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mulltiple skipping

For many years I have been plagued with heart skips.  Now I'm into bigeminys.  These occur most of the day, and have messed up my life to a point where I'm afraid to do any exercise.  I took an echo stress test and did not pass it, so I went for a catherization.  I do have heart disease, but nothing they were concerned about.  At 67 I realize most people do have something.  I take atentolol 25 mg, avapro 250 mg. and synthroid 112mg. I go to a very good teaching hospital for my second opinion, but they claim they will not hurt me.  They are afraid to try other medications, as they are dangerous.  If I came to Cleveland Clinic, is there anything that can be done besides an ablation?  Believe me, I would be the best guinea pig you would ever see.  No one I know has ever had these as many years as I.  If I could only have the years back that these pvc's took from me.  When I should have been living instead of running to the doctors or hospitals.
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21064 tn?1309308733
Fran,
Ah yes, the vicious PVC and anxiety cycle.  I know it all too well.  

Yes, I was given heparin for the left side...I believe it was because of an increased risk of clotting.  I asked for a copy of the report the second time around. I am absolutely amazed at what they can do with the heart's electrical "problems."

Did you ever get the email I sent?  I sent it twice to the "mdiodat" address.

Fred,
I am so sorry that you continue to struggle with painful pvcs. I just can't imagine having pain every time my heart misfires.  I'm sure you have been to a number of doctors and specialists.  Have you been able to see anyone at CC or the Mayo Clinic?  What about antiarrythmics?  Is that something your doctor would consider?

rsd_wife,
Hello and welcome to our "home away from home."  You're definitely not alone. With all that you have going on in your life, I can only imagine the role stress must play.  I certainly understand your concerns about taking Xanax, but under the guidance of a good physician you may find a small dose helpful. You may also want to ask your doctor about trying an "event monitor." It is different than a Holter monitor in that you can record the event when you actually feel it happening. I think my 30 day event monitor was around $900, but I believe they will work with you if you don't have insurance.  For many of us it was helpful to know that the doctor could actually SEE what was happening during our episodes.  I think you hit the nail on the head when you talk about the anxiety associated with the heart skips. It has plagued many of us here on the board.  However, once you are sure you are medically OK, it will serve you best to deal with any associated anxiety (sometimes, that's the hardest part). Talk frankly with your doctor about your fears.  It will help him/her to know how to proceed with tests, guidance, etc.  This is a great place to find friends, comfort and a safe place to ask any cardiac related questions you may have.

Here's to a great day everyone!

Connie
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Avatar universal
Hi Connie! Yes, you're so helpful as usual! and so kind too. Did they really give you heparin for ablation of the left ventricle focus? Then it really must be riskier...My cardio told me there would be a risk of thrombi. But actually, he smiled when I asked about ablation. He says he would never recommend it for PVCs, at least when BBs are helpful. If they aren't, I think his second choice would be antiarrhythmics...We'll see...For now BBs do help in my case. I agree with you and Upbeat that I should keep a positive outlook about Inderal. If it stop working, I will think about it when it happens...

Again, the psychological issues connected with PVCs are as important as the symptoms themselves. I don't think mine are directly caused by anxiety, but they certainly trigger anxiety to some extent, which in turns....OK, a vicious circle!

Smiles everyone

Fran
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Avatar universal
Hi everyone. I found this site thorugh searching for info on skipped heart beats. Sorry to hear so many poeple have this, but sort of glad today thta I am not alone. 34, mom of 2, married to husband totally bedbound/disabled by complex regional pain syndrome- life is busy and stressful alot of time for me. I have always had anxiety problems, and the last year has been especially rough. I have had extra heartbeats/palpitations, for many years... some days tons, other days none, and it seemed like it depended on stress, caffiene, smoking, lack of sleep, wether I would get tons or not. It would upset me, but I would rationalize it some.. I would see the doc, ask him about it, hed say dont worry... so I tried to just deal with it and ignore them as best I could. Some days when they were frquent, I would go and take a nap, and sometimes the rest would help.

A month or so ago I got a run of them, I guess you could say. I was in a store, and the palpitaions started- for me, it feels like my heart is flip flopping in there... anyway, a doc told me a long time ago to hold my breath and bear down to try to stop them, so I did... but it didnt stop.. it lasted only a few seconds I am sure, but in my mind, it seemed like an eternity! When it was happening all I kept thinking was " God, please dont knock me out here in the middle of the Ben Franklin store" and then it stopped. NOw, I am not sure if it was heart related or not, but when it was over, I took a deep breath, and tried to calm down, but broke out into a sweat, and felt woosy... walked to the front of the store, and realized I was probably having a panic attack now. Tried to continue calmly looking around, because I had one child with me and didnt want to scare her- and eventually went on about my buisiness errands, etc. but worried dreadfully about that happening again. That worry has turned into a giant monster now.

