PVCs back...need advice

[jwall378]

I am a 33 year old male. Last April I started having heart palps...the "skipped beat" kind. My MD referred me to a cardiologist. She gave me the cardiac workup. Echo, stress, EKG, bloodwork. All came back negative. I did the 24hr Holter monitor. It showed PVCs. I was having an average of 2-3 per minute while awake and a few per hour while sleeping. She claims they're harmless. Given a history of anxiety, she gave me 10mg propranolol 2x per day and 1/4mg Xanax 2x per day. I was ok until this past November. The PVCs came back, but worse. I've been feeling 5-7 per minute. They seem to increase with exercise (especially in cold weather) and while eating and after eating. Certain sitting positions also seem to make them worse. The meds don't seem to help much anymore. I don't have another appointment with my cardiologist until April. Should I see her sooner? If all my tests were negative in April, could something have changed with my heart in the past 9 months? Are PVCs really not dangerous...even with as many as I am having? My BP has always been perfect and my heart rate has always been around 70-80. No changes there. I'm also in recovery. I drank heavy for 10 years and have been sober for the past 5 years. Could my drinking years ago present some sort of issues with my heart now? Thanks for any input.

[MichelleP_3811]

I had a lot of gas that I had no clue how to get rid of since there isn't much online about it but the pvcs made me so sick after about 4 days of them being so incessant I did an inadvertant fast and wound up eating very little, a banana and maybe some granola and water for a couple of days.  I just couldn't eat and by the second day of not eating much I started to feel better and now all the crazy gas is gone. Well not totally but it's more normal, basically just after I eat.  But I also still have some pvcs.  When I had them pretty bad I took some bayer asprin and had some pretty bad stomach pains which made me realize my stomach may be having issues so though I cleared up the excessive gas and crazy amount of pvcs I still likely need to go and get my stomach fully evaluated since I still have some minor stomach pains but I had been through a lot medically with having my svt ablated last year and then getting the pvcs bad I am taking a small break from doctors.  But my hope is once I do get around to fully addressing all stomach issues I will clear the pvcs for good.  But at least they are managable now.   So I guess try doing a semi fast but if you do decide to do it make sure you drink a lot of water.  It's important to stay hydrated.  Or you might want to just try some antacids though I have heard long term use of those can deplete you of magnesium which can affect your heart so you will want to watch overuse.  Anyways, I don't have a proven medical remedy just something that seemed to work for me.   The stomach seems to be a big factor in my pvcs but that doesn't me it is the same for everyone but worth a thought if your stomach too seems to be a trigger.  Take care.

[jwall378]

What kind of stomach issues did you have and how did you resolve them?

[MichelleP_3811]

I might also suggest looking into stomach issues first before opting for an ablation especially considering you seem to have the most symptoms after eating.  It could be your vagus nerve being irritated that is leading to your pvc problem.  Stomach has definitely been an issue for me.  I was probably having around as many pvcs as you fora  time and I managed to clear up some stomach problems and now my pvcs are down to less that 100 a day so try and address any stress or stomach issue first before opting for the expensive ablation.  I would not rule it out if my ability to function was compromised but only after I have ruled out any other factors that could be making the pvcs worse.  Good luck, I hope you can get a handle on this bout your are going through.

[RVVq]

Here's what honourable Dr. Indrajit Choudhuri, a renown electrophysiologist, has to say about PVCs:

"Frequent PVCs are not dangerous themselves but it may reflect an irritability of the cardiac electrical system due to blockages in the arteries of the heart (coronary artery disease), weakening of the heart muscle (cardiomyopathy), or just excessive sensitivity of a specific location to produce extra beats (i.e. PVCs) particularly in response to stress or anxiety or any source of excess adrenaline release. Depending on the underlying condition, ventricular tachycardia can develop."

Based on my personal knowledge  frequent PVCs can be caused by sublinical heart infections (like chronic myocarditis), dysfunction of the central nervous system (which also manifests as anxiety/panic disorders) and minor abnormalities in the ventricles.
I suggest you gen an MRI done to rule out any structural abnormalities. If nothing shows up, than proceed with ablation. At experienced centres the success rates for unifocal PVC ablations range over  from 80-90%, with minimal complications. Ablation is the only way to get rid of PVCs. However, they might settle down themselves, or even completely dissapear with time. They can also become completely asymptomatic.
So ablation is only a good option if they bother and disrupt your life so much that you are contemplating suicide.

Good luck and good health!