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116881 tn?1189755823

PVC/PAC's lead to death??

I have had these things now for years! I also have controlled high blood pressure with medication.  I am soooo worried that these skipped beats will lead to a deadly arrythmia.  I have had all the tests -- EKG, stress echo, 30 day event monitor, blood tests -- all come back with PAC's and PVC's. The Doc says don;t worry and i really want to not worry ... does anyone KNOW why or how these skipped neats do (or do not ) lead to serious problems?  Its getting to the point where I am afraid to be away from a short distance to the hospital!  Please help!
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Avatar universal
often -that was harsh- but true. i am much better now. and you are right all the days i wasted sitting and wondering if this was the day was time i wasted and is now gone. thanks for your encouraging words-sometimes we all need that.


carey-thanks for your kindness--i hope all is well for you. i am better- i still check my pulse some just not all day. it been five days without any bad skipped beats- i have had a couple of light flutters- i have only been on my bb for about 2 1/2 weeks i think it is helping.  my mind is alot better too. i had to go for a check up and my doctor explained that this is a common thing and i would be okay.  i also understand a little more about what is going on. well i thank God that i am emtionally and physically better - i feel more like myself.  
Hope you are better. let me know ...dawna
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Avatar universal
This is such true advice and Iam trying to do just that.  It just creeps up on me when the damn things keep coming and coming.  I tried to napp today and the PVCs wouldnt stop, so I just got up.  I have a baby and so needed the sleep.  I have just had a stress test and am waiting on the results.  So the stress is out of control.  They put me on BB and Ive been on Wellbutrin for 3 years.  So I guess from what everyone says, everything is going to be just fine.  Thank you for the postings they sure have helped me out.  Iam going to the beach tomorrow and enjoy life, PVCs and all.
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116881 tn?1189755823
Often,

Very good advice and very true.  I can't tell you how much I would like to take that attitude!  Its just so difficult to do when you are trying to do the things you love and a run of skipped beats and breathlessness stops you in your tracks.  I have been walking on a beach or shopping in the mall enjoying myself, and BOOM they hit.  Its so very hard to be nonchalant about them when experiencing those types of symptoms.  BUT point taken and thanks for the thoughts.

Dawn Jo,

I do not yet take a BB.  My Dr just prescribed Inderal as needed when I am feeling symptoms.  And I know what you're talking about with the one big DROP.  Its enought to ruin the next several hours of your night and I usually end up waking up in the morning thinking about it.  Its the dread and anticipation thats so hard to deal with.  And the bad thing is that that probably helps bring it on.  Night before last I was having dinner with my husband.  Out of the blue I get 4 or 5 in a row.  I couldn't finish eating because with mine my heart will race afterwards -- probably fear but who knows.  I guess if the docs knew a little more about it, it would help ease my anxiety.  But they just don't know.  All we can really do is try the solutions given to use and do our best to go about the day.  Take care!  
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219704 tn?1338609105
One word; Outstanding!!
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216614 tn?1195665072
How do you know eating hamburger won't lead to death?  How do you know crossing the street won't lead to death?  Maybe someone tampered with that tube of toothpaste you bought last week.  Are you sure that truck down the corner isn't a dirty bomb in disguise?  What if that nice young man next door is the latest serial killer?  

We start to die the moment we are born.  The only unequivocable fact in life is that it ends with death.  