I went to the family doc a couple weeks later and told him about it. I was literally scared to death to even go to the doc, because I had convinvec myself it was going to happen again and wipe me out. (gotta love anxiety/panic disorders) He ran EKG, said pulse was high but ok (I am a big coward... white coat syndrome, once they go to take my pulse, bp, anything, heart rate jumps high) and said lets get a holter monitor and look for these skips. He said he believed it was stress related, but just in case, ordered thyroid check, told me to wipe out cigs/caffiene/choc. and make a seperate appt to talk about depression/anxiety meds. Thyroid came back ok. Almost no coffee or cigs now. ( I was a huge coffee drinker- all the time, and smoked a good bit- these have been horribly hard to let go of!!)

I wore the Holter for 24 hours and didnt feel any real skips/pal. while wearing it... but dont you know, when I returned it, driving home, I had another big skip episode like in the store. Scared me so bad I broke into tears and pull off the road... frustrated and scared to death again! I didnt get sweaty like before- I tried when it was happening to take a big deep breath and control myself... but lost it when it straightened out.

I am waiting for Holter results now. And wondering if I should ask for more tests. Years ago, when I was 18, had an echo, for unrelated chest injury, and had normal heart then, just fast hbeat. I take Zanatc for reflux, which is a killer, but other than that, occasional Tums, Tylenol, and thats it. I was given a script for Zanax, but reluctant to take it. My husband requires alot of care, and I am afraid it will knock me out. I took it years ago for panic, and it made me sleepy.

I get minor skips when I get upset sometimes. Have for years... just have not had the bigger skips. Does anyone else haev skips/palpitations like this? I think I remember having one or two before recently, and telling my husband I thought it owuldnt stop skipping, but it was a long time ago. I am wodnering now if I should ask for an echo, or some other tests. I had a panic attack back in Nov. and ended up in ER. Had chest xray, cardiac blood work up, and they said all fine- stress.

Any suggestions anyone has would be great. I do not have health insurance, but can try to afford appt and such as I go. Hey- when its your heart, you find the way to pay, right? =)

Sorry to only post about myself this way- I have tried for days to post a question here but it wont let me.

I sincerely wish everyone the best. Take care and thanks for reading this if you made it rhough with me this far. =)
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Avatar universal
applehorse I can sympathize and empathize with you. I've had PVCs for at least 22 years and my last holter May 2005 showed 24% of my heart beats were PVCs unifocal in RV. Since then I've increased to constant trigeminy now, so I guess it's at least 30% PVCs. You are not alone, but I know that doesn't help much.

I was so reluctant to take anything, even beta blockers, but when you are in bigeminy or trigeminy, geez you have to try something. So I tried toperol. It's only 12 to 25mg/day, and does NOTHING for the frequency, but the sensation of the PVCs has lessened so much I have been able to get back to "life". I just want to say that a 1 in 2000 chance of dying during an ablation is huge, HUGE, if those are the right odds, I'd say you should think about it longer. Have you tried different BBs to see if you get a different effect or a different dose of BBs?  I know how frustrated you, and your family must be, but the doctors at the Clevland Clinic, and others recommend ablation only as a last resort--their own words. I hope that you may try some other options, even just waiting a little while before you make up your mind, because sometimes, for no reason, PVCs just go away--not in my case, but they have in others!!

Fran, I don't know if all antiarrythmics are the same, but I've heard you need to be monitored, sometimes in hospital when you start them because they have the potential to give you life-threatening rhythms. Keep positive about your success with inderal so far and you may never need to consider anything else.
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Avatar universal
I sympathize.  I have had a similar problem.  For almost 6 months now I have had constant PVCs either in bigeminy, trigeminy, quad, etc.  Can
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Avatar universal
"If I could only have the years back that these pvc's took from me. When I should have been living instead of running to the doctors or hospitals."

you just stated your own problem. i know theyre scary, and its hard to beleive its not harmful for your heart to constantly stop, but you cant let them run your life. theyre very annoying but won't kill you, you have to learn to ignore them and just deal with them. id consider seeking counseling to help you cope with them. often times theyre related to anxiety, and it sound like that might be an issue for you. best of luck to you.
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Avatar universal
My name is Jim, , 42yo. This is the first time writing to a forum. I have been reading the heart forum alot but Iv'e gotten new symptoms. I have tried to post a new topic, but I cant get on. In February 05, I rear ended someone at about 35 mph. The following day my heart started racing and I went to the ER thinking heart attack. There was no heart attack but my enzymes were elevated so they kept me over night.

