PVC's, PAC's, Sinus Tach

Hi!

I'm in desperate need of some guidance. When I go see my cardiologist I always forget to ask questions and I feel like a bother calling to ask. As background information, I'm a 26 year old white female at normal height and weight who is moderately active and eats a good balanced diet for the most part.

For the past 4-5 years I've been dealing with episodes of Tachycardia, PVC's and PAC's. I've had an echo, echo stress test, several EKG's and 2 holter monitor placements. All have come back fine- just showing sinus tachycardia at around 140-150.  I've been told time and time again that what I am experiencing is completely benign. I'm currently taking between 20mg Propranolol 2-4 times daily. I've also recently starting taking Xanax 0.5mg 2-3 times daily to see if it helps the palpitations.Even with the medication, I can experience a few skipped beats in a minute. Some are so forceful I can feel it in my toes.

My questions are as follows:

1) Sometimes I produce 100's of PVC's/PAC's a day- could they ALL be attributed to anxiety? I feel like its a catch 22. The "skipped beats" cause the panic which in turn causes more palpitations. Could 100's of these be caused by anxiety alone?

2) At what point is an ablation warranted? My cardiologist says she feels that it would not want to pose a real risk via ablation procedure for something she is sure is benign. The notion is completely logical for me but the anxiety the palpitations cause me seem psychologically malignant. While they are not "technically" physically restricting or ailing- I'm certainly not enjoying my life to it's fullest because of these palpitations. All I want to do is sleep when I'm experiencing them because they scare me so much.

3) I noticed that all of this started after stopping Adderall (adderrall) which I had been on a high dose of for approximately 2-3 years. Could a drug like that cause any permanent damage to the heart which would cause these palpitations?

Thank you so incredibly much in advance.

[jkfrench]

Well I was just talking to a friend about this.  I really believe that anxiety can cause these to be so much worse than they need to be.  There must be some part of our brain that just responds to flight or fright.  When I have a skip that feels different than my normal skips (like the quick double beats I have been getting), I get scared.  My brain doesn't know if I'm scared because someone is pointing a gun at me or what.  It just understands I'm frightened and then releases adrenaline.  It is a vicious cycle.  If we are really in a "sensitized state" then it doesn't take more than a thought to trigger the release.  I think that is my problem now.  Because of hormones and perimenopause, my heart skips have increased.  I am also have more of the double beats that I think are pacs because my holter showed pac couplets (but very few).  Now they have increased as well as my pvcs.  So I'm getting all kinds of fluttering.  I'm glad to see you are trying the xanax.  My doctor told me to break a .025mg in half and take 1/2 in am and 1/2 in pm but that is not working so I think I will just try taking a whole table every 8 hours as he originally wanted me to.
If they continue to get worse, then maybe it is the xanax.    I also get hundreds in a day.  Then I can have days with just a handful.  Unfortunately those dyas are few and far between and my heart is not giving me enough time to stop the anxiety cycle.  I see my other doctor on Tuesday and I am going to ask her for something to help.  My doctor won't even discuss ablation.  He said I"m just not having enough.  But who knows, they just see a 24 hour report.  One day can be blissful and the next is horrible.  Then  you worry, well he hasn't seen that yet.  It hasn't been caught  (flight or fright).  = anxiety.
I feel sorry for our doctors sometimes.  They just have a hard time getting through to us.
My heart is skipping as I am typing this.   You are not alone.
Jodie