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PVCs - multiple causes?

I am a 61-year-old non smoking male and think that I may have several things contributing to PVCs.   First noticed  an occasional
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I am 70 years old, wore the holter monitor several years ago when I was going crazy with multiple PVC's.  They finally went away by themselves (?) Now they are back, BIG TIME.  I am having attacks that scare me to death, I think I am dying, I feel shaky inside (like you haven't eaten all day).  I feel panicky and have been on the verge of going to the ER.  I saw the doctor again less than a month ago and he offered me "a big dose of reassurance".  I try to keep thinking about that when I am in such a panic, but it doesn't work.  I am taking my blood pressure too often, taking my pulse and breathing like a horse that has been running!  Which I happen to realize just makes things worse. I do not drink, smoke and am not overweight.  I also walk 2-1/2 miles every morning.  But these PVC's are taking over my life; in fact, they seem to have a life of their own.  The only consolation is that after reading some of the postings, I realize I am certainly not alone.  I feel so desperate and my husband is so concerned about me I feel guilty telling him how I feel.  Any suggestions?
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Avatar universal
Funny you should say try not checking my pulse to see if Im still alive. The right side of my neck is sore from me checking over and over again. I know its silly since I am breathing and all and i know my heart is beating..but I think the instinct to MAKE sure is overwhelming. I will do my best to not check and I am happy to say the PVCs are slowing as the medicine leaves my body. I dont think I will ever be free from them but I will do my best to not let them run my life. I dont panic as much anymore but sometimes it does freak me out beyond all belief. I thank you for the helpful advice and will be checking the posts for any updates and replying when I feel I cant cope. This posting board has been a godsend as I actually feel better talking to people like you that know what I am feeling and knowing that a simple.. hey get over it wont come from you. I started eating bananas right after I read it might help and will start back on my vitamins once the antibiotic is all out of my system.Thanks again for everything !! And you will be happy to know that I havent checked my pulse in over 10 minutes  :)
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The "sick" feeling that a skip causes is very difficult to ignore. That feeling is caused by the heart pumping out a little more blood than usual, since the skip caused it to fill up a little more. However, when you are particularly upset about them happening, it's a vicious little circle ... you pay more attention and you feel them more, and you get more anxious, and get some more...

You really need to try an experiment.  Spend a week where you don't actually check your pulse (this is very difficult!).  Then see how you feel the following week...by then your anxiety may be down and most of those annoying skips may be difficult to notice.  If so, keep it up...that is, avoid the pulse check.

I went through a similar period (lasted more than a year) where I couldn't avoid feeling every single skip...I was in panic.  It was very difficult to stop checking up on myself. These days I know that some days are bad and so what? I focus on the fact that some days are good, and that these things are nothing more complicated than hiccups.

