PVC's and PAC's

Thank you for taking my question.  I am a 51 year old female.  I have had PVC's and PAC's and salvos since my early 20's.  I have had every test they can possibly do and they find nothing wrong with my heart.  These still scare me to death though.  Some days I will get only a few and other days I will get a couple of them an hour.  I was laying in bed this morning and got a few of them within a minute and they scared me so much!  It either feels like a drop in my heartbeat or it is like a kick in the chest because they are so strong.  My questions are:

1. Would it be possible they missed something with my heart when I have had all the testing done?
2. How many of these things are a normal amount to have each day?
3. Would everyone have these abnormal beats and just not feel them (that is actually beyond my believing because they are so strong and so uncomfortable I can't see that people would not feel them).
4. Sometimes when I just "think" about them I can bring them on?  Is that normal?
5. Any amount of stress or anxiety brings them on as well.  I always know that when I am stressed about something I am going to get a good bout of them.
6. Am I just worrying myself about nothing if they truly say I have normal heart and there is absoloutly nothing wrong with it?  I do recall when I had an EP study 14 years ago the EP mentioned I had a "slick sinus node".  He said that was a good thing.  He said something that it was like a 20 years old sinus node or something to that effect.  

Thank you for your advice!

[Jerry_NJ]

Sorry you haven't gotten any helpful advice.  If you are a regular reader here on PVC you know the "standard" answers better than I do... I am an AFib suffer myself...no PVC (other than those caused by the AFib, and I in fact usually don't notice them - I'd say there a a few per minute.  I can hear them if I listen with a stethoscope).   My AFib caused "PVC" activity is not considered PVC, and that may be because I don't really fell them, they are just extra heart beats. This is one of the battles my medications have to fight, keeping the extra few enough in number that I don't have tacycardia, dangerous high heart rate.

Your emotions will surely add to your heart rhythm problems, try to put it out of your mind, believing that your heart is healthy (all those tests) should help and it does in fact suggest strongly that the PVC will not kill you.

Have you ever discussed ablation with your doctor?

[michellepetkus]

From everything I have read it is believed that ectopic beats are not considered a threat in a healthy heart.  That doesn't necessarily ease the mind of the person who has them but medical research has not found them to be a threat.  I will try to answer your questions as best I can though I am not a doctor so you may want to ask your doctor to be absolutely sure.

1. Would it be possible they missed something with my heart when I have had all the testing done?  

It is not likely that they missed anything however, if you haven't had your heart checked in 30 years you may want to get a check up to make sure everything is still fine.  

2. How many of these things are a normal amount to have each day?

I am not sure what numbers are considered normal.  From what I have read everyone will have these at some point in their life though I am not convinced everyone has them everyday.  I would say a few random ones here or there may be considered normal though the bigger delineation is if they are dangerous or not.  And from what I understand they can become dangerous if a person is experiencing 20,000 or more a day, has them in runs lasting longer than 30 second (ventricular tachycardia) or has troubling symptoms with them like chest pain, shortness of breath or passing out.  Essentially if they are interfering with your ability to function then intervention may be in order.

3. Would everyone have these abnormal beats and just not feel them (that is actually beyond my believing because they are so strong and so uncomfortable I can't see that people would not feel them).

I believe the reason yours may feel so uncomfortable may be due to the timing of your beats and the amount of blood that is out of balance.  I am not sure of the science so hopefully someone can get on and explain it better but it basically has to do with the amount of blood being off balance that causes the feelings of an especially hard beat.  I know my pvcs aren't always the same so hopefully your hard ones will calm down a bit for you soon.

4. Sometimes when I just "think" about them I can bring them on?  Is that normal?

It's not abnormal for that to happen because it is likely when you think about them you bring on a bit of stress which is a big trigger for some reason though personally I tend to think it is because we start to breath a bit shallow and fast that sets them off but regardless you can trigger them by thinking of them if you are stressing for sure.

5. Any amount of stress or anxiety brings them on as well.  I always know that when I am stressed about something I am going to get a good bout of them.

As above, yes stress and anxiety are one of the biggest triggers so any stress management you can adopt will help you greatly and any calming techniques you can apply once you are stressing will help calm them down.  Deep breathing and releasing the tension helps me.

6. Am I just worrying myself about nothing if they truly say I have normal heart and there is absoloutly nothing wrong with it?

No one can say for certain you have nothing to worry about besides a doctor.  But once you have had a full work up and your heart is considered healthy structurally then these odd little beats are not considered a threat to your long term health or mortality.  If you are having an extreme amount of them that is interfering with your ability to function then an ablation may be offered though they really are generally reserved for people who are in danger of life threatening complications because in general ablations for ectopics are met with mixed results and sometimes the ablations cause more problems making the situation worse so it is not a route cardiologists take lightly.  In any event, try to not let your ectopics run your life.  They are annoying and disconcerting at times but the more you can move ahead and go about your life the less they will hold you hostage.  So go and get a check up if you haven't had one in a while and hopefully that will ease your mind about your own personal situation.  Take care and stay strong.  If you have any more questions just let us know.

[Midijane]

Hello Stardust- I'm going to answer by number here
1. I imagine anything is possible but before worrying yourself too much about things being mossed, I think a quick sit down with your doc would make you feel so much better.
2. There really is no normal amount of PACs and PVCs a person could have per day. It just varies depending on our hearts.
3. I have taken care of people who can tell exactly what rhythm they are having because they know their history and body so well. Most folks, however, can't tell a thing is going on with their heart rhythm (ie PACs/PVCs). Again, it really just depends on the individual.
4,5. Sound related to me. In other words, Anxiety.
6. Has it been that long (14 years) since you've had yourself checked out? If it has been awhile since your last evaluation, why not set up an office visit with your Cardiologist. Our docs are there for us when we need them, we just have to make the appointment to discuss our concerns.

PS- I literally have to write down my concerns before going to see my doc and practice how I am going to present my symptoms because I know I tend to present a laundry list of issues to my doc which only confuses things. Write down your top concerns and even take a few quick notes at your visit if that helps.

Take good care :)