Lots of PVCs a day, can it lead to heart problems?

[Madge270]

Is it really true that if one has more than 4000 PVCs a day, a person may be predisposed to ventricular problems or cardiomyopathy later on? I hope not. I was finally doing okay and not worrying about my 8000 or so PVCs a day, and now I'm worried.  My EP said nothing about this a few months ago and said I'm fine. Echocardiogram was okay too. Scares me though, to hear about research like this.

[Madge270]

Hi, Lisa...

So far mine haven't gotten worse, but they often do as one gets older. For me, it may be a waiting game. If I need an ablation but they use antibiotics for that procedure (and I think they do), I might want to wait until there's a new family of antibiotics that I might safely be able to take without it closing my throat. As it stands now, I might need to be on a ventilator if I need an antibiotic for anything, even just a strep throat.  And my doctor tells me that the MRSA staph rate for those on ventilators is rising...so a ventilator is risky for me too, apparently.  

I'm just hoping my PVCs don't get worse,or cause cardiomyopathy, and I hope that there's a procedure out there in the future that could help me without the need for antibiotics being used.

I don't go much of anywhere during flu/strep season, since there are a lot of bacterial infections then. It makes even shopping for groceries difficult, since a sick person who checks you out would handle every food item you buy. (This is also a problem for those who have had transplants or who are on chemo and need to avoid bacterial infections.)  Where we live, there aren't any  stores where you can check yourself out via computerized machine. I'm hoping there will be soon.  It will take some of the worry out of shopping when there's a lot of illness out there.

Sorry to have gotten off the subject here. Lisa, I really appreciate your comments.

[Mom2four85]

PVC induced CM can be reversed; I believe that is what happened with Connie - Momto3? [sorry if I got the name wrong - brain fog] but i think she too had an enormous amount of pvc's - 30,000 and I think she had 3 or 4 ablations.

Even after 1 year with a pacemaker/icd, 6 months of meds, my CM has not reversed or gotten any better.  I am the 1 in the million who have bad luck or just a bad heart that pvc's were just a side note of - who the heck knows? not any doctor I've gone to in the past year.

Madge270 I have gone every other month or more for checkups and to have my meds regulated plus my PM/ICD interrogated to check my lead status.

If you think your pvc's are worsening or your symptoms have changed, it's always worth it to get a 2nd or 3rd opinion - not all doctors are the same and some may have more knowledge of problems than others so it's always worth a shot.

[Madge270]

I just want to thank you all for replying and giving me some information and reassurance.  It meant a lot to me.  Lisa, I'm wondering...do you get regular checkups now and then, so that a doctor is monitoring your PVCs?  My EP/cardiologist didn't say anything about coming in at regular intervals, so I guess I'm on my own.

I'm going to try donating blood next month, for the first time, at the age of 67. I've always been afraid of the needles and I have small veins. However, a friend of mine needed blood recently, and it was in short supply. I realized that if people don't donate blood, not as many people can be helped.  So, I'm going to do it.  (I'll admit that I'm wondering whether my arrhythmia will be affected adversely, that maybe giving blood could cause me to have PVCs more often or something.  These PVCs just started, out of the blue, last year. I keep wondering why I suddenly got them. They haven't been as bad lately,  What if donating blood somehow makes them worse again?

That being said, I'm going to try to donate anyway. It's a good thing to do.

[user01938474]

I'm worried because when I wore a 48 hour holter, the doctors only noticed about 5% PVCs. Lately I feel they have increased, but it really is on a day-by-day basis. Some days I would estimate to have closer to 20% ectopics and some days less than 5%. I have had up to 3 or 4 straight hours of bigeminy and when every other beat is a PVC this becomes worrisome.
I don't really know what the point of this post is, besides my confusion and being kinda scared.
Perhaps I should go in for another checkup and do another holter when these seem to be really bad? Is it ever worth getting a second opinion (I'm in Chicago, the cardiologist I've seen is supposed to be one of the best, but I just wonder if someone else can give me another look and different perspective - anyone here in the Chicago area?)

