runs of PVC/PAC

[TTBB]

Hi, I am 36 and have had PAC/PVC since I was 28.  At first all my PAC/PVC are singles.  Stress echo is normal and my cardiologist assured me that with a structurally normal heart, they are benign.  I've been trying to conceive but only ended in 3 miscarriages.  To make things worse, with each pregnancy and miscarriage, my palpitations got worse.  Then after a recent miscarriage, I start to feel long runs of palpitation (>3 in a row).  I don't know whether they are PAC or PVC, they last from 4-8 beats.  Fortunately I have them only once or twice a day but when they happen, I am so scared and I would stay anxious for the rest of the day.  I called my cardiologist and she told me two things:
1. a structurally normal heart won't change, so I don't need to repeat any test (my last stress echo was in 2009, previous one is 2002, both normal) within, say 10 years.  

2. stop counting how many PVC/PAC or how many of them in a row.  She told me that all of them are benign no matter how many and how frequent, since my heart is normal.  When I asked her in what condition am I in real danger (I have a family history of heart disease from mother's side), she told me the only red alert would be when my heart rate > 140 for 24 hours.  

I know there are many discussions on this forum about runs of PAC/PVC, but I never read something about these two points.  I really like my cardiologist as she has given me a lot of assurance but I would feel better if another doctor would second her opinions.  

[Mom2four85]

you could always wear one of the AED vests under your clothing and no one would notice =)

I think I would take plumbing over electrical any day too, yet I really think I have both - double whammy...I want to know who has the voodoo doll with my name on it???

[RNRita]

Oh, I"ve thought about it.  Then I could take it with me when I travel and people could REALLY call me a nutcase!  They are expensive but I could have gotten a discount through my job at one point.  I didn't do it....I should have.

[poohbear2026]

Have any of you actually bought a AED for your home.  I've often thought about it but they are awful expensive.

[rilesnic]

Me too! Give me the plumbing problem any day over this mess! And you're right about the AED...they have to know how to use it or it's no good to us!

[RNRita]

Listen, if you have heart disease there are a whack of things they can do for you.....They can fix you up after a heart attack to be almost as good as new and lead a long life.  If you have a heart attack and you take aspirin within the first 30 minutes, you have a much higher rate of success and not much damage.

If you have an arrhythmia that leads to a lethal arrhythmia, there is not a thing that can be done unless you are near someone with an AED that knows how to use it.  I think THAT is our difference here.  We may NEVER have a heart attack, but if these rhythms go haywire, what are our chances.  I'd rather have heart disease and no arrhythmia.  At least I'd know what to do to fix it.  

Now, how about the medical professionals think about that for a change.  Yes, we have to live our lives with something that can happen for many years without hurting us, but if it decides to, it is the end of the road. I think THAT is what I have the most problems dealing with.

[rilesnic]

I get these "runs" too. Like Rita, I find mine more prominant while driving, while alone, or in social situations. I am always looking for the exits and I too want to travel the world. I used to fly all the time...I can barely ride as a passenger in my husband's dodge for an hour to the beach or to Houston without going into complete panic...with terrible runs of PVC's. I am truly amazed at how much these things have affected my life. I get so upset when I am having a bad day, (and last week was actually a bad week). I take it out on everyone around me. They (pvc's) make me very aggitated. I tell them, just be me for a few minutes and see how you feel. Lately, I constantly feel this funny feeling through my upper chest and throat...hard to explain, it's just not right. I know it is heart related. My heart is structurally normal too, but like another post said, heart disease can happen at any time...then you have the plumbing problem on top of the electrical problem. If hearts didn't change from normal to not normal, no one would have to worry about heart disease.

[Mom2four85]

RNRita; I was told to do that too muahahhaha..I did it lost 40 lbs instead of 30 I wanted to lose. I ate everything the dr told me; my insides were so green...the "spa" was ran by my pcp and I saw him personally each week for 6 months...

I kept with it for almost 2 years straight - I exercised 4-6 times a week sometimes more walking night also, walking/running had a weight machine and darn I was tanned! and guess what? my symptoms worsened! rotfl that's when I noticed my heart felt like it was stopping; aside from the normal pvc feeling.

I'm going with the theory that I was abducted by aliens..yeah that's what happened to me - if I didn't have the medical records to prove my theory I wouldn't believe it myself.

[RNRita]

I'll say.  Your story scares the bejesus out of me.  So I started exercising again........I am sure diet and exercise is the answer....HAHHAHAHAHHAHHHAHAHAHHAHAHA

[Mom2four85]

RNRita; that's what I'm saying -  my heart can't change, so what the h e double hockey sticks have doctors missed? not just one doctor but 10 or 12 doctors? a doctor who teaches other doctors even....my heart just didn't get like this I don't think..."normal" one day then poof I am going to die in 3 -4 weeks time...that's a tough pill to swallow

[RNRita]

It never ceases to amaze me how doctors can say such stupid things.  1. If your heart is structurally normal, it can't change.  Um...I know my heart isn't going to start deforming, but heart disease can start at any time, and the presence of PVCs and other cardiac arrhythmias along with heart disease is indeed cause for concern.  It is about time I get checked for that again.

