more question(s) of the day

How can you tell the difference between a PAC or PVC?   Also, what CAUSES (not triggers) SVT's?   Can physical exertion (strenous exercise), stress, caffiene, alcohol etc. CAUSE this condition?  Anyone want to go over the different types of SVT or have a good resourse to research them?
Thanks!
MQ45

[Jerry_NJ]

Did I miss it, or did everyone avoid answering your the easy part of your questions?

PAC = Premature Atrial Contraction, is in many of us not felt, but may be.  Is different that Atrial Fibrillation and Flutter in that a PAC is a contraction of the atrium, not a quiver. I believe PAC is normally not treated and is not dangerous.

PVC = Premature Ventricle Contraction, is as the name says, a contraction of the (big powerful) ventricle (not sure if it happens to both or just one ventricle).  This too is often not treated and not dangerous, however, if it is frequent I believe it can be very unpleasant.  In some it is not noticed or troublesome.

I suffer from Atrial Fibrillation (full time - permanent).  This condition sometimes causes an extra left ventricle contraction, but I do not notice it unless I am "feeling" my pulse, such as when counting my heart rate.  This experience is why I believe a PVC, even a few per minute, may go unnoticed by the patient/victim.

[Jannie411]

Hi Maura,

In my (non-medical professional) opinion, I don't think exertion/exercise, stress, caffeine, or alcohol cause SVT's, but they certainly have the potential to make an existing SVT situation worse.  I believe I was probably born with SVT, although it didn't show up until adolescence.

Some good resources for learning more about SVT are the Cleveland Clinic website, the Mayo Clinic website, and WebMD website.

Hope this helps!  

[jkfrench]

It is almost impossible to figure out what triggers all this stuff.  I do know stress will increase my pvcs's but as far as food, exercise and alcholol goes there is no way of knowing.  When I'm in a good period with just a few pvcs a day I can eat chocolate, drink a martini, work out with no problems at all.  
As far as svt goes.  Well, today I was sitting down completely relaxed holding my little dog and had about a 15 beat run of pat.  I was so relaxed it was crazy so again, no rhyme or reason.
What is more important is to treat the panic you feel afterwards so that you don't spiral out of control.  I'm learning to do that by taking 1/2 of a .025mg of xanax after even the smallest pat attack so that I don't continue thinking about it.  Otherwise, I will worry for a few hours and be on guard for another one, which of course is what sets mine off.  Fortunately this doesn't happen every day and therefore the Xanax has lasted for 5 months so far.
Jodie

[merileegal]

What I've learned is that no two people are the same when it comes to these. I've tried journaling everything I've eaten and written down supplements. Krill oil seems to trigger mine but for others it helps. I can drink diet dr. pepper but can't tolerate green tea. Stress for sure gets to me. It is probably the worst offender. Like the previous post, when you have one of these try and handle it calmly which is really hard sometimes. For me it depends on where it happens. If I'm in public places it's hard to do a vagal maneuver and not look conspicuous. When I'm at home, I do the vagal thing and it almost always converts right back to normal. Also, I just read somewhere that the sooner you try to convert back to normal rhythm, the shorter the episode will be. I've found that to be very true for me.

I'm not sure myselft what the difference is between pacs and pvc's. I think that pacs feel more like fluttering. Pvcs feel like a missed heart beat followed by an really hard beat. I too would like to see what other people say about this.

[jojob55]

What is the vagal maneuver and how do you do it?
I have pvc's and after one sometime my heart rate speeds up for just a little while, maybe 1 to 2 min. Would this benefit me.
It could be because they scare the $%^& out of me and it's my adrenalin kicking up a notch.
I am looking for answers for something that will never make any sense to me as they happen if I am stressed or not and I do not drink, smoke or do drugs and I am a 56 year old female with no underlying conditons except hypothyroidism.
I have an appointment with a cardiologist on the 13th for a stress/echo, should I ask my doctor anything specific?
Any helpful tips would be great!

Thanks Jo

[Jerry_NJ]

Did I miss it, or did everyone avoid answering your the easy part of your questions?

PAC = Premature Atrial Contraction, is in many of us not felt, but may be.  Is different that Atrial Fibrillation and Flutter in that a PAC is a contraction of the atrium, not a quiver. I believe PAC is normally not treated and is not dangerous.

PVC = Premature Ventricle Contraction, is as the name says, a contraction of the (big powerful) ventricle (not sure if it happens to both or just one ventricle).  This too is often not treated and not dangerous, however, if it is frequent I believe it can be very unpleasant.  In some it is not noticed or troublesome.

I suffer from Atrial Fibrillation (full time - permanent).  This condition sometimes causes an extra left ventricle contraction, but I do not notice it unless I am "feeling" my pulse, such as when counting my heart rate.  This experience is why I believe a PVC, even a few per minute, may go unnoticed by the patient/victim.

[merileegal]

There are different types of vagal manauvers. I usually breath in as deep as I can into my lungs until I feel like my lungs are gong to burst. Then I breath out slowly. I do this until it converts which it does most of the time.  Others cough, drink ice water, throw cold water on the face, or bear down. Google vagal manauvers and it will give more and explain why it works. It is really scary when it happens! However, when you're able to make them go away using one of the manauvers, they will be less threatening.

Good luck with the cardiologists. The thyroid can cause rhythm irregularities. They've checked mine for years, literally since my 30's and I'm 59 now, to see if that is what triggers my arrhythmias and it is always normal.

