Aa
PVC's/ PAC's
I'm 33 years old when I was 27 I had a short episode of A-fib my Cardiologist though it was holiday heart. After that short episode I was never troubled by any arrhythmias until three months ago I started having palpatations. My Cardiologist put me on a 24 hour monitor which reveled 20,800 superventricular beats and 1,800 pvc's. All my lab results where normal,nuclear stress test normal,echo normal.My Cardiologist recommeded a wait and see approach since I had no other symptoms. My only other medical problem is HTN for which I take 150mg Avapro.I'm not over weight, don't smoke and don't drink anymore. My question is.
1. Should I consider medication to suppress the arrhythmias?
2. Does this predispose me to going into other A-fib episode?
3. Would sugery be an option should this continue?
Thank you!
1. Should I consider medication to suppress the arrhythmias?
2. Does this predispose me to going into other A-fib episode?
3. Would sugery be an option should this continue?
Thank you!
engine1,
Thanks for the post.
Q:"1. Should I consider medication to suppress the arrhythmias?"
In general terms, we consider suppressive therapy for arrhythmias when the total percentage of beats reaches 8-12%. 20,800 beats in a 24 hour period is roughly 20-25% of the expected total number of beats. However, other patient factors need consideration, like symptom status before decisions are made.
Q:"2. Does this predispose me to going into other A-fib episode?"
The answer is that depends on what were the supraventricular beats. If the majority of the beats were from a sustained SVT, then perhaps no. If the majority of the beats were PACs, then perhaps yes. A review of the holter should allow answer of this question.
Q:"3. Would sugery be an option should this continue?"
An ablation procedure is an option for cure of afib in certain selected patients. Ablation procedures use catheters introduced via needle sticks as opposed to direct cutting. Very, very few ablation procedures require general anesthesia, certainly less than 1%.
Thanks for the post.
Q:"1. Should I consider medication to suppress the arrhythmias?"
In general terms, we consider suppressive therapy for arrhythmias when the total percentage of beats reaches 8-12%. 20,800 beats in a 24 hour period is roughly 20-25% of the expected total number of beats. However, other patient factors need consideration, like symptom status before decisions are made.
Q:"2. Does this predispose me to going into other A-fib episode?"
The answer is that depends on what were the supraventricular beats. If the majority of the beats were from a sustained SVT, then perhaps no. If the majority of the beats were PACs, then perhaps yes. A review of the holter should allow answer of this question.
Q:"3. Would sugery be an option should this continue?"
An ablation procedure is an option for cure of afib in certain selected patients. Ablation procedures use catheters introduced via needle sticks as opposed to direct cutting. Very, very few ablation procedures require general anesthesia, certainly less than 1%.
I have tried to post, but system always says filled quota for the day so here we go.I hope its okay to seek help here.
I am a 43 year old female with a history of sinus tach related to panic attacks. This started 9 years ago and I do take meds for the anxiety. Starting in October I started having bouts of rare PAC's went to the doc, had holter monitor, echo, blood work. Everything looks good.I have had a lot more heart palps this month, they drive me crazy. I do take atenonol 25mg. per day and my doctor increased it to 37.5.
In nutshell I feel this hard beat and then am a bit tachy for a few minutes, this can repeat itself over the next hour. My doc seems to think the palps come then the anxiety comes in.For months I was waking up off and on during the night with a fast heart rate until I began taking my beta blocker in the morning and evening.Now I seem to sleep better but these ugly things (palps) bother me in the day especially if my day is busy and I haven't been eating every couple of hours not eating seems to aggravate all this.
My dad has afib and had a heart attack in October caused by afib/aflutter.My doctor assures me that I am okay. But I get scared everytime I feel that jump in my throat. It is helpful to read that others feel as I do. This has been a stress filled month....could I be hyper sensitive to feeling these right now or does being tired bring more pac's on?? My doctor said we could do the holter again, which I will probably give a try. I also have seen a Natuopath who has put me on magnesuim malate with potassuim. I would eat dirt to stop these. Any hints would be appreciated !!! My heart goes out to all of you.!!!!
