frequent PVC's

[gina6169]

hi. i have been having problems for the last 5 months. it started slowly. at first i felt occasional skipped beats, then it was constantly. i ended up in the ER where of course i was diagnosed with a panic attack. i then saw a cardiologist who ordered an EKG, echo, holter monitor and thallium stress test. all were normal. the holter showed over 900 PVC's in 24 hours but no coupling. he diagnosed me with idiopathic PVC's associated with stress. i have recently been divorced, but the worst of the stress was well over a year ago. anyway, he started me on lopressor and xanax. it calmed them down for a while but then they got worse. he doubled my dose to 50mg twice daily, and again it helped at first then not at all. with his advice i went off the meds, and once again it calmed down, but now its back with a vengeance. it disrupts my whole day and i can barely make it with the xanax. wwhat i feel is my heart pounding out of my chest with some irregularity and sometimes i swear it flutters. recently i have been having pressure in my chest as well, but no pain. i feel like the doctor thinks i'm crazy but i know something is wrong. i am 39 year old female, otherwise healthy,exercise regularly, and at my vist my blood pressure was high at135/90 which is a first for me.
the doctor said my heart is over reacting to adrenaline for some reason, but maybe i have high levels to begin with. through my research  i came across pheochromocytoma...is this something i should mention or am i crazy?
please help.

[Michael J. McWilliams, M.D.]

Pheochromocytomas are very rare conditions.  It would be very rare.

900 PVCs on a Holter is actually not that money.  In the last few weeks I have seen three patients with over 32000,   35000, and 45000 PVCs.  It would be important to note to see on a Holter if you are having symptoms with PVCs or if you are just feeling your heart beat.  Without meeting you and seeing the tests, it is difficult to say exactly what is going on but from reading your comments above it sounds like anxiety is getting the best of you.  Some forms of PVCs can be ablated but this is only worth doing if your symptoms are from PVCs.

I will sometimes try calcium channel blockers to see if I can calm the PVCs down but this doesn't always work either.

I hope this answers your question.

[linier]

I just wanted to tell you how much I know how you feel.  I too several months ago stared having constant PVC's  (I had them for years, but never that bad).  I felt every one-it upset me so much I'd be in tears.  I could hardly function.  They had me on  Lopressor 50 mg 3x a day which did nothing but give me bad dreams.  Well, I decided on ablation-and I have to tell you though they are not gone completely, they are so much better and liveable. The procedure was so worth it!  God bless.  

[Barbmag]

I was just going to add my comments re. PVC's which I have on a daily basis. For a little history, I am 62 (female), had an ablation for Tachycardia in '93 but I have suffered from PVC''s for as long as I can remember. I can not determine what triggers them and it is when they are in 'runs' that last for hours that make me crazy!! I am careful about diet, exercise and try to make smart choices every day so that I do not get these v bothersome palps.  I have seen many cardiologist, so I have had all of the tests that I need and I started on Toprol XL, 50 mg a couple of yrs ago, to do avail, really. I am wondering if an ablation would help with these and I would v much wonder, Linier if you could give me any more details about your 'condition' etc...how many PVC's would you say you had a day and did you try any meds before the ablation. My cardio mentioned that we could try an anti arrhythmia med but I have read some v disturging things about those and I just wonder if that would cause more of a risk factor than actually having PVC's which most doctors are not all that concerned about. I know there is a risk factor for the ablation as well and so I am so frustrated b/c I just do not know what to do. I get these PVC on a daily basis not all lasting hours but some last several minutes. It is when they go on for hours that is the most uncomfortable. an worrisome, ,like last night, they went on for 5 hrs. I tied to stay calm but the adrenaline kicks in so that makes me a bit agitated, esp when the PVC's last a long, long time.  

If you have any suggestions or can let me know what your situation was, etc, I would so appreciate it. I am glad to hear that your ablation went well. I have read that most of the times an ablation will not work for PVC'.

Thanks for any replies!!!!
~Barb

[upbeat633]

Just a short peek into my situation, I hope will help you with some of your questions or concerns.

I have high frequency pvcs, and they seem to be ever increasing the older I get. My last holter recorded on average 24,000/day. Doctors, cardiologists still not concerned.

