Why do you all think you have PVCs?

[is_something_wrong]

I can't help but notice since I joined this community some months ago, people with skipped beats or palpitations tend to ask questions about PVCs. Like all flips in the chest are PVCs.

The upper chambers in the heart are more "irritable" than the main chambers. In other words, they are more likely to produce premature beats (PACs). A few examples:

Which is more common - A-fib (atrial) or V-fib (ventricular)?
Which is more common - SVT (atrial) or VT (V-tach) (ventricular)?

Both PACs and PVCs are usually benign, so it's really not an issue, I was just a little curious.

Even so-called "wide complex beats" on EKG are often PACs. If a PAC occurs very early, it can show as a wide complex on EKG, because the right ventricle is a little slower recovering than the left, leading the electricity to the left ventricle, and then to the right, thus mimic a PVC that origin in the left ventricle.

Just so you know :-)

[myt6]

I'm back.  Magnesium supplement stopped them cold..............for 30 days.  Not a one............then, they started up again with a vengeance.  Bigeminy for one solid hour.  Then two-skip, three-skip.....one skip....one skip etc....etc.....atenolol does not stop them.

[capecoddebbie]

I am a 60 yr. old female.  I, too have had PVC's for about 2 years.  (Actually, I have had them all my adult life, but then they were 1000 per day, now they are over 3000 per day).  I know just how you feel!  They run my life, also.  I did the echocardiogram, holter monitor and see my cardiologist every six months.  He said they were benign, unless my heart starts to go very fast, or I feel faint or have considerable chest pain.  Oh great, benign unless...!!!  It is very hard to forget this when the pvc's are going crazy!

Mine seem to be directly related to eating and stress.  I get them more when I eat, seems like just the act of eating gets them going worse.  I am never without them.  Sometimes I go a 1/2 hour without them, but they start again.  My doctor said some people are just more body sensitive than others, and feel them, while others never even know they are happening.  WOW!  I can't imagine someone would not feel the stopping and crashing, one after another.  Hang in there.  I am going to try yoga.  Taking a slow calming deep breath, and purposely trying to relax my chest and abdomen seem to help me.  

[merileegal]

I've learned so much! I've had missed, skipped, flip floppy things for a long time and haven't been too worried about them. It's the tachycardia that gets me. But it is interesting to know what those beats are called prior to the svt because that's when I freeze and brace myself. It helps me understand that my heart hasn't  decided to just stop beating. It also helps me understand that funny feeling I get in my throat. I just saw my ep and I asked about the monitor results for the pacs and pvcs. He said I didn't have any pvcs just a lot of pacs and that is what I had right befor the svt started that they caught on the monitor.

[is_something_wrong]

I don't think it's possible to feel the difference between a PAC and a PVC.

Rapid beats in a row are almost always PACs. Salvos of PVCs are rare.
The sensations in your throat are often early PACs, where the atrial contraction falls on the systolic phase of the previous beat. Instead of pumping blood down to the heart chambers, the blood flows the other way, back to the throat, because the ventricular blood pressure generated is way higher than the atrial.

This may also happen with a PVC, but in that case it's the next sinus beat (after the PVC) which isn't conducted, that creates this effect.

But you are correct - we all have an occational PVC!

[SassyLassie]

Very interesting thread.  The two times I wore the holter monitor, it said I was only having PAC's. But, some of the ones I had felt like the PVC's you folks are describing. Most of mine are like little "blips" that I feel in my throat, now I remember reading that one of the posters did not mind that, but, I HATE it, it scares me and takes my breath away.

Here is the pattern of some of mine.
First example: beat, beat, beat, (normal in other words) then a pause, then a harder beat,  another pause, then back to normal.

Second, and I hate this and I don't think it has been caught on a machine either.....
Normal beats, then a pause, then some fast beats in a row, usually around 7 or 10, then a long pause, then back to normal. This scares me silly, and right before it starts, I usually have a weird feeling in my tummy.