Regarding your observation of more skips when pregnant or when some other chest-centered distress is occurring, it's very likely that your skips are being caused by pulmonary vein foci (check the archives herein).  These foci are regions of the vein near the heart that are electrically active and sometimes cause the atria to start up a heart beat prematurely.  These foci are well known to be aggravated by movement, exercise, pressure from bloating, GERD, and anything else that can physically disturb them.  Sometimes people can find body positions which lessen the skips, and then it's clear it's the PV foci at work.  There are technologies afoot that may soon be used to rub these guys out (ablations using catheters inserted in the veins)...just hang in there and know that you have nothing that unusual or dangerous...you've been handed a challenge in overcoming something,  not succumbing to something.  In my case I play competitive soccer (age 53) and ignore the hiccups and am having a blast.
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Avatar universal
Hi,
  I have had PVCs for over 6 years now. First time I had one I was pregnaunt with my son. Went to the ER because I was convinced I was dying. They hooked me up to an EKG machine but failed to find the problem. So i went home and was fine. Had not a one till perhaps 4 months later. Over the next year I had various things done.. an ultra sound of my heart which showed my heart to be fine. Wore that god awful heart monitor 2 times and ill be darned if it didnt catch them. Finally in the middle of the night while i was having 7 -8 in a row every minute did they finally catch them and said well there it is. PVCs you will die with them not of them. Dont worry just relax and live your life. The Doctors all told me that many many people have them BUT dont feel them. I would LOVE to be in that group. It use to be absolutely terrifying when they happened and I would freak out and cry and panic. Turn into a bonafied fruit loop. I dont have them every day...I have went for years without having them. I find them more of a bother now as I know I wont die from them.. but my thing is this.. I have bronchitis right now.. went to the ER and the Doctor gave me Erythromycin. I informed him as I do every doctor that I have occasional PVCs and he didnt seem to worried. Well 2 days into taking the meds I began having PVCs. pretty much all day every day for the last 4 days. I finally called the pharmacy because I was thinking the steroid might be the cause and they said Nope it was the antibiotic and I would be fine once i stopped taking it. Well its been 36 hours * yes* I have been counting since i stopped the antibiotic. I actually stopped taking the prednisone as well. How long till the medicine wears off? Will this actually hurt my heart in the long run? I was told it wont hurt me and once the medicine leaves my system I should go back to my occasional PVC's. I do know that heartburn makes them appear sometimes but overall I have been lucky that I dont have them everyday. I still do my best to define the feeling and the only way I can describe them is and this is for all the old timers out there that recall records :) when the record skips or gets stuck for a moment.. that sound you hear is how It feels in my chest. Not that it hurts.. its just odd. I wouldnt wish this feeling on my worst enemy. I will take some ideas from Mike there and go to the store and buy some bananas. Start taking some vitamins. I dont drink caffeine or alcohal. I dont eat chocolate. I thank god i found this board. I have never felt better since i started reading some of these posts. To all who have PVCs Im sorry but im not sorry I found you all. Makes me feel better to know I am not alone and that i have options. I will stop blabbing now. Thanks for answering the questions if you can find them up in there.
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Avatar universal
Panic attacks are a real threat to your well-being.  They are beyond psychological and should be treated very carefully by physicians, since they result in a change in the state of your nervous system which pretty much lowers the trigger points for PAC and PVC induction.  Too often doctors hope to cure your panic by blatantly ignoring it, the theory being that you will realize what an idiot you are, completely toss off the panic, and become your normal self.  Obviously they are laboring under a delusion brought on by the lack of proper training and/or a callous attitude adopted to avoid stress in their own lives.

It takes a real effort of will to get past the panic once it sets in.  Don't blame yourself.  Lack of information is generally the biggest reason for panic, not to mention a heart going pitter-patter.  As you can see from the zillions of postings herein, a sound heart with skips is nothing to worry about because it leads to no particular serious problems.  I am sure everyone with these skips agrees that they are distressing because they are abnormal.  The fact is they are benign and can do you no further damage than make you crazy.  So there it is.
Accept that you have changed.  Accept that they are part of your makeup.  Ignore them to the best of your ability (for example, don't be checking up to see how many you have right now).  In time, they will play a lesser and lesser role in your mind... to the point where you really don't care if they are happening or not.  That's when you are cured of your panic attack.

Good Luck.  It took me a good year to accomplish this, so it's no easy road.  On the flip side, if they really bother you and you cannot get past them, the technology exists and is improving that can cure you of these things.  Chin up.

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Avatar universal
I have entered this section while sitting at home instead of being at work feeling sick. I don't know what's wrong. I have suffered these PVC's (as I now know what they are called) for years. They come and make me feel very scared and nervous. I have been diagnosed as having panic attacks. But it is a bit like what came first the chicken or the egg. Does the PVC bring on a panic attack (as I first thought) or does the panic attack and anxiety (without knowing I was stressed) bring on the PVC? I am feeling a bit better after reading these comments, especially Mike from uk. I am going to envest in some Gaviscon as I often do feel better after the pardonable burp. All this makes me feel so unhappy as you do feel you are going to die when this happens. I did not realise it was such a common thing and it makes everyone feel yuck. I hate it. I have had a halter monitor and a scan and they say I have an enlarged right ventrical. Medication I was told has too many side effects - and the age old saying was told to me - "Go home and don't worry". Easy to say as they say NEXT. I feel a lot better when I have had tests and they assure me everything is OK. Perhaps I am due again.
Thanks for all the interesting info.
Sandra C
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Avatar universal
If these PACs/PVCs continue and really trouble you, have them checked out by an EP (electrophysiologist), a cardiologist specializing in arrhythmias, for a second opinion.  There's a treatment for everything.  