You (and everyone) have a choice to make.  You can believe your doctor and start to LIVE...or you can spend your time sitting at the computer, reading all kinds of info on whatever disease you know or think you have.  In the meantime, how many moments are you missing?  I know they are scary, but once you are told yours are benign, why do you continue to look for a reason to be more scared.  Shut the damn computer off, take a breath, and go out and enjoy the sunshine, or the rain, or the water, or the garden, or your children, or your spouse, or your family, or a sappy movie, or the big sale at the mall.  Me, if I am going to "go", I think I would rather be doing something I liked with someone I loved, than be sitting at a computer scaring myself silly.  And that is what I am off to do.
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Avatar universal
Living leads to death.  The sad thing is, we are all born to die, and this is a fact that cannot be escaped.  I know that your sensations are scary, but since everything in "life" is "life threatening", try to work with what you have.  Chances are that some of us will not "go" due to heart problems.  LIVE it as best as you can.  I'm getting ready for a date with my husband...wooo hooo!!!!
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Avatar universal
thanks for understanding. at least we know what each other is going thru. my husband is the greatest man in the world but nothing scares him, if he knew he was fixing to die he would not be scared at all. so he cant understand  what i am going thru. so it is nice to know some one is out there that does. do you take beta blocker- the tiredness has wore off and now i really cant tell- i am slightly more mellow for 1-2 hours after i take them i guess. i will go 1-2 days with nothing then like last nite i was in bed reading and i had a skipped beat just one, but that is all it takes  to relight the anxiety and i start pusle checking and well you know.  they said that it could take up to a few weeks before my body adjust to the blocker and they stop and that i might still have one sometimes and the famous" its nothing to worry about" i wish i could have the mind set of my husband.  do your skipped beats come from the upper or lower chamber? well thanks for your time.    .....dawna
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116881 tn?1189755823
You and I sound identical.  I wish I had answers but if you are reading these posts, you know I dont.  All I can offer is a caring ear and to tell you youre not alone and I totally understand what youre going through.  
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Avatar universal
My name is dawna-i am 35 years old and healthy. i have for the past few years had a skipped beat here and there just figured it was stress.  almost two weeks ago i had to go to the hospital and was admitted for 24 hours due to the skipped beats.  i was having 3 and 4 in a row and it was coming from the lower chamber.  i had an ekg, ecogram of my heart and lots of blood work. the doctor told me my heart was healthy and all the test looked good and put me on a beta blocker. well since then i have been on the internet and reading which i thought would relax me but in turn has about drove me crazy- it sounds like coming from the bottom chamber can suddenly kill you my cardi doctor and family doctor whom i do trust said that is not the case with me since my heart is healthy otherwise.  this has turned into almost an obsession and truely i want to understand that i am okay and i am not going to suddenly drop dead. i have been on the beta blocker almost 2 weeks- not that the tired feeling is almost gone it seems fine however last night i had on strong skipped beat that scared me and now all my anxiety is back. i have 3 kids, 12 months, 11 yrs, and 6 yrs and i have got to pull myself together. am i at risk for cardic arrest or am i in the clear? my aunt who is a rn said i am not knowledgeable in this area and i should not be reading a bunch of stuff on the internet and confusing myself-maybe she is right.  i too just want to understand so i can relax or plan my funeral-just kidding but i really am scared and  you seem so knowlegable and just wanted to know if you could help to understand. please write back.
                                                                                             dawna
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Avatar universal
That's a tough question, since I am no expert.  However, as I understand it, a re-entry pathway serves as a conduit for repetitive premature triggering of the normal heart beat.  So, I would guess that SVT, AFib, and similar atrial arrhythmias would be examples.  The same can happen for the lower part of the heart with re-entry pathways running things like NSVT or VT.  So, if you are only having PACs or PVCs, with hardly anything that seems prolonged, then I would guess that there are no significant re-entry pathways picking up that joker's signalling.  If you get occassional short runs of something or other, lasting seconds, then you might have a re-entry circuit, but it's not very efficient (good thing).

-Arthur
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116881 tn?1189755823
Ok, so you had to know I was going to ask you this! :)  In  my search for answers ....  How do you know if you have one of those re-entry pathways??
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116881 tn?1189755823
Its all very good advice.  I really appreciate everyones input.  I actually had a follow up with my Dr yesterday because I have to see him every now and again for HBP.  Anyway, I told him EXACTLY how i was feeling about these things and what my fears were.  You know they get paid like $100 for about 6 or 7 miuntes worth of interaction so I figured he could take a few more minutes to put my mind at ease.  Which he did try.  He is a very caring Doctor I think.   Anyway, he basically said what everyone is saying here and that is that if you aren't showing symptoms of the reentry pathway you will very likely NOT ever get the off rhythms like A-Fib, VF, SVT etc.  They will likely just remain what they are-- benign PVC/PAC's.  
DO I believe him?  God, i hope so!  I love the headache to brain tumor analogy.  Thats my mind at work, MOMto3!
And Arthur-- spot on on the explanation.  Thanks for taking the time.
This whole thing seems to be more of a HEAD problem than a HEART problem!    
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Avatar universal
"You need to do something about the situation yourself.  Identify the behavior/habit that needs to be broken, and break it.  Of course it's not easy...if it was, everyone would be doing it."
You have hit the nail on the head!  THANK YOU!!!  Pulsetakers please take it to heart! :-)
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61536 tn?1340698163
I absolutely love a reply one of the Heart Forum doctors left a few years ago.  It totally calmed my worries.  He explained exactly what you're asking, and it was extremely reassuring.  I will do my very best to find it for you.