So, the reason I know I have PAC's and maybe other kinds is because the holter said I had PAC's, but, I bet once in a while, a PVC sneaks in.

[rahel161]

I  was  just diagnosed with PVCs and PACs    6 months ago  with  runs lasting  2 hrs or more about 3xs a day.  I go to sleep and I have them, I stand up and sit down and have them or go from standing to kneeling. During exercise, not so much. I still do my cardio  and weights, I am not letting this get me down.  I loose alot of sleep from this.  It is bad  at night and almost every morning I wake up with them. I cut out caffeine, alcohol.

I had2 EKGs that never caught anything except mild arrythmias, and a prolong QT wave.   My family Dr. said it was just stress and suggessted it was psychosomatic.  I was so angry. I said look I have a family hx of  cardiac disease  I want to be referred to  a cardiologist or I want you to put me on a 24 hr monitor, these are not in my head there is something wrong. He referred me to a cardiologist who put me on a 3 week monitoring device. The cardiologist called me 2 days later telling me to stop exercising,  and make sure I didn't have cafenine  ( which I already did). He said there were so many he wanted to put me on a Beta Blocker.  He told me about cadiac remodeling where if there is irregularities in the hearts electrical system overtime it can translate into a protein change.  This is also seen with patients who have Afib.

I was on advair and albuterol, allegra D  a few years ago, which I think set all of this off.  

Things I do to cope:
cardio exercise, walking,
cut out all caffeeine- no pseudophed- no cold medicine of any kind ( still take zyrtec or claratin ) Do not take the Clartitin D  since it has pseudophedrine . Watch out a lot of pain killers  like migraine meds have it. Watch out for Midol or pamprin! theyse can have caffeine!

I take a Magnesium supplment and Omega 3 vitamins. .. these help tremendously especially the Mag.

Avoid alchohol
Stay hydrated-- if you don't drink enough your heart has to work harder  since there is less blood volume, also it throws your electrolytes off.
I take a vitamin D3 also since I lift weights.  
Avoid spicy food
Avoid salty food
Avoid MSG too
( i generally try to avoid going to resturants)

Look into your birth control- birth control alone can bring on PACs or PVS.  Ortho tricylcin made mine worse..  

Loestrin is the best ( if you can handle what it does to your mood)

Also pregnancy and Menopause can aggrevate it- and premenopausal hormonal changes.

Avoid stress ( haha yeah right!)

Take up yoga and meditation/ regular exercise.

When you are having them  if you are able to - go on the computer, watch t.v  do something to distract your self and ignore it.

I have recently considered going on a Beta Blocker because I am losing so much sleep. My family's cardiac hx is complex and has started with PACS and PVCs, god willing I won't have my families problems like mitral valve regurg, AFIB, SVTS, arrythmias, congestive HF,  hyperlipidemia,  pulmonary hypertension,... etc. the list goes on.

I wish every one the best. People that don't have these ( even docs) don't know how frightening it is. It is terrifying to wake up to a heart that feels like it is going to fail. I envy those who walk around blissfully unaware of their properly functioning tickers :)

Good luck everyone.  If you feel in your gut something is wrong, and your MD brushes you off. Be persistent or change your damn doctor!

[bbxx]

Every test I have ever had for the last 20 years says pvcs and very rare pacs. I feel mine and all my ekgs and holters confirmed I knew what I was feeling.
As to why? I bet (this is not from research or actually knowing anything)--but a hunch--I bet the pvcs are from MVP and the regurgitations. I also have 1st degree heart block--acquired from meds--sooooo I have no idea if that adds to anything or not.

[mrcoop]

BTW, I beleive its hormone related...since diagnosed with hypothyroid (actaully went to the er and was having severe skipped beats, fast heart rate, very high blood pressure...and no, I was not having an anxiety attack!)...and found I was hypo.  Since then, my skipped beats are all over the place at times and sometimes never a peep from the ticker.

