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PVC patterns and pattern changes - significant? What are yours?

Hi everyone,

So, 4 months ago out of the blue I started getting PVCs at around 8000 per day. They initally thought pacs, but confirmed PVCS after all the usual tests (which otherwise said I was okay). I was told they were 'fascicular' in nature, although i've no idea what this means in practice...

Anway, I got them continuously around 6/minute with no let up or change in frequency irrespective of exercise or rest (although they stopped briefly at high heart rate levels).

Over 3 months they remained continuous for week(s) and then suddenly out of the blue from one second to the next dissappeared entirely for a few days to a week (even the Holter showed a day with lots of spikes and then suddenly zero from 3pm the next day!). Then they would come back again continuously for many days again - this pattern continued so they were on/off for days/weeks each. Exercise or rest made no real differency (although I didn't notice them at high heart rates). Is this pattern common to anybody?

Anyway, the last month has been different. They have been on or off at different times during the day in opposed to for days or weeks. I always wake up without them, then 10 minutes in to my walk to work they come on and probably remain a hour or two after I reach my office desk. If I go to the gym to do some weights at lunchtime, they start again some minutes in to my programme and remain most of the afternoon. I usually do not have them in the eveings after I have been sitting in front of the TV for a few hours! So I get them every working day to varying degrees, but at weekends when I do no long walk etc I can sometime get none at all. Regardless, when they are "on" they are always at the rate of around 6 per minute.

So the new pattern seems to revolve around them starting suddenly when my heart reaches "medium" levels and then hanging around some hours later until I have had lots of rest.

Does anybody else have their PVCs *start* during exercise?

Would be interested to hear others patterns I hear about poeple having them for month or years but am never quite sure if they are talking about "non stop"...

Regards
8 Responses
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967168 tn?1477584489
I've had fainting episodes brought on by physical exertion my entire life; I can't tell you how many times I fainted running, walking or things like moving furniture, boxes etc sometimes it's been with arrhythmia's and some times none at all so it's a bit complex what my triggers really are.

They think from testing that I was possibly going into VTach/VFib episodes back in Jan 2009 but there's no way to know since I didn't get testing done before July 2009 [grumbles about dr's]....

How it started for me was feeling like my heart was quivering not really beating and not like normal pvc's I'd had...very difficult to explain - it's the weirdest feeling I've ever had and feeling a searing bursting pain.

My first really scary episode was driving home from taking my son to school and feeling pain then I fainted; ran off the road and woke up disoriented.  It happened again 2 or 3 more times in Feb & March 2009 when we were out walking at night; same thing and I fainted.  

It didn't happen again until July with my stress test; then in August with my EPS - I felt the bursting/searing when he started and tried to sit up and yelled for him to stop; just brings back bad memories so I won't go into great details.

I've had VTach episodes since my ICD implant so I know what they feel like now and pretty sure that's what it was.
Helpful - 0
Avatar universal
mom2four,do you think that if you did not get the ablation,that you could have went into a V-tach cardiac arrest? that was so scary that they were able to induce the V-tach so easily.
Helpful - 0
967168 tn?1477584489
I've had some type of arrhythmia off and on for about 35 years since age 9 along with fainting episodes sometimes with arrhythmia's sometimes completly unrelated - no rhyme or reason.

everything under the sun was blamed; drs said I did it for attention, not eating, stress, anxiety, not sleeping, gaining weight, exercising too much aging etc etc

I ignored it all my life and trusted dr's never thinking anything could be wrong with me.  There wasn't anything I let interfere with what I wanted to do, when I had bad episodes or fainted I just waited till they were over or pushed through them.

I had my first EKG in Nov 2004 that showed nothing; not even palps even though I was having them daily and even during the test as well as shortness of breath and chest pain.  Then I had another EKG in April 2007 that showed I was in bigeminy and some other minor things but I was told it was all "normal".

I broke my foot in June 2009 and my primary did a full exam.  He heard what he thought were valve problems and pvc's and did 2 types of EKG's and sent me to a cardiologist.

Tons of testing later I found out I was having 50,000+ multifocal pvc's, VT runs and problems with my exercise stress test and I fainted.  I saw 3 Ep's because the first one told me if I didn't have an ablation I would most likely go into heart failure but I didn't believe him; the 2nd one said my pvc's were no problem everyone gets them; here's a magic pill (Toprol) which put me in the ER, 3rd EP said yes they were a problem I needed an abltion.

I had the procedure done and found I had dangerous arrhythmia's (polymorphic VT) went into "VTach, VFib and VF arrest during the procedure.  It wasn't until I had a cardiac cath they found what they thought was causing the problem (HOCM) and had to have a pacemaker/defibrillator implanted after ruling out ARVD/C.