Thanks in advance!
-Erik

[jondsam]

The condition of PVC induced cardiomyopathy is very reversible.  I have read many doctors journals about people who had thousands of PVC's a day and it caused cardiomyopathy.  After an ablation to rid them of the PVC's and NSVT the cardiomyopathy regressed in only a year.  So its really nothing to get to worried about

[jondsam]

My cardio doctor who is the head of the department at the Wake Forest school of medicine, says it is very true.  There are numerous studies that show greater than 4000 ectopics a day can lead to cardiomyopathy .  However, he said this is over many many years not just something that happens in a few years. He also said PVC's sometimes come and go, so maybe after suffering for awhile they will go away.  Lets use common sense on this one, of course when your heart is pausing and then having to violently beat to push out extra blood from the PVC compensatory pause, this must not be good.  Of course after years that kind of pumping must cause some other issues like cardiomyopathy.

[Mom2four85]

Madge270 that's my problem also, when I take bb's and other meds they drop my bp/hr too low and I NCS/OI so that makes it difficult for me to find an effective treatment for me

Right now, I have about the same amount of pvc's as you do and I live with them and just ignore them mainly - but I haven't been checked in 4 months so who knows my numbers are now, but no way I'm going back on meds and I'm leery of another ablation after my first one

Just keep a watchfull eye on your symptoms before it does evolve into something more like mine did :(

[Madge270]

Thanks, Lisa.  I wish I could take a beta blocker without my  blood pressure and pulse dropping so much, and without my acid reflux getting really difficult to manage.  So far, I'm doing okay without a beta blocker, although I know it would probably lessen my PVCs.

Really appreciate your comments.

[Mom2four85]

"I remember seeing a rough estimate of something over 40,000 would be worrisome"

most doctors and research use this method -- 6,000 - 8,000 pvc's in a 24 hr period is treated with medicine and anything above 15-20% of your total 24 HR they look at surgery - it's an individual thing though - not a set number and really depends on your doctor and other symptoms or problems

basically 15 - 20 % or more of your total 24/hr HB's; which in the normal heart  (100,000 hb's) would be 15,000 - 20,000 pvc's in a 24/hr period  may call for surgery and possibly a cause for concern of cardiomyopthy to develop

if someone were having 40,000 pvc's (27 pvc's per minute) in a 24 hour period it would probably lead to CM and other problems due to the overload it would put on the heart which would make it quiver and work very inefficiently

[Madge270]

Thank you all so much for replying and for some reassurance.  This was weighing heavily on my mind. I'm not usually a worrier, but the thought of cardiomyopathy did have me concerned.  Until then, I just ignored the PVCs as best I could, stopped taking my pulse all the time, and just tried to enjoy life.
.
This whole thing is so strange. When I do  feel the PVCs, it's not fun, so I'm sure it's awful for those who feel every irregular beat.  Again, thanks.  You are all so kind and helpful. I love this site.

[Mom2four85]

I think this question is in the wrong section? I'm a member of both heart rhythm and dysautonomia so I saw it

pvc's CAN lead to cardiomyopathy, not that it will and rarely does that happen - I believe we did a poll last year and there were 3 of us of the rhythm community out of the thousands that developed cardiomyopathy ---- that being said - those 3 of us had an enormous amount of pvc's daily - roughly 25,000+ pvc's in a 24 hr period

this info that 4,000+ pvc's can lead to cardiomyopathy is from a post of mine which I questioned the reliability of the article; there are so many reports & research that even doctors disagree - I think this was taken out of context from my post and the entire report should be read first

here's the link: http://emedicine.medscape.com/article/761148-followup

Look under Prognosis - 1st paragraph "One caveat to this is that emerging data suggest that very frequent ventricular ectopy (>4000/24 h) may be associated with the development of cardiomyopathy related to abnormal electrical activation of the heart"

I would like to find some new research that shows some concrete number of a wide spread research done just to see how many do develop CM from pvc's and what other issues were going on heart related

[user01938474]

I remember seeing a rough estimate of something over 40,000 would be worrisome. And I think that would mean getting a lot of bigeminy/trigeminy for nearly the whole day with no breaks of normal heart rhythm.

This is a good question that I'd like to know the answer to. I get runs of bigeminy (PVC every other beat) and after a few hours of this at night I start to think this can't be good for the heart!

[patient915]

I don't believe that is true.  I have over 10,000 a day and over the years I have had 3 different cardiologists tell me that's okay and they don't matter.  However, I've never heard about research either way so I'm not sure.