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PVCs
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PVCs

22 y/o female with no previous heart problems. I have been having very frequent PVCs. I have had them off and on for as long as I can remember... but I am now getting them that last as long as 10 minutes off and on. I have seen my doctor for this... she did an ekg and I have also wore a heart monitor. She says they are benign and not to worry about them but I still can't seem to get my head around the fact that they wont' cause any problems. It just doesn't seem normal for my heart to do this and not cause any problems.  There was a few things on my results from my heart monitor that she did not explain and I was just wondering if anyone knew what they meant.  Multifocal PVCs, Ventricular couplet, & Bigeminy noted... what does this mean and should I be worried about it??? During the 24hr period that I wore the monitor I had 22 avg 9/ hr pvcs, 0.2% of total. And aberrant total was 272 avg 11/hr. 0.2% of total. I am still unsure what this means as well. Doctor thinks that I may have anxiety which she says will cause them. I just feel very nervous/anxious for no reason sometimes. My PVCs are driving me nuts... I am so worried about them!
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Avatar_f_tn
Multifocal means they are coming from more than one area---which I was told just means makes it more difficult to get rid of them if you ablate. Couplet means two in a row I believe and Bigeminy means every other beat is a pvc. I too have them and many people on the board here say they too have them. It sounds like y ou dont have hardly anypvcs if I understand what your report mean. Cindi on here is amazing with this stuff as are several others.I am sure they will reply soon as they can, but 0.2 % is VERY FEW! :)
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995271_tn?1408549100
0.2% PVC burden for 24 hours isn't something a medical person would describe as frequent.  That's infrequent.

That means 0.2% of your total beats over a 24 hour period were PVCs.  You had a total of 272 PVCs in 24 hours.    I know it's many to you, but to a cardiologist it's not.

Based on what you're describing you have infrequent and isolated PVCs.   This is the lowest category of PVC classification, meaning it's not considered urgent.  On a scale of 1 to 4, 4 being the worst and 1 being the lightest PVC classification, you'd be a 1.

A cardiologist would not advise medication at this point.  

You should focus on lifestyle changes at your age.  

I've had them in the 4,000+ per day range.  There are some on this board who tolerate 20,000-50,000 per day.

Mine come and go, like most.  I manage with lifestyle, though I've tried medications.  The thing with medications is you will need to always depend on them, and they will remodel your heart muscle and sometimes make them worse.

Don't be afraid to try any option to make you life better.  
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Avatar_f_tn
I know this is probably something that is not serious but I can't seem to stop worrying about them and I know that makes them worse. Im just afraid they are going to become serious or that the doctor missed something and they are serious. I just can't understand how all of a sudden I just started having these and how they can not be anything when they feel so weird.
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967168_tn?1343732745
aembry; there are certain patterns on tests that show up and doctors/techs have learned to read the patterns to see if they may be dangerous; it all depends on where they come from and if you have any structural heart problems, if they consider them to be problematic - having said that, sometimes yes they do miss things

even if you had 30,000, 40,000 or 50,000 pvc's does not mean they will turn serious or dangerous and kill you; however it can lead to pvc induced cardiomyopathy, which in most cases is reversible with proper care

I know pvc's and arrythmia's are scarey, but many of us suffer tons and find ways to cope.  

Please look at your lifestyle - check your caffeine intake, alcohol, drugs, smoking, exercise habits, stress/anxiety and ask for your blood levels to be checked such as potassium; which is often low in pvc sufferers.  Keep a journal of symptoms and what you were doing or eating at the time they happen and see if you can find your triggers and eliminate them.

I wish they would sticky a doctors q&a on this forum for everyone for common questions and concerns like yours; we all have the same questions when we first come here and understand what you're going through.

good luck and take care of yourself
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Avatar_f_tn
Thanks for the responses! I could not imagine having 30,000 or more of these things a day.  I do not smoke, do drugs or drink and I no longer drink caffeine! So I don't know what could be causing these. The last time I had blood work done was in Feb. and my potassium levels were 2.5 I think, so I may need to have that checked again.

Does the fact that they are multifocal or that I had a couplet not make them more of a concern? I had read somewhere that you should be concerned if they were coming from more than one place in your heart. I had read about ventricular tachycardia and fibrillation and that is what really made me sooo scared of pvcs. Is there any kind of connection between vtach & pvcs?
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Avatar_f_tn
Potassium level was 3.5 the last time I went not 2.5.
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967168_tn?1343732745
If you go to the search at the top of the page and put in VT or Vtach, ventricular tachycardia you'll find a ton of info and doctors answers - look in the expert section where the Medhelp Doctors answer questions.

