Question about risk of developing sudden death

[Carey01]

I have been reading these posts for years and a lot of wonderfulp people on this site have 100's if not thousands of PVCS/PACS per day and somehow manage.  MY hats off to all of you!  My question is this:  How does one KNOW  that their PVC/PACS exisiting in a structurally normal heart with no past heart failure will not go into to a run of PVC/PACS leading to V Tach or some other deadly arrythmia.  The fear of this happening has left me almost unable to travel because im worried that my bnign skips will suddenly change face and all come together.  I have to go out of town this weekend and am thinkingof cancelling.  Any information would be so helpful.

Thanks-
Carey

[Wisconsin2007]

I guess the stat I've read in a few places that eased my mind was the one that said that 90% of people 60 and over have PVC's.  9 out of 10.

If PVC's significantly increased the odds of death, I would think there wouldn't be too many people over the age of 60.  But there are.  And most of 'em have PVC's.

I also read just over half of those over 40 have them.  Most of those folks must be making it to 60, right?  

There was another study that showed 40+% of shift workers had PVC's and another that showed that 10-15% of elementary-aged kids have them.

Clearly, having them is not the ideal.  I'd prefer a perfect metronome for a heartbeat.  Even the study that showed that >7 PVC's per minute after exercise was an indicator of increased chance of death, the increased chance was 50%.  

Put another way, a 56 year old person (avg age for that study) had just over a 5% chance of dying over the course of that study (which may have been 10 years), for any cause.

If that same person had >7 PVC's per minute post-exercise, that chance increased to 7.5%, for any cause.  

I'm not sure if the study indicated that the 2.5% increased odds were tied directly to the PVC's, or if there were comorbidity issues (like a 300 pound person with PVC's dying of an MI unrelated to PVC, or a heavy drinker with PVC's dying from liver disease), but that's something that would valuable to know.  

[celticsrotdog]

I've had these things on and off since I was 18. I'm 28 now. They got way worse a few months ago. I started taking a fairly high dose of xanax and they have been happening much less. I don't have insurance and I haven't had any tests done for about 10 years, back then they were all normal. So think about that anxiety, not even having caught them on a monitor or anything. I run a lot of miles, play basketball, lift weights and am always figuring I might drop dead. I've read all the studies about how pvc's after exercise puts you at a 2 times higher risk of cardiac death. I've read surveys that say pvc's in people with healthy hearts still indicate a higher risk of death than those who do not get them. I've also read the studies that show they don't increase risk. I have no idea what to beleive and I don't think doctors know much of anything about pvc's. I don't really feel like that can be normal heart activity.  Oh by the way whoever was asking about alprazolam that's just a generic for xanax. If anxiety is contributing to the pvc's it can work wonders, has for me anyways. We may all be at risk for increased sudden death. Sometimes all the reassurance on this board almost irritates me because I don't think anybody knows that they will not lead to something serious. I've never had anything like v tach or a fib (that i know of anyways). However have you ever heard of anyone in this forum who has those things that doens't also have pvc's? I haven't and that makes me think it all has to be related. Just live a normal life as much as you can and if something is going to happen worrying about it won't help. I really suggest the xanax or other benzodiazapines to those who can't get past the anxiety. However they are very addictive and habit forming but hey for me the risk of that is worth it compared to not being able to function. Good luck to all

[jkfrench]

yes, it is under the post The results are in.   :)

[Carey01]

What did your Dr say?  Did he call you?

[RNRita]

I HAD to jump in here. I once cancelled a trip to Disney because of PVCs and anxiety.  What a dork I was.  Then right before my last Disney trip, after being all excited, I had my first really horrible run and I thought I was going to die.  (I have had these, sometimes 5000 a day, for 30 years.) I almost cancelled, but I was talked into going. I was miserable most of the drive down.  I didn't even have much of an appetite while I was there because of anxiety.  But, I still managed to have fun.  I had one bout on the way home, but it went away.  That was 2 years ago.  Tonight I will be leaving for Disney again.  My PVCs started acting up, along with the anxiety...I wonder why.  I just said, " EF YOU!"  (yes, sometimes I talk to them) and thought, "I'm going no matter what."  It seems that after I "yelled" at myself a few times, everything went away and I am now excited again.  Remember, excitement is a hairline from anxiety and your body can interpret the two as the same, mix them up, and make you feel like an idiot!  Don't stop living, by being afraid to die.

[missalisa]

Sorry for being crass. I've been known to come across that way. I have a dry sense of humor, and sometimes it appears insensitive. I'll work on it.

