per DAY, not month, during the very worst episodes.  My EP always tells me to exercise MORE, but when I get my heart rate up, they start.  I recently had a stress echo and fired off some pvcs during the test.  They were "noted" in the report, but I was told that they were not the "ominous" kind and my heart functioned perfectly during the test and the results were normal.  I think I need to exercise and get back into shape.  My pvcs are monomorphic and in the right ventricle.  My EP said they would be very easy to ablate.

Debbie

[is_something_wrong]

At 12-17k PVCs a day I would seriously consider that, if they are easy to ablate with low risk.

If you could exercise more after an ablation and through that stay in good shape with good mental health not ruined by PVCs, at least I personally would strongly consider it.

I know how devastating premature beats during exercise can feel. I controlled mine with beta blockers, and when I got into better shape they went away. If you can't control yours even with antiarrhythmics, I guess last option is ablation (or living with them). Of course, if you are choosing the last alternative, you can't let them ruin your life quality and that's not easy.

[dmacd74]

Hi again!  You are so kind to respond - thank you, and thank you for being so active on this board.  I enjoy seeing your name because you offer such kind, caring, smart responses.  You have helped me more than you know!

Anyways, I think I am going to fight through my fear and try and exercise again.  I am going to start off slow, and not jump into it too fast and furious.  Maybe my lack of conditioning is what is causing them....I will keep you posted...and thank you again!

Debbie

[Mom2four85]

I would def look into an ablation; it may cure you or they may find what's causing the problem when they go in if they don't know right now.

I had some weird things go on in my stress test also that no one can explain; it's frustrating when dr's don't know or tell you it's nothing because we feel it inside.  I was told exercise and rest pvc's both were nothing to worry about; clean echo no structural heart problems etc etc...12 or 14 doctors later i'm still looking for answers.  I think maybe sometimes I expect too much and think doctor's shoud know everyting :P  I feel sorry for them with me as a patient lol

I'm sorry I can't remember if you've tried meds or ablation before? my mind just seems to get worse each time I try and use is hehehehe If meds arent' working with your numbers no structural problems etc you may be very successful with ablation.

If you can work through the runs while exercising or when they're done keep exercising; it will help you greatly when you need it - a strong healthy heart...thankfully I kept exercising when mine were bad or my heart may not have held up to what it went through.

[dmacd74]

Thank you for all the great responses.  I am going to try and work through the pvcs but getting back into shape.  I am going to start slowly....

[RavenOma]

Has your doc ever checked your magnesium level? Mine turned out to be very low and I've been on magnesium supplements now for over 6 months and they have improved dramatically. At last check, I had only 800 in about a week.

[burtsbakery12]

I am so glad to read all of your responses. I am 39 and have had PVC's at rest for a few years, had been doing really well with them(was taking magnesium supplements). Just recently, I started having them during exertion(going up stairs). It really scared me. I was also scared to excersise. I will make an appt with doc just to be sure, but your responses really make me more at ease. Trying to just pray, trust God and relax. Thanks so much everyone!

[The_Jack_Knows]

I am 67 have always been in good health but had to stop exercising for a few months, not for health reasons.  Then went to pull to swim laps got 4 in then had PVCs and shortness of breath. That turned into some dizziness at rest with hot flash. Ended up in ER told I had unstable angina. Had serial cardiac enzymes and EKGs to rule out heart attack (MI). Also had echocardiogram and chest Xray. All normal. Cardiologist said he wanted to do a treadmill stress test and if positive would do an angiogram, if negative would not do angiogram.

I was not satisfied with that and told the cardiologist that I would rather have the angiogram to rule out coronary artery blockage. If my stress test would have been negative I would not know if I had blockage. My doctor agreed and I had an angiogram. To my relief I had no blockage at all. The angiogram was a piece of cake, the worst part was when they pulled the tape off of my are along with my hair when they removed the IV.

I feel much better mentally knowing that my coronary arteries are fine, but I will still go on a heart healthy diet to keep it that way.

See my primary care next week and will probably start gradually getting back into shape. I believe overexertion and the lack of oxygen when swimming lead to the PVCs after all when your face is in the water one cannot breath.

[grendslori]

When you have a structurely sound heart with monomorphic pvcs you generally fine to exercise. Polymorphic is a different story because it is all different types of pvcs coming from all over the ventricle, they are more dangerous.