Pediatric Heart Expert Forum
Palpitations
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Questions in this forum are answered by pediatric cardiologists, cardiothoracic surgeons and anesthesiologists from The Children's Hospital of Philadelphia. This forum is for questions and support about pediatric heart problems, symptoms and topics such as heart murmurs, palpitations, fainting, chest pain, congenital heart defects (including management and intervention), fetal cardiology, adult congenital cardiology, arrhythmias and pre-participation athletic screening.

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Palpitations

My son had a holter and it showed 48 PVC's and 3 PAC's.  He is 18 and very worried about all these strange sensations he gets.  I get PVC's and PAC's as well and would like to know if it is a hereditary thing or is he just too sensitive to these things?  He has been for testing and has a completely normal heart.  They say don't worry but he is worried and so am I.  What is a normal amount of PVC's and PAC's for an individual to have in one day?
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Extra beats from the lower chambers (PVCs) and upper chambers (PACs) are generally considered benign if: 1) the baseline ECG is normal with no electrical conduction issues  and 2) if the heart is structurally and functionally normal.  If the beats are all single beats (not coming in "runs") this is also considered benign.  The number of beats that you describe is an extremely small number given the usual total number of heart beats in a 24 hour period.  So these are likely benign ectopic beats.  the fact that your son feels them is what worries him.  If he has seen a cardiologist and had appropriate testing, then reassurance is generally the rule.  It certainly does not sound like there are enough beats to warrant medical intervention.  One missing piece of information is "when" does he usually feel these extra beats?  if at rest, and not with exercise, that is usually benign as well.  If they occur primarily with exercise, then that needs to be followed by the cardiologist.  Needless to say your son should avoid caffeine and stimulants and should keep well hydrated, as relative dehydration can exacerbate these extra beats.
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Jeffrey R Boris, M.D.Blank
The Children’s Hospital of Philadelphia
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