They did a lot of tests ekg, treadmill, chest xray, blood test, thyroid, ultra sound of heart and neck, 30 day monitor, 2 day monitor. They said every thing "structurelly" is fine with my heart.

I began getting rapid heart beats about 2 - 3 times per week. for about 4 months. About 4 month later they came back.

About 3 week ago I started getting "skipped beats", scared the heck out of me. They happen 3-4 times per minute, but sometimes they stop for a few hours.Went to ER, they did all the tests and said anxiety. This is the third MD who said aneiety. Iwas given Ativan 1mg.

I now get a numb tengling afeeling round my face, mostly forehead and sides. I can really feel it when i raise my eye brows or scrunch my forhead. Can this all be anxiety related.

I have a hard time believing anxiety because until the car accident I was in PERFECT health. I also had bronchitis prior to the skiped heart beats.Since the sipping started, the rapid stopped.

Any feed back is really appreciated. Sometimes I feel like I'm going to die. I am really scared at times. I stay strong for my wife and kids.

Biggest question. Did the car accident on February 04, 2005 cause all these problems?

Someone PLEASE respond

My private email is ***@****
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Avatar universal
Your numb tingling feeling might be related to the Ativan. I took Xanax for a while and it gave me this throbbing, lightheaded feeling as well as made my upper torso feel like it was vibrating. Very strange! So it might not be the anxiety itself, but the medication you are using to treat it.  Of course, it could be something completely different, too.
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Avatar universal
"Did the car accident on February 04, 2005 cause all these problems?"

I'm no shrink, but I have quite a bit of experience with both panic and skipped beats or pvcs, and my guess is that some people might be more susceptible to trauma than others.  Your car accident was a kind of trauma, even if you weren't really hurt.  I have been hit in a rear-end collision myself, and I know that it's shocking in a way that's hard to describe.

If you've been given a clean bill of health as far as your heart is concerned, it couldn't hurt to make an appointment with a good shrink (an MD as opposed to a counselor, because an MD can prescribe meds, if needed).  Then, you can go over your medical history and discuss the possibility of maybe some kind of panic response.

It could just give you your life back.  Believe me, it's really nice when you can make the anxiety or panic go away, regardless of what your healthy but nervous heart is doing.
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Avatar universal
You're psychic!! I was thinking exactly the same thing this morning!!! I was praising the miraculous effect Inderal is having on me - at least for now - and I thought of how people must have felt before BBs and other drugs were invented.
Maybe there was less stress in the past, but there were a lot of other problems and hardship people had to deal with, so I really don't think PVCs and tachy were less common. I guess people just lived with them more easily, accepting them as they did with lots of other things. For example, my menstrual cycle is often painful and I take an analgesic as soon as I feel some pain. I'm sure many women had this problem in the past too, but since there were no analgesics to take they'd simply accept pain as a part of life. Who knows...maybe in the future drugs will be invented which will make PVCs disappear with only 1 pill or 2...And then the people of the future will marvel at our patience for tackling life with PVCs which BBs can't really eliminate...LOL

Fran
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Avatar universal
Are all types of antiarrhythmics dangerous? Do they all imply increased risk of dangerous arrhythmias, or are some only  toxic? Just curious...in case BBs stop working for me. My cardio said he would never recommend ablation, especially for my focus which he said is in the left ventricle....

Thanks for any feedback

Fran
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Avatar universal
antiarrhythmics can be dangerous because and can increase the risk of some arrhythmias much like how some medications for GI problems can cause more GI problems. That is why in benign palpitations they are rarely perscribed. You can read articles online about how in the 70s and earlier people with PVCs were treated with very potent heart medications and there was so significant diffeence between them and ones who didn't receive the medication.

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21064 tn?1309308733
Hello. I'm so sorry to hear about your persistent pvcs.  Just wondering if your doctor has considered a different beta blocker.  I tried a few different BB's and found that Inderal worked best for me.  Others have had great improvement with toprol and atenolol.  Over a period of twenty some years, I was on/off beta blockers several times. For different reasons, I'd sometimes stop taking them and then resume.

