Ideopatic PVCs Disappeared?

[Chiquita37]

I am a 37y/o healthy female mother of 3.  A year ago I started having PVCs, lots of them.  Having a scientific background, I started looking for a reason.  Around a year ago, I had undiagnosed Mononucleosis.  I was also under a lot of stress because one of my daughters was at the Hospital, where I spent 2 weeks without sleeping well.  Around the same time I went to my cardio who prescribed Atelonol in a very low dose because of the PVCs that I was describing.  Well, after 2 weeks on Atelonol I started having more PVCs.  Since then, they have always been there with me.  I have tried everything including eating healthy, exercises, quitting chocolate, coffee, tried Lemon Balm tea, Magnesium...etc.  I still drink wine occasionally and work under a lot of stress. A 24 hrs holter back in April showed 8,000 events, but another 24hrs holter in November showed 15,000, about 800 per hour.  My doctor was concern on the appointment.  After this I cried for a weekend.  I consulted a personal coach and talked about my stress at work.  On Monday, instead of the crazy PVCs, I only had a few at night.  Then I have not felt any since Monday.  That is 3 days without then.  It is weird because after hating them now It feel that I expect one after every heartbeat.  Well, once again I am looking for a scientific reason for them to stop.  I am afraid of doing something that would start them.  What could had been?  I have a doctor appointment tomorrow (Electrophysiologist) and I am scared.

[itdood]

The root cause of PVCs is something called "enhanced automaticity".  try googling "heart enhanced automaticity" without the quotes and read up on that.  There's much information on the subject.

If you search for "Rogaine Heart PVC", you'll see a lot of posts, some of which are legit medical boards posting notices that palpitations are a side effect of Rogaine.

One explanation is that Rogaine was originally developed as a high blood pressure medication. Rogain's action of high blood pressure control is by making the smooth muscles of arteries relax, called vaso dilation.   However it failed clinical trials for HBP control.  It was then discovered to promote hair growth and was repurposed.  The vaso dilation is probably what is making your enhanced automaticity worse, probably coupled with your other life-style issues such as high stress.   It's basically making some pacer cells in your ventricles more twitchy because the there is more free blood flow by the vasodilation.   Also, there is warning about using beta blockers and rogain at the same time.  Personally I think beta blockade is USELESS for controlling enhanced automaticity (a.k.a. ectopic heart beats).  My opinion here is probably a bit too strong :-)

[Chiquita37]

Oops forgot to address it correctly.  It is a great feeling not to have PVCs. I am glad that you were able to find your trigger.

[Chiquita37]

Thanks for your comments.  I would be cautious with the tea.  Regarding the Rogaine, I am thinking about posting a complaint to the manufacturer.  I would like to hear their opinion about my PVCs. It is interesting how "harmless"drugs can cause so much damage.  I would encourage everyone with PVCs to think about everything that has changed since they started having PVCs.  It could help to find a possible trigger.  I am certified coach myself and I'll be willing to help anyone to move forward.  It helped me.

[Madge270]

One more thing.  Lemon balm tea probably wouldn't be a good idea for those with heartburn issues.  I grow and sell herbs at markets all summer and I sell a lot of lemon balm. It's a wonderful herb, but I use it sparingly because it's a member of the mint family. And mint is NOT good for acid reflux. It's great for irritable bowel problems, but is a trigger for heartburn in many people. So, I no longer can drink lemon balm tea.  I sneak a little into soups and stews to get the benefits of lemon balm's immune system-strengthening, but I don't use a lot.

[Madge270]

This may not be a matter that would concern you, but for me the trigger that caused PVCs appears to have been Nexium for acid reflux/GERD.  I was on it from 2005 until 2008, when I began tapering off because Nexium costs so much. On the off days, I just used Mylanta cherry for heartburn (calcium and magnesium only).  Eventually I only took Nexium every four or five days and had reduced the dosage to 20 mg. when I did take it.

As I took less Nexium, my PVCs (which had been about 8000 a day), began to lessen. My doctor suggested trying to get off Nexium completely,  and not to take other prescription acid blockers such as ranitidine or Pepcid. He said to use DGL licorice (couldn't because it gave me diarrhea) or just watch my diet and use the Mylanta tablets.  He also had me take a low-dose calcium/magnesium/ vitamin D3 tablet each day.
I've been totally free of PVCs since January of 2009.  I've had stress tests and have been monitored.  No sign of them.

The doctor says there's now some research that suggests that long term use of Nexium or other PPIs (and possibly H2 blockers like Pepcid)  can eventually cause your body to have low levels of calcium, magnesium and some B vitamins. Supplements work for some, but  not for others.