My 24 hour holter said I had 716 PVCs. There was one run of three together, coming from the lower chambers. The rest came from the upper. That was two weeks ago.

Since then, I have had days where I feel very few, and days where I have 3 a minute. Today, after exercising, I had about 10 a minute for about 10 minutes. Then I looked on these boards and saw a study about how PVCs of more than 7 a minute after exercise are a sign of impending cardiac events and death. That did not help. In fact, it sent me into a spiral of depression. I told my family I think I'm marked for death, and that we have to plan for that possibility. It is terribly unnerving living with this.

My doctor seems to think I'm fine. But he could be wrong. I am seeking a second opinion, but want to find the best doctor I can.

[Wisconsin2007]

Though I find your last post a little crass, I have had some of the same thoughts.  Like if I had to choose a way to go, suffering through months of chemo and radiation would not be fun.  Well, no dying would be fun.  But all of a sudden losing oxygen to your brain wouldn't really give you any pain.  You'd just take an abrupt nap and that'd be that.  Not a bad way to go, as ways to go are concerned.

As for your PVC's being relatively constant, day and night - were they perfectly constant, or just that you had them frequently in the daytime and night time?  Because I had that for awhile, too.  6 months or so.  Some days worse, some days better.  But all with at least 5K PVC's a day, through the morning, noon and night.  

Even now, wearing this event monitor, I'm only having 10-40 of them a day.  So even consistent PVC's can change in frequency.  

[missalisa]

Oh, and I found the "Develop Sudden Death" line inadvertently amusing. You cannot develop a sudden death. That's why it's sudden death. :-)

Of all the things to worry about, sudden death should be pretty low on the list. If it comes, it will be sudden, and you will be dead. Story over.

[missalisa]

There must be a cause of PACs/PVCs. I really don't understand why more research has not been done to figure it out. I just got my holter results back, and they were consistent, day and night, which the doctor thinks means they are not anxiety-produced, or triggered by food or drink. They are something else. I wish modern science would tackle this thing and figure it out. None of us are satisfied with the "you're fine" diagnosis, because our bodies tell us otherwise. Something is amiss. Something caused it. If there was a cause, there must be a fix. They just don't have it yet. I imagine someday science will discover the cause, and future generations will look back on these message boards with pity for us who lived through the dark ages of PVC ignorance.

[Wisconsin2007]

I'd eaten a bunch of chocolate last night, then hopped onto the treadmill to try to produce some symptoms.  I had handful of PVC's over a 40 minute period, one of them kinda hard, so I pressed the button on the event monitor.  What the heck, right?  I was feeling pretty good about myself, felt like I was climbing out of this funk of odd rhythms, stress and anxiousness.

Then we (the family) go to the store today - I know it's going to cut into the time I need to get things done and make me more anxious (and that's why I go - to try to coax these rhythms out).  I'm fine until near the end of the trip, start feeling jittery, decide to put my finger to my carotid and I catch three quick beats bumpbumpbump before it returns to a normal rhythm.  All my enthusiasm leaves me and I get bummed thinking about what this might mean in terms of meds, long term prognoses, limitations in activities, etc.

And that's where I sit right now.  So I guess it's a good time to have this thread to read.  Crazy to let three stupid beats wreck my day.  

[jkfrench]

I'm in the same boat as you right now.  My skips increased in intensity 2 months ago.  I can go hours with one every 5 beat then every 10 beat and so on.  I get a few hours of relief then they start up when I lay down to try and sleep.  I had the holter on yesterday and it was one of the worst days I've ever had.  I laid in bed last night from 11:30 to almost 3:00 feeling these skips.  I tried to lie on my right side.  I took a deep breath and wham a whole string of something that lasted a few seconds.  I have no idea what it was.  Felt like 4 quick beats in a row.
Made me sit up and panic.
I saw my doctor this morning who is going to call me tonight with the results because I was so upset.  He told me that if I let them (the pvc's) win, they most surely will.  He also said they will settle down again.
He offered me something called alprazolam and told me to break it in half.  He said to take it for a short period.  Has anyone heard of that pill?  I'm sure it is an anxiety pill.  Anyway, I don't want to take it.  I really hope that this holter comes back okay and I really hope that I can believe him this time.  
AND, I can totally relate to canceling trips because of this.  When your heart is jumping around benign or not it is exhausting.