The best?  "It doesn't matter how many you have...they are always benign."  I ain't buyin' it and she oughtn't a be sellin' it!

Yes, I think 99% of us are fine, and I use that term knowing how relative it is at any point in my day.  I have had these over 30 years and STILL can get freaked out when they come while I'm driving, when clusters (and I mean in a row, not with normals in between) come when I am alone, or when I am in a spot I can't get out of.  Coincidence?  Maybe, but it happens.  The quality of my life has been affected big time.  I wanted to travel the world.  I will not get in an airplane.  Once one took off and my heart started going into SVT....it stopped once the G-force stopped, but made me understand that flying would never be for me.  NOW how will I get to Europe?  Seafreight?  I can't even visit Arizona....

So, maybe we sound like a bunch of whining babies, but I ask you...would any of those doctors switch bodies for a year with me?  A month?  A week? I doubt it.

[Mom2four85]

btw I forgot to add - I did see the head of cardiology at a major university in Tampa, FL highly educated and 30 years of experience; teacher of EP's...she agreed I probably needed an Ablation, had no structural damage.  She treated others with very frequent pvc's - she had me try her "miracle" drug Toprol - one dose and I ended up in the ER with a hr of 40 and bp of 70/40 which they could not fix for over 11 hours and sent me home.

[Mom2four85]

oh this brings up so many questions and discussions in my head =) I know there are some who do not agree with my point of view BUT until a dr confirms my obsession with answers I will keep questioning...

I was told like all of you - no structural heart problems - no worries right? if you look at all of my tests I had no structural heart problems. I was told this by my cardiologist on 7/1/2009 again by my original EP on 7/14/2009, and 2 follow up EP's in July 2009...my echo showed minimal things wrong but I've been told by numerous dr's even in April 2010 that none of my tests showed anything to alarm dr's...

The only thing that may be questionable, was on 7/26/2009 an EKG/CT showed an enlarged heart and very frequent multi focal pvc's which I was told wasn't a big deal. I had numerous blood tests from June 25, 2009 until my EPS on August 26, 2009 - EVERYTHING was tested...even genetics.

Echo - I question, too much info I've gathered shows some inconsistencies in their 'standard' protocol of methods used but no dr can tell me what their standards are (even here on MH). I wish I could find this answer, it would ease my mind.  My stress test showed it was borderline abnormal and my bp would not raise past 150/90 even when my hr was high no answers other than it's my ANS problems.

Now, if all of this is true and if my heart was "structurally normal" then it didn't just morph into not being normal did it?  I think; or can it?...do dr's really know enough and research enough to find out? I personally don't think so.  The majority of studies are eons ago and very few are new and funding is short; the newest study on pvc's I can find is March or April 2010.

If you look at my tests & ekg's in my profile and pictures, you'll find I had a ton of pvc's and no "structural heart" problems according to dr's in July 2009, even on August 22, 2009 when I had my sleep study done I had NO pvc's in the time I was in the clinic.  If you look back at my April 2007 ekg you can see something was going on...

Maybe aliens abducted me and switched hearts? wait...I slept walked and morphed into another creature perhaps?  On August 26, 2009 I somehow wound up going into VFib and was diagnosed with Polymorphic VT & malignant heart arrhythmia's and developed non-ischemic cardiomyopathy with a "structurally normal" heart.

Jodie, can I borrow your husband? :P

I do have a new cardiologist/ep and if they can't yield any answers then I'm going to take a trip to Cleveland or Mayo clinic - we all deserve answers and it's not all in our heads.

no offense meant to anyone and you should always trust your dr I'm advised and I did that, trusted dr after dr...blindly led to believe whatever my dr's told me and really believed nothing was wrong; hid my head in the sand...

[TTBB]

Hi, it seems I mis-use the phrase "runs of PVC".  What I feel is probably bigeminy for a short period of time.  Sometimes I can clearly count each of them, pause, beat; pause, beat, etc.  Sometimes they are just a bunch of totally irregular messy beats, and they are pretty fast so that I can never count them.  Bypeep is right, my doctor also told me that what we feel is the normal beat, and we cannot really tell how many pause are in between (say, if it is back to back PVC, we only feel one pause, maybe longer though).  Only a holter monitor can tell, but again my cardiologist didn't let me repeat it (last holter monitor was in 2009 and it only caught singles).  She told me that even if it is indeed 'runs of PVC', as long as my heart is normal, there is still nothing to be worried about (or nothing can be done, especially because I plan to conceive).
    
But it is still scary, when it starts, my whole body freeze and I have to wait for it to come back to normal to breath again.  I so miss the days when I only have singles.

Thank you all for sharing your experience!  The past two weeks were so hard: all these runs or bigeminy came back on the same day when my miscarriage bleeding started.  So I had to deal with them both at the same time...  