I am a 43 year old female with a history of sinus tach related to panic attacks. This started 9 years ago and I do take meds for the anxiety. Starting in October I started having bouts of rare PAC's went to the doc, had holter monitor, echo, blood work. Everything looks good.I have had a lot more heart palps this month, they drive me crazy. I do take atenonol 25mg. per day and my doctor increased it to 37.5.
In nutshell I feel this hard beat and then am a bit tachy for a few minutes, this can repeat itself over the next hour. My doc seems to think the palps come then the anxiety comes in.For months I was waking up off and on during the night with a fast heart rate until I began taking my beta blocker in the morning and evening.Now I seem to sleep better but these ugly things (palps) bother me in the day especially if my day is busy and I haven't been eating every couple of hours not eating seems to aggravate all this.
My dad has afib and had a heart attack in October caused by afib/aflutter.My doctor assures me that I am okay. But I get scared everytime I feel that jump in my throat. It is helpful to read that others feel as I do. This has been a stress filled month....could I be hyper sensitive to feeling these right now or does being tired bring more pac's on?? My doctor said we could do the holter again, which I will probably give a try. I also have seen a Natuopath who has put me on magnesuim malate with potassuim. I would eat dirt to stop these. Any hints would be appreciated !!! My heart goes out to all of you.!!!!
Pluto,
You always seem to ask very interesting questions! You ask above why PACs often lead to afib. Here's my understanding. To have afib, two conditions must be fulfilled: (1) you need an electrical trigger like the etopic pulse causing a PAC; and (2) you need an arrhythmic substrate (i.e., an atrium that is overly sensitive/susceptible either because of abnormal electrochemistry or size).
(1) Studies have shown (see e.g., http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15078396&dopt=Abstract ) that PACs almost always precede the start of afib (I read in another article where 93% of afib cases are associated with PAC initiation).
(2) The electrochemical susceptibilty/sensitivity of the substrate is related to factors such as stress, ingestion of alcohol, imbalance between critical ions (Na, Ca, Mg, K), etc. So a person with PACs would tend to be more susceptible to experiencing "holiday heart" even though their heart might otherwise be "structurally sound".
The other factor that makes the atrium highly susceptible is its size. The normal size range of the left atrium is 3-4 cm. Generally, atria enlarge as time passes (i.e., strong correlation with age, blood pressure, valve problems, etc.). So, if for no other reason, as a person ages their LA increases. AFIB is essentially an oscillation phenomena dependent on the surface area of the atria. Unfortunately relatively small changes in atrial size lead to faily large area differences. A person with an LA of say 4.5 cm has an atrial area that's 65% larger than someone with a LA of 3.5 cm (when the LA exceeds 5, the area more than doubles). So, even if that person's atrial electrochemistry is "normal", they are predisposed to support afib (i.e., the setup of multiple reeentrant electrical wavelets) if they have PACs. In such cases, to prevent afib, the sensitivity of the heart has to be turned way down using antiarrhythmic drugs or if ablation is opted, substrate modification is needed.
Now why doesn't this happen with PVCs? Here I'm not so sure. I would guess it has something to do with the physical characteristics of the atria vs the ventricles. An overworked atria expands while an overworked ventrical thickens so that even when it's outer diameter increases, it's inner diameter may be shrinking. Also, the ventricles are "wired" differently than the atria. The ventricles have three bundle branches while the atrial wiring is far simpler. I suspect that the branching fibers sub-divide the ventricles in a way that makes it more difficult to sustain wavelets. Just a guess.
Tony
You always seem to ask very interesting questions! You ask above why PACs often lead to afib. Here's my understanding. To have afib, two conditions must be fulfilled: (1) you need an electrical trigger like the etopic pulse causing a PAC; and (2) you need an arrhythmic substrate (i.e., an atrium that is overly sensitive/susceptible either because of abnormal electrochemistry or size).
(1) Studies have shown (see e.g., http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15078396&dopt=Abstract ) that PACs almost always precede the start of afib (I read in another article where 93% of afib cases are associated with PAC initiation).
