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pvc cardiomyopathy?
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pvc cardiomyopathy?

I am  in bigemini most of the time, for 2 years. I always have at least a few PVC's every minute. I have never had a day in 2 years without PVC's. What are my risks of this condition? My Dr. never mentioned this possiblity to me. How and what happens to the heart?
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Avatar_f_tn
Well, we sound very much alike, although I have had a day or two without pvcs. Those are rare and very strange.

Like you I am in almost constant bigeminy or trigeminy or couplets, or triplets.

But in a recent visit to an electrophysiologist, he stated cardiomyopathy related to high frequency pvcs is very very rare. I know that Momto3 on this forum did develop CM though, but I think she had many many years of high frequency.

I have had high frequency for at least 12 years, with the last two being in the range 1200+pvcs/hr. Even after all of this, my last echo in March was still normal for heart size.
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257552_tn?1404606154
Hi,

If you were in Bigeminy most of the time, you would have 30 PVCs (or more) every minute. Bigeminy is the recurring pattern of a normal beat followed by a PVC.

Beat, PVC, Beat, PVC, Beat, etc.

Are you in Bigeminy? (30 or more per minute) or do you often have at least a few PVCs every minute?

Or are you saying that you are in Bigeminy most of the time, and in addition, you notice additional palpitations.

Be well.

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Avatar_f_tn
It seems to me my normal rhythm is bigeminy there are times that I check my pulse and I will be in tri or quadra gemini. Right now I'am in trigemini.  It's extremely rare that I am not aware of having palpitations. The other day I was waiting on a line, in a good ripping bigemini and I though this would have sent me to the ER, when they first started.  I've had PVC's for probably 15 years but they would come and go. These started after a very bad episode if tachacardia.  Every Dr. I've seen says it's O.K., all the tests come back fine. My EP won't give me a 24 hour halter cause he said the results would just cause me to be concerned, and I shouldn't be. I have learned to live with them, I don't like it but what can I do?
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Avatar_f_tn
Yes, it seems like we are in the same boat!
How often do you go for an echo. I would like to get a stress echo, since I have pain at times, I haven't had one in well over a year.
I would love just one day without these stinkers LOL.
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21064_tn?1309312333
I definitely know what it's like to be in persistent bigeminy.  It was so normal for me to be in arrythmia, that having normal beats (after ablations) felt really weird.  

I'm not sure how long I was having frequent PVC's but I had at least some form of PVCs for 25 years.  Sometimes they were frequent, other times they were not.  What's interesting is that in January of 2002 (and previous years), my echocardiogram showed no evidence of CM at all.  By December, my EF had dropped to 40% and no noticeable change in PVC's.  I don't really know when the turning point occurred and it sure surprised me, but now I'm acutely aware of any changes in symptoms.

I'm kind of surprised that your doctor will not order a Holter monitor.  Is he certain you have no other underlying arrythmias?  Probably not, but I'm just kind of surprised.  I had Holters with tens of thousands of PVC's and no CM.  Then, out of nowhere the CM appeared...There was some thought that the PVC's were not the cause, but after the ablations, my EF slowly rose back to normal where it remains.  
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Avatar_f_tn
I've had an event monitor I gues he's going on that data. Can you tell me how you felt? how did your symptoms change? I wasn't aware this could happen, and I want to at least get the right tests. What does it mean when your EF drops?
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21064_tn?1309312333
Event monitors are great as long as you are aware of the arrythmia.  Would you say you can tell when you're having a PVC, bigeminy, nsvt?  

Ejection fraction represents the proportion of blood ejected out of the left ventricle during each heartbeat.  A normal EF is beteen 55-70%.  50 is sometimes considered low normal.  If the EF drops too low, it can lead to CHF.  That's where the symptoms would probably be most apparent.  About a year prior to the change in my EF, I had SOB,  increasing fatigue and abdominal bloating/discomfort.  BUT my tests were all normal, including a Holter that recorded about 22,000 PVCs, bigeminy, couplets, nsvt.  The SOB and fatigure may very well have been anxiety-related, and the bloating may have been from overbreathing.  After a few months, the symptoms disappeared, but the PVCs remained.  The following year, I had a routine annual echocardiogram (to assess a leaky valve) and the doctor called me at work to tell me about the reduced EF and the cardiomyopathy.  I was shocked!!  Sometime after the initial diagnosis, I remember noticing that my ankles were swollen, but that's it; I felt fine. The swelling has been a non-issue since the ablations.

