I've had PVCs on and off for 40 years, since the day after Easter year this in far greater numbers than historically. The first visit to the E.R. showed frequent PVCs accompanied by PACs occurring once for every three PVCs. In the blood tests, electrolytes were normal with no marker for MI, and a chest X-Ray was normal. These PVCs get really bad after eating, and such episodes were captured on the Holter, but no concern mentioned to me. I'd also go into a geminy (every 4 or 5 beats) when a laid down to sleep, and have slept propped up since then. Yet I eventually slip into a laying position during the night and I've woken during the night and am quite clear of geminy patterns and clear of PVCs. But PVCs start up again early in the morning while waking for work.
I had a recent 24 hr Holter monitor, it showed 6000 PVCs and no runs. I've seen two cardiologists (one wanted to redo my stress-echo test from mid December 2013 with a nuclear stress possibly followed by a cath procedure, all based on an inverted T-Wave I've had all of my life), the cardiologist that did the Stress Echo (my primary cardiologist) in December insists everything is OK when viewing the E.R. reports (I've been there twice) and the Holter monitor results. I've seen one E.P. who instantly offered to ablate it, saying the problem is "probably" in the RVOT, then saw an older E.P. that is well respected in my city that emphatically said the problem is not in the RVOT, but the Purkinje fibers, saying it is still able to be ablated.
The older E.P. wants to use anti-arrhythmic drugs to control or reduce the PVCs, but I'm circumspect about that avenue. Someone suggested to me to ask for Acebutolol, the E.P. readily agreed, and I've had some success with it (I had been on Atenolol 25 mg bid but am now on Acebutolol 200 mg tid) I'm able to eat much more normally, though my heart bangs around to a degree, and was able to lay down normally, but that has back tracked a little.
Friday, after walking steep stairs to enter work, I was fine, but shortly after that while walking on the level, my heart picked-up a persistent dysrhythmia, feeling like a normal rate uniformly and frequently visited by uncompensated PVCs (i.e. no compensatory pause was apparent). This went on for a good 5 minutes, even climbing the stairs to the shop, no other symptoms, no pain, no shortness of breath, no dizziness, just an annoying thump interspersed like clockwork with my regular rate. When I sat down, it persisted, then resolved into frequent compensated PVCs that I'm familiar with. This is the second time this has occurred, the first being in May also while walking.
I phoned the E.P., he said I passed my December Stress Echo, and said not to worry unless I get dizzy or pass out. I was a little non-plussed, since not seeing the rhythm on the Holter or on a Dr. Office EKG how he could be so cavalier about it? What might I be experiencing? Could it be bigeminy or trigeminy at a higher heart rate since I was walking and therefore not feel familiar. Could they have been compensated PVCs but since the Heart Rate was higher, the delay seemed far less. Can you switch between interpolated PVCs and compensated PVCs?
I am feeling for you. I don't know what the differences are between the interpolated and compensated PVCs, but if your EP said you passed your stress echo, you might take some comfort in that. I have been getting some relief for awhile from my PVCs. Has your EP or Cardiologist done a Nuclear Stress Test on you? My best to you, and hope your distress and PVCs go away soon, and stay gone.