I think the weirdest thing for me is to wrap my mind around the fact before abltion I had rare pac's/psvt and very frequent pvc's/vt but after ablation, my pvc's went away for awhile yet I developed quite a bit of pac's and psvt/svt then my pvc's/vt came back full force.

If you read in the dr's expert forums http://www.medhelp.org/forums/Heart-Rhythm/show/91 http://www.medhelp.org/forums/Heart-Disease/show/114, you'll find the dr's say pvc's are nothing more than a nuisance until they become very numerous >15% daily or roughly 15,000 pvc's daily, then they may cause some problems.

VT (>3 pvc's in a row w/HR at least 100 bpm) most often occurs in the presence of demonstrable structural heart disease; but in structurally normal hearts it's usually benign and can be tolerated well even if it is scary to hear the word "VT" some use the word "VTach" which I wish they would remove from the medical dictionary  =)   it's just too often misunderstood.

Tachycardia rates between 110 and 150 may be tolerated even if sustained for minutes to hours. However, faster rates >180 beats per minute may cause drops in arterial pressure and produce syncope.

Very fast rates (>220) are imminently dangerous because they rarely terminate spontaneously and invariably cause drops in blood pressure and low cardiac output.

This is why it's important to have a full cardiac workup to check the structural parts of the heart just to be safe; have a complete blood workup including electrolytes and to find what may be the cause or triggers.
Helpful - 0
1807132 tn?1318743597
I have just discovered I have pvcs.  I was ablated for avnrt about 6 weeks ago.  Prior I noticed fluttering but always thought it was related to the svt I had and I figured that they would go away once that was fixed.  Then last week I started to get the flutters that lasted actually until today so about a week.  They were pretty intense maybe somewhere around 20,000 and by the end of the day I was in terrible pain.  I am new to them but what I can tell so far is that mine are likely adrenaline based.  When I get super busy and stressed I was falling into svt daily which was actually being triggered by the pvcs though since the svt overshadowed the pvcs I did not realize that was what was happening.  But now that I had the svt corrected the pvcs started up and got stuck like the svt use to.  And I have to say I kind of found the svt to be less annoying.  At least that would only last from a minute to the most an hour or so.  This all day thing is just awful.  In any event, I think if they persist for days or more that means there is some sort of reentry going on with the signal being stuck.  For me everything ramped them up.  If I stayed in one postition there were fewer of them but if I changed any sort of postion they would pick up, from laying to standing or vice versa.  Bending, leaning, running, eating actually can trigger them for me.  I think for me that the irriated ventrical cells that are miss firing must be somewhere near the stomach and thus get set off when the stars align just right and I have maybe a gassy meal or something combined with hightened adrenaline. I was so sickened by having them for 5 days straight that I could no longer eat and basically had nothing to eat yesterday and lo and behold today they have gone away so maybe I just needed to let the area settle down.  Not sure if that would be the same for everyone.  Not sure if that will work for me in the future since this was my first prolonged episdoe and I don't have enough experience with them yet.   However, I was told by my doctor that with distance from the ablation I should get to a point where I don't notice them though I am not sure if that will be true or not.  Time will tell.  I was also told that they will never go away because once the cells are damaged they stay damaged so it is matter of finding your triggers and avoiding them, sometimes easier said then done and then maybe trying to find what works for you to get them to stop cycling.   But supposedly unless they start to beat more than 3 in a row they are of no consequence and should have no adverse affects on the heart though our sanity who can say.  
Helpful - 0
Avatar universal
Hi I have them since years,but the last four months has been miserable non stop everyday all day long,check everything,but lately I have them for hours and stop and start again.this week when laydown I dont have much or non,but whe I get up or walk or do anything they start again ,so I guess we are in the same page of frustration.  And I can feel every single one high frecuence and low.

Helpful - 0
Avatar universal
Hi I have them since years,but the last four months has been miserable non stop everyday all day long,check everything,but lately I have them for hours and stop and start again.this week when laydown I dont have much or non,but whe I get up or walk or do anything they start again ,so I guess we are in the same page of frustration.  And I can feel every single one high frecuence and low.

Helpful - 0
1839422 tn?1319661709
I never have the same pattern there always different every day.  I have tried to see if it pertains to anything I eat or do it does not.  I know the I get them after I have eaten.  I am on BB acebutolol for them because they make me anxious.  It seems to lighten the load but does not take them away by any means.  I get mine after food. No matter what I eat.   Its scary but all tests point to good health.  
Helpful - 0
1703392 tn?1307450500
I have episodes of PVCs usually post exercise or after something physically demanding. They usually start up 2-3 hours later. Sometimes it's just a few; other times they happen every other minute and last for hours.
Helpful - 0
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