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Avatar universal

PVC Couplet

Hi, I had a question regarding PVC couplets.  I wore a heart loop monitor for 60 days and recorded PVC's, PAC's, sinus tachycardia and one couplet of three PVC's.  I also had a echocardiogram which was normal.  The stress test was also normal.  I am a 42 year old female with daily PVC's, but only 10 or so.  I only recorded one of the couplets in the 30 day period.  My doctor feels that it is not serious but wants to monitor me every 6 months to see that they are not increasing in frequency.  Can you tell me if couplets of PVC's are more dangerous and can they become a more serious arrhythmia?  When I get the couplet it feels like my heart is flip/flopping for 5 seconds or so, but once in awhile, this flip/flopping feeling last longer.  Could they be coming in longer couplets and how many is too many?  Thanks for your response.
24 Responses
239757 tn?1213813182

thanks for the post.

They are not dangerous of indicative of a more significant arrythmia. With your normal evaluation, they are benign other than the symptoms they may cause you.  You might refer to the forum to see how others have dealt with their symptoms.

good luck
21064 tn?1309312333
You mentioned that a Holter monitor picked up one couplet of 3 pvcs.  I am not a doctor, just someone who has had her share of pvcs over many years.  As far as I know, a couplet is 2 consecutive pcvs.  Whereas, a run or "nonsustained VT" is 3 or more consecutive pvcs.  For me, the couplets and runs are flip-floppy in nature.  

I'd be surprised if, in the setting of a normal cardiac workup, the pvcs or isolated run would be cause for alarm.  But, follow up visits are a great way to keep an eye on things and for peace of mind : )

Avatar universal
you are probably right.  I guess I thought that a couplet meant a run of PVC's in a row without a normal beat in between which I had three of.  Thanks for your comment.  I do read this forum as I have had PVC's since I was a teenager and it helps to know I am not alone.  I know I have a lot less than some, but they are nontheless very bothersome and I feel every single one.  Thanks again.
Avatar universal
Hello, I just read your post. Im in the same situation. I had a run of three pvcs in a row three and a half years ago, that was my first one that I knew of. Since then I have had many runs of them and up to 26beats. So this is considered NSVT. Yes I freaked out alot. Although I have been to many cardiologist and ep specialest. With having a normal cardiac workup and in a normal heart setting and a good ef of 68-70 they are not worried. I have also had to ep studies. Which they could not induce the nsvt. I have been reassured many many times that this is not life threating. But I do know how terrible this feels and how scarey it is. I have actually seen four very good cardio/ep specialest and another one I spoke to who is a friend of a doctor I know. This paticular cardio/ep was very very reasurring not to mention the cardios on this forum. I have also been told that I do not need to take meds. However a year ago last January I did try three low does of toprol xl and that is when I had the 26 beat run. I had a loop recorder implanted so I was able to record it. I have also worn many of monitors as well. But yes three pvcs in a row is considered nsvt. If all your cardiac workups and test are fine then there is no need to worry. haha easy to say I know the fear is still there. I deal with it every day. anyway just wanted to share what I do know.
Take care
wmac also if you want to email me you can
Avatar universal
I loved the doctor's response...I never get tired of being reassured about PVCs!
I'd like to know how often you think a person with PVCs in a normal heart should have cardiac evaluation - holter and/or echo. I wore 24-hour holter in 2003 (tons of PVCs but no doubles or NSVT), and echo was fine. The cardio said it was all benign and didn't even suggest a follow-up! Do you guys have periodical cardiac evaluation for benign arrhythmias like PVCs or sinus tachy?

Thanks for any feedback!

21064 tn?1309312333
Hi Fran,

For sure...never can get too much reassurance : )

I've always been checked periodically for pvcs.  I also have a leaky valve, so maybe that's why I was watched a little more...not sure.  My chief complaint was always the pvcs -- flip/flopping.  I think the doctors usually recommend a visit if you notice any change in your pvcs, etc.  I usually had a holter ordered when I would notice a new type of arrythmia, or if the frequency was increasing.  I remember one Holter in particular where I had 22,000 pvcs, fifty-some couplets, some triplets and thousands of bigeminal episodes.  Still, it was "benign" absent any changes in heart function, etc.  