You can live well and function fine with 30,000 & even 50,000 pvc's - it's all a state of mine and letting them control your life or not.  I had 50,000 pvc's for quite awhile and didn't know I had THAT many, heck I didn't even know it was pvc's until the dr put a name to what I felt.  A few years ago, I was told by a doctor my heart was fine and I was "deconditioned" even though I was walking/running 4-5 times a week.

I sit on the pvc fence myself :P trying to reassure others that you probably won't have dangerous arrythmia's but at the same time know mine were brushed under the rug by a doctor.  I had a ton even then - bigeminy & trigeminy patterns (couplets, triplets etc), but I have other things going on and that made my problem worse - in a structurally normal heart there is no problem with pvc's or even vt - so an echo would clear any question of that up for you.

PVC's in frequent continuous episodes can become a form of ventricular tachycardia (VT) and can become dangerous (V-Fib).  Typically, if 3 or more PVCs occur in a row it is indicative of ventricular tachycardia, but NOT ALL VT's are dangerous.  

I was told by my EP that only 1% of pvc's are considered dangerous, although I've read 1%-5%. Dr's typically treat between 6,000 - 8,000 pvc's with meds and anything above 15% - 20% of a total 24 HR they treat with surgery.  

At higher continuous amounts, it can damage the heart and lead to cardiomyopathy.  Although, follow up research has shown this can happen at much lower thresholds of  >4000 pvc's - http://emedicine.medscape.com/article/761148-followup

I've suffered from frequent pvc's and vtach for awhile and it's something I still question - what triggers v-tach to become something dangerous?  Dr's use a scale to categorize which ones they think will be dangerous; but it's debatable [the article expands on this method].

"LV function and where your PVC's originate is more important then your where you fit on the scale" - it's in the medscape article, I think page 3.

You can have many different arrythmia's originating from different areas, but for them to be dangerous they have to have the morphology that stands out (your cardio or EP will know).  I have malignant polymorphic VT - and my pvc's were originating from one place - the RVOT; so I'm not sure on the multifocal part being more serious - I'm sure someone else will know.

Hopefully that answers some of your questions and I've explained correctly the way my doctors and research I've read.

Here's an example of one of the dr's posts:  a thread about VT and an answer from one of the CC dr's

http://www.medhelp.org/posts/Heart-Disease/Idiopathic-Ventricular-Tachycardia-Ablation/show/1327314

"If your heart function is normal, there really isn't any danger from having the VT runs.  The only thing worth assessing is the number of PVC's in a 24 hour period.  If it's greater than 15% of all the heart beats than there is a small risk of developing a PVC induced cardiomyopathy."

"We typically don't ablate PVC's unless they are symptomatic or if they are very numerous (great than 15%).  The VT isn't ablated unless it's sustained or very symptomatic with episodes of passing out or nearly passing out.  Sometimes it's difficult to induce the Vt in the lab but becasue the PVCs typically look like the VT we sometimes go after them"

"This is very unlikley to progress to VF or SCD.  If the PVC's/NSVT is really bothering you then you should have it done to relieve your symptoms, not to prevent SCD or VF"
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Avatar_f_tn
Do you think this could possibly have something to do with my pottasium levels? I have not had it checked but I am thinking that I might need too since the last time I had blood work my levels were the lowest that they were suppoes to be. Can potassium levels cause pvcs if it is just a little low? And does anyone know how long it takes to get your levels back up after starting a vitamin?
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Avatar_f_tn
Also, what would it mean by frequent, multifocal pvcs, with one pair? What does the one pair mean?
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967168_tn?1343732745
Aembry was this on your test results or in the article?
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Avatar_f_tn
Yes this was on my test results
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Avatar_f_tn
Do you know what it means by the one pair? And, do you know how long it takes to get your potassium levels back up if they are under 3.5?
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967168_tn?1343732745
I'm not sure what one pair mean...one pair of...? one pair of multifocal pvc's maybe?

here's a great site I'm a member of that shows all the normal values for things like potassium: http://www.skippinghearts.com/articles/normal-heart-test-values/  (skipping hearts . c o m) it says 3.5-5.0 for potassium

I did read in the heart disease community here that eating a banana or two a day helped someone's wife get hers up, but at 3.5 yours isn't that low but you may want to shoot for 4.0 and see (ask your dr about this see what he says)

if click on the skipping hearts info tab under potassium it has alot of info from NIH
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Avatar_f_tn
Okay thank you! Yea I'm not sure what it means because that's all it says! My doctor really didn't explain it that well to me that's why I have so many questions still. I have not had my potassium checked lately but I think I may go back this week and have them to check it. It was checked earlier in the yr when it was 3.5 so it could be lower I dunno!
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