I requested an echo in March because my pvcs were increasing again, and I was having several long strings of them. Echo fine.

But I was concerned by the multiples so I requested an appointment with an EP.

He ordered a 30 day event monitor, it showed multiples, but "nothing unusual" according to the EP, since echo and ekg were fine. He suggested a stress test, but since I don't get short of breath, and since by my own observation the pvcs go away with aerobic exercise, he suggested I try acebutolol. BUT he advised strongly against anti-arrythmics because this could produce a serious arrhythmia, and he said he would not even consider an ablation because the procedure is not intended for pvcs. And because pvcs are considered benign he could not ethically suggest a procedure that comes with a 1% chance of stroke or creating a more serious arrhythmia. By the way, he estimated my pvcs near 30,000/day based on the multiples, but he wasn't the least bit concerned (regarding the number). He said no matter the number, no matter the pattern, pvcs in a structually normal heart are benign.

I find I do best with a solid 8 hrs of sleep (more is good), and I keep well hydrated. I limit triggers but do not avoid them because I haven't found that eliminating anything (even in combination) helps all that much. Anxiety makes me feel them more, but it doesn't increase them, and likewise when I'm fully relaxed I don't get less. But I am still here, and when I can focus on other things, I'm generally having a pretty good life.  I hope knowing my situation helps answer some of your questions about meds and ablation.

[Barbmag]

Thanks again for your reply and info. Your 'history' sounds familiar!

I fiind it interesting that the EP that I saw last month ( a new dr for me b/c we are new to  Charlotte) said we could try either an anti arrhythmia med (they scare me so I hope to never have to go on one of those, ever!!) or even an ablation. I want to be as conservative as I can be with my treatments so I will not consider either one of these, at least not now. I keep trying to remind myself that my PVC's are benign and not to get upset when I have runs of them. That is sometimes hard to do. This doctor also gave me an RX for Xanax to take on an as needed basis. I am so afraid to take anything like that so I have not filled the RX.  I do take  Cal/Mag and v interested in essential oils such as lavender to help calm things!!!

Thanks again for your help!

[Seasoul772]

Hi! I wanted to reply because I'm having the same runs of pvc's that you are. I went for almost 2 years with only occasional pvc's but now the runs of them have returned and seem to be more frequent. I am going through menopause which may be triggering them. Sometimes I find that if I eat something with a significant amount of potassium, such as avocado, prunes or prune juice, or chick peas, it seems to calm them down more often than not. Don't know if its psychological or if I really do need potassium when I get them. Once several years ago when I was in the ER with them the doc said my bloodwork showed somewhat low levels of potassium and magnesium. So, maybe there is something to it. Anyway, just wanted to touch base with you and tell you I definitely can relate to your story. Hope yours have improved since you last posted!

[dafan]

Hello, As a fellow PVC sufferer i can sympathize. In my case i had borderline hypertension and pvc ( which started abruptly at age 49) I hate to make these statements because i am not a dr. But in my opinion, years of heavy exercize and moderate to heavy drinking for 4 years( 4 to 5 glasses of wine everynite) probably put a little extra load on my heart. I was started on Toprol xl 25mg around the first of 2005 and really no effect on the pvc but blood pressure was brought well under control 115/75 range. Then in the spring of 2006 i noticed definately that the pvc had diminished drastically, from id say around 1000 to 2500 a day down to only a handful. At times they do flare up, say for a couple of days when i might have a couple hours at maybe 1 a minute, but this only occurs about every 3 to 4 months. I also stopped drinking at that time but do continue exercize. So, whether my lifestyle contributed or not... not sure... and whether the toprol affected the pvc... not sure either ... but they have diminished at least for the time being. Good luck to all.