Have a great day!

Avatar universal
Hi Connie,
thanks for your reply. Gee, I thought my 3500 PVCs were a lot!! Actually I was surprised so few were recorded, I felt as if I had had a billion!

You are very reassuring! Thank you.
Avatar universal
I have an appointment with an EP tomorrow for a consult and my cardiologist mentioned that maybe he would do an implantable loop because they are having trouble getting my arrhythmia recorded. Everytime I wear something I get no symptoms only premature beats. I really want to know what the fluttery feeling is I feel at times and the times I feel like there is a racecar zooomiiing in my chest. Then my heart rate goes up to 120-130. However to tell the truth I am scared do death about an implantable loop. Could you tell me something about it and why did you wear one?
Avatar universal
Sorry about the previous post...I shouldn't have "spoken" to you like that.  I realize you were talking about people with heart disease, but still, there was no cause for that.  I'm just having a bad day.  I've been suffering from palpitations for 1 1/2 years and they've ruined my life, it is true.  I just get VERY frustrated sometimes because I have everything to live for and live like an 80 year old shut-in because my heart decides to act up.
I apologize.
21064 tn?1309312333
Looks like we've researched the same guidelines.  The ACC website is full of great information.  

Have you heard anything back from the CCF evaluation?  Hoping for good news.
Avatar universal
Hello, Well I had worn so many monitors and we did capture my nsvt alot, but I also kept getting a very fast faint heart racing and it was different than what the nsvt felt like. The insurance company will only allow one to have the king of hearts for a certian amount of time. I was presistant about capturing this different rhythm and the cardio had mentioned it several times but I was to chicken to do so finally I did. The loop recorder is about the size of a cigarette lighter but not as thick. They made a small insision about 1-1 1/2 wide below my left callor bone abpit 4inches below it. Then once they do that they just make a little pocket in there meaning they move stuff around and then they slip it in there and they didnt stich it they just taped it. I was sore afterwards, Im a hairdresser and it was amazing that I had a hard time lifting my left arm for a few days but then I was fine. They set the recordings to automatically record if heart rate gets to fast for istance if my heart rate got to 190 it would automatically record and if the heart rate got to slow like mine was 40 it would automatically record. It could do five of those, then I could record three of my own. They will give you a activator and you will wear it around your neck to activate your recordings. The problem was that I live 120 miles from the cardio and I was going to have to travel every time my monitor was filled up to have them download it. But the rep for medtronics had the computer brought here to my doc in my home town and had someone train him how to download it and if it there were a question he would just fax it to my cardio. So if that is a problem for you too ask for them to do that for you. The batteries are good for 12-14 months. I had mine in from oct to may then I asked them to take it out. Then my doc just went through the same insision and took it out. When they put it in and took it out they gave me versead and a local and I didnt feel a thing I was in lala land. I also kept breaking out from the king of hearts stickys. So this was a nice thing for me to have done it. They captured my 26 beat run of nsvt which is why I had the first ep done. But it does not hurt to have this done I do have a nice dent in my chest now from it though. So if they want you to have this done I would do it. good luck
Avatar universal
So you are saying that to say what...that we shouldn't take the doctor's word for it and just accept that these stupid skips, couplets, nsvt, etc. are going to kill us?  There are lots of afraid people here, and I'm one of them.  My life has been literally RUINED - it is a shambles right now because of PACs and PVCs.  These things have nearly caused my husband to  divorce me (due to the fact that I am scared of living anymore), me to go to a mental hospital, me to fail out of a top 5 law school, etc. ad nauseum.  I'm finally in therapy and it is helping somewhat (I shouldn't even be on this site...my intensive "health anxiety" therapy includes no symptom surfing).  I am young and have a healthy heart and my cardio told me even if I DO have NSVT (which he doubts) it won't kill me.  I'm not trying to go off on you and maybe I'm misunderstanding you and I'm also not one to keep my head in the sand but I don't think so many cardiologists would be lying to us and giving us a false sense of security that we are not dying when we are.
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