In short, benign PACs and PVCs are experienced by all people.  Some more than others, certainly.  I was assured when I learned recently that a relative of mine who lived to 108 had palpitations her whole life!  lol

Hang in there.
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21064 tn?1309308733
You really need to trust your doctor or find a new one.  The occasional skipped beats are harmless.  I've had them for close to 30 years that I know of, and I'm still here : )

I was one of the patients who was having 1000+ per hour and it still didn't cause any trouble for a long time.  Eventually, I needed a couple of ablations, but that took care of stuff and now I'm back to occasional ectopics.  If you have a change in symptoms and are concerned, have your doctor listen and determine if there are changes.  If not, just accept them.  I completely agree with the hiccup analogy. Sure, they are annoying, drive you batty, but they aren't gonna hurt you.  

It's kind of like saying a headache CAN BE be a brain tumor. You can find that on the net, and yes, it can be an indicator, but generally a headache does not point to a brain tumor.  If it were a brain tumor, a person would typically develop additional symptoms that would prompt an appointment with a doctor.

connie
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162069 tn?1224677411
hi there,  been reading your posts here, just thought i would throw something in.  my daughter is 22 years old and was diagnosed with idiopathic dilated cardiomyopathy 2 1/2 years ago.   we had no idea when we went for a routine check with her pediatric cardiologist (she was born with an anuerysmal bulge on her mitral valve/aortic junction giving her mild regurg occasional premature beats)   she has been on med regimen of coreg, vasotec, & inspra with no improvement in her ejection fraction (35%).  after she had mentioned one day that she felt "her heart beating"  she was placed on a 24hr holter,  that showed pac's     30,752 in a 24 period.  got a second opion at university of mich. they added digoxin to her other meds, and is scheduled for ablation on july 17.    
here is where i put in that my daughter is mildly developmentally disabled.  the only thing about all of this that has caused her any anxiety or irritation is heart monitors.  she is going into her second month of an event monitor and they bug her badly (which in turn bugs everyone around her!)   if she feels "something in her chest"  she tells me, and i worry, but i can't let this be the focus of her existence.  she will come home from her day program and say she felt a little dizzy or something, but she doesn't let it concern her anymore than that, she knows it will pass, she will sit down, and she will tell someone if goes on for more than a couple minutes.    at some point you have to try to trust your dr. if you don't trust your dr, find one you can trust.    she is more worried everyday that she may have to sit next to someone she doesn't like on the way home  
try to take it easy is all i mean to say           dawn
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Avatar universal
It's kind of a conundrum...folks keep saying that if you have a structurally normal heart, don't worry about the skips.  Of course, if the heart was structurally normal, then there wouldn't be very many skips.  The structural normality generally refers to the cardiac muscle and it's health.  So, even with a healthy muscle, you can get skips.  The persistent stuff, like PSVT, PAF, AF... comes from the bad luck of having some of those "foci" located in such a way as to provide actual alternative circuits for the heart to use.  So, given some focus which acts to prematurely depolarize the normal circuits, you may also have other foci which act to pick up that signal and route it around and around, intersecting or by-passing the normal circuits.  This stuff is refered to as 're-entry' pathways.  The heart is still pretty normal, with a good muscle system and good oxygenation...guaranteed to last a lifetime.  But, there are those little foci located through the atria which can pick up and carry on a repeating signal (under the right circumstances).  Generally, these conditions are best treated by ablation of the original offending focus...for without the intiation, the repetitive signalling can't go on.  Hope this helps.
-Arthur
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116881 tn?1189755823
I could not imagine training a sport with all that going on.  Hopefully, someday I will be able to swim strenuously and ignore the skips.  Do you think the people who have A Fib and PSVT and other heart issues have structurally abnormal hearts that are leading to those conditions?  You had mentioned that you have A Fib as well.
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Avatar universal
Well, many skips in a row...

If they are skips that come from the top of the heart (the atria, eg, PACs, PAF, AF, SVT, etc), which it sounds like is your situation, then it doesn't really matter how many show up in a row, or how often it happens.  This is because the main pumping system is in the lower part of your heart (the ventricles), namely, the left ventricle.  Regardless of what's happening with the atria (skipping, fluttering, spitting up), the ventricle runs at a certain pace, and will push out the blood sufficiently well enough at a reasonable pace that most folks won't have any symptoms.  

However, if the bottom part, the ventricle, is acting up, then that's another matter.  Even then, these types of skips (PVCs) are generally benign, since once again, there exists a relatively strong pacemaker here that keeps things flowing.  Having said that, if the ventricle gets into a tizzy, and starts skipping a lot of times in a row, then the blood flow can be significantly affected, and symptoms can follow.  If the ventricle gets into a fibrillation mode (tons of skips in a row), then very little blood flows, since the main pumper is now just jittering instead of pumping (VFIB)...this is the one everyone fears, because this one leads to death.  