I know this is a rare "side effect" of chronic PVCs, but I think it's important for those people with frequent PVCs to be aware of the possibilty.  As long as your heart is healthy and you feel well, the PVCs are still benign.
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162069_tn?1224681011
i would ask your doctor again for a holter.  my daughter has cardiomyopathy, and at this point we don't know if this is caused by pac's and svt's, but it is entirely possible.  she was born with a anuerysmal mass at the mitral-aortic junction, and this has given her arrythmia, but during her childhood they were not a large amount and caused her no problems.   we found out about the cardiomyopathy during a routine cardiology visit, a nurse at her school found her pulse to be very low and we went for a checkup,   she was admitted that day with an ef of 32      now three years later we have switched drs and now working with drs at the univ of mich and they have added digoxin to her regimen of coreg, inspra, vasotec...   she has about 30,000 pac's on 48 hr holter, but her svt's are down considerably, which is improving the cardiomyopathy   due to the mass on her heart, an ablation was unsuccessful as they were not able to ablate on the left, and the left is where everything is originating..  they are reluctant to do a major invasive procedure at this point,  but at some point it will have to be considered when she begins to build up a tolerance to her current medications      i wish you the best        dawn
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446335_tn?1223951956
Just reading this thread from folks who have large quantities of PVCs...

I do too but not in any consistent pattern, so I might have a few per minute all the way up to 20+.  And sometimes I'll actually go quiet for hours/days.

What I'm wondering is are any of you being treated with medication for these PVCs?  My doctor put me on 50mg of Atenolol, then upped it to 100mg.  I still have PVCs.  What the Atenolol HAS done is take my blood pressure down, and I think it produces some side effects (cold feet) as well.  Obviously I don't want to be a lifetime user if I don't have to be.  Any thoughts/feedback on Atenolol or beta blockers and PVCs?  Thanks.

Dave
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21064_tn?1309312333
Hi davemc,

I took Indeal (beta blocker) on/off for the better part of 12+ years.  It helped to curb the frequency and intensity of my PVC's, but who knows, that may have happened even without the RX.  It defintely kept my heart for working too hard and kept my BP low (90-100/50-60).  Over time, the medication lost its effectiveness for the PVCs, so I stopped taking it for quite awhile.  Since I was only taking it for symptomatic relief, it was not a problem for me to stop.  More recently, I have been able to take it "as needed" and it seems to work fairly well.  Medically, I didn't need the medication, it just helped with symptom relief.
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454966_tn?1225162361
I also suffer with pvc's,pac's,svt,runs of pvc's. About beta-blockers...i personally didn't like them at all. I was on them for eight years and they just made all my symptoms worse and made my bp way to low bradicardic. I was short of breath on them and had a really low EF. Now that i am off them i have more svt and a higher bp but feel a 100 % better off them.

I have a high bp med that i only will take for a day if my bp gets too high because of svt or stress because the high bp med drops my bp way too low too. It's really nice to come on here and have all of you guys to talk with. I pray every one has a peacful day!

Tara :)
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Avatar_f_tn
Cardiomyopathy is a low EF?   What happens to a heart with cardiomyopathy? and  are the changes reversable?

I also take inderal.  I take 2.5 mg (I cut the pill in quarters), I take 1/4 am and pm. If I'am having a bad day I will take more. I find that I don't need it all the time just when the palps are strong or my heart rate gets fast. Sometimes I find it works better if I let the palps get a bit stronger before taking it. What I mean is If I have higher levels of inderal in my system it doesn't have the same effect,and it dosn't control the PVC's as well. Taking it preventatively,in a long acting pill, which is how it is prescribed dosen't work for me. I take just enough to get me thru.   Does that make sense?

davemac,
Try to take the lowest doasage that will let you tolerate the PVC's. I tried atenolol, 12.5 mg worked but it also knocked me out for a couple of hours. I couldn't split the pill any smaller other wise, It did help me. Unfortunately they haven't come up with a pill to totally get rid of the PVC's. I tried many different pills till I found the one that gets me thru the day with the least side effects.
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21064_tn?1309312333
Yep, I understand about the Inderal.  At one time, I was taking 80mg LA and 20mg for breakthrough episodes.  Over time, I found that 10mg as needed worked much better.  When I first started taking Inderal, in the very early 1980's, doctors were recommending ongoing levels in your system (no "as needed"), but about 5-10 years ago, they seemed to be OK with patients taking it like we do.  Works for me!

Medline defines cardiomyopathy as: a weakening of the heart muscle or a change in heart muscle structure. It is often associated with inadequate heart pumping or other heart function abnormalities.

Specific types of cardiomyopathy include:

DILATED CARDIOMYOPATHY - a global, usually idiopathic myocardial disorder characterized by a marked enlargement and inadequate function of the left ventricle. It may affect young people. Dilated cardiomyopathy includes many conditions:
  
     Ischemic cardiomyopathy: This is caused by heart attacks, which leave scars in the heart muscle (myocardium).

     Idiopathic cardiomyopathy: The term "idiopathic" means that the cause is unknown.

     Hypertensive cardiomyopathy: This is seen in people who have high blood pressure for a long time, particuarly when it has gone untreated for years.
  
     Infectious cardiomyopathy: HIV, Lyme disease, Chagas disease, viral myocarditis, and other infections have been linked to dilated cardiomyopathy.

     Alcoholic cardiomyopathy: This type of dilated cardiomyopathy usually begins about 10 years after sustained, heavy alcohol consumption. It can occur with both typical signs of heart failure, as well as with atrial fibrillation or other heart rhythm problems.

     Toxic cardiomyopathy: In additional to alcohol, cocaine use, and some chemotherapy drugs can also produce dilated cardiomyopathy.

