Increase in PVC's

[7318]

I have a long history of occasional PVC's (25 years), have been seeing a cardiologist every 6 months for the past 10 years. I have a stress echo about every two to three years. I have probably had at least 25 or more EKG's in the past 20 years, at least 6 nuclear and stress echos, have worn Holter Monitors on 4 occasions and have been told that my heart is completely healthy. However at times, I have episodes of PVC's, to include bigeminy and trigeminy that may last for several hours, which makes it almost impossible to sleep or function. I take 400mg of Acebutolol daily, but I still have the PVC's. I am so frustated and the anxiety is causing a real problem. Does anyone have any advise, as this situation has affected my whole life in such a negative way. I have seen three cardiologists and numerous other doctors, and they all say to just try to ignore the PVC's and go on with life, but that has become very difficult to do. I am 59 years old, have never drank nor smoked, exercise regularly, do not use caffeine. Can anyone please give me some reassurance?

7318

[Madge270]

You are right on about beta blockers, itdood! I have over 8000 PVCs a day, but usually only feel them after eating  or when "slumping" in a recliner or chair, where I lean back.

My local doctor tried to get me to take metoprolol, but my EP cardio doctor said not to unless I really needed it. He reasoned, as you do, that since I have more PVCs when my pulse is slower and they lessen when my pulse is in the mid-eighties or higher, why slow my heart down and have more PVCs?  I do feel the irregular beats some, but if I walk a little or get busy doing things,  they lessen  and I don't notice the PVCs much.

[CFS1]

I have had the identical experience you are having with PVCs.  I felt like they were totally taking away my life.  I was on atenolol for 3 years and I really do believe it made my PVCs worse.  I was switched to bystolic, I pretty much need a beta blocker because I also have episodes of A fib and SVT.  But anyway, fingers crossed, the bystolic has seemed to decrease my PVCs as long as I don't take a dose more than 5 mg.  It works much better for me than atenolol or lopressor.

[questionnone]

I am going to ask my EP today about Beta Blockers causing more PVCs because I think so too! I have felt my pulse with my hand on my chest when beta blockers are effective and do notice that my heart rate is slowing down but it also feels like my heart is having a hard time pumping, then I get PVCs. I get them quite often now. For the first few weeks on the beta blocker I guess I didn't notice them but these last few weeks I feel them all the time, like a thump in my chest as if I were getting the wind knocked out of me or something. But what do you think happens when someone has a tachycardia that requires a beta blocker to protect the heart? It's like trading a tachycardia for PVCs and we all know that if you get big amounts of PVCs it does damage to the heart.

[itdood]

Hi, I have the same issues as you.  I have benign PVCs.    Your comment about you taking a beta blocker and not trying other types of strategies stands out to me, so I'll focus on this.  I'm not a big fan of treating benign PVCs with class II antiarrhythmics like a BB.

The main reason I think beta blockers are useless for PVCs (or can make them worse) is because of how benign PVCs occur and how beta blockers work.

Benign PVCs are usually the result of Enhanced Automaticity.  Some backup pacer cells in your heart are too excitable and fire when they shouldn't.  One of the triggers for these to fire is a slower heart rate.  Beta blockers slow down your heart rate, therefore may provide more opportunity for ventricular pacers to kick in.

Docs prescribe beta blockers for benign PVCs if the PVCs are bothersome.  There's no clinical reason to do so and in fact is an off-label use.  The theory is that they reduce the contractive force of the heart so you might feel them less.    There's the possibility though that the beta blocker also creates a scenario that favors PVCs (slowing down the heart).  It's quite common for people to report increased frequency of PVCs on beta blockers.  

But, there are some who've found meds that work for them.

The conclusion to my brain dump, and I'm surprised you haven't done this earlier, is that you should tell your doc that the treatment strategy you're on isn't helping.  Work with your doctor to figure it out.    Remember to never stop or start a medication without first talking to your doctor.  Also, if you've been taking this BB for a long time, it may be tough coming off it as you will rebound.  You must be weaned off it or taper with a replacement med.

[cindy707]

Jerry?  Itdood?

[Carey01]

Boy do I know ho wyou feel -- same story on my part.I have tried EVERYTHING and they really jsut have a mind of their own.  I am dealing with being in a pattern of them daily right now and the Dr is changing my medicine to Biostolic for HBP and the skipped beats.  Do you take anything for yours?