Remember that everyone without exception gets skips from the upper and lower chambers of the heart every day...everyone.  If you have atrial arrhythmias then the chances of getting into VFIB are practically zilch.  Even if you get ventricular arrhythmias, the chances of VFIB are still quite low (since the heart has a couple of pacemaker systems to insure constant beating).  Folks that die of VFIB generally have some structural issues with the heart (for example, ischemia which affects the blood supply to the ventricle muscle)

I hope this puts things into perspective.  I get mostly atrial arrhythmias (PACs and once in a while a short run of AF), and I play soccer and train at a very stressful level.  I've overcome my fear with information and discipline.  Initially it was tough, but eventually, it's no big deal.

-Arthur
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116881 tn?1189755823
It helps very much .. thanks for taking the time to explain. Symptom+Fear+Lack of understanding=Very difficult daily life for me!

So one more question if I may ....

You know how the problem can be if you get say 10 in a row (what is that called) and pass out and die because your heart didn't pump the blood effectively etc   ..........  what causes that to happen?  Is that nearly impossible with a structurally health heart as well?  You have explained some sort of re entry pathway problem ... DO you need that defect for that to happen?  

I really am trying to understand so I can put this aside for good.  Everytime I get skips I think they are going to come in a row and lights out!  

Again, thanks so much.  You sound like you've done a lot of reading and research on these things.  

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Avatar universal
I don't think they are anything like toothaches...a better analogy would be hiccups.  Remember, there is nothing structurally screwed up here...so, the problems lies with the wiring.  Picture the setting up of dominoes in a line.  When complete, you push the first domino, and bingo, they fall nicely in a row, until the last one falls.  Then you set them up again.  This is how the electrical cells work in the heart.  It takes a little while to set up the dominoes (in the heart, the electrical cardiac cells "line up" with their charges ready to go, this is called polarization).  Then when enough dominoes are set, the "charge" is released.. this is called depolarization.  After that, the cells begin "lining up" their charges again.  When the charge is released, you get a heart beat.

Now, besides the cells that make up our circuits, there are islands of electrically active cells distributed throughout the heart...most of these amount to nothing, since they're not close enough to any of the normal circuits.  But, some of them may be close enough to cause an occassional problem.  The domino analogy would have us place a joker near the line of dominoes, who would once in a while, stick his finger on one of those dominoes and cause the whole thing to go prematurely.  That joker is the "focus" that is often mentioned.  A focus is an island of electrically active cells.

So that's the basic mechanism for setting off premature beats.  The lousy feeling comes from (1) missing a beat, and (2) feeling the makeup volume on the next beat.  (1) missing a beat...it's not really missing...it's just a beat that carried a smaller volume of blood (since it was premature), so it was hard to notice.  (2) the makeup beat has an extra load of blood because of the smaller beat ahead of it.  It does feel crappy, and can sometimes feel uncomfortable.

That's the story.  Why they show up when they do is a matter of cellular physiology...the focus needs to find a way for its electrical signalling to reach your dominoes...and this can happen due to very minor changes your nervous system (heightened), changes to your heart as it ages, or as it grows larger due to exercise, or any number of other factors.  Again, with a structurally normal heart, these things are not a sign of worse things to come or of a seriously malignant condition (like a toothache).  They really are very similar to hiccups.

Hope this helps.

-Arthur
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Avatar universal
Thank you, thank you, thank you!!!!
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116881 tn?1189755823
And by the way, my tooth analogy, what I was getting at was that my biggest question (fear) is whether one thing leads to another ...  
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116881 tn?1189755823
Explanation accepted  .I guess I understand what your saying about strengthening the problem by worrying and seeking assurance -- the problem for me is that there IS a lot of contradictory info out there.  Everytime I become convinced that OK PVC/PACS are benign in a structurally normal heart and I ignore the big thuds and drops and painful skips -- I end up reading something that says they could go into something more serious.  Right or wrong?  Who knows? -- I always end up thinking HOW DO I KNOW MINE WONT START TO COME IN RUNS OF 20, 40, 50 ETC??!
I do appreciate the explanation you spelled out in the Doc forum.  Maybe I'm just dense but it is a little hard to understand.  Even when I ask my Dr how he knows mine will not come one after another and BOOM thats it -- he says "because I know."  Well, that does not help.  I would love facts that I can understand.  I think along these lines:
So you have a toothache.  Turns out to be a cavity.  It hurts but you dont fix it.  The you need a root canal (because it progressed) and by the time you get the root canal the tooth has broken off into your gum and now you need oral surgery.  Do you see what I mean?
Anyway, thanks for taking the time to respond and anything facts (no matter how hard to understand) are GREATLY appreciated and I promiseto print them and post them to my nightstand!
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