Premature Atrial Contractions (PACs)

[RobinH]

For about a week now, I've been experiencing PACs. Feels like a really powerful heartbeat. Sometimes it occurs every other beat...sometimes every tenth or twentieth. I also can described it like hiccups of my heart. Anyway, my cardio surgeon says they're nothing to worry about and are quite common after valve surgery. He said because I am thin, I am probably feeling them more so than a bigger person. They bother me and I find them very unsettling; however, I don't want to have to resort to medication to quiet them. My question is....any advice on how to quiet my mind and ignore them when they're happening. They are expecially prevalent when I go to bed and I'm having a hard time going to sleep while my chest goes thumpety thump!

Many thanks!

Robin

 

[ALCapshaw2]

YES, PAC's (and PVC's) are the Common Cold of Cardiology and are generally considered to be benign as indicated by the Yawn on your Cardio's face when you tell him about your symptoms.

I'm wondering why you don't want to medicate.

Beta Blockers are often quite effective in suppressing PAC's (and PVC's), often at very low doses, at least in my experience. I was put on 100 mg of Toprol and complained about feeling 'dragged out'. The prescribing cardio told me that was "the minimum theraputic dose".

Another cardio suggested cutting the dose in half for 2 weeks. WOW! I felt MUCH more energetic and had no PAC's. He then had me cut that dose in half again for 2 more weeks. Basically NO change. Finally he had me STOP taking the Toprol. Around 10 days later, random PAC's reappeared. Back to 25 mg of Toprol XL (extended release) which controlled my PAC's for a couple of years (when I developed exercise induced A-Fib and had to switch to a low dose of Sotalol for better control).

 

[RobinH]

Al - I do take Toprol XL 25 mg which they put me on after my surgery. I'm not really adverse to taking more meds but I guess I'd rather wait to see if the PACs go away. I recently came off of Amiodorone and Medrol steroid pack.

 

[Susan BAV]

Just a little personal experience in this regard; hope the info is helpful...

Just a little personal experience in this regard; hope the info is helpful...

Hi Robin -

Did they do a test to diagnose they are PACs? Post-op, I had some flips and flutters, on and off, but as my heart healed it seemed to fade away. And several months post-op and afterward, I noticed that if I would be less active, then my heart would have some arrhythmias; but if I would just exercise reasonably and regularly they would go away. Simply put, I felt like if I kept my heart in a healthier and more active/muscular state that it beat better.

Recently, I've been having some unusually heavy PVCs (that I couldn't ignore) and my cardio told me that my magnesium and potassium were low enough that they needed brought up because he said that he's found that, for those with tendencies toward arrhythmias, bringing up those two minerals helped.

So he wrote prescriptions for magnesium and potassium (after a blood test) and I'm going to see him again in a few weeks and he's going to do another blood test.

I too always hate to take anything unnecessarily; there were some meds that my dad used to take and a side effect made his sodium very low and his potassium very high and this caused him some problems.

Does your doctor think your arrhythmia could be related to an adjustment within your body to coming off those other powerful meds?

 

[Smiley2000]

For about a week now, I've been experiencing PACs. Feels like a really powerful heartbeat. Sometimes it occurs every other beat...sometimes every tenth or twentieth. I also can described it like hiccups of my heart. Anyway, my cardio surgeon says they're nothing to worry about and are quite common after valve surgery. He said because I am thin, I am probably feeling them more so than a bigger person. They bother me and I find them very unsettling; however, I don't want to have to resort to medication to quiet them. My question is....any advice on how to quiet my mind and ignore them when they're happening. They are expecially prevalent when I go to bed and I'm having a hard time going to sleep while my chest goes thumpety thump!

Many thanks!

Robin

Hi Robin.

I have had PAC's/PVC's pre-op and even now, almost 4 months post-op I have them every day, all day long. I had Tachycardia (130+ even while I was sleeping!) so this heart hiccups are just annoying, but it feels much better than having tachy! As long as you have had a EKG that confirms it is not a-fib then you shouldn't worry about it to much.

Just think of it as if you are pregnant and the baby is kicking... your secret that no one else is aware of...

my heart keeps me "company" when I am bored or just before I fall asleep.

You have two choices: get anxious over something that is not dangerous, or just relax and as long as your heart is pumping (even if it is thumpaty thump) you are doing great

 

[ALCapshaw2]

Al - I do take Toprol XL 25 mg which they put me on after my surgery. I'm not really adverse to taking more meds but I guess I'd rather wait to see if the PACs go away. I recently came off of Amiodorone and Medrol steroid pack.

Susan's comment about having your magnesium and potassium levels checked is a Good Idea. Some of our other members have also indicated that magnesium supplements helped them.

I hate that many Surgeons just put their patients on Amiodarone for any arrhythmias that crop up. I guess they do it 'because it works' but still...

I'm thinking there was a note about other arrhythmias cropping up after coming off Amiodarone. You might want to ask your cardio and/or pharmacist about that.

Increasing your Toprol dose is another option.

I would start with the electrolyte checkup (a simple blood test).

You 'sound' like you are doing pretty well now so that is good.

'AL Capshaw'