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PVC's after exercise
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PVC's after exercise

I know that this is a question that has been asked a lot but it still is confusing to me.  Do pvc's after exercise mean an increase risk of cardiac problems.  I have had a full work up.  Holter, electrocardiogram, blood tests and a stress test and everything came out normal except for the pvc's.  I had pvc's after the stress test but my doctor didn't seem at all concerned.  I also had pvc's on the holtar while at rest.  When do pvc's after exercise become a problem?  Also, could adrenaline in your system, added to adrenaline caused by exercise result in pvc's after exercise?  I am a 22 year old female who is in reasonably good health.  I do exercise despite having pvc's after sometimes.  
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230125_tn?1193369457
Hi Amykay,
This is a very tricky question and remember when tickertock asked it several years ago because I had to do a literature search then too.  I still don’t know how to answer it.  For people with a structurally normal heart, the immediate risk of simple exercise induced PVCs appears to be similar than control populations.  Over the long term, there may be a slight increase risk in people with PVCs.  We don’t know if this because the people with exercise induced PVCs are showing a tendency to develop heart problems later in life or the people that had the exercise induced PVCs has a small population of people at higher risk for other reasons that initially manifest as PVCs and show up later.  I think the verdict is truly still out on this one.  

The problem is one of definitions.  In a recent article on exercised induced ventricular arrhythmias (EIVA), they defined this as ” EIVA were defined as frequent premature ventricular complexes (PVCs) constituting more than 10% of all ventricular depolarizations during any 30-second ECG recording, or a run of three or more consecutive PVCs during the exercise test or recovery.”  They concluded that “EIVA are independent predictors of cardiovascular mortality after adjusting for other clinical and exercise test variables; combination with resting PVCs carries the highest risk.”  Look closely at the definition of EIVA though – this includes an extreme minority of the people that we see with exercise induced PVCs, who usually just have a few, not 10%.  The article reference is Ann Noninvasive Electrocardiol. 2005 Jan;10(1):47-52.

PVCs after exercise have an increased likelihood of being associated with coronary disease.  This does not mean that people with recovery phase pvc’s have coronary disease, it means that when compared to exercise phase PVCs, recovery phase PVCs are more often associated with coronary disease.

Also, could adrenaline in your system, added to adrenaline caused by exercise result in pvc's after exercise?

It would seem to make sense but everyone has that situation after a stress test, so it has to be more than that.  We can vaguely say that it has something to do with the affected persons heart muscle and there autonomic tone.  In a structurally normal heart, it can have something to do with after depolarizations (either early or delayed – referred to as EADs and DADs).  This is a complicated discussion and is very difficult to understand.


Be careful what you read though--you have to know how to fully interpret the qualifications and definitions in the article or a healthy person can really scare themselves into thinking they are sick.  This is a very confusing area in the literature and some articles contradict each other with opposing findings.

I hope this answers more questions than it creates. Hopefully we (physicians) will have better answers to these questions in the future.
7 Comments
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84483_tn?1289941537
I asked a similar question sometime back, apparently person who have PVCs at rest , during and after exercise are at no apparently significant increased risks, for some reason persons having PVCs post exercise were at a slight increase for cardiac events, again it is my understanding this study might not apply to everyday PVCs sufferers regardless of when their PVCs occur and they still have a benign prognosis.
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84483_tn?1289941537
PVCs have a trigger/mind of their own, I used get exercise induced PVCs, now when I have PVCs they usually occur at rest , go figure that one. I noticed an increase in the amount I have lately but nothing significant, I dont usually get the hard thump or skip/rollover anymore , but more like a sinking feeling that my heart has frozen for a moment or two, I think I prefer it slightly to the hard skip or thump.

Just about everyone will have PVCs at sometimes in their lives so the risk for us all is about the same once no significant cardiac anomalies are detected. My dad used to have PVCs about 6-12 a minute almost all day, the thing is he never feels them, his GP seemed concerned about them and put him on 25mg of atenolol daily even though he had a slow heartrate to start with, amazingly his PVCs have reduced dramatically since being on atenolol though his rate now is in the low 50s from about the usually 55-60bpm, so it appears to me beta blockers do indeed decrease PVCs in some persons, I would say it does for me too and I'm on 100mg daily. He'll be 80 his next B'day and is stronger physically than most men I know in their 40s and 50s.His dad had them too all his life and died at 93, he was aware of them as young man but not as he got older.

I think personally persons with PVCs are no more increased risks than anyone else, Like DR. MJM stated the jury is still out and studies will often contradict one study after another, anyways since holter monitoring and technology has advanced from the early 80s, this affliction(PVCs) that was once thought to be signal of impending doom, apparently has turned to be nothing more than a common nuisance without any significant prognostic implications, just my opinions.
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Avatar_f_tn
I've been having PVC's during exercise, after exercise, no exercise for 45 yrs and as you can see I am still alive.  My heart was checked out several times over the years, the recent one last year, and I am a o.k.

The Cardiologist told me to ignore the PVC's and keep on exercising which I am doing.

Sometimes your subconscious mind can bring them on i.e. "will I get PVC's again this time while exercising", I'm sure I bring mine on at times.

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Avatar_n_tn
Everyone's comments have been very helpful.  Thank you!  And thank you Doctor MJM.  Your answer was definitely helpful.
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Avatar_m_tn
Wow! Great postings by tickertock and Barbarella. VERY REASSURING ticker tock that you have a strong male family history of people living into their 80s-90s with these things. I have a family history of PVC also but I seemed blessed with the most.  

I agree with Barbarella that your mind takes over-if I worry enough I can get PVCs before, during, or after excercise-but if I am mellow nothing happens.  The thing is I think a LOT of times we don't even realize we're worrying about them "coming back" but I feel our subconcious is VERY powerful.

I read an article that seems VERY true--people prone to PVCs should avoid a "sudden rush" of excercise and just build up slow.  
Be well all
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84483_tn?1289941537
Yep , sometime I take my genes for comfort, though most had hypertension from which I suffer which is well controlled these days. Nearly everyone on both sides suffered PVCs , palpitation and tachycardia, I might add anxiety also seems to run in my family also ( not so so proud of that :).Can only deal with the hand you're dealt I guess.

I never noticed my palps so well controlled til cozaar and atenolol were combined, made a huge difference in my opinion.

I think regardless of genes and longevity in the family, it is still important not to take it for granted and do all the right things.

One thing I learned though Longevity is inherited, I know a lady just down the road from me , a distant relative her BP has been around 200/110 for the last 25 years and she's going on 99 , nothing won't move it at all. The youngest in her family to die was 86(cancer) and she's been complaining of a rollin over heart ever since I can remember!
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705586_tn?1314228532
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