Are sporatic episodes of continuous PVCs/PACs cause for concern?

[klm1992]

I have been experiencing PVCs/PACs for a little under a year now. I have had a battery of tests (24-hour Holter, Month-Long Event Monitor, EKG, Echo, Stress Echo) and my doctor hasn't found anything that points out a more serious heart condition, which is good.

Some days I experience almost no noticeable symptoms, and other days (like earlier today) I will get into a heart rhythm pattern where I am taking my pulse and can feel PVCs/PACs (not sure how to differentiate which is which, tests have shown I experience both) occurring continuously on about every third or fourth heart beat. It can happen after just a bit of movement (like walking from my car into the house) slight exertion (like climbing up a flight of stairs), or in the middle of a workout - there really doesn't seem to be a rhyme or reason, it just never occurs when I'm completely at rest. I don't get light headed or experience any chest pain or difficulty breathing when this occurs - it mainly just causes quite a bit of anxiety until I am able to rest and do some deep breathing exercises that help a lot with getting my heart rhythm back to normal.

I am really just wondering if anyone has any advice about how to address this? Should I seek care when I have these multiple PVCs/PACs in a row? I have been to the ER once before when symptoms like this occurred, but (of course) my heart was basically back to normal by the time I made it in and was seen by a doctor. I have also spoken to an ask-a-nurse line and was told anytime I have more than 3 irregular beats in a minute, I should seek care, but if I did that I would be in the ER every week...

A little more background about me: I am 25 years old, overweight and with slightly elevated blood pressure (not quite in the high range at the moment, but probably classified at pre-hypertension), and have dealt with moderate anxiety for many years (not severe enough to cause panic attacks or impact my day-to-day function, but just always kinda there) all of which most likely factor into my experiencing PVCs/PACs, and I'm very realistic about accepting that. I am working currently to get my weight and blood pressure down to a healthier level through diet and exercise and cut caffeine, alcohol and sodium down in my diet, as well as seeking counseling for anxiety. I am hoping all of these measures will improve my overall heart health and health in general.

Just hoping for some feedback from those who have dealt with similar issues with PVCs and PACs - wondering if anyone has found this to lead to more serious issues, or if there are any other tests I can inquire about with my doctor to rule out anything more serious? Or if it would be recommended to seek care when these episodes occur?

[Occupant]

I have had them as long as I can remember and, like you, I can't tell them apart. A Holter monitor showed approx. 38,000/day and yours - according to you - amount to less than 5000/day. My cardiologist said at the last visit: "You are ok and don't have to come back to see me, contact your family doctor if you have a problem" and so should you. The only difference between you and I is - and I think it is a big one - that I am 81 years old.