[mady01]

HI i also suffer pvc's way you all describe yours ,i sometimes get them after eating ,i can handle a few palps here and there ,not the frequent ones that are so irregular for hours.....i FEEL for all of you i have been diagnosed with [skipped beats]  been to cardio numerous  times, over the years for reasurrance i take [atenonol] 50 mg...still i remain scared when scary ones start they disrupt my life ,...sometimes beats feel like they start in my stomach thats when i get the erractic ones does anyone else ever feel them in stomach ?....thank you

[circadrt]

Hi Mady,

I am 58 yo male and have had these since college years. I have a healthy heart according to the MANY tests and doctors I have seen over the years. I also have anxiety disorder, which is under control most of the time, but high stress or worry about things or not enough sleep and I can get PVC's more the next day or that day.

As for feeling them in the stomach...I get them and feel them there with kind if a muscle twitching feeling - like you can get in an eye lid muscle sometimes that drives you nuts! :) I also have felt them in my neck or back muscles along with a strong back muscle twitch or tic or spasm. Since benign PVC's are all tied into the central nervous system, the vagus nerve and other things all linked, if you get a strong twitch in a muscle or other symptoms in your stomach or back muscles, it makes sense to me that you (and I also) could get a PVC and feel it there. I have had cardiologists tell me they had patients feel them in their wrists!

I want to stress here that what we focus on usually becomes stronger. So if we are thinking about getting them even when we don't have them, we have some general anxiety stuff going on and treating that by many ways other than just drugs (which can cause skipped beats even) is really the way to prevent them best and also get to the probable cause for getting them or getting so many of them so often. When I listen to relaxation tapes or (cheap to buy and great to get to sleep) or get busy doing something so I am not *anticipating* them, I tend to not get them.

The mind is more powerful than any drug. If those of us who have anxiety issues or depression issues can get on top of that with medication and also other things like counseling and other self help methods to stay calm and relaxed and get out of the "Oh no" and "What if" way of thinking, I am sure we would all find that we have ALOT fewer PVC's, and when we do get them we do not immediately tense up and start the hormonal secretions into our bloodstream (cortisol adrenaline, catecholamines, etc) which does nothing but make the PVC's worse and last longer.

Good luck with this. I also find that once I am reassured that almost everyone gets PVC's daily (they just do not feel them) and it is 100% normal and not harmful in healthy hearts with no other serious diseases going on, that if I can wean myself away from READING forums and books and other things about them (which just focuses the mind on them more!) the better off I am. If a person reads about headaches and what the different types are and what they can mean, etc. often, they probably are going to get more frequent and even more severe headaches! I know it's not easy to NOT go where people "like us" are and talk about it, but really, after a point, it causes more harm than good, IMO.

Best of luck to you!

[mady01]

Hi Circadrt:, Thank you sooooooooo much for sharing how you deal with pvc's etc,wow we are same age i have been getting palps since i was 32 yrs old and i have had anxiety since i was 29 ,.......yes you are so right about the mind being si powerful.i agree what you say about the relaxation tapes,i have few ,plus i listen to music helps at times.....i was so desperate because like you say more you read think you have everything ..,so true here i'm looking uo hairloss and i find other topics lol so i go from thinking i have anerysom's in stomach to everything ,i am always stressed out and i want take vitamin i think it will make my palpitations start at time right after i eat i feel some weird thumps....you are right i am anxious about my hairloss for 4 years now ,i can't controll what its doing ,others say they can't tell ,i can and it consumes me looking for answers why ..i do go for councling once a week helps some,your right about not enough sleep i notice i get them worse also ,i am now reading about visualization ,where says tell yourself ,[i am  happy healthy peacful and calm] than when negative fear statrs to say cancel,so i am trying this.......its not normal to live in FEAR every single day when i first saw cardio about palps he said they were 'skipped beats' than in 2000,i asked could please check me out again because beats were frequent he did one test he never thought i needed it was a stress test where give dye and a quesionable area came up i had a catherazation done and the dr did it said your heart is healthy i give you another 45 years run marathon if you want lol....well i felt good about that news than my dad passed away in 2005...i got theses raid irregular beats for hours came from stomach and since that year few more episodes i had a EKG chest x ray bloodworl last year it was normal ,i see my md once every 3 months i told him about the weird rapid beats but he didn't seem be that concerned ....so now i am hoping CONQUER this fear with heart .......thank you so much for the info i don't feel so alone when others share how they feel,i will try more relaxation tapes ,thank's for listening i'm hoping for better days to come and focus on positive things ...good luck to you also you sound like your doing well congrats .