Frenchie

[nervouslady]

This is a helpful thread, thanks for bumping it.  Agreed how much of this stuff is anxiety induced/related.  It's hard to think that way when so much of it is tangible, physiological reponses to stress though.  My cardiologist said my runs of NSVT are not caused by anxiety but can be egged on by it.  As for the other arrhythmias that I get, the majority are likely caused by being anxious.

Interesting that a lot of people started getting these when their mortality came into view/question.  Same for me.  I was so healty, normal, never an issue beyond a cold or the flu, and then bam!  Stroke. And no one ever was able to figure out why.  Stroke?  ME?  But I'm a healthy 24 year old!  It changed my whole world and I haven't been the same since.  I do worry about my health excessively as a result and feel like something unexpected will strike me again like that.  Including my heart stopping, sudden cardiac death, having another stroke, etc etc etc.  But everyone here is right - if it happens, it happens, and what could I have done to stop it or predict it?  Very little, if anything.  Just like the time I had a stroke, I had no warning signs, no symptoms, felt fine. I even went into the ER after the stroke and they sent me home, I looked fine to them.  

I have to find a way to not worry about dying spontaneously.  If it's my time, then I guess it's my time.  Until then, I need to let it go and enjoy life again, skips and blips and all.

[au2311]

bump

[Artaud]

Hi,

You need to try and relax. The more you fret, the more PVCs you will get. As I said, I had some 600 and more PVCs per day for more than a year, the Doctor was unconcerned. Some people on this forum have had more than 10,000 PVCs per day without any serious problems.

If you are concerned, ask for a Loop Event Monitor to be worn for a month. You can remove it to shower and then put it back on when you are done. Anytime you have a problem, you press the button and the event is recorded. You call the event in to a Technical Center, and they can instantly see what you had. I was sure that I was going to die at any second by a fast arrhythmia I was having. The Event Monitor revealed it to be PSVT, and the Technical Center sounded almost bored when I phoned the results in, "Oh, you had a little PSVT" they would say. This kind of stuff, PSVT, is routine, the Doctors Offices see it day in and day out. Just because we perceive it as dangerous doesn't mean that it is dangerous.

Why do you continue to worry about a life threatening arrhythmia?  Most Doctors are not that cavalier about their diagnosis, they don't send you out of the office while crossing their fingers behind their backs saying "I hope she doesn't die tonight". If they feel there is a problem, they address it. If they feel that there is no problem, they don't spend too much time worrying about it. After a few calls to my Cardiologist about various symptoms that I had, I was crestfallen when he said that he has "Patients with serious problems to take care of". In effect, he was saying that I was being a pain about my concerns. I have been going to Doctors since I was 15 years old for my arrhythmia, which comes and goes, but as I get older, it comes more often than it goes anymore. Yet my Doctors have always told me that my condition was benign, not to worry about it. I am 50 years old and still going, they must have been right, despite my concerns.

If you haven't seen a Doctor recently, do so. If you have and you are not convinced by his/her diagnosis, get a second opinion.

Be well.

[upbeat633]

how many do you get in a row? I very frequently now get couplets and triplets, followed by one or two or three regular beats, then another couplet or triplet and on and on it goes. I am so happy if get more than 5 regular beats, it makes me think I'm going to get more, but it never lasts.

I guess every time my rhythm changes it causes me to question the whole benign explanation. I wonder, probably like everyone else does at some point or another...is this the time it's going to lead to something more sinister? I've been told NO. It doesn't matter the number of pvcs (my last holter recorded 24,000/day) it doesn't matter the pattern, bigeminy, trigeminy, couplets, triplets, nsvt (non-sustained ventricular tachycardia, a string of pvcs without a normal beat, but lasting less than 30 seconds). . I've gotten as many as 62 pvcs in a row, but because my heart rate is below 100, they still don't think much of it (of course it's not happening to them lol). Makes me think I'm chasing butterflies sometimes when I ask if my pvcs are harmful, like its a past time that is frivolous.

I hope you've gotten some relief both from the pvcs and with the responses you've received so far. If you feel yours are extra bothersome, has your doctor suggested anything like a beta-blocker? BBs have helped some people. I personally haven't found much relief in reducing the number, but I think they can reduce the sensation which is just as good for some people.

[Carey01]

I agree  with everyones kind words -- does anyone know if you have to have extra pathways or some other irregular structure to your heart to develop a life threatening arrythmia???  I was jsutstarting to feel like -OK deal with it -- and tonight I was excercising and WHAM they hit in a row again.  Mine actually feel like a squeezing pain for a brief second at times.  I just want to know when I get them to breather through and they will eventually go away!
Oh, too, some people have asked if I have had the full round of tests -- the answer is yes. DX benign PVC/PAC.  

