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Frequent PVC´s
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Frequent PVC´s

2712493?1206892165
Dear Doctor,

I’m very concerned about the frequency of my PVC´s?

In the past (5 year ago) I got a tachycardia that last for more than a day and went to the ER. It was benign, so I started to be followed by a cardio.

At that time (2002), I made a Holter – It was normal only with 2 PVC in a day, a Stress Test that was also OK (had only 1 PVC in the recovery period) and a heart echo, also OK.

Every year I do EKG, as well as blood and urine tests that are all fine. I’m a 42 year old caucasian man, with normal weight (BMI=24), don’t smoke, don’t drink alcohol and never took drugs.

2,5 year ago I repeated the Stress Test that was again OK. My cardio say’s that my next Stress Test should be done by the end of 2009. My BP is roundly 135/85.

Some years ago I started to have some skipped beats (I think PVC because exams did before), but they weren’t very frequent. At maximum a couple in a minute and not in a continuous mode.

My cardio said to don’t concern and only gave me OLCADIL to take when it was more boring (It’s an anxiety med, not for the heart). Well, I have it but never took and my cardio said that it was not a problem and, has least as I took it, the better.

But now, since one week ago (last Sunday) I’m getting skipped beats that are very frequent. Some minutes I got more that 6 and other minutes 1 or 2, but not lesser. I don’t remember, since awake, to have a clear minute (without PVC’s). Since my cardio is in holidays, I report to the Health Centre that sent me to report in the ER of the Hospital, last Monday.

I also have to refer that I have no other symptoms like pain, dizziness or something like that, just the palps.

There they ran an EKG and only saw 1 PVC, although I and, as well the both Doctors from Health Centre and Hospital, fill the skipped beats taking my pulse.

At Hospital they ran also some blood tests, for cardiac enzymes and a chest X-Ray. They were OK so they sent me home without no med. Just told to speak with my cardio and only advised to take OLCADIL for my anxiety state.

Now, the things aren’t any better and I’m getting concerned, since my cardio will only return in a couple of weeks.

My main questions are:

- Could this situation trig a problematic health state for my heart?

- If I start to get more that 6 PVC/min could it be dangerous? – What’s the issue about this limit amount?

- Is there an upper limit for PVC’s a day when medic treatment should be applied? – I’m speaking only about clinical significance (homodynamic, heart damage, etc.) and not about the disturbance of the symptoms

- Is it possible and normal to have periods (large months) without any PVC´s or very few that doesn’t count, and then, they start very frequent (like this time) and occur every time for weeks or more?

- Assuming that they are only PVC or PAC, can I have them with this frequency for months without damaging the heart. Or should I take heart meds. Most of the time I read that meds are mostly to anxiety issues and not to really cure or reduce with significance the PVCs.

- What can we recommend further for this situation?

Thanks a lot and best regards,

Jose
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4 Comments Post a Comment
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Avatar_n_tn
You have posted this on the community forum.  If you want a doctor to respond, you need to go to the "Ask a Doctor" forum.
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257552_tn?1404606154
Hi,

There are no Doctors here, as sueinns said in the previous post. As a sufferer of an arrhythmia, as many people are on this forum, maybe I can tell you my experience.

My main questions are:

- Could this situation trig a problematic health state for my heart?

Hearts that are Structurally Sound, in other words, they have no valve or blood circulation problems, PVCs are still very common and often regarded as benign. The important thing is to get an examination from your Doctor to rule-out any problems with the heart that would cause the PVCs. If the Doctor feels your heart is healthy, and that the PVCs are not harmful, then you may need to learn to live with them.

- If I start to get more that 6 PVC/min could it be dangerous? – What’s the issue about this limit amount?

This is a rather persistent statement on the Internet. Some people, with otherwise healthy hearts, may experience 10,000 PVCs per day without need of treatment or without any serious limitations on their activities. 10,000 Divided by 24 = 417 PVC per Hour. 417 Divided by 60 = 6.95 (roughly 7) PVCs per Minute. But remember, this rate is equivalent to having 10,000 per day, or 7 per minute, for every minute throughout the day. This does not mean that 6 or more per minute a few times a day is the same as 6 per minute every minute throughout the day. Also, some people develop Bigeminy for hours at a time, often the cause is benign. Bigeminy is a PVC EVERY OTHER beat, or Beat, PVC, Beat, PVC, etc. This would yield 30 per minute (approximately), yet is often not considered serious.

- Is there an upper limit for PVC’s a day when medic treatment should be applied? – I’m speaking only about clinical significance (hemodynamic, heart damage, etc.) and not about the disturbance of the symptoms

I believe that you need to have somewhat more than 10% of the total number of heart beats per day occurring as premature beats before it is considered as possibly (and eventually) harmful to the heart, causing PVC induced cardiomypathy. If your pulse averages 75, you have over 100,000 heart beats per day. Once again, we are back to the figure of more than 10,000 before they really need to be treated. (Assuming an otherwise healthy heart).

- Is it possible and normal to have periods (large months) without any PVC´s or very few that doesn’t count, and then, they start very frequent (like this time) and occur every time for weeks or more?

I just came out of my last episode of PVCs, more than 600 per day, with Trigeminy episodes lasting for an hour or so periodically, all of this over a period of more than a year. Suddenly, they went away about 2 weeks after my last stress test.

- Assuming that they are only PVC or PAC, can I have them with this frequency for months without damaging the heart. Or should I take heart meds. Most of the time I read that meds are mostly to anxiety issues and not to really cure or reduce with significance the PVCs.

As I said, some people have thousands per day for years without causing any problems. Beta Blockers are usually the first treatment option, as they have an excellent safety record. The more serious Antiarrhythmic drugs can actually cause an arrhythmia, and can be more dangerous if not properly monitored.

- What can we recommend further for this situation?

Sleep, (as much as possible), no Caffeine, No Alcohol, avoid decongestants and diet medications, and avoid Mega Vitamin and Mineral Supplements.

Most importantly, keep in touch with your Doctor, advise him/her of changes in your symptoms.

Be well.
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465464_tn?1211646774
Hello,

I found your answer very usefull for my situation. It was really of great help.

Thank you very much.

José
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Avatar_n_tn
I too am a long time sufferer of pvcs/pacs.....also an avid runner - about 40 miles per week with resting heart rate of 44bpm.  In excellent health....noticed a slight difference in this problem....sometimes, out of the blue my heart will beat like 3 quick beats in a row, followed by a pause....then 3 or 4 more quick beats, etc.....I usually cough real hard and it seems to get back in normal rhythm.....anyone else out there have this happening?
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