(2) The electrochemical susceptibilty/sensitivity of the substrate is related to factors such as stress, ingestion of alcohol, imbalance between critical ions (Na, Ca, Mg, K), etc. So a person with PACs would tend to be more susceptible to experiencing "holiday heart" even though their heart might otherwise be "structurally sound".
The other factor that makes the atrium highly susceptible is its size. The normal size range of the left atrium is 3-4 cm. Generally, atria enlarge as time passes (i.e., strong correlation with age, blood pressure, valve problems, etc.). So, if for no other reason, as a person ages their LA increases. AFIB is essentially an oscillation phenomena dependent on the surface area of the atria. Unfortunately relatively small changes in atrial size lead to faily large area differences. A person with an LA of say 4.5 cm has an atrial area that's 65% larger than someone with a LA of 3.5 cm (when the LA exceeds 5, the area more than doubles). So, even if that person's atrial electrochemistry is "normal", they are predisposed to support afib (i.e., the setup of multiple reeentrant electrical wavelets) if they have PACs. In such cases, to prevent afib, the sensitivity of the heart has to be turned way down using antiarrhythmic drugs or if ablation is opted, substrate modification is needed.
Now why doesn't this happen with PVCs? Here I'm not so sure. I would guess it has something to do with the physical characteristics of the atria vs the ventricles. An overworked atria expands while an overworked ventrical thickens so that even when it's outer diameter increases, it's inner diameter may be shrinking. Also, the ventricles are "wired" differently than the atria. The ventricles have three bundle branches while the atrial wiring is far simpler. I suspect that the branching fibers sub-divide the ventricles in a way that makes it more difficult to sustain wavelets. Just a guess.
Tony
what is meant by aortic unfolding. I have PVC and have know this for years. Recent radiology report states ( The heart is of boderline size. There is mild aortic unfolding. No changes form 07/19/02. My daughter died at age 22yr. cardiomyopathy. ohter daughter had a slight mitral valve. we all took SELDANE with erthomycin.
The web page http://www.alldoctors.com.au/ask_doctor/ALB_A/ab_951.asp describes aortic unfolding and its significance as follows:
"Aortic Unfolding
DESCRIPTION: The aorta is the main artery of the body and is about 2cm across. It starts from the top of the heart, bends (or folds) over, and then runs down the back of the chest and belly along the inside of the backbone. It looks like an upside down
"Aortic Unfolding
DESCRIPTION: The aorta is the main artery of the body and is about 2cm across. It starts from the top of the heart, bends (or folds) over, and then runs down the back of the chest and belly along the inside of the backbone. It looks like an upside down
Hank,
Thanks for the compliment but whatever I know about medicine is from reading and even then it's mostly about atrial fibrillation (because that's what ails me). I'm a government scientist (Ph.D. physics) working on defense related optical problems. I do have some background in biophysics and chemistry from many years ago. Being a researcher and a physicist, I'm trained to analyze problems by devising simple physical models to explain behavior. So I generally have an engineering view of how the electrical bio-pump we call the heart works. Anyway, it gets me more face time with my cardiologist (and better treatment) because he's amused when I explain my theories. In the end, though, I generally follow his advice.
You seemed to know quite a bit yourself, Hank. You have a very logical and inquisitive mind.
Tony
Thanks for the compliment but whatever I know about medicine is from reading and even then it's mostly about atrial fibrillation (because that's what ails me). I'm a government scientist (Ph.D. physics) working on defense related optical problems. I do have some background in biophysics and chemistry from many years ago. Being a researcher and a physicist, I'm trained to analyze problems by devising simple physical models to explain behavior. So I generally have an engineering view of how the electrical bio-pump we call the heart works. Anyway, it gets me more face time with my cardiologist (and better treatment) because he's amused when I explain my theories. In the end, though, I generally follow his advice.
You seemed to know quite a bit yourself, Hank. You have a very logical and inquisitive mind.
Tony
I also have had A-fib before. I am 35 years old. I know how you feel.
I also have had A-fib before. I am 35 years old. I know how you feel.
I also have had A-fib before. I am 35 years old. I know how you feel. You and Hank have quite a bit of knowledge and I enjoy reading your comments. I have done a lot of research myself having the PVC's, PAC's and A-Fib. Take care.
