PVC's, Beta Blockers, heredity

[lizziejane]

I am a 61 year-old woman who first noticed "skipped beats" (pvc's) when I was about 10 years old.  I developed bouts of tachycardia (which triggered some agoraphobic symptoms) after my first pregnancy about 40 years ago.  The arrythmia has increased with age, and I no longer seem to have periods of being free of pvc's for more than a day or two, and only occasionally.  Right now, I experience them daily, and quite frequently, about 5-8 per minute. About 17 years ago, I had a bad case of bronchitis/pneumonia, and that is when my arrythmia took a turn for the worse.  I ended up in the emergency room with tachycardia, pvc's, and bouts of bigeminy.  The workup included an echo, holter, and blood work.  I was placed on Propranalol, which I still take (20 mg. 4 X a day).    I don't experience dizziness or shortness of breath. However, they get much worse when I lie on my left side, when I am ill or stressed, or after a rich, fatty meal.  I am able to go about my daily routine, and I continue to work, but I would love to be free of this condition that has plagued me for most of my life. Strangely, taking a Bufferin sometimes diminishes them for a while.  My father also had this condition, and ended up with atrial fib in his 60's.  As a result he died of a stroke at 71.  My two daughters also have frequent pvc's.Questions:  (1)  Propranalol seems to have lost its effectiveness, and I am wondering what might be a more helpful medication.  (2) Can having pvc's, bigeminy, etc. for so many years lead to heart failure? (3) Is there any research that has been done on a hereditary connection?  (4) How successful is ablation, and at what point should it be considered?  (5)  Are there any supplements that may help? Thank you.

[Momto3]

I agree with Celeste77....She's given you some great information!!   Here are a few additional comments from a former high frequency pvcer.  I am also polymorpic, but it was determined that I had 2 predominant foci.  I had 2 ablations and today, only have what I call "typical" periods of pvcs.


1) I ran into the same problem with propanolol after taking it for many years.  I took 80-100mg daily in varying doses over the years.  Has your doctor ever mentioned the long acting form?  It is in a time release capsule so you only take it once/day.  Oddly enough, I came to a point where the Inderal was most effective when I took 20mg "as needed."

2) In my case, pvcs did lead to cardiomyopathy.  It was discovered during an annual echo.  As Celeste indicated, it can happen when a person has tens of thousands of PVC's daily for a period of time.  I was so used to having the pvcs that I have no idea if their frequency changed, but I did end up with CM.  Ablations took care of the pvcs and the CM resolved.  

3)  I agree that there is probably a familiar tendency.

4)  Ablation was not really a highly discussed option until I ended up with CM.  Then, more aggressive treatment became necessary.  I had the option of taking anti-arrythmics (tried flecainide and rhythmol, both effective) for the rest of my life (I was mid 40's at the time) or trying ablation(s).

I had two procedures because the foci were on the left and right side of my heart.  

5)  I've never taken herbal supplements or magnesiun, though my electrolytes were monitored.  They were at normal levels so I never supplemented.  Ironically, a few days before the second ablation, my potassium had dropped a bit.  Cantaloupe and bananas and I was ready to go : )

Good luck and hope you are feeling better!

Connie

[Celeste77]

I'm 43 and I'd love to be free of this condition also! I have multiform (3 foci) PVC's and have been plagued with them daily at a rate of 5 to 30 a minute for about 13 months now. After 23 years of them off and on, I am still struggling with the anxiety and stress they can cause. Like you, they are worse when I'm ill or stressed and after a rich meal, but I find some relief when laying on my left side.... Other triggers for me; heat, menstration, MSG and aspartame, too much sugar.
I've been pushing for an ablation, with some luck, I'll have one before the years end. :)

Here's what I know concerning your questions:

1) I believe it's all trial and error when it comes to which beta might help an individual.
Sectral (Acebutolol) is the only beta I know of that lists PVC's specifically on it's indication list.

"Acebutolol hydrochloride capsules are indicated in the management of ventricular premature beats; it reduces the total number of premature beats, as well as the number of paired and multi-form ventricular ectopic beats, and R-on-T beats."
In one study I read, it showed a 70% reduction of all forms of PVC's in about 650 patients.

2) PVC's can lead to Cardiomyopathies in very rare instances. Case reports show that it happens (rarely) in some patients that have tens of thousands of PVC's daily over many years. Treatment consists of ablation and meds which usually clears up the cardiomyopathy in most cases.

3) I've never found any research showing a hereditary connection, although my Cardio believes there might be a genetic componant that makes one more prone to high frequency etopics.  My deceased grandmother, my mother, 2 brothers, my daughter and myself all had/have high frequency polymorphic symptomatic PVC's.

4) Ablation is usually reserved for those with 10's of thousands daily and those who are extremely symptomatic with little or no tolerance/success with meds like Beta's or Class III antiarrhythmics  like Flecainide.
I believe the success rate is around 60% on the first attempt. Unfortunetely, it's not unusual for one foci to be ablated only to have another one start up.

5) I've had some success with liquid magnesium (pills are very hard for the body to absorb), higher potassium intake (food) and staying hydrated. I've never been brave enough to try herbs like Hawthorne, but I've read that it does work for some people.

I hope this helps alittle and I hope you find some relief from these nasty PVC's soon!