[merileegal]

In my research last night on pvs and pacs, I found some youtube videos of what they sounds like and looks like on an ekg. It was interesting to listen to heart beats that are similiar to mine. I just googled youtube then "pvc" . On one video they said a pac is not an arrythmia but an ectopic beat. I'm still learning myself. I was told in my 30's that I had lone atrial fribillation and that it was pretty innocent unless I have an episode longer that 24 hours because the blood can clot. I had a difficult episode in February so I saw a different cardiolgist. He said he didn't think I had afib. I wore a King of hearts and had an episode and was diagnosed with Supraventricular Tacycardia and that can be fixed (they said) with an ablation. I also had lots of pvcs and pacs. They said they were nothing to worry about.

[mq45]

Thank you all for the helpful information!  
My cardiologist said an SVT episode is preceeded by a premature beat.  I'm not sure if it is PAC or PVC, but JoJob...sounds like this is what you are experiencing. Very similar to my experiences.  My episodes are very short, so have not had to do a vagal maneuver, but it's good to know!   Going in this week for another consultation and then will probably schedule the ablation.  Very scary, but look forward to being "back to normal"   Have those of you who have had the ablation procedure gotten "back to normal"?    

[MJY714]

Hi, I am experiencing skipped beats and find all your responses so helpful. It certainly helps to share the experience with others. Some can live with PVCs without issue but in others ( me!) it causes a lot of anxiety which probably makes things worse. Magnesium, a little xanax and the ability to relax as much as possible really help.
Thanks, MJ

[mq45]

Hi all,
A quick update...met with my 2nd electropysiologist yesterday (my first doesn't work with my particular insurance) and I have decided to go ahead with the ablation procedure! Scheduled for June 27...YIKES!   This one does not use a general anesthesia, which I'm both happy and nervous about.  Tom, am I correct in that you did not have a GA either?  How was that experience?
Also, he mentioned that my "palpitations", extra beats, or premature beats (whatever they are) will NOT go away.  I said that those of us with SVT are hypersensitive to our heartbeats and that hopefully after 3-6 months I will not be so AWARE of those extra beats.   Any experience there Tom or Jannie?  Are you still experiencing missed or extra beats?
Jo-good luck with your appt. on the 13th!
Maura

[tom_h]

Maura, that's great to hear about your upcoming ablation!  Believe me when I tell you that it has renewed my life again.  I'm running and skating, losing weight, and feeling absolutely great!  

What kid of SVT do you suffer from?

My ablation was done under general anesthesia, and consequently was trouble free; I fell asleep, I woke up and it was over.  Jannie was awake for hers, so she's the one who can give you all the gory details!

Afterwards the ablation, I continued to experience PVC's.  Of course, now they didn't trigger the SVT.  Lately though, they've disappeared.  Like I mentioned, I've been exercising very hard.  I haven't worked out this hard since my speedskating days.  I had been experiencing clusters of PVC's while at rest, but they went away once I brought my heart rate up during a workout.  Now, they've disappear completely.  I'd be delighted about this, but they've done this before only to return after a month's absence.   I didn't notice any reduction in the sensation of feeling a PVC.  Mine still hit hard, although I wasn't as concerned about the impending SVT episode that usually followed a cluster of PVC's.  I was averaging 4 SVT episodes per month, so the cluster were always there, perhaps disappearing for a couple of days inbetween.  Keep us posted on your progress!

[Jannie411]

Good luck with your upcoming ablation, Maura.  My ablation went smoothly and with no problems and I hope your ablation experience will be the same way.  I am very happy I had the ablation and am enjoying life to the fullest now.  My only regret is that I couldn't have had it done 10 years ago.  I am losing weight slowly but steadily.  The best part is not having to think twice before I do anything that formerly would have caused PVC's and an SVT attack.

Post-ablation, there were a few instances where I felt like SVT was going to start up, but within seconds things went back to normal.  When I went for my check-up with my EP two weeks ago, he took an EKG and listened to my heart, said everything was fine, and gave me the green light to get off the beta blocker completely and move forward without any restrictions.  My next appointment with the EP is a year from now, but he said if I had questions or concerns to call him anytime.  I was fortunate in that I had AVNRT, which the EP said was the easiest type to fix and I am very satisfied with the way things turned out.

It's now been six weeks since my ablation and I have not experienced any PVC's for the past 4 weeks.  All symptoms pretty much vanished after week 2.  

I will be thinking of you on June 27.....please keep us posted on your progress.  So happy for you that soon you too will be able to live a normal life!

[mq45]

Thanks you guys...you are great! So supportive!
Tom, the Dr.'s say they won't know for sure what type of SVT it is until they go in (sound about right?), but they think it is AVNRT.  Let's hope!
I'll keep you updated!

[tom_h]

My pleasure, Maura.  AVNRT is the most common form of SVT.  I had a form of AVRT called Circus Movement Tachycardia.  It was easy to fire up, find and ablate, although the conductive partway was very wide requiring 17 burns to bridge the conductive muscle.  Keep us in the loop, and we'll be glad to address any concerns as the big day approaches.

[Jannie411]

Yes, that's correct - they won't know for sure what type of SVT you have until they go in.  I found out what type I had while the ablation was in progress, my EP came over to talk to me several times during the ablation.    I was awake and very alert for the entire procedure - my choice - as I am fascinated by all things medical, and wanted to see what they were doing.  It was awesome how he was able to fix a nearly lifelong problem in the short space of a few hours.

Take care!