HOW DO I DIFFERENTIATE BETWEEN THE FEEL OF PVC'S VERSUS BEING IN AFIB?

[MISSREBECCA]

HELLO AND BEST WISHES FOR GOOD HEALTH TO ALL!

THIS WINTER I WAS RUSHED TO THE HOSPITAL TO FIND OUT THAT I WAS IN AFIB WITH RAPPID VENTRICULAR RESPONSE TIMED AT ITS HIGHEST AT 195 BPM.  CHEMICAL CARDIOVERSION WAS NOT A SUCCESS, SO I UNDERWENT ELECTRICAL CARDIOVERSION BACK TO SINUS RHYTHM.

SINCE THIS EPISODE, I HAVE BEEN AWARE OF FREQUENT PALPITATION SENSATIONS IN THE FORM OF DELAYED HEARTBEATS FOLLOWED BY HEAVY THUDS, TIGHTNESS IN THE CHEST ANDTHE NEED TO COUGH.  I NEVER NOTICED THESE SENSATION BEFORE MY BEINT IN AFIB.

FOLLOW-UP EXAM BY CARDIOLOGIST WITH ECHO AND HOLTER TESTS SHOW SINUS RHYTHM WITH BENIGN YET FREQUENT PVC'S, PRIMARILY OF THE BIGEMINY NATURE.  

THE CARDIOLOGIST TOLD ME I WAS FINE AND THAT  DID NOT NEED FURTHER MONITORING UNLESS I WAS TO GO BACK INTO AFIB.

MY CONCERNS ARE AS FOLLOWS:

1.  DID THE AFIB IRRITATE MY HEART TO CAUSE SUBSEQUENT  PVC SYNDROME?

2.  DO PVC'S ACT AS PORTALS THROUGH WHICH AFIB, VFIB, AND TACCYCHARDIAS CAN DEVELOP AND/OR MORE EASILY REOCCUR?

3.  HOW DOI DIFFERENTIATE BETWEEN THE IRREGULARITY OF AFIB VERSUS THE IRREGULARITY OF BIGEMINY?  WOULD THE CONCURRENT PRESENCE OF ELEVATED HEART RATE OR TACHY BE THE DISCERNING FACTOR?  

4.  DOC. SAYS FREQUENT PVC'S DO NOT DAMAGE THE HEART MUSCLE, HOWEVER I AM READING OTHERWIZE ON THE INTERNET.  WHAT GIVES ON THIS?

BTW, I AM A 42 YEAR OLD FEMALE IN WHAT I BELIEVED TO BE GOOD HEALTH.  AFIB WAS DETERMINED TO BE TEMPORAL DUE TO SKEWED ELECTROLYTES, OVER THE COUNTER COLD MEDICINE, AND AN HERBAL REMEDY THAT I WAS TAKING FOR ENERGY.

THANKS SO MUCH

[Michael J. McWilliams, M.D.]

1.  Atrial fibrillation does not cause PVCs.
2. PVCs do not lead to atrial fibrillation.  With a normal heart (EKG, echo, stress test), PVCs do not lead to Vfib.  The majority of people have PVCs everyday -- sudden death is relatively rare.
3.  Fast heart rates can help discern afib from PVC. If year heart rate is racing, it could be afib.  There is no easy way to know.
4. Stop reading the internet on PVCs.  Your doctors know what they are doing.  If they think you are in danger, they will tell you.  I am not sure how else to say that.  The reality is that the people that don't worry about them, don't post or read up about them.  That leaves the group of people with more symptoms and often more anxieties about them to post.  The other problem is that you can find any opinion you want to about any topic with a google search.  

I hope this helps.

[artskip]

You know whats interesting, when someone has uncontrollable hiccups that have gone on for days sometimes weeks, it make the papers. We who suffer every day every hour every minute with PVC's are told to not worry about it. You know what Doc easier said than done.

[ireneo]

I understand that anything concerning the heart is more frightening than standard hiccups. However, it is very possible to have a benign heart condition. We tend to think if it's heart related it's going to be fatal. Not so. My heart has been erratic for my whole life with PAC's, PVC's and atrial tachy times. Yet I'm now 55. I've had 3 children and raised them successfully, work at a demanding job with wildlife and go to the gym. So it is possible to have a wacky heart and live a perfectly normal life. Hope this is encouraging.

[artskip]

I know your right. I just get tried of hearing don't worry about it.

