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what do 2 pvc's in a row feel like, are they bad?
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what do 2 pvc's in a row feel like, are they bad?

Just curious.  Last night i had what felt like pvc, beat, pvc, long pause, beat, pvc, then normal.  I am on verpamil 240mg and it has done a great job of controlling my PVC's.  this is the 2nd or 3rd time this has happened to me in the last 2 years.  each time i have had no other symptoms, no urge to pass out, no lightheadedness, nothing.  when i caught my pulse, it might have been at the very start of the first pvc and just felt longer.  


I have had tests done when the first time something like this happened about two years ago, ekg, chest xray and blood work, all normal.  My cardio also said that my pvc's are "normal"

Are 2-3 pvc's bad?
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1124887_tn?1313758491
First I didn't know that Verapamil had that much effect on PVCs (not saying it hasn't, I just didn't know), however, I know it has effect on PACs, so are you sure you really have PVCs, or do you just assume that premature beats are PVCs?

PVCs (or PACs) in a row would be described like beat-pvc-pvc-------beat, so it seems you are describing PVCs in bi- or trigeminy for a short while. As my cardiologist said, they can occur in certain patterns, but usually there is no system in the madness.

As long as you feel fine and your heart is checked by a doctor, don't worry :)
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995271_tn?1408549100
I had two PVCs in a row which was confirmed on an event monitor.  It's called a "couplet".  It felt like a regular PVC to me, only much more violent.   I was lying down at the time. It made me jump out of bed.  I only felt a single thump and pause but like I said, it hit hard.  I didn't experience any other symptoms.    

There's no way to tell what you felt based on a description.  If there's one thing I've learned after being on an event monitor for 30 days is that what I thought I felt was never confirmed by the event monitor.

2-3 PVCs are called couplets or triplets respectively.  They aren't bad if you've been confirmed not to have any heart muscle issues.

From what you are describing it doesn't sound like a couplet to me, it sounds  a maybe 2 or 3 PVCs every other beat or what's called bigeminy.  
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Avatar_m_tn
but what does the long pause mean?  it felt like 2-4 seconds long.  Again, it made me jump a bit too, i had a couple beats after this longer pause, then another pvc then back to normal.  For the rest of the night and so far today, im normal.
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1807132_tn?1318747197
Were you checking your pulse when you felt the pause and counting the seconds or just making a guess how long it was?  Most pvcs are followed by a pause as the heart resets itself.  The slower your general heart rate the longer the pause will feel.  If your pause is longer than one beat would have been then it could be some sort of avnode block but you would need to get that captured to verify if that is what is indeed happening and not just a momentary dip in the strength of your beat, having a weak pulse.  If you did not feel short of breath or feel as though you couldn't catch your breath I wonder if it was a true 2-4 second pause but I am not in your body and you have the best vantage point.  But since you don't seem to experience any ill effects from the episodes and this only happens once in a very blue moon it is likely not anything to worry about but if you are concerned go back for a checkup espcially if it has been a couple of years and the symptoms persist.  But again, unless the pvcs are interupting your ablity to function you will likely be told to try and live with them.  Kind of frustrating but that is what we all have to deal with unfortunately.  Take care and keep us posted on how you are doing.
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Avatar_m_tn
Thanks Michelle,  I did not count the seconds, just made a guess, sure felt like 3-4 to me.

And this is the second time in 60 days its happened.  First time in the car, nothing, went on shopping with no issues.  Yesterday, it started after i vigerously scratched my ear, i was sitting at the computer.  No lightheadedness, no shortness of breath, nothing.

I wonder if i caught my pulse at just the right time for it to feel like a long pause, also, i wonder if i caught the pulse in my neck in such a way i could not feel the pulse and was too startled to realize it.  

Right after it happened and i tried to feel my pulse i got up and felt another flip flop.  my caught my pulse and everything was normal.  

During this episode i felt the flip flop, tried to feel my pulse and got what i described, then another flip flop and a normal beat
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Avatar_m_tn
sorry for the double.  to be clear, if i did not rush to put my hand to my pulse, i probably would have brushed this off as another standard pvc and went along with life
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995271_tn?1408549100
Your heart beat is supposed to originate in something called the "sinoatrial node".  It's on the upper right side of your heart.  This impulse fires off the top part of your heart, called the atrium.  As this impulse spreads across the muscle it will run into something about 1/3 of the way down your heart called the "atrioventricular node".

The impulse then rapidly goes down into the ventricles and makes both ventricles contract at the same time.

The PVC is a called an extrasystole.  A systole is an actual beat from your heart that has moved a lot of blood and comes from the ventricles only. A systole is what causes a pulse.  Only the ventricles have enough muscle power and volume to cause a systole. You ventricles have much more muscle mass than your atria.

The reason for the pause is because your ventricles have already prematurely fired a beat on their own when they weren't supposed to, this is what a PVC is.

The pause is there because the extra ventricular beat fired while a normal impulse was coming its way.  The extra beat simply ignores the current impulse, it's already contracting when it arrives.  However, the SA node keeps on sending impulses at it's normal pace.  The pause is the ventricle waiting for the next impulse to arrive from the SA node.  The slower your rate at the time of the PVC the longer the pause will be.  It makes more sense if you look at this on an EKG.  You will see the normal beats keep coming at the same interval.  The PVC ignores the normal signal obviously but then has to wait for the next SA impulse for it to beat again, hence a pause.


The reason for the feelings you get from a PVC are multiple

1.  If a pacer cell in your ventricles fires a beat (PVC), the contraction propagates across the ventricle originating from the pacer cell.  This means that ventricles will not contract in a coordinated fashion at the same time.  Remember that normally the ventricles receive this signal from the atrioventricular node, which means the contraction is well coordinated and timed.  With a PVC the contraction spreads across more like a wave.

2.  During a PVC your ventricles and atria are contracting at the same time, this causes something similar to hydrolic shock.  Blood is a liquid, it's not compressible.  If all four chamber are contracting at the same you can see why it would cause a shudder.

3.  Because a systole was premature, the next will seem like pause.  In actuality there is no pause, the SA is still ticking away like a clock.  The issue is that the ventricles went before their turn.

Below is a normal heart beat.  The + signs are a beat impulse.  The sa line shows the sa node firing the beats and the atria.  The av lines shows the impulse timing hitting the ventricles.    Notice that slight delay, that timing makes the heart beat properly

sa-------+-------+-------+-------+-------+
av---------+-------+-------+-------+-------+




Here's a PVC, represented by the letter P

sa--------+-------+-------+-------+-------+
av---------+--P------------+-------+-------+
                        
See the space after that P is longer?  that's the "pause".  sa node is still going along like a clock.  The second sa + obviously won't fire the ventricles because they are either firing at the time or in recovery from the pvc.

hope that helps, I hope my diagram doesn't get mess up when I post it..




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Avatar_m_tn
ok. that makes more sense, so that 2 second pause really is just the time it takes for my heart to reset during this pvc?  it just seems like it lasted forever.  but i feel like this explains it for me.  Before yesterday, this happened to me back in november and then once in may of 2010, from what i can remember.  
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Avatar_m_tn
could it be i caught a PVC just as it was happening and thats why it felt long?

Maybe its in my head, maybe i felt the thud, reached for my pulse and felt the pause, only to not feel a beat, but there really be one?  

I am going to assume since i had no symptoms, and i am feeling fine now, theres nothing wrong.  If it was serious, i would know
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Avatar_m_tn
i think it was a part of my active imagination.  I had a similar feeling tonight getting into my car, felt my pulse, short pause and regular beats.  No other symptoms,  guess i have to learn to live with em
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