Most of these annoying skips are indeed considered benign (ie, not life-threatening) so most cardios will suggest not to worry about them, and if you do, take some meds.  Most of these skips are caused by aberrant cardiac tissue found at the attachment points of pulmonary veins to the heart, and are often referred to as PV foci.  Technology exists to remove them (rf ablation) presuming that the benefit of the procedure outweighs the risks.

So, have those annoying skips checked out by a specialist and make an informed decision re. your next step.  It does sound like your annoyed (and frightened); that would make me go directly to an expert I can trust and follow his/her advice.  Good Luck.

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Avatar universal
I started having what I describe as heart flutters this past week-end. It scared the hell out of me.  Last night they occured again, and I decided to go to my family physician today.  He says I am having PVC'S and PAC'S.  I have read a few of the postings and see that indigestion may have something to do with the occurance of these irregular heart beats.  Although my phy. says i shouldn't worry, as I am sitting here tonigt and my heart isn't beating right I am worried.  Any sugesstions on how to cope with this problem are appreciated.
Sincerely,
Lee
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Avatar universal
Hi everyone.

I'm 34 and new to the site. Frequent PVCs have been a part of my life for about 5 years. This is about the same time I've suffered from severe gastric reflux, which is (just about) controlled with 20mg Losec daily. The Losec doesn't have any effect on the PVCs, but I'll now also be trying Maalox as suggested by Mike. I've had two tachycardic episode, lasting only a few seconds, but they were as scary as hell.

When I first started suffering from PVCs, they would come on more or less in three situations: 1. when I was just dropping off to sleep; 2. after a large meal; 3. after exercise. Now they happen all the time. I have had a few PVC-free periods, usually lasting a few weeks, but I have no idea why they stop and start up again, which is very frustrating. My guess is that they never actually stopped, but weren't violent enough for me to notice them.

However, one occasion from March 1999 sticks clearly in my mind - I'd been 'PVC-free' for about 3 weeks, when I went on skiing holiday in the French Alps. The night I arrived, the PVCs started up again, and continued very obviously for the entire week, especially when I was on the slopes. I'm not a very good skier anyway, and I wasn't particuarly exerting myself. Obviously at altitude the air is thinner, so I wonder if 'poor breathing' could be a contributory factor.

All the best to everyone.

Paul
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Avatar universal
I also want to add that my EP doctor told me that stress, GI disturbances, menstrual cycles, certain foods, alcohol, caffeine,tobacco, etc are TRIGGERS not CAUSES of this problem. Sometimes it's difficult for them to find the CAUSE. Mine happens to be in my pulmonary vein. No easy treatment, involves open heart surgery with high risk as it's a new procedure. They've found that verapamil long acting and tenormin are working for me <thank God> and will try medicines first on you to see which ones you respond to for symptom relief. There is no rhyme or reason to when or why they happen, but if you have them you need to see an EP doctor, he or she deals with the electrical conduction system in your heart and will help you get to the CAUSE and hopefully find the cure! Good luck to all :)
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Hi Lauren
From the odd extra heartbeat which I managed to catch on an event recorder the cardio suspected I had a focus in my right ventricle as the extra beat always came from the same area.  He says it isn't dangerous and that I should just try to live with it - HA!!!  I wish I knew a way.  I see from cardios posts on this forum that they routinely do ablation for this kind of thing and I find my thoughts going lovingly in this direction - oh to be free of it, this blasted focus (or two or three or more).
I am taking bucket loads of Maalox as Mike Brewer advises together with a daily 20mg Losec and I am feeling more normal.
If you leave me your email address, I'll write to you.
We just have to try to convince ourselves that this horrific extra beating, like being on the big dipper from hell, is nothing to worry about!
Love Jonesey
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Avatar universal
Hi Jonesey,

reading your psot is describinbg "me"..

I also was free of the flips and flops for 3 motnhs and it is ALL BACK.

