Run of PVCs or worse? Ongoing issues.

[wndbr]

First some background:
32 year old male.  Former smoker.  Former caffeine user.  No other drugs.
First experienced sensation of "skipped beats" at age 11.  Remained undiagnosed at the time, but was diagnosed with PACs at age 20 and PVCs at age 25.  These diagnoses were made by 24-hour and 4 week monitors.

Late last year, while do nothing but standing, I had a sudden rapid increase of heart rate with the sensation of being out of rhythm.  Was transported to hospital via EMS and released.

Current issue:
April of this year, I experienced the sensation again: rapid heart rate, rhythm disturbance.  It feels as if my heart is beating out of control.  It feels like there are 3 hard rapid beats, an off beat, a couple rapid, off.  These chain together for what feels like a minute before rapidly calming down.

I was hospitalized for 2 days.  Echo was performed which showed nothing wrong.  I had one small issue while in the hospital which was told to me to be PVC bigeminy with right bundle branch block.  This felt similar to my previous issues but ended as soon as it began.

Upon entering the hospital, I officially quit smoking and quit caffeine.  As a precaution, I've made some strict dietary changes to reduce fat and sodium intake.  In the months since I was released, I haven't had any major runs of palpitations, but on certain days I do feel off and can feel the episode acting like it's going to begin.

I've experienced left chest, shoulder, and arm pain which landed me in the hospital for another day. Despite not tests, I was discharged and told it was probably muscle.

30 day event monitor caught nothing of note. Just PVCs. EP prescribed Verapamil as needed and I haven't taken any.

Should I be worried or have I just been having runs of PVCs?  I wouldn't know the difference between those and VTACH.

[MichelleP_3811]

In an otherwise healthy heart pvcs are not considered a danger, even short runs of them. Where they become a concern is if they get caught in what is called a reentry situation.  This means a premature beat in the ventricles cause the signal to get stuck in a loop making the ventricle beat faster and out of rhythm with the atria.  This is extremely dangerous if not treated quickly.  However, most people have what is called isolated beats or one offs.  People can have many one offs in a row but if it isn't caused by the signal being stuck in the ventricles it is likely the heart will eventually reset itself quite quickly which is what yours did.  if you sense this happening again try and cough and see if you can break up any patterns.  However, the sense you felt it was beating out of control can be concerning if it persists so just keep an eye on things and go back to the doctor if it becomes more frequent or starts to last longer.  Quieting smoking and caffeine were very wise. Also try and make sure you are well hydrated.  Watch sugar and carbs and tend to any acid reflux you may have.  Do a proper warm up and cool down and hopefully you can lessen the amount of premature beats you are having even more.  The fact your heart is evaluated as normal bodes well for you so try to not worry.  If things progress, you start passing out or get bad chest pain then obviously go back to the doctor but at this point I would say try to not worry.  Take care.

[wndbr]

Thank you for the reply. In the meantime, I had a exercise nuclear stress test which I received the results of today. While the final report should normal or mostly normal results, there was one area of concern which showed left ventricular hypertrophy with raised st segment. My GP said it may be nothing and he will review an echocardiogram I had in April to confirm that it is just a normal variation/one-off event.