[upbeat633]

It is why we visit, to get the support and understanding of people who know what it is like to have our hearts flip-flopping around.

I've said it before: no one but yourself sees the lights being switched on and off (pvcs) in that structurally normal house you live in (heart), so they don't know what you experience from minute to minute, or hour to hour, or day to day, but many of us here do.

Live your life to the best of your capability otherwise the arrythmia has already taken it from you. I've just spent two hours (two hours I'll never get back) researching the archives of internal medicine because someone on the heart disease forum suggested something about higher risk with pvcs. But I didn't find anything that changed my mind about pvcs being benign. So you need to put everything into perspective. As mentioned in earlier replies, the risk of so many other things is higher. I just had minor surgery with general anesthesia, I was more scared about that than the pvcs that day.

[dolfnlvr]

We know it gets to you.  It gets to all of us too.  That's why we come here...to get the support and the kind words of understanding that many of us are hard pressed to find elsewhere.  We all understand how you feel at times, and, while it's easy to say, "live life NOW because we all live with the unknown about 10 minutes from now," it can be hard to do when your heart is flipping out.  

Our heart delivers our life blood...literally.  And when it's not acting "normally" we fret.  It's natural, it's expected.  But when it gets to be too much to handle, and you feel yourself heading face first into a full blown panic attack because of a fear of death due to (PVC's/PAC's/SVT or whatever you fill in this blank with) come here and get some supporting words.  There's security in numbers.

Feel better.

[BLM_56]

Carey,
  Do you actually HAVE an arrhythmia or are you just worried about it?  If you do, have you seen a cardiologist?  I have had an atrial arrhythmia for over a decade.  I'm still here.

Once upon a time, on a Friday during final exams in the 2nd semester of my freshman (1st for you folks not in the U.S.) year of college I went with a couple of friends to fly.  One of my friends had a pilot's license and we wanted to get away from school for a bit.  We ended up losing power on takeoff and flying into the side of a culvert 5 ft (say a meter and 1.2) from a 15 meter drop into a box canyon.  All were hurt but I was treated in the emergency room and released.  On the following Monday Lubbock Texas, where I was going to school got hit with the 4th worst tornado ever to hit the U.S.  It did $1.4 Billion (in today's money) damage, killed 26 people outright and injured another 500 more.  It devastated 25 square miles (thats 61/2 THOUSAND hectares) of the heart of the city.  the initial touchdown for the storm was less than a mile from where I was going to school.  Six weeks later I had a blowout in the rain on the freeway during rush hour and came within a meter of dropping 40 feet into a storm drain channel.  I had two of my 3 siblings in the vehicle with me. Six weeks after THAT I turned 19.  

I had 3 perfect chances to cash in my chips in 6 weeks.  I'M STILL HERE!  Apparently it wasn't my time.  My Dad had heart failure, 3 stents put in and a quintuple bypass but died of a stroke from eating too much salad and not getting his INR checked often enough.  He coulda died from the heart failure.  He coulda had a major heart attack before the stents were put in or before he had the bypass.  He coulda but he didn't.  Why?  I think it just wasn't yet his time.  I could have died the summer of 1970 (and a couple of other times like when the thrust revers on a C-141 deployed IN FLIGHT while the plane was on final approach to land) but I didn't .  I think my number has yet to come up.  When it does - which could be in less than 12 hours as I write this - I'll go BUT NOT BEFORE.

You cannot live your life in fear of what MIGHT happen.  Do what you are planning, be prudent and go on.  Remember, courage is not the absence of fear.  Courage is the refusal to let fear rule your life.

At this moment my heart feels like it wants to do it's version of that scene in the galley in "Alien".  Tomorrow morning it might just up and quit.  But I am NOT going to live in fear of it.

Old saying: Don't sweat the small stuff.  2nd part to that is that it is ALL small stuff.

Bill

[Momto3]

So glad everything checked out great!  You're gonna be just fine : )   Yep, those flip-flops and crazy beats are unnearving for sure.  Your new mantra, "They're benign and I'm fine."

[Carey01]

OH and yes I have had all the tests --- and my heart is structurally fine.  i keep reminding myself of that but in a bout of hard bangs and reading about somebody who was told they were fine and they weren't, well, I seem to forget very quickly.  

[Carey01]

Thanks everyone -- you are all right.  Life is so fragile and I know down deep your time is your time and you cant just stop living due to a big what if -- but sometimes, many times, it gets to me.  Thanks so much for the support.