Magnesium is necessary for normal heart function. Calcium is necessary for strong bones. My doctor thinks that, since I  now have more magnesium available to my body, my heart is able to function without PVCs.

I subscribe to Public Citizens "Worst Pills, Best Pills," and in a recent issue of that newsletter, heart arrhythmias (caused by lower levels of magnesium in those taking PPIs like Nexium) are definitely a side effect. Sometimes the PVCs can be serious or fatal.  Calcium depletion, kidney damage, and low levels of B vitamins  are also side effects.

I know that every person is different, but I just wanted to mention this, in case some of you with PVCs that seem to have  no apparent cause (and who take prescription medication for frequent heartburn) might want to discuss this with your doctors. I can't be totally sure that Nexium was the culprit, but it certainly looks like it was.

[Chiquita37]

Thanks for all the advise.  I will definitely think about not having the ablation, especially now that they "disappeared".  No more Rogaine...rather go bald.  I am very happy about feeling better...hope it last.  Take care you too.  

[MichelleP_3811]

If they have essentially stopped I would definitely take that into consideration before an ablation.  The key to a successful ablation is they have to induce/ trigger the problem.  If the irritated spot has settled then they will not be able to map it and see how and where the signal is going off.  If they can't map it they can't ablate it.  People have gone in for hours without success and it is a very expensive procedure.  I also find it odd that they are giving you an event monitor.  Event monitors generally work for sporadic hard to catch events.  You wear the monitor only to hit the record button when you have symptoms.  The monitor only holds two recordings and then you have to phone the recordings in.  I would think with pvcs you would be dialing in constantly.  A holter that monitors your heart all day long is a much better option.  But the event monitor is generally used to catch svts (rapid heart beats).  Do you by any chance fall into a super fast rate during some of your pvcs flare ups?  The pvcs are a big trigger.   I had an svt called avnrt and my heart rate would beat at upwards of 230bpm.  The svts are easier to fix because they originate from an isolated spot likely due to some extra fibers as opposed to errant cells.  I would ask the cardiologist why they are giving you the monitor especially since you had a holter in november.  The reason I question it is my pvcs triggered my svt.  Do they think you have an svt?  I wonder because with as many pvcs as you are having I would think you would be conscious of the rapid heart rate likely having a lot of episodes yourself.  It's possible wpw syndrome is involved but even then the lower fast rate of around 150ish I would think still would be felt. In any event, do take some time to truly consider the ablation.  Do some research before you take it on.  Take care and stay well.

[CFS56]

Yes, Rogaine can definitely affect your heart.  My husbands cardiologist told him not to use it.

[Chiquita37]

Experience makes science ;-).  Thanks for posting.  Another successful day w/o PVCs.  I just thought of something else that I stopped doing.  I am not longer taking Rogaine for hair loss.  Could that be my trigger?
Doctor suggested ablation today - you were right - but before that I will carefully think about that.  Also, he ordered the 30 days monitor.

[MichelleP_3811]

Just to be clear this is the members section so most of us are people just like yourself trying to figure this all out so our science is not necessarily from a professional angle but rather experience.  I discovered I had pvcs after I had an ablation for an svt.  At about 6 weeks past the ablation my pvcs went crazy bad like yours.  I got really sick had trouble sleeping, eating and just functioning in general.  It seemed everything I did triggered them.  I went back to the doctor who assured me they would pass.  They settled down to a more manageable amount.  I can now see a little how they get triggered.  For me there are a couple of key triggers, my breathing or breathing shallow and stomach issues and stress/adrenaline.  Interestingly enough the pvcs triggered by stress or breathing too shallow don't bother me as much but the ones triggered by stomach issues are a real bother.  So ultimately there can be any number of reasons why they get triggered.  Interesting though in your case, they have eased up now that you have seen the doctor?  This could be coincidence or it could be that you have been stressing about them thus keeping yourself in a vicious cycle of having them.  It happens to a lot of us.  What I will say is if you are offered an ablation, mine wouldn't even consider it unless I was having more than 20,000 a day, but if you are offered one take some time to contemplate if it is the right choice.  Ablations for pvcs have mixed success results.  If you have pvcs coming from different areas of the heart it is almost impossible to get all the irritated spots.  And there are cases where ablations have made the situation worse.  It's a tricky condition to correct with ablation but use your best judgment on what to do.  Good luck with your appointment but I think it is encouraging that they have slowed down a lot for you.  My EP didn't think mine would ever go away though others have expressed that they can so the fact that yours did slow down is a good indication that they may be manageable for you.  Take care and keep us posted on how you are doing.