[mady01]

Hi how can you tell if it'd the Adrenaline when palps start .......i had a horrible day i felt irregular beats in my  stomach and they are scary than i have run to bathroom ,i wonder what the connection is......i don't know whaere to put myself than i think maybe something wrong with my stomach it consumes me all day....i tryed work so hard on fighting the fear today i felt depressed just crying feeling hopless......my sister came visit i get nervous than i' feel i'm relaxed i'm so sick of this kind FEAR,i'm at a loss why stomach their wicked .....does anyone else get them there also ,i was distracted all day couldn't focus on anything ...thank you.....mady

[jkfrench]

I HATE the ones you feel in your stomach.   They ruin my day.  They make me feel "numb" for an instant.    I'm told it depends on the timing of the pvc.  
Have a great weekend...I just made a martini and I'm going to enjoy it!
Frenchie

[mady01]

thank you for the reply.......oh i wish i had nerve have a beer lol........yes enjoy your martini i use to drink them years ago, i like olive now my heart palps has me scared everything so frustrating ...have a nice weekend ......mady

[kat4]

Hi, Mady,

Alcohol can make heart palpitations worse.

It is pretty common for people to have to go to the bathroom more when they are having heart palpitations.

Some meds can cause hair loss, you might look up any you are taking.  But it might be that your anxiety is causing you to magnify that.

Try to work on relaxation :) easier said than done, I know.

[mady01]

Hi Kat4,Thank You for the reply,i heard alcohol can cause palpitations also ,i know years ago when i drank few light beers ,at the time i didn't feel palps ,but next day i did for sure.......i'm just so confused about the stomach feeling these scary beats start from there ,yes at times i do get anxious and it hits me in the stomach when i'm nervous ,but sometimes i fear everything i eat ...i had a slimfast bar and this one day i had a reaction or something but other days i don't ,i'm always upset about hairloss ......i wonder about the atenonol i take for b pressure but i feel i'm on it alot years ,i guess may be too late try get dr wean me off ,oh Magnify yes i make a big deal out everything i suffer ocd so it's difficult ...i am trying 'Relaxation 'hoping to Conquer this fear .

[circadrt]

Hi Again Mady,

I read your recent posts. What I see over and over in them is that you have had and continue to have untreated anxiety-high stress issues, which will continue to feed your obsessing over and worrying about the PVC's and for that matter, any other physical sensation. I am not saying if you are sick don't see a doctor or get medical help. I am talking specifcally about your huge concerns with the palpitations over such a long period of time, despite medical expert reassurances.

I don't know your situation regarding personal physician, etc. I will tell you what I know for sure: ANYONE (including me many years ago) who has PVC's and who has seen cardiologists, been tested, and has been told they are benign, needs to believe that, and if anxiety is preventing them from believing that and getting on with life, then need additional help. This additional help for me and anyone else needs to be in-person counseling - talk therapy - with someone **who knows about anxiety disorders** (and a good counselor -not a psychiatrist - can be found in most cities and in large cities you can find income-fee based counselors, so it is not that expensive). You have, like many people who get benign PVC's and continue to focus on them, years of "sensitizing" your mind and body so that you focus on them, ANTICIPATE them, and can actually cause them because of your mind-body connection.

On top of finding a good counselor-therapist who can help you turn around how you think about your physical sensations and health, you could also possibly be helped by some short-intermediate term use of anti-anxiety medications. There are many on the market that address obsessive worry and the very type of thing that you talk about and show in your writing here. It is important to not just take the medications for anxiety without going to talk therapy, because you want to learn how to NOT pay attention to your body as you have for so long. Drugs will only help attenuate the anxiety symptoms some. Some anti-anxiety pills, like plain old diazepam, also are muscle relaxants and can help in actually slowing down the overly sensitive heart's electrical system and your central nervous system so you are less likely to have PAB's or PVB's. It's important not to just pop pills, or you will get hooked on the pills and you will NOT be getting to the bottom cause of the problem.