Posting doesn't mean all we do is worry. I've learned a lot of coping skills from many people on this site. Reading others stories helps you know your not alone in this. Most people who don't have PVC's or other irregular rhythms really can't relate to what we go through. They can't imagine what its like. My friend said once she had a (one) skipped beat and freaked out, she thought she'd loose her mind if she had them all the time. They can sympathize up to a point but after awhile they may not want to hear about it anymore.

[ireneo]

Yes, I know what you mean about folks that don't have much going heart wise. They don't get it. And if they do have a skipped beat or two, they think they know how you feel. I'm so fortunate that my heart has been weird all my life. Even after 3 ablations it acts up every day. But that seems normal to me. Another thing that has helped me stay calm is watching my step-Dad suffer with his end stage congestive heart failure. I feel so thankful I'm able to do all that I do in a day. If he goes out to lunch with us, he's exhausted. That's very sad.

Hang in there. Not everyone will be sensitive to your thoughts and concerns. Don't let them get you down. Just keep chugging and skipping along.

[raq1967]

I had NO idea what PVC's were when I went to the ER with lightheadedness, shortness of breath,  heart pounding, and exhaustion.   After many tests, including echo (no significant regurgitation), blood tests (rule out heart attack), chest xray (normal), stress test (mild ischemia and took less than 7 minutes to achieve max heart rate - very abnormal), and CT scan angio (normal), I was told everything is fine.  I  just have pvc's and feel it more than others.  My question was what is a pvc and what does it feel like?

3 months later, still short of breath, still exhausted, still lightheadedness, and various other symptoms, I was tired of the doctors that should know something telling me everything was ok....or anxiety.   I went to Mayo Clinic where they were astounded at the number of pvc's I was having.  At the rate they measured, 20,000 a day.   And they listened and said this is NOT normal.

So, it is in a patient's best interest to question their doctor if it does not make sense.  It is in a patient's best  interest to understand their medical issues.  In fact, the doctors at Mayo expressly told me to look up certain things on the Internet to research them.

I am very concerned when it is automatically assumed it is all in a patients head or anxiety when the doctor cannot explain what is wrong based upon test results.  

And who wouldn't be anxious if overnight they became a shell of the person they were before?   And the doctors who are being paid (aka $20 to post a question on this forum) are discounting them?  


"Stop reading the internet on PVCs.  Your doctors know what they are doing.  If they think you are in danger, they will tell you.  I am not sure how else to say that.  The reality is that the people that don't worry about them, don't post or read up about them.  That leaves the group of people with more symptoms and often more anxietiesGeneralized anxiety disorder
Separation anxiety
Stress and anxiety about them to post.  The other problem is that you can find any opinion you want to about any topic with a google search.  "

[artskip]

When I was discussing my PVC's with my family Dr.who has known me for about 35 years. He said PVC's will not harm me or do any damage to my heart, I said so it normal to have this? He said no it is not normal but it will not kill me. He also said it's not in my head or in my case anxiety or stress related. He said I have messed up electrical pathway. It's kind of like what comes first the chicken or the egg. What comes first the  PVC's or the anxiety. It's different for everyone. But if you aren't prone to PVC's you could have all the stress in the world and your not going to get them. They are not all in your head. But adrenaline and anxiety will fuel the beast. PVC can weaken you emotionally.
I completely agree with you, as a patient you are your own best adovate. We have to be educated on the subject. We need to talk to others and learn how to deal with this situation, by seeing how other have adjusted to this problem.
I also believe it is a frustrating problem for the Dr's as well. There is really no 100% effective medicine or cure for them.  Unless they are living in a PVC ridden body they will never known what we go through.  I have learned you can't look to to many Drs for compassion these days. Hang in there

[raq1967]

I return to Mayo next week to finalize testing for the diagnosis of my symptoms, of which one piece being addressed is the pvc's.   And I'll be sure to post here what the final diagnosis/treatment is.  

And I know there could be non-heart related issues causing the heart to behave improperly (ie electrical, autonomic nervous system).   But just because the heart is structurally sound does not mean that mental health issues are causing the medical issues.

I think what really got me was this dr's response on multiple postings - all blaming anxiety.  Dr's are too quick to blame anxiety for medical problems simply because they do not understand them.   In addition, I have had some horrid experiences with doctors who are supposed to care about my medical well being but are only concerned with the bottom line ($$$).  So to say that 'your doctor knows what they are doing' is not necessarily true.

I think your response is much more appropriate.  These are not normal, but will not kill you.  Could have many causes, and stress/anxiety can exacerbate them.   Avoid stress/anxiety as much as possible, etc.   And if you are concerned with your doctors response, get a second opinion by visiting a different doctor.

Thanks for  your good thoughts!!!