     Peripartum cardiomyopathy: This type appears in women during the last trimester of pregnancy or after childbirth.

     Tachycardia mediated cardiomyopathy: This occurs in people who have an abnormally fast heart rate.

HYPERTROPHIC CARDIOMYOPATHY - This occurs when the left and right heart muscles grow to be different sizes. In up to 70% of cases, there is a family history of this condition.

RESTRICTIVE CARDIOMYOPATHY - This disorder affects the heart muscle's ability to relax between contractions. The heart cannot relax adequately after each contraction (systole), which prevents it from filling with enough blood.
  
A low ef indicates poor pumping power.  The heart can remodel itself, lose power, the walls can harden...essentially, it is less effective.  In some cases, CM can be reversed.  There are several members here who have been able to raise their EF with diet, exercise and medications.  If you want to find out more from them, try posting a question with a heading like:  "Anyone able to improve cardiomyopathy."

In my case, reversal was accomplished by managing the PVCs (ablations).  Last check my EF was at 60% and holding.

Hope that helps : )
connie


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Avatar_f_tn
Thanks for the great info! Is the EF checked by an echo, or a stress echo? If so how often do you get one done?
I have 4 dogs all of them big, and one of them a husky,super high energy. I think you just hope for the best till there over 2, things settle down a bit after that. I keep the husky crated when I not home even now, and shes's 8. She tends to be very creative, one day when she was a pup I forgot to put her in the crate and she literally ate my couch! Good luck and a hug to the pup!
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21064_tn?1309312333
You're welcome!  Yes, EF is geneally measured by echo. Stress echos are OK, but may not be quite as accurate since the techs/docs are watching for other things too. In my case, a regular echo seems to generate more specific information.  I was alternating between an echo and a stress echo every six months, but I just got clearance to wait for about 10 months this time.  It would have been a year, but we're trying to schedule the test around weather (in Cleveland) and holidays.   Do you have a copy of your recent echos?  If not, you may want to call the doc's office and ask for copies.  You don't need everything, but it's nice to have test results.  That way, you can also watch for significant changes.

THANKS for the advice for my dog!  He will be 2 at the end of May and I think he knows I've set that as a target date!  This is the most stubborn dog I have ever owned!  He's smart, but sometimes bossy and bull-headed.  Other times, he's cuddly and sweet.  I'm hoping that we'll start to see BIG improvements very soon!  We have crate trained several dogs and our last two goldens were out of the crate ALL DAY and never chewed (Now I know that was luck!!), did not jump on people, no significant mouthing (beyond early puppy days), did not bark incessantly.....BUT, Samson's a whole different story!  My most challenging dog yet.  He loves his crate so we haven't taken it down and he's almost two!  We have baby gates too!  I'm hoping all the perseverance pays off.  Oh, and HIGH energy!!  I think he could run from coast to coast...well, not quite : )

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47427_tn?1238442851
The question I have is "Can frequent PVC's cause cardiomyopathy or do frequent PVC's sometimes serve as the first warning sign of otherwise subclinical cardiomyopathy?".
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21064_tn?1309312333
In my case, frequent PVCs (over many years) was found to be the cause of the cardiomyopathy.  At first, that was only speculation, so the doctor wanted me to have serial check ups to monitor changes in EF.  Sure enough, once the PVCs were quiet, the CM resolved and the EF gradually normalized.  It's called PVC-induced cardiomyopathy.

Because I have a leaky valve, that was thought to be the culprit.  But, tests and such led to the diagnosis of PVC-induced CM.  The real test was to see what happened post ablaiton.  All good.  

Do you have PVCs?
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Avatar_m_tn
Both.

PVCs can cause more serious heart problems or can be the result of more serious heart problems.

In any event, they are associated with worse long term outcomes than people without the PVCs.

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21064_tn?1309312333
Hey,

Nice to see you posting!  How have you been?

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Avatar_f_tn
How do you know this?  My dr. said that even with my high #''s of pvc's, they are benign, and it won't effect me negatively.  Yet, you say so emphatically that you know that they will cut my life shorter than normal heart rhythmns? I would love to see the articles where you got your information.  My email is:
***@****
Please!!! send me an email or a link where I can find this horrible information.

Thank you so much~
Melissa
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Avatar_f_tn
This person should have never post something like that and scare people.  Listen to your doctor and get a second opinion if you want.  But, I would not worry. I have had tens of thousand of pvcs some times daily for over  15 years. Some times 30 in a minute. then they stop for months at a time. My doctor tells me my heart is sound. I get a yearly check up.    Take care
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Avatar_f_tn
They say PVC's do not hurt you alone.  I have over 30,000 pvcs in a 24/hr period.  I do though now for the past few years also have low ejf of 30 - 35.  Cardiologist seems a little unsure about all of this.  I am on 2.5 mg of lisinopril and 9.9 mg 2x daily of carvedilol.  Over the last three years my numbers have not improved, but they also have not got worse.   Is there anyone else out there in this situation...it scares me especially reading from the other person who posted that it will shorten your life.  I worry about that all the time.
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