Erik
Erik
I don't know how I managed to post three times like this.
Erik,
I also enjoy reading your comments, which are always well researched. You're a very caring person and always willing to help out. Bless you. Sorry I made that "cardiac neurotics" crack a few weeks ago. That was very inconsiderate of me.
I've had PACs/palpatations for 30 years and afib for at least three years that I know of (I actually think I had afib off and on for decades but could never catch it on a Holter). I feel pretty good right now at age 62 with the help of Rythmol, which is keeping me in NSR (at least most of the time).
Best regards to you and Hank,
Tony
I also enjoy reading your comments, which are always well researched. You're a very caring person and always willing to help out. Bless you. Sorry I made that "cardiac neurotics" crack a few weeks ago. That was very inconsiderate of me.
I've had PACs/palpatations for 30 years and afib for at least three years that I know of (I actually think I had afib off and on for decades but could never catch it on a Holter). I feel pretty good right now at age 62 with the help of Rythmol, which is keeping me in NSR (at least most of the time).
Best regards to you and Hank,
Tony
wasn't seldane pulled off the market. I know it was a prescription I had some. But it was pulled and they said it was a dangerous drug and that there could be some problems from that drug.
There are many physicians who read and follow medical help sites. It gives us more insight into our patients' concerns and fears. Thought you should know this the next time you choose to generalize about our manipulative motives.
If you are indeed a dcotor you are very immature for being one.
You should go back to school for some "Courtesy 101". You may be booksmart, but you lack people skills. You are on a site that has an opinionated group of people posting comments and helping one another. The doctors who answer questions on this site are fine with us, so why should we care what you think?
You should go back to school for some "Courtesy 101". You may be booksmart, but you lack people skills. You are on a site that has an opinionated group of people posting comments and helping one another. The doctors who answer questions on this site are fine with us, so why should we care what you think?
Sorry to have invaded your space.
Peace, and may God be with you.
Peace, and may God be with you.
Please stop with the immaturity. Your comments to ADrocks were insensitive and will likely scare others from posting on this site. Hank, I see that you're back on the board and creating animosity. Please temper your responses and lets have a kinder and gentler board.
Animosity is a bit strong...it actually means "active hatred"
I am sure no one here actively hates anyone else here.
However, I have noticed that strong opinions beget strong responses...and like everything else in this incredibly mysterious world, it's a normal part of conversation. Folks here just want to get to the bottom of things...so buck up.
-Arthur
I am sure no one here actively hates anyone else here.
However, I have noticed that strong opinions beget strong responses...and like everything else in this incredibly mysterious world, it's a normal part of conversation. Folks here just want to get to the bottom of things...so buck up.
-Arthur
Arthur, thanks for looking up animosity in the dictionary. I did not intend to state that Hank is "actively hating" anyone. I do think that his and Erik's repsonses were childish and inppropriate. I also think that Hank's response to me was in the same vein. I enjoy a good discussion but not the way this one was presented.
Guys,
Don't get sucked into responding to inflammatry posts my friends! Simply ignore them. My own take is just to stick to addressing the issues to hand: I've NO time whatsoever to get drawn into bickering of any nature.
Respect,
BM
Don't get sucked into responding to inflammatry posts my friends! Simply ignore them. My own take is just to stick to addressing the issues to hand: I've NO time whatsoever to get drawn into bickering of any nature.
Respect,
BM
Once ADrocks stopped posting his/her cry baby posts everything was fine until Pantywaist or Parunuweap or whoever it is chimed in.
First of all, I wish people would leave Hank alone. He has done nothing to anyone. He is a very thoughtful, compassionate and intelligent person. We are all better people for having read his posts. When I see him or anyone else being attacked on this forum I stick up for them.
As far as my comments being immature. I speak my mind and I don't mince words. I am a friend to all of you. Most of you are intelligent people and I enjoy reading your comments. It seems a few people always ruin it for everyone. Let's take Bigmicks's advice and don't get sucked into this petty nonsense. Even me, the free speaker, will try to keep my mouth shut. Let's get back to what we do best. Sharing knowledge.
