Heart Rhythm Community
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1701959 tn?1488555141

PVC Flutter?

So I get PVCs daily. Normally just a thump, sometimes harder then others. Yesterday though while sitting at my desk I got a flutter feeling... Felt like a butterfly in my chest, for a couple of seconds, then the hard thump of the reset. Scared the crap out of me. I've had the full work up, all tests came back normal and my EP said I have benign PVCs. I have no other symptoms with my PVCs other then I feel them.

So now this new feeling has me freaking out. Has anyone ever had that feeling recorded on a monitor? I have heard some say their PVCs feel like flutters, other say their PACs feel like flutters...  Of course, me being an anxiety nut, immediately I start thinking NSVT. :(
11 Responses
1807132 tn?1318747197
For me I think the flutters had to do with sinus tachycardia, my heart rate being a bit more elevated than it should.  I had a holter that caught pacs and pvcs and it stated there was some sinus arrhythmia and sinus tachycardia but no svt.  I did not have any svt that day but I do remember having the flutter feeling so at least in my case the flutters was one of the above things that was caught on my holter and I am leaning towards sinus tachycardia because I didn't have enough pacs or pvcs for it to be a run of those and besides they were deemed isolated with no indications of any runs.  Have you checked your heart rate when you feel the flutters?  If it is not sinus tachycardia I could see it being more of a trigimeny or bigimeny run.  Having them close together but I would think you would definitely know if it was nsvt but next time you feel it check your pulse to see if you can tell what it is doing.  That said, if you are not feeling faint or passing out or short of breath whatever it is, is likely nothing to worry about.  Easier said than done but true.
Avatar universal
hi i have had this quite a bit.the way i described it to my doc  was that it felt like 3 palpitations back to back. i always think im going into heart failure its really scary,i try to breath in deep but it takes my breath away.and i have started to get them more and more but my doctor told me that when i was wearing my monitor he said i had a third heart sound and sometimes if im sitting or laying down it gets worse,so he told me to walk around every thirty minutes or so for about 5 to 10 minutes and it has really helped,he also said what can feel like palpitations could be just blood rushing threw my arteries really fast from sitting and not moving which feels really similar. hope your feeling better
Avatar universal
To help ease your mind about these sensations, consider reading the explanations of PVCs and other benign ectopic beats written by John Kenyon, a skilled cardiac nurse/technician who posts at a site forbidden by medhelp.  Just copy and google this:

kenyon forums/backup/topic-24286.html

Please note particularly his observation that in the setting of a healthy heart, "There's little correlation between the perceived force, number, etc., of them, and the actual characteristics of a given PVC."

In other words, if you have been tested (especially if repeatedly tested) and found to have benign ectopics, the various ways you perceive them--such as flutters, thumps, ripples, or twinges different from the usual--are NOT significant, provided you do not have other signs of real heart problems, such as disabling, crushing pain in the center of your chest, vomiting, and a drenching whole-body cold sweat.

Avatar universal
this was pasted hope it will help.Your question is a very common one, and understandably a concern. I hopefully can put your mind at ease about this, though. PVCs, the most common heartbeat irregularity, occurs in almost everyone at some time or another. Some people have them very frequently, others only occasionally, others sporadically. Your Holter monitor findings are very ordinary, and 65 PVCs in a 24 hour period amount to an average of less than three per hour, which is actually infrequent, although in most cases they occur in random patterns, so some could be closer together than others. What sometimes feels like multiple PVCs (which sensation you describe in your post) can be one of several innocent things: most commonly it is one PVC which, for some unknown reason, can sometimes be percieved as a "fluttering" sensation. There's little correlation between the perceived force, number, etc., of them, and the actual characteristics of a given PVC. Group beating (ventricular bigemeny, trigenemy, etc.) means every second, third, fourth, etc., beat is a PVC in a given period of time. Some people have bigemeny as their normal rhythm. Some people aren't even aware it's happening. Also, you could actually have, on occasion, more than one consecutive PVC, and as I'm sure you've found out, three or more in a row are considered, for technical purposes, a "run" of V-tach. In reality this is an arbitrary definition, and a very conservative one.

PVCs, without any other electrical or structural abnormality, are of virtually no diagnostic nor prognostic value at all. They occur in everyone in various sorts of patterns, and again, absent any structural or neurocardiological disease, they have no real meaning. They can, however, be very alarming when they occur, and can provoke a good deal of anxiety which, unforntunately, causes the release of adrenaline, which in turn makes the heart muscle more irritable, and often thus sets off yet more PVCs, sometimes making the sufferer a nervous wreck. This is truly unfortunate, because without significant left ventricular dysfunction PVCs have no meaning at all (and even with LV dysfunction they are only an indicator, not a cause, of potential trouble).