[mrcoop]

for me...a pac is a pause...its normal beat, with no extra beat, but a pause...the doc says that is a pac Iam feeling which was caugt on ecg when I had it...but when I have a pvc caught on a ecg, its an extra beat followed by apause and then a thump.  For whatever reason, my extra beat is buried in the pac, really don't understand it...they both annoy me, but the pac is much harder to feel and is what I have 80% of the time...sometimes I have several a minute that can last for weeks....

[AAPLAY1980]

I HAVE BEEN GETTING PVCs FOR ABOUT 2 YEARS NOW. THEY ARE RUNING MY LIFE ALL I THINK ABOUT IS PVCs. EVERY TIME THEY GO AWAY I THINK TO MY SELF IM OVER THIS. AND I ALSO THINK THAT WHEN THEY COME BACK THEY WERE NOT GOING TO BOTHER ME.
  BUT BAM WHEN THEY ARE BACK IM ALL SCARED AGAIN. ITS HARD TO CONTROL. DOCTOR SAID TO ME IT IS NOT NORMAL IF YOU DONT GET PVCs. hope this helps.

[CFS56]

I have both PVCs and PACs documented on EKG and holter.  I can definitely tell the difference in the way they feel.  PVCs are a more pronounced "stop" to my normal rhythm, my heart truly feels like it skips an entire beat and then I have a "thump".  PACs are like an extra beat.  And when my heart goes into tachycardia and is irregular it's almost like I can feel the top part of my heart beating faster and independently of the bottom.  I know that sounds crazy but that's what it feels like.  I was in the ER when it did that once and doctor said it was PACs, then I went into afib.

[itdood]

" I hope I don't insult you and I don't want to start a "fight" here :-) "

heck no, no offence at all.  The statement goes against my perceptions so I'm trying to learn more. perception is the reality for people :-)

[is_something_wrong]

A little Norwegian crash course, Google translate is not useful translating these terms:

Forkamrene = Upper chambers (atrias)

It also tends to use the expressions: Extra layer, extra battle or extra stroke for "extrasystoles". Stupid thing...

[is_something_wrong]

You can, for instance, look at this (Q and A from a Norwegian cardiologist)

http://doktoronline.no/qa/forum/34/qa3414078.html

You might want to use Google Translate, though the translation is really weird. Hopefully you'll understand some of it :-)

Itdood: I really hope I didn't offend you in any way. I have great respect for you and your answers, I hope I don't insult you and I don't want to start a "fight" here :-)

[itdood]

Do you have a source for this statement?

"  'wide complex beats' on EKG are often PACs"

[bypeep]

I had a 24hr Holter recently and thought for sure I was having PVC's because each time I'd get a palp, I could literally hear it through my chest and it felt like I was getting punched.  I tagged each event and when the report came back, they were PAC's.  They gave me a copy of the strips and I went over them assuming that they "had" to be strange PAC's to be so forceful, but nope, just a tiny blip and nothing out of the ordinary.  

[Mom2four85]

take a gander at my ekg's in my profile :P that's only a small portion of the ekg's I've had done in the past year - I wish I had the ekg's from the hospital where I had all kinds of different arrythmia's all on the same ekg; I'll have to send to all the places and get them and post them

I've got some wide QRS segments - weird ones during my treadmill test; dr's are amazed at and wonder why I don't camp their doorsteps when I've had pvc's back to back 24/7.  

Pvc's - the darn things HURT - that "dropped" HB is enough for anyone to pause.   I developed pac's (caught on monitors) after I had surgery and I had no clue what they were and asked - PAC's - mine felt more like a flutter - tickling, than the "thud" I felt with pvc's.  Also, I know my EP told me when your HR is lower, you tend to feel arrythmia's more I don't know how much that affects others as well.

From my experience - I think A-Fib and Svt is the more common thing, but VT and Pvc's are felt more frequently, but I don't know I'm not a dr just a patient with a very perplexing heart & neurological system :P

[is_something_wrong]

Hi,

Yes, that's a normally conducted PAC.

I saw a wide complex PAC in my EKG after stress test. I freaked out and was sure it was a PVC (that's when I was afraid of that). My cardiologist said, uhm.. that one's.. uhm.. supraventricular.