I had always told the same thing as you. The doctors did not really want to prescribe anything stronger b/c of the potential for pro-arrythmic and other potentially serious side effects. Eventually, I ended up on antiarrythmics, but not until I ran into other problems.  As I recall, there is a HUGE study (CAST) which indicates that antiarrythmics must be used very carefully in patients with varying degrees of heart disease.  Has your doctor suggested any alternatives for symptomatic relief?  

Connie
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Avatar universal
Thanks Upbeat! You're so kind. Yes I'll try to keep a positive attitude. It's just that when you go through a bad PVC-tachy period you start losing faith...Then, if it gets better for long enough, you almost forget about it - that's what happened to me all through 2005 :-).

You said your PVCs are in your right ventricle. Do you know if there's any difference between those in the right and those in the left ventricles? I have no idea which differences there can be; just curious! I only think, from what I understood during my cardio visit last Friday, that those in the left ventricle would be more dangerous to ablate, but OK, I don't want to start thinking of ablation now! :-)

About antiarrhythmics, yes in the past they were used more freely. My colleague had PVCs and tachy in her 20s, that was about 25 years ago, and she was immediately treated with antiarrhythmics! Her symptoms then fated, so it was probably a benign condition that should have been treated with BBs; at least that's what she says and she's a nurse so I guess she knows...

It's amazing to witness the huge strides of medicine.

Take care everyone

Fran
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21064 tn?1309308733
I was only prescribed Tambacor (flecainide) and Propafenone (rhythmol) after I developed CM.  Up until that point, the use of an antiarrythmic was not recommended.  I was always told they were very potent medications with potentially serious side effects.  Especially, for the treatment of benign pvcs.

When antiarrythmics became necessary, I was monitored for 3 days in the hospital.  I much preferred Inderal -- other than the initial period of exhaustion, they worked best for me and had little to no side effects.  The pvcs didn't disappear, they just seemed less bothersome.

I ended up with two ablations, one for RVOT and one for left. Based on EKC and Holter, the doctor was pretty sure that the second site was also on the right.  But, when they mapped everything, it turned out to be LVOT.  My husband said that the doctor had to get his permission to ablate on the left side because it is riskier.  YIKES!!  When they ablated the left side, one of the catheters was inserted through the femoral artery and then passed through the aorta and into the left side of my heart. They gave me IV heparin when they ablated for LVOT.
Hopefully, the Inderal will keep on working : )

Have a great day!
Connie
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Avatar universal
I don't think it makes a difference in terms of the PVC whether the foci is located in the right or the left ventricle. And some people have multiple foci.

Regarding the difference in risk, or the doctors ability to ablate a left ventricle foci, well, I honestly don't know.

Funny and probably a good thing, how we can forget so easily how lousy we feel when we have PVCs and then when we don't, life is grand, capital G.  Wishing you, and all, the best.
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Avatar universal
Hello! As always you are so helpful. Thanks for the great info. I was just wondering if you were given the same odds/risks as the other poster--applehorse. Is it really 1 in 2000 risk of dying?? And I guess, based on your post, that goes up if it's left ventricle. That would have been a tough decision for your hubby. Glad you are still posting, and for the most part PVC FREE.
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Avatar universal
Zoi
Hello everyone. i am new to this site. Found it quite by accident, and became very interested in the experiences of others coping with abnormal hearth rhythms. I have been dealing with ectopic beats for ~ 10 years. It started wtih 1 or two a year (that I noticed), then a few a month, a few a week, a few a day and now a few a minute. These things have an evolution. Couldn't help but laugh after reading some of the posts - I see myself in so many of the comments. I have become obsessed with these extra beats. They are the first thing i think about in the morning, the last thing before i fall asleep - and all day in between. I hate them actually, and have tried every natural remedy one can think of that might help. I have overdosed on Mg; take Q10, selenium, multi vitamins, flax seed oil, protien powder, vit C, hawthorn, aloe vera, probiotics and more... Started meditatin, yoga and reiki. The only thing that helps is during my cardio routine when my heart rate goes up and i do not feel them. this is the only rest i get from these horrible extra beats. they are ruining my life. I try to ignore them, but i feel them quite intensly. Sometimes I have the odd episode of VT - this one really freaks me out. and has never been caught on the holter.   Mostly, however, it is 1 to three extra beats in a row, and anywhere from 1 to 10 a minute. When they get really frequent I want to run and hide, but there is no where to go... so I guess we have to learn to live with this suffering. On the other hand, it does make me appreciate some of the things I had once taken for granted. it reminds me how transient life is. I think in the past people tolerated suffering more readily as there were simply few options for them. also the death rates were higher. i don't know the stats but h eart disease is on the rise, could be r/t diet, pollutants, stress etc...  I am on a mission to find a natural cure for this thing.  I am just not sure that once an abnormal pattern is established in the heart if the pathway doesn't become so ingrained that it is almost impossible to change back to a normal rhythm. You know, like how neural pathways are established in the brain and change can be sooo difficult (these too are just electical signals - jeese is that what makes us tick, a bunch of electrical signals and hormones ...). I don't know... The only t thing I know is that these ectopic beats are ruining my life. If this wasn't such a tragedy it would be comic. It helps to share.
Zoi