[jkfrench]

I refer to my clusters as you do.  PVC's for a while but always normal beats in between.  Just very random pvcs.  maybe 4 in a minute, then nothing for 2 minutes, then 3 in 30 seconds, then nothing for a minute , then 1 every two beats for a few beats and so on.  I hate those because it just gives you more time to worry whether they will start coming every other beat.  

My good days are when I just feel a few here and there but they don't continue.  Unfortunately I have been having more bad days than good days.  

MY PAT (which I believe is just another name for NSVT or SVT) also feels like yours except I don't feel pressure in my throat.  I feel a skip or two, then very faint rolling or rumbling where I can't get a pulse (so a pause much longer than the pause between the pvc's) then a fast heartrate of 220 for a few seconds, minutes or once hours.  (that is how it was caught because I went to the ER)

Man, I should have married a cardiologist  lol

Jodie

[bypeep]

Just tossing this out - food for thought.  If you are actually able to count them, I would worry a lot less! lol

And, if they haven't confirmed you are actually having "runs" even after monitoring, perhaps they just feel like runs and truly aren't?  Bigeminy can sometimes feel like runs too.  Also, clusters in short periods of time can.  But, when I refer to clusters I mean palps constantly for a while, but having normal beats after each one.  They seem like they're all coming on top of each other.  I have times like this and it *****.

My NSVT produces almost no sensation other than a pressure in my throat and lack of pulse at neck or wrist.  Sometimes I will feel a rolling/rumbling but it's very faint.  Most times it's really more perceived as a long pause.  The 9 beat one they caught almost dropped my jaw because I could have sworn it was a couplet when I felt it.  I would probably feel less apprehensive about them if I were able to count each beat, at least then I'd know it wasn't superfast.

It's really hard to let this go and I think a lot of us struggle with all the "what ifs."  So, I understand your anxiety.  Just hope that you can find a way to ease your fears. :)  Take care!

[cindy707]

I always try to put it into perspective that the human heart beats over 100,000 times on an average in a 24 hour period...for some reason that helps.....

[TTBB]

Cindy and Jodie, thank you so much for your reply!  My PVC/PAC are also in clusters.  In good days I may not feel anything for a week, but when they start, I may have hundreds of them in one hour.  One clear trigger is hormone fluctuations (especially with pregnancy and then miscarriages), but there also bad days when I couldn't see why they are happening.  I am glad to learn that at least another doctor agrees that number and frequency of PVC does not matter.  Did he mention heart rate?  My resting HR is usually 60 (40-50 when asleep), and even with the anxiety after a long row of palpitations, I found my HR to be less than 90, and it comes down to 70 as soon as I calm down.  My doctor told me that I can just use this way to tell that whatever palpitation I have is benign.  She told me to go to ER only when the HR > 140 even I am relaxed.  

[jkfrench]

I have had two doctors tell me that it doesn't matter how many skips  you are having if your heart is structurally normal.
a.  I called a cardio on call because I was getting them in clusters.  Like 4 a minute, then 2 a minute then 0 a minute then 3 minutes later I would get 4 or 5 a minute and so forth.
When I explained this to him, he told me "we are not concerned how many pvc's you are getting.  It just doesn't matter if you had your heart checked out.
b.  When I saw my cardio last week I asked him again.  There were 288 pvcs on my last 24 hour holter.  It seemed like a lot more, but as I said they were coming in clusters.  I could have nothing for hours and then 100 in an hour.  I asked him, "what if it was 2880 pvc's.  Would you tell me anything different.  He said no.  He told me to do whatever I wanted, including sky diving (yea right) or scuba diving.  He told me it was his job to reassure me.  I also get 5 or 6 in a row.  Just a surge of 5 or 6 hard pounds.
So, it sounds like my doctor has agreed with yours.  Hope that helps.  Sounds like you are in the same boat as me.  It is almost impossible to believe them when your heart is all over the place and you are coughing and feeling so tired.  How is it possible to believe we will be fine.  BUT, according to our doctors...we are.
Hang in there
Jodie

[cindy707]

The great news is that you really like the doc that is treating you and trust her obviously however it looks to me like you are looking for confirmation of her diagnosis.  I would definately agree that if it makes you feel better do it but to me the bigger question would be to the doc...so what are we going to do about it?  In this day and age alot of options are out there for you so do not lose hope.  I would definately tell her that this is effecting your life and that you want to get a little more proactive.  If you are trying to get pregnant the chances are that the doc will not want to put you on meds like a low dose beta blocker that takes the edge off of these incidents of occurance because they can effect the fetus...however i would call her office, tell the secretary that you want to schedule out a 15 minute block of time with her and read from a list you have made about the whats ifs...could be's.....all of it and then if it were me i would ask her if she thinks that whether or not the PVC's/PAC's are benign is not the issue for you but how they are effecting you and your family....at that point personally i think i would ask her if you are a candidate for an ablation because an ablation is not a treatment but a cure.....what you have is electrically based within your system and is easily remedied...i would just look at every option open to you....who knows why you are miscarry ing......could be anxiety, could be just about anything but i would give myself the best odds possible....good luck to you and your family and i hope once this passes for you that you can be successful in expanding your family......