My chronic PVCs strictly accord to my diastolic BP point (which causes which?)

[MrGlitch]

Since the beginning of June, I've experienced up to 20,000+ PVCs per day. Some days I have them every 2 or 3 beats continually for 24 hours at a  time, non-stop. I've been to ER 4 times since 2009 for these things and I've seen two different cardiologists. I've tried metoprolol and propranolol - neither has helped. And I've experimented with eliminating and changing certain parts of my diet, as well as increasing my daily exercise routine. None of that though has seemed to result in a correlative difference in the misbeat frequency/patterns I'm experiencing.

I had an echocardiogram --ordered by the first cardiologist-- which showed my heart structure to be normal. And I wore a monitor for one week --ordered by the second cardiologist-- which, despite that it recorded my hugely frequent PVC's, she didn't seem to think they were life-threatening. Interestingly, this second cardiologist failed to listen to my heart with a stethoscope one single time during the two visits I had with her. I'm unsure whether that's something I should be concerned about.

I made attempts to express to both of the cardiologists I saw that there is one definite correlation I have observed about my PVCs. That is, that when my diastolic BP is higher (it will raise about 10 points periodically and remain there for a while), my PVCs entirely vanish. Then once the diastolic numbers drops back into the range that they usually maintain, my PVCs resume in plentiful form. Mind you, this is when I'm measuring my BP at home in private. I suffer from social anxiety, so when I go to a medical facility my diastolic BP elevates about 30 points so my PVCs then become virtually nonexistent. This has happened during my ER assessments and during my cardiologist appointments.

(Note: The following description is from when I am not taking medication and it has been out of my system for a long while.) At home, irrespective of my diastolic BP numbers, my systolic numbers are always 110 +/- 3 or 4. That seldom ever changes. But I still experience the two aforementioned states of my diastolic pressures. They are: a typically low range (55 to 59) which is present approximately 90% of the time. And an occasionally high range (65 to 71) which is present the remaining 10% or so of the time. Again, the high diastolic periods always correlate to no PVCs at all; whereas the low diastolic periods typically correlate to huge PVC flurries.

My questions are: 1) What does this mean? And 2) which causes which? Do the low diastolic periods somehow cause my PVCs? Or do my PVCs cause my low diastolic periods?

Any opinions will be appreciated.    

[itdood]

another idea, if you are using a BP machine and you're throwing 20% PVCs it might not be getting an accurate read on systole or diastole.

[MrGlitch]

Well, my systolic readings have been consistent (at 110 +/- 3 or 4) irrespective of my diastolic readings. But, yes, I've considered that the diastolic readings could be inaccurate because of the missing/subdued beats during my PVC activity. However, I doubt that they are and I'll explain why. I've been measuring my BP fairly regularly for a number of years, and doing so with two separate BP measurement devices. When I first started experiencing heavy flurries of PVCs in 2009, I started on a permanent regimen of cardio exercise. That resulted in my PVCs vanishing and remaining gone for nearly 7 years. During this period, my diastolic pressure was typically between 55 and 60 with a normal sinus rhythm. When my PVC flurries returned in June of this year, my diastolic readings were no different during the my episodes - still between 55 and 60. It's only in the past several months that I've noticed the occasional increase in diastolic pressure. Moreover, I never accept a reading if it's taken from a stretch of beats within which my BP measurement device's 'erratic heartbeat' icon has illuminated. So, I'm not yet convinced that the readings taken during my PVC episodes are untrustworthy.

[itdood]

Correlation does not = causation.    The root cause of your PVCs is most likely "enhanced automaticity" (EA).  Whatever is causing the EA is probably also affecting your diastolic pressure. Endocrine fluctuations or dysautonomia come to mind there.  Not that there's anything wrong with either, but the sensitivity is there and as these fluctuate it brings on EA and higher diastolic pressure.

[MrGlitch]

Agreed, correlation doesn't equal causation. But unless it's a consistently repeating coincidence --which is quite unlikely-- it could mean that there's an important connection between the two occurrences. I should have probably stated my question differently. Such as, is it possible that the lower diastolic pressure modes I normally experience are somehow triggering/stimulating/facilitating the ectopic signals and thus the erratic beats?

I understand from your reply that you believe it's more likely both my PVCs and my lower diastolic pressures are effects of the EA activity. So perhaps it's something like: said EA activity is triggering the extra contractions of my ventricles, then those flawed beats are in turn lowering my diastolic BP? If that's what's going on I suppose it begs the question of whether others experiencing PVC's as well have lower diastolic pressures during their episodes?

[itdood]

I'm guessing but it seems to make sense that having a lot of PVCs would lower blood pressure because it's not as efficient.    In all my travels and research I haven't heard anything like that but I see what you're saying.