An example of this from the literature:

http://library.med.utah.edu/kw/ecg/ecg_outline/Lesson5/ventricular.html

(funny enough the name is: Not all sore thumbs are PVC's :-)

[itdood]

I've never seen an ecg with a PAC that contains a wide QRS.  Of all the ecgs I've seen with a PAC (not that many), the only way I can even see a PAC is the R-R timing..  PACs are tiny little things.

Compare that to a PVC ecg, the entire QRS is bizarre, I mean the thing stands out like a sore thumb.  Because the ventricles are firing at different times it's the widest QRS you will ever see.

A picture is worth a thousand words, so here's my point

http://imgur.com/CJUJL.jpg


So, just based on the electrical activity we see with a PAC versus a PVC, it's a logical conclusion to state that PVCs can be felt more and will cause the person more distress in terms of symptoms.   This isn't a blanket statement, but I think for the majority of people this applies.

[is_something_wrong]

Hi,

This is an interesting discussion :)

I know that PVCs sometimes causes the next sinus beat to occur when the AV valves are shut, causing backfiring of blood and pulsations in the neck. But a PAC can, too, if it occurs extremely early. Though, the atrias won't be completely filled and the sensation will be less bothersome.

What I don't understand, is the sensation of LV and RV contracting at different times. PACs often have a RBBB morphology and it occurs because the RV is still refractory when the PAC fires, causing a wide QRS complex. Permanent RBBB or LBBB is not uncommon, and I don't think people with this phenomenon are suffering from permanent palpitations?

Ventricles have more muscle mass than atrias, but a PAC also activates the ventricles? I would assume (and my cardiologist told me) the PAC itself causes a more noticeable beat than the PVC, thus PACs are often perceived as a "double" beat, and PVCs as skipped beats.

What I can strongly agree, though, is that the compensatory pause after a PVC is somewhat longer than after a PAC, and the next beat will be stronger after a PVC. However, I've monitored PACs on EKG and they felt terrible. So I guess there are individual differences.

[kay2486]

i know what you mean by the feeling, i know they are pvcs because ive been told and they are an awful thud and then the feeling of the hearts stopped for longer than it has, pacs are much lighter  feeling they dont bother me but the pvcs do, they can't go unnoticed

[chuparosa]

I'm kinda like ireneo. I gave up trying to figure out why I have palps. It's just what my heart does. I think its only natural to try to figure out why you have them and what they are. It is kinda fascinating in a way and also a bit disconcerting that you have little control over them.

[itdood]

p.s., another reason PVCs get more attention too is because they feel so horrible.  People with PVCs tend to seek medical attention more often.  People with PVCs tend to reach out more for help due to the severity of the sensations.    Like I said in my post above, if I had just PACs I wouldn't even go the doc for them.  Perhaps most people are like this and that's why we see this skew towards people with PVCs on the board looking for answers.

[itdood]

I've caught PAC's and PVCs on ekg during holters and stress tests.  I know the difference by the way they feel.  PACs are more of a tiny flutter that don't bother me at all.  They're kinda cute in a way.  I wouldn't even seek medical attention for them.  PVCs make my entire chest move.  they are a wicked thud.  The main diff being that a PVC will cause the right and left ventricle to contract at different times, where a PAC will trigger the ventricle through the AV node so at least the ventricles contract at the same time.  The ventricles have so much more muscle mass than the atria that yea, you'd expect to feel those more.  Valves slam shut when the atria is contracting.  It's nasty.  Some of the regulars on this board have this level of experience.

I think what you're trying to say is that people are wrongly diagnosing themselves with PVCs by feeling, or, answerers on this board are skewed in this direction.  I've never gotten this impression.  Almost all the interaction I've had are with people that have been formally diagnosed with PVCs.  Those that are not formerly diagnosed but asking for opinion on this board what their "flutter" is for the most part get the proper advise of it's probably ectopic activity of some sort but it needs to be seen on an EKG to be sure.