What is an ectopic focus in the ventricle?  How did your cardiologist come to this conclusion and is it serious or cqan be made serious by reflux?

I HATE this also. It makes me a nervous wreck.  I don't want to be around anyone when I am in this state. I am doing poorly while typing this.  Laying down seems to calm these heart flip flops.  It is like perhaps taking pressure off something.  Pls. stay in touch and my best to you also.
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Avatar universal
Hi All
Mike - I have read your message before but was very glad to read it and remind myself about it again tonite as I have had a dreadful palpitation day ending up in casualty.    
I have been pvc free for three months, it's been bliss, and for the past 9 days I have been plagued with some awful palpitations - and dreadful indigestion.  I feel as though my stomach is bumping into my heart, that I have a balloon under my heart.  I have an awful lot of gas and acid indigestion right now and am burping from my shoes.  I do not eat any kind of foods to cause indigestion and so I cannot understand why I am getting it.
I had a barium swallow maybe 14 years ago so perhaps it is time I had another one to see what is going on with my oesophagus & stomach.  I had an endoscopy maybe 5 or 6 years ago and that was OK.
I am trying very hard to stay calm but I have this terrible feeling of pressure around my heart/oesophagus/stomach, the bumping into each other feeling, and the heart is going haywire.  The cardiologist says that he thinks I have an ectopic focus in the right ventricle so I am assuming that all of this indigestion is triggering it into action.
I have re-started myself on 20mg Losec in the last two days, and I am taking both gaviscon and Maalox.
Hoping to get right soon.
Hoping everyone else is doing OK.
Best Regards
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Avatar universal
Hi once more!

It's a good start to take proton pump inhibitors (Prilosec) as I do.

However, the MAIN POINT of my advice is that the esophagus needs direct protection against not only any remaining acid, but BILE which Prilosec does not affect.

Good luck.

Mike
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Thanks for the helpful advice and comments.
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Thanks again for sharing this again, Mike. I read it months ago.

Well, I have been diagnosed with Reflux/Gerd and I had/have a stricture in the esophagus (EGD)which the doc said he balooned but I do not think so. Barium Swallow with the new GI doc showed it was still there.  I am (was)on Nexium which I started in April, 2001.  In March, I started having horrid PVC's.  I had the Dobutermine Stress test and the 24 hour Echo. The Cardio said, 24 hr. Monitor showed Benign upper chamber PVC's which were quite bad.  He wanted to know if I was taking Asthma inhalers.  I was not but i do know this can cause irregular and fast heart rates. he did write down the name of my Gastro doc though.

I started on the Nexium (Reflex med)(cousin to Prilosec) and the PVC's were lessened.  I got off the Nexium for 2 months (for other side effects) and Lo and Behold the PVC's are back BIG TIME!!  I notice that when they hit me, I need to burp.  Sometimes, they cause me to be lightheaded too.  

My Theory (NOT A DOC)is that somehow the Vagus Nerve gets involved.  This nerve is responsible for heart rate, respiration and BP, I believe. (have respiratory wheezing but not coming from the lungs, Gerd related too, they suspect) This Vagus nerve travels into the gut.  So, when one thing wants to act up, the other parts that are vagus connected can get into the act also.

I am going back on the Nexium tomorrow.  I hate these PVC's.

Well wishes to both of you.
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Avatar universal
I've been away from the site for some months. I see people are still (correctly in my view) linking PVC's to an inflamed esophagus.
For the sake of those that have not seen my story I append it here. Sorry for the length of it.....From: Mike Brewer  70403.***@****

Originally posted 19 January 2001

Dear All

PVC
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Avatar universal
Dear Lars,

Gastric reflux is a common trigger of PVCs and usually is helped by medications such as Protonix (pantoprazole) which is a proton pump inhibitor.  Electrolyte imbalances, particularly of potassium and magnesium, can also increase PVCs.  Supplements are sometimes needed.  Many individuals note a decrease in PVCs by avoiding tobacco, alcohol and caffeine.  Beta-blockers are a commonly used medication to help control PVCs but they are not medically necessary are are for symptom relief only.  You can find many other suggestions by other readers as to what has helped decrease their PVCs in the archives by searching under PVC.
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