You asked how you can tell if it is adrenaline that is causing or involved when you get palpitations. I think it is safe to say that ANYONE who has long term problems with high stress and especially anxiety disorder is going to always have higher than normal levels of all of the stress hormones in their system (adrenaline, nor-epinephrine, cortisol, catecholamines, etc.) so it is certainly part of it. But the main piece I want to try to get across to you is it doesn't matter about the hormones as much as it matters that your thought patterns, developed over many years, are creating much more of these hormones, thereby setting you up to get the palpitations in the first place!  And the more you focus or worry or feel victimized and at the mercy of your body, the less likely you are to getting them to calm down or go away. That's why the counseling is vital. You can learn various ways to relax on a daily or even hourly basis, (whenever you feel the need to do so) before the chemicals are increased in your system. That's why it is so important.

Meditation, self-hypnosis tapes-CD's and other things are all just a small part of what you can learn to use at home, so you can gain control over the anxiety instead of it "controlling you" and adding worrisome physical symptoms (in this case, primarily palpitations, but I would bet you have other symptoms as well - gastrointestinal stuff  like indigestion is another very common symptom).

So you can continue to "swap symptoms" and ask questions of others online who have similar problems, but the bottom line is that is not going to help get it under control. I read everything I could and saw alot of doctors and went to the ER many times before I finally was ready to take responsibility for my thoughts and my mind creating the anxiety that was feeding my physical cardio-related symptoms. It is sometimes easier to continue to complain and worry and talk about and study all about this stuff. But after a certain point it becomes yet another powerful trigger that just feeds into your anxiety and makes things worse instead of better. I hope that makes sense to you.

I think you are a very nice person from what I know here. You deserve a MUCH higher quality of life than you seem to have. I would like to see you get that, and I think it is only going to happen when you see the kinds of people who can help you with many different ways identify and deal with and overcome your anxiety issues. I waited 20 years before I got help on the anxiety. I wasted alot of time and was miserable because I put it off as long as I did. Now I know many tools for relaxation and for keeping my mind from creating the kind of worry and rumination and obsession on my body sensations and symptoms. I very rarely get palpitations anymore, and when I do I know how to deal with that so it does not get worse. I also make sure I get enough sleep and I avoid alcohol and caffeine and other things that can trigger them in people in general.

I am sure you can get on top of things. But to do so, you are going to get help as I suggest above. You have already seen the heart "specialists." You know you have a long term anxiety-stress problem. Now it is up to you to decide how much longer you want to continue "as is," or if you are ready to approach things from a different angle help wise. I hope you'll seriously consider taking a different route. As Dr. Phil would say, "How's that been working for you??"  :)

All the best to you.

Dennis

[mady01]

Hi circadrt, thank you soooooooooo much for taking time to share your thoughts and to try help me ,i appreciate it very much ,and you know i go to councling once a week since 2002 ,it is not helping much as you can see.........i use have a wonderful therapist and he helped me get some controll with my ocd and FEARS anxiety and help me focus on trying to deal with everything ,but he left work a crisis center ,and the pyschiatrist i see doesn't help much its like i hear are you getting out taking your meds hes not ,getting down to what really interfering with my life ...and yes i never changed seems like i'm trying do it on my own when ,at times ocd cause me to stay where i'm at ,i tryed to work out of ocd books and read up on when your body is scared ,that is me ....your right i do need a councler but one on one at this point in group theirs like 15 people we all have different problems .........i think its wonderful uyou have taken controll of your life after 20 years good for you ,i hope to do that i feel so needy i hate it.makes me sad ,i am asking for one on one therapist someone help me with what i'm going through ,i know bad to look up certain things on internet ,i think i have everything and thsi is no way to live in Constant fear of what my body going to do ......i kn ow years ago i had a pyschiatrist told me when i first was diagnosedc with ocd ,that it's like 2 wires that don't  connect and when you take pill for it like prozac or paxil it will make things work normal ....the prozac made me nervous and paxil made me headaches nauseated ,i was hoping to just take xanax for anxiety i'm stuck on beta blocker atenonol .....many thanks to you ,hopefully i can get controll like you did i can post it here take care.

[mady01]

A related discussion, constant fear was started.