First of all, I wish people would leave Hank alone. He has done nothing to anyone. He is a very thoughtful, compassionate and intelligent person. We are all better people for having read his posts. When I see him or anyone else being attacked on this forum I stick up for them.
As far as my comments being immature. I speak my mind and I don't mince words. I am a friend to all of you. Most of you are intelligent people and I enjoy reading your comments. It seems a few people always ruin it for everyone. Let's take Bigmicks's advice and don't get sucked into this petty nonsense. Even me, the free speaker, will try to keep my mouth shut. Let's get back to what we do best. Sharing knowledge.
It scares me to post, but no one knows who I am so I guess it will be OK.
I read this forum a couple of times a week to see that other people have similar problems like me, and how they deal with them. Especially the stuff about medicines and palps.
Sometimes people write stuff and make recommendations that alarm me. Like someone wrote about a virus Cocksakee(?), and all the stuff seemed to apply to how I was feeling, but when I posted for more info, no one responded and I was left swirling. Many of you may say "buck-up", but that's what happened.
I'm not asking anybody to change, just sharing how I feel. I feel like the technical stuff from non-medical but knowledgable people sometimes makes things worse for me. Maybe I should just stop reading, but I still really like knowing that others out there are like me and OK.
Also, I do not agree that having someone state that they disagree with one of you, even strongly, is a personal attack. It is simply a difference of opinion, which I like and hope people will still be OK doing
respectfully
Carl
I read this forum a couple of times a week to see that other people have similar problems like me, and how they deal with them. Especially the stuff about medicines and palps.
Sometimes people write stuff and make recommendations that alarm me. Like someone wrote about a virus Cocksakee(?), and all the stuff seemed to apply to how I was feeling, but when I posted for more info, no one responded and I was left swirling. Many of you may say "buck-up", but that's what happened.
I'm not asking anybody to change, just sharing how I feel. I feel like the technical stuff from non-medical but knowledgable people sometimes makes things worse for me. Maybe I should just stop reading, but I still really like knowing that others out there are like me and OK.
Also, I do not agree that having someone state that they disagree with one of you, even strongly, is a personal attack. It is simply a difference of opinion, which I like and hope people will still be OK doing
respectfully
Carl
Hi all - am new to the site - but not to the PVC's! Have had them for years. I did find that the red and yellow dyes in M&M's trigger them - and those dyes are in a number of other prepared foods. I use a mullein weed tea - made with the leaves and black strap molasses that works great in controlling them - 1 tbs usually does the trick and the tea lasts a whole year and than molds when the new plants are back out.
I'll be finding out on June 14th when I see cardiologist (who is also an EP).
Cheers,
BM
Cheers,
BM
Ive had afib for over 10 years, and have taken Atenenol, Verapimail, Lanoxin, slept with a CPAP mask, and nothing has helped. The attacks occur on an average of about one every 6 weeks and last about 3-8hours. Since I've started taking CoQ 10, and a magnesium, potassium calcium combo, the attacks seem to have become shorter, but still as violent. I have quit going to the emergency room as they follow protocol with an IV, but simply wait for me to convert, and then send me home. A thalidimide strss test didn't turn up anything, blood pressure and cholesterol are normal. I am 66 yrs old, female, and basically healthy, but these attacks scare the heck out of me, and my doctor, and cardiologist have me currently taking an asprin each day. Any suggestions. By the way, I can usually tell when an attack will occur ( only during the night when I am asleep) because the day preceeding the attack, I experience skipped beats.
You are reading content posted in the Heart Disease Forum
Is a low-fat diet really that heart healthy after all? James D. Nicolantonio, PharmD, urges us to reconsider decades-long dietary guidelines.
Can depression and anxiety cause heart disease? Get the facts in this Missouri Medicine report.
Fish oil, folic acid, vitamin C. Find out if these supplements are heart-healthy or overhyped.
Learn what happens before, during and after a heart attack occurs.
What are the pros and cons of taking fish oil for heart health? Find out in this article from Missouri Medicine.
How to lower your heart attack risk.