In short, your doctor is appropriately circumspect in his answer, and PVCs really are almost always best ignored -- if possible. Sometimes it can be difficult to ignore them, which is the big problem. If they are very frequent or bothersome sometimes the doctor will prescribe a beta blocker to reduce the frequency of them, which usually helps cut down on their frequency and makes them more difficult to percieve, so that is a fallback possibility if they start to really bother you. Still, they have virtually no clinical significance otherwise, and often this knowlege is sufficient to ease the mind of a given patient enough that they are no longer seen as a problem. Hopefully this will be the case with you.
Avatar universal
Thanks thats really interesting achillea.helps alot, cause my doctor never really explained it too well.
Avatar universal
oh my gosh im sorry for posting all this on your page!!! but achillea was right.It's very difficult for a lot of people to reconcile the benign nature of PVCs with the way they feel (or at least as they are perceived in a lot of people -- not everyone feels them, which I find strange, but only because I feel mine quite clearly). Still, they carry no diagnostic nor prognostic value at all. It was once believed that frequent PVCs were ominous in very specific settings critical clinical settings, but now it has been determined beyond any reasonable doubt that even in those specific settings (people with severe heart disease and compromised function due to damage from prior heart attack or structural disease) half of those who die because of advanced heart disease have had no PVCs during or immediately prior to the terminal event. In other words, PVCs don't cause sudden cardiac death, nor do they predict it. They are rarely treated now, even in those serious clinical settings. They are normal in the general population, and some people have them extremely frequently (sometimes thousands in 24 hours) while others have them only occasionally. The rates of occurrence evidenced by your Holter monitor recordings would rank as occasional to infrequent, but the extremely unpleasant sensation (and some are just far more sensitive to it than others) makes some feel there must be something sinister going on. It's understandable, too. The heart, when it's working in an orderly fashion, is not usually noticed. However, like our breathing, once attention has been attracted to it, it is very difficult to ignore.

The phenomenon of bigemeny (and trigemeny and quadragemeny -- I think they stopped naming after every fourth beat) is based on a physiological rule that's actually rather arcane, but the rule itself proves that even bigemeny is a benign rhythm; However, it can be, for some people, extremely uncomfortable. I've found that sometimes people will notice it and at other times not. Part of the reason for this is the timing of PVCs, and bigemeny, since it is very regular in its irregularity, follows its own rule, that when a PVC fires while the tricuspid valve is shut, it causes a much more noticebale "kick" and sometimes a very creepy sensation of backing up into the jugular in the neck, which is exactly what happens. With bigemeny if the first one happens at that point in the cycle, then the rest in that "row" will also. It makes no difference and nothing bad will happen, but those feel even more "wrong" than PVCs that occur when the tricuspid valve is open and the extra blood that collects in the half second or less of the pause before the next regular beat can be pushed out more easily, so doesn't cause the "water hammer" effect.

It's all very technical and involves both electrical and plumbing issues, but the bottom line is that your doctor is absolutely correct: they are benign, and it doesn't matter how many you have (except in a psychological sense). There are some who have bigemeny as their "normal" rhythm, and in some it goes away with exercise only to return upon cooling down. The only time PVCs are of any interest at all is when they occur in a setting of severe left ventricular dysfunction or marked structural disease (causing the same dysfunction in a different way). Either of these will have far more troubling and debilitating symptoms that PVCs, either is quite evident of cardiac workup, and even with all that said, the patient may not have any more PVCs than a randomly chosen healthy person and they still aren't usually treated, just noted.

It sounds as though you've done a lot of calming if you've gotten your average resting heart rate down from the 90s to the 70s, which speaks well for your emotional health, which is the primary concern. You're perfectly safe in resuming a fitness program, though you will likely notice PVCs when you change from an active to a resting status or sometimes vice versa. (For some they always go away with exercise and return after, and for others it works the opposite way). Avoidance of caffeine, nicotine, alcohol, sleep disturbances and stress are a few ways to possibly reduce the frequency of the palpitations, but even then there's no guarantee they won't just kick up now and again, and that's perfectly normal.

You definitely can put your concerns to rest. Following through by slowly learning to not notice or not attach any value to those occasional unpleasant sensations is another matter, and for most of us, only time and experience will really convince us they're harmless, no matter what our doctors tells us. It's hard to ignore someone who keeps tapping you on the shoulder -- or inside the chest.

I hope this helps dispel your concerns as much as is possible. It's a remarkably common concern, but people tend not to mention it to others for some reason. If they did, we'd all probably be better off. Thanks for bringing your concerns here. Best of luck to you.
Avatar universal
Just a note:  Mr. Kenyon would probably be pleased if he received credit for the long posts above, which were actually full quotes, minus quotation marks, taken from his discussion of PVCs at this site:

kenyon forums/backup/topic-24286.html
Avatar universal
Yes since your post is above with the link and I said it was pasted and that u were right I figured she would know.  But to those reading that was dr kenyons words, he has answered my questions before and is a wonderful doctor and intelligent man.
Avatar universal
Yes since your post is above with the link and I said it was pasted and that u were right I figured she would know.  But to those reading that was dr kenyons words, he has answered my questions before and is a wonderful doctor and intelligent man.
1464004 tn?1384139333
"To help ease your mind about these sensations, consider reading the explanations of PVCs and other benign ectopic beats written by John Kenyon, a skilled cardiac nurse/technician who posts at a site forbidden by medhelp."
Do you know why the site has been forbidden by Medhelp?
Avatar universal
Your guess is as good as mine.  But I bet human kindness is not part of it.
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