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Avatar universal
Welcome to the board, I'm sure you will find lots of support here. Sorry to hear you too suffer from PVCs.

Everything you've described is about the best you can do. Keep exercising if that helps. I have pretty high frequency, but it does go down a bit when I exercise.

Not sure what the cause of PVCs is for myself, and sure as heck don't know what it might be for any one else, even the doctors will tell you they don't know. But I have come to believe strongly that electrical pathways get set up, some how, and just get stronger with repeated exposure to what ever trigger sets them off. A cardiac specialist would know better, but it seems a plausible explanation to me. It also poses an intersting question as to whether it can be reversed (if that is how it is set up),,,,but more importantly gives me hope that it could change for the better some day.

Oh, and tickertock, I believe also that the number of people who experience PVCs may be increasing, and the frequency of PVCs in those people may be rising too. What's UP??? Have you heard the theory that the earth's magnetic poles are changing, flip-flopping? hmmmm,,, hee hee. Well, it's as good as any other explanation. lol
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Avatar universal
thank you everyone for your concern.  It seems so many people are struggling with this problem.  I don't know anyone close to me that has this problem, and sometimes I think I'm the only one until I get on this forum.  Believe me, I have tried everything.  I used to be a smoker------gave that up 5 years ago.  I tried yoga, counceling, exercise, etc, etc.  Nothing helps.  Just deal with it they tell me.  Thanks for listening.
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21064 tn?1309308733
Hi there!

As I recall the odds were something like 1/200 for a complication. Not sure about actual numbers for dying during the procedure. I remember not wanting to sign on the dotted line, but figured I had to sign or go home : )

Yeah, apparently left side is a bit more complicated. The catheter has to cross through the aortic arch!! I asked my husband why the doctor had to ask his permission to ablate on the left side.  When he told me she said it was riskier, I was like...UM!! Hello!! HEY!! The doctor said they would prefer not to have to end the procedure and have me come back again. That's why they asked him for permission.  GOOD PLAN!  I told my husband that I was so glad he told her to go ahead. He told her I would not have wanted to be sent home, only to have to come back again. NOT!!

Still nearly PVC-free, but having some shortness of breath. I'm thinking anxiety, but keeping an eye on exercise tolerance and such. It's always something : 0  Ain't the 40's grand?  LOL
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Avatar universal
I am going to watch this thread for the answer.   I have had that skipping feeling on and off for many years.  It will plague me for a month or so, then disappear for a year.  I can feel the "skips", and they will occur repeatedly for a few hours, then stop, then resume.  I have not had the pairing that you have.  I had a recent EKG for another matter and was told that everything showed up fine.  

You must be very concerned.  I hope that you can get some reassurance here.

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84483 tn?1289937937

I wonder what people did for these "skips" , PVCs,PACs, etc, hundreds of years ago, I wonder if they were as wide spread back then. Did those back then that had them ignore them or were they "crippled" by them, I'd sure like to know.

I don't know  but these complaints of heart "skips" , PVCs and flutters same to be reaching an epidemic proportion, the reason I say this is I know several people who never ever complained of PVCs all of a sudden are afflicted with them or either have just become aware them, What's up with that? Oh just an personal observation and a thought.
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74076 tn?1189755832
Hi Barbara,

There are medications that can suppress PVCs.  Our general approach is to use beta blockers first.  If the beta blockers don't work and you are still extremely symptomatic, we may try an antiarrhythmic.

If you have coronary artery disease, we can no longer use certain classes of medications like flecainide or propafenone.  I have never used amiodarone or sotalol for PVCs.  

We are always hesitant to use ablation because PVCs do cause significant physical harm to people but ablations can.  Ablations ara always a last resort.

We would have to see the whole picture before I could comment on medications we may or may not use and there is individual physician variation in what they are willing to try -- but I am sure you have already run into this.

I hope this answer part of your question.  Good luck and thanks for posting.
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