PACs - Scaring me big time

[SkippedNotesPA]

Hi everyone-

I've been lurking here on and off for a few months and I have found lots of your stories to be inspirational.. It's oddly reassuring to know that there are other our there who are dealing with things like PACs and PVCs and are surviving and in some cases thriving.  I have been diagnosed with PACs, and up until a few days ago, I thought they had gone away, but alas, they just came back with a vengeance, and I am a combination of scared, annoyed, angry, and confused.  I'm going to take a few paragraphs and tell my story.. hopefully someone can read it and let me know if they have a similar story or some advice...I apologize in advance for the long message!

I'm a 38 yo male with a history of anxiety and panic, which I have largely been able to overcome over the past 8 years.  However,  I ended up in the ER after calling 911 in March 2011.  I was feeling perfectly fine and then out of the blue my heart starting beating irregularly.  I had no pain, no shortness of breath, just skipping and thumping.  It was NOTHING like any of the panic/anxiety symptoms I have had in the past.  I was totally in a perfectly content and stress-free mood when the symptoms began.   After a few minutes it had not stopped so i called 911 and ended up in the ER, where I spent about 3 or so hours.  The heart monitors there did pick up an irregular beat, which the ER doc said were PACs.  He sent me home and said it was nothing to worry about, even though the irregular beats were continuing.  For the next few days I had near-constant PACs.  I could not sleep, I could not work, I could not do anything but worry about dying.

I went to my primary care doc the next day and he also said that while I did for a fact have PACs, I should not worry at all and just live my life.  To be safe, though, he sent me for an echo, an exercise stress test, and a 24-hour holter monitor, which happened a few days later.  Naturally, on the day of the tests, I was feeling better PAC wise, with very few of them.  I had the echo, then the stress test, both of which went great, and then I was fitted with the holter and sent home.  However, just as I was about to pull out from the cardiologist's office, the PACs came back in a big way.  I went back to the office and told the receptionist, who grabbed a nurse.  She ran an EKG on me and said something about "sinus arrythmia" and grabbed a printout and ran out talk to a cardiologist.  About 30 seconds later she came back in, smiling and said that the doc, who is their top electrophysiologist, said they are PACs and are nothing to worry about; she said that she expected they would see me again in the future and then I was sent home.  

I had the palpitations/PACs pretty frequently that night and next day, and the monitor did in fact capture them.  I went back to my primary care doc a week or so later, who told me the echo and stress test were normal, but that the PACs were again picked up by the holter.  I was never told how many PACs I had, etc, but again, that there was really nothing they could do.  He gave me some Xanax to help with the anxiety and that was about that.  For the next few weeks I had episodes, but eventually they mostly went away... until last week when they started again!

I was on a plane flying for business when they started on Monday (a week ago).  I had them for much of the week and then the last 2 nights I barely could sleep they were so bad.  I wanted to go to the ER, but then I figured they'd come to the same conclusion as last time and just tell me to relax and give me some type of anxiety med.  So now, I am wondering what I should do next.  Should I go back my my primary care doc and see if he has any new thoughts?  Should I just go talk to a cardiologist and see what he or she has to say?  Now that I am thinking about it, I realized that my primary care doc never sent me back to the cardiologist, even though the nurse said she thought I'd be back after they captured my post- stress test PACs.

I've been scared to exercise, even though I really want to and need to as I want to lose a bunch of weight and get into shape.  So I kinda of feel caught in a sort of purgatory here.  Are there meds/supplements that help?  Certain kinds of diets?   I generally avoid most caffeine since my early bouts of anxiety.

Any thoughts / comments / advice welcome!

Thanks for listening!

Keith

[IMFletcher]

Hi -

I have been suffering from PVCs/PACs for a long time - more recently the PVCs have flared up, and I am getting them constantly throughout the day...usually in isolation, but the frequency has increased over the last few months. I also have episodes where I get PVCs every few beats, and this can last for hours...very uncomfortable.

The more I read, speak with my cardiologist, and chat with others on this site, the more I believe we all have the learn to accept the irregular beats, and learn to manage our anxiety (I am sure if it was a benign muscle twitch in your calf, it would be much easier to ignore!!). I do notice that the busier I am, the less I notice the PVCs/PACs...An idle mid is usually the enemy!!

We all tend to hyper focus on the sensations that are generated by premature beats, and I believe we have inadvertently trained ourselves to "feel" everything that happens with our heart...Every doctor has informed me that benign ectopics are very common, and almost 100 percent of those monitored would have at least a few in a 24 hour period. If you have had all the tests, and been given a benign diagnosis, then you have to trust your cardiologist, or seek another opinion to be sure. I think we all need reassurance. It is the bad episodes that are very hard to ignore, and dismiss. The challenge is to learn to accept, and keep living our lives. Stopping exercise, or depriving yourself of things you enjoy will only diminish the quality of your life...staying fit and active is never a bad thing...

Try and avoid the common triggers, stay hydrated, and most importantly try to stay positive. There are so many of us who have the exact same problems, and you will discover several on this site have been dealing with premature beats for years. There are good days and bad days - just like anything in life. Benign PVCs/PACs are very common, and you have nothing to be worried about. Good luck, and I hope you are able to navigate through this. You are not alone!

[is_something_wrong]

First, yes, you need to avoid caffeine.

You have an almost classical description of PACs. I have them too. They can really ruin the life quality when they are flaring up.

If they are caused by adrenaline (stress and anxiety) which they usually are (even if you don't notice it), a beta blocker may be helpful. I'm taking that and my PACs are almost gone. At least that may be an idea to discuss with your doctor until you get your anxiety under control. Beta blockers (especially the nonselective ones) also have abilities that reduces anxiety (and are, in my opinion, better for the body than taking Xanax or similar benzo drugs).

Thank you for a great description of your PACs, this could have been my post 2 years ago :) I know it's easy to "understand" that the PACs are benign, but far worse to accept it when they are at their worst. As you probably know, 70-100% of us have PACs on a 24 hour Holter and sinus arrhythmia is a common, healthy and benign finding in young men and women. They can often be mixed up, though, so you believe sinus arrhythmia is PACs and PACs are sinus arrhythmia.

Try to lose attention to your heart and heart rhythm. Easier said than done, of course, but this is probably something you've had for a long time, you just pay more attention to it now, which again makes the PACs more frequent.