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[scarypvc]

I am a 29 y.o. Male, 195 lbs, 6ft tall.  Being treated with Diovan 160mg daily for white coat htn, and toprolxl 75 mg daily for symptomatic pac's and pvc's.  About 4-5 years ago I started to develop what I called "skipped beats".  Went to the cardiologist and had ekg, 30 day event monitor, stress echo.  Echo came back normal, 30 day monitor showed pac's and pvc's.  No runs or other arrythmias detected.  Since then I have also had 2 more 30 day monitors, 1 48 hour holter, and another stress echo.  Stress echo again was "normal" with non-specific ST changes on recovery that my cardio said not to worry about.  My question is this...it seems like about every 3-6 months I get "runs" or groups of skips or what feels like several hard beats in a row.  I don't get light headed or feel bad, but I get very worried and anxious.  I almost want to wear a monitor 24/7 because it makes me feel better knowing if I have one of these at least I will be able to record it.  What would you be concerned about here.  What is the likelihood I will develop VTach or Vfib with a "normal" heart on the echo's.  How often should I repeat these tests, and is there anything out there for someone who wants peace of mind.  Could I get a monitor that I keep and record these things for a year or something.  I just want to go back to not worrying I am going to die everytime I have one of these runs.  Thanks for your advice

[Michael J. McWilliams, M.D.]

In my opinion, a monitor won't give you peace of mind, it gives you more information to think about.  Your risk of VT or VF is essentially the same as anyone with a structurally normal heart and high blood pressure.

Your doctor is probably not ordering these tests because they need them to make decision, they are probably ordering them to help give you peace of mind.  You can expect to have  a spike in pac/pvcs every so often and you can also expect that they will disappear as quickly as they came.

The real probably the worrying about dying issue is just worrying. You have already had all the tests you need to reassure yourself of that.  Now you have to convince yourself --- spending money or text tests probably won't help here.

I hope this helps.

[scarypvc]

How often would you want your patients to return for further testing?

[scarypvc]

I had one last question for you...if a patient of yours had 2 normal stress echos, and no recordable arrythmia's on several holters and event monitors, would there be any other testing you would order for someone who feels "runs" of skips that have never been recorded.  My biggest fear is that we haven't explored this enough and are missing something.  Also, is it normal that a person could almost induce PVC's by feeling his/her pulse.  I swear that when I feel my pulse, (a nervous habit I developed after developing these PA/Vc's), I can almost make myself get a skip.  Thanks for your help.

[Carrie41]

Yes Scary!  I can make myself have PVC's and PAC's just by thinking about them and feeling my pulse.  I would be interested to see what the Doc says about that.  I really feel you can make yourself have them.