So does anyone really know what the "normal" amount of PVC's/PAC's per day would be? I have read that isolated is okay but I really can't find out how many "isolated" is??? I get around 50 thumps, skips, blips or whatever you want to call them and I think that is quite a few but I really don't know? Anybody really have any hard evidence what occasional or frequent is??
Isolated = not coupled (paired), in other words single PACs or PVCs. Nothing to do with numbers.
I guess my answer is like all the others. I believe there isn't any maximum number, and in healthy hearts, single PACs and PVCs are treated due to the symptoms, not that they are dangerous.
50 is nothing. That's about what I usually have and what my Holter confirmed. Though the last three days I've been working 12 hour days and my father just surgery on the aorta. I guess I'm at about 300 a day now. It's really annoying and I'm about to go crazy. I have PACs, not PVCs but they feel just as annoying.
Different Holter programs have different definitions of rare, occational, frequent and very frequent. I guess the ranges are approx:
Rare: <250 to 500
Get a work up done...at least have an event Holter monitor study to determine what they are.
I have benign PAC's/PVC's and the number varies from episode to episode and day to day. All my test come back normal..echo, stress, CTA scan. Normal is reassuring but during an episode not very comforting. I would worry when they begin to interfere with normal routine.
My holter from 2009 state 288 pvc's and it was recorded as occasional on the summary printout.
So it makes you wonder. However, EVERY doctor I have talked to about this say the number doesn't matter as long as your heart it structurally normal.
Sorry, some parts of my post fell out, not really sure why.. Probably a bug somewhere.
>10.000 are considered very frequent I think.
If <250 are rare, 251 would be considered occational, so that would match with the post by Jkfrench.
Well, I'm not sure how significant PVC couplets are. From the book Zareba: Noninvasive electrocardiology in clinical practice (great book by the way, especially chapter one, can be downloaded from Google Books) PVCs aren't considered a risk factor without the setting of heart disease. The scale by dr. Bernhard Lown applies to those with CAD, it goes as follows:
0: No PVCs
1: Rare PVCs
2: Occational/frequent PVCs
3: Multiform PVCs
4: a) Couplets, b) triplets
5: Early PVCs
My cardiologist told me that even early PVCs aren't a risk if the heart is healthy.
By the way: I visited my dad in the intensive care unit yesterday (after aortic surgery) I was sitting there keeping an eye on the EKG monitor for a couple of hours. He actually did have a PVC couplet. None of the nurses or doctors reacted, so I guess this phenomenon isn't so bad.
I didn't put down Lown Grading System because it's been contradicted, and articles say in modern medicine it is of little clinical value these days, but at least it does give us something to go by. http://www.ncbi.nlm.nih.gov/pubmed/7446410
I found a few different Classification of Arrhythmias - Just remember as Is_something_wrong says - the Lown Grading System was used for ventricular arrhythmias in studies of ischaemic heart disease http://www.ncbi.nlm.nih.gov/pmc/articles/PMC482587/pdf/brheartj00184-0097.pdf
Grade 0 = No premature beats
Grade 1 = Occasional (30/h)
Grade 3 = Multiform
Grade 4 = Repetitive (A = Couplets, B = Salvos of = or > 3)
Grade 5 = R-on-T pattern
Simple - 0 = no ventricular premature beats (VPBs)
1A = < 30 VPBs/hour and < 1/minute = < 30 VPBs/hour and occasionally ? 1/minute
2 = 3 VPBs/hour
3 = multiform VPBs - Complex
4A = repetitive VPBs - couplets (2 in a row)
4B = repetitive VBPs - runs of ventricular tachycardia (3 3 in a row)
5 = early VPBs - R on T
What I find interesting is; I would be in 4B Grading here, because I have not seen that I have R on T or early VPBs that I know of, but also would be graded as 3 because of multiform complex pvc's but you can only be in 1 classification and each article says alittle bit differently than the other.
One article also says they found that paired ventricular extrasystoles and ventricular tachycardia had more prognostic significance than R on T ventricular extrasystoles. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC482587/
I hope one day they will listen to patients and do something similar for patients with no ischaemic heart disease, as of yet I haven't found anything.
Funny thing is, you won't find ONE doctor that actually tells you what's "normal" amount of PVCs / PACs and what's abnormal.
I guess one reason is that if they do Holter tests, they do them for a reason. I don't think they see so many Holter tests from people without palpitations.
In addition, premature beats are usually a benign phenomenon.
Some examples: My uncle "suffers" from a ventricular parasystole. Which means that when his heart rate is below 100 or so, he experiences a PVC for every fifth heart beat or so. That would be 15-20.000 PVCs a day. The only time he notices them is when the doctor tells him.
My girlfriend "suffers" from PACs. If I'm checking her pulse, I can feel 2-5 PACs (double beats) a minute. I don't think she even knows what a PAC is.
On the other hand, I'm suffering from PACs. Like I mentioned above, my Holter said 50, and yesterday, along with all the stress, I think I had 300 or so. They cluster up when I'm calm and my heart rate is below 60. I hate them. I notice every single one.
The closest I can get to an answer is this article:
Well, I suppose the bottom line is that no one every truly knows what your heart is doing unless being monitored all the time. I have quite a few pvc pairs. For all I know others that live to be old and helathy also have them.
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