[Sammie4258]

My brother died of a sudden heart attack at 42 years old.  From that point on, 6 members of my immediate family began having panick attacks and irregular heart beats.  It's the "what if's" that will kill us.  Aren't humans funky.  I wonder if animals ever have this sort of stuff or do they just take life as it comes.
sammie

[Artaud]

Hi,

There are no guarantees in life. You can be leaving the Cardiologist, with a clean Bill of Health, only to be killed in a car crash on the way home. Life is like this.

Not only do I have periodic and fairly aggressive bouts with arrhythmias, experiencing more than 600 PVCs per day, episodes of Bigeminy and Trigeminy, PSVT, and the like, but I have also suffered (separate incidents) through loss of vision in one eye, (returned within 5 minutes), and a ludicrous episode of double vision, with dizziness that I can't describe, holding onto the walls and looking for a place to fall so that I would not strike anything, only to be told after many tests that it was:

1. Vascular Constriction for the loss of vision, and: 2. Basilar Migraine for the double vision and dizziness.

I have been tested to the max, CAT Scan without contrast, MRI, MRA, CAT Scan with contrast, Ultrasound Studies on my Carotids, etc. I am sure my chart at the Doctor's office has been split many times (it gets too big). What guarantee do I have that I am not going to have a stroke? None. But, what reassurance do I have that I am not a candidate for an pending stroke, see the above studies.

Same with your heart. Testing and experience is the reassurance that you and the rest of us on this forum have.

You may or may not be surprised to know that some people, without any PVCs or other overt arrhythmias, have heart rhythms that can decay into a dangerous arrhythmia without any advanced warning. Yet these people do not seek testing, as they are unaware of their condition.

Also, there are a many people walking around in life that have, just as many of us do, benign arrhythmias, often worse than many people on this forum, yet cannot feel them at all. Yet during a pre-employment physical or a routine physical at their Doctor's office, the arrhythmia is found. If the arrhythmia is discovered to be benign, the patient does not even need to be fully informed about the arrhythmia, as some people may obsess about it.

Now us, some members of this forum, with concerns about the often relatively mild symptoms we feel. Due to our concerns, we seek medical advice. As a result of this, we are tested (reassurance that the heart is not having valvular or circulatory problems), and examined (the skill and experience of qualified Doctors, offering more reassurance). We have gained, sometimes quite often, something that the other two groups above did not do of their own volition, testing and counseling by qualified Doctors.

And, the presence of many forms of arrhythmias does not signify an increased chance of mortality. Hard to believe? Not really. My 4 year old Dog lies on my lap periodically, he weighs 100 lbs. Ever since he was younger, I noticed that as his chest presses on my leg, his heart paused often. Eventually doing research due to my own problems, I discovered that mammals have what is referred to as Respiratory Sinus Arrhythmia. The heart speeds up as we inhale air and slows down as we exhale air. His actually pauses every time he breathes out. I asked the vet about it, she said that his heart actually does it less than many other dog's hearts do. Wow, you should feel it. But think about it, where did that precise, clock like pacing of the his heart go? It’s not essential that the heart is a precision machine, it must move blood reliably to keep us conscious and to keep the muscles supplied with oxygen. But does it need to be perfect in rhythm to do that? No.

When I went to school to be a Pharmacy Technician (I did not complete the course), they discussed the Autonomic Nervous System, the Vagal Nerve, and the Sino Atrial Node on the Heart. When we are afraid, adrenaline makes the heart rate quicken, so that we may Fight or take Flight. But, when the fear is over, the Vagal Nerve, acting on the SA Node, slows the heart down. But what happens if the Vagal Nerve response was too aggressive, would the heart stop? No, the Atrio Ventricular Node (AV) is next in line. If the SA Node fails to discharge, the AV Node does, maintaining the heart rate. But it maintains it at a slower pace. These are great fail safe mechanisms. The heart is designed to beat, not to stop. Mankind would not have made it this far if the heart was a frail muscle, waiting for the slightest mistake in rhythm to take it to disaster.

Lastly, in the 1980s, the Cardiac Arrhythmia Suppression Trial (CAST) was performed to see what the difference was between people (Post MI I believe) with arrhythmias if they were treated for the arrhythmia or untreated (by the use of placebos). Incredibly, they discovered that the survival rate for the placebo group was higher than the group receiving treatment for the arrhythmia, and the study was stopped.

Hope this helps.