PVCs...I think....I hope?

[tommy]

Since last Friday I've had an irregular heartbeat. This started up out of the blue. I get an early beat, and then a pause where that beat should have been. The early beat is weak and often undetectable without a stethoscope. Sometimes I get two of those early beats back to back. This activity is persistent - as much as 10 times per minute - for hours on end.

They feel a little weird, but not painful. Absolutely no other symptoms. BP, HR, temp, all okay. No dizziness, no nothing. When I get distracted with work or a good basketball game (see below), I don't feel them.

Called the on-call cardio over the weekend. He said that absent other symptoms, I should be okay until I could see my regular cardio. Saw my regular cardio Tuesday. He's not too concerned, thinks they are PVCs - should be benign and not restrict me in anyway. He said that they can start for no apparent reason and sometimes just go away.

He would be more concerned about a-fib. I'm already on Coumadin. The beta blockers might cause issues with sports because they restrict the heart rate, He has a patient that runs with a-fib and beta blockers and seems to do okay. So I did the holter monitor for 24 hours and an echo. I was due for an echo anyway. Results next week. Oddly the beat was fairly regular for the echo- only saw about 10-12 strange blips in the 1/2 hour test. We'll see about the holter.

My cardio said I could do my workouts, actually was encouraging. Then the nurse that wired me to the holter told me not to sweat or the leads would fall off. I went for a 10 minute walk to elevate my heart rate a bit for the holter. After I turned in the holter today, I walked a mile in 16 minutes. Heart rate averaged 97 (I have a Polar HR monitor). No issues. Seems pretty decent.

I'm still a bit spooked. Am I over reacting? Any thoughts?

On the lighter side, my son was at the Aggie-Longhorn basketball game last night. Or as he would put it the AGGIE - tu game. These Texas rivalries are a big deal. The game was a nail biter that was decided by a long shot at the buzzer. The Aggies dropped #6 Texas 46-43. Heres a link to a post game video on the Aggie website. My son was one of the storm troopers.

http://www.aggieathletics.com/games.php?SID=MBB&SSID=6651

 

[ALCapshaw2]

AH, YES, PVC's / PAC's.... pesky little things aren't they?

I'm told you can't tell which it really is (or which is predominant if both are occurring(sp?) or alternating without having an EKG or monitor.

I had them for several months 2 years post op followed by activity induced A-Fib due to another 'developing' issue, and then they miraculously cleared up. Sotalol brought the A-Fib under control.

By 'trial and error' I determined that CHOCOLATE (probably Caffeine) was triggering my (mostly) PAC's with some PVC's thrown in for good measure. I had to COMPLETELY eliminate ALL sources of Caffeine to make it go away. Now I can eat chocolate again... who knows, but I suspect SOMETHING is changing. If you can talk your cardio into another Echo, that might help pinpoint what is happening (AFTER you get your Holter monitor results).

For your peace of mind, I hope you and your cardio can 'pin it down' more definitively.

'AL Capshaw'

 

[JimL]

Tommy, have you tried magnesium? It works for me, much better than amiodarone ever did. I take 500 mg of magnesium gluconate daily. Stress is the big factor for an irregular heartbeat, and there's not much to be done about that.

 

[EVELYN]

Tommy

My husband, Tyce, had PVC's for years.....until OHS and his AVR replacement. Since that time, he hasn't "skipped a beat" (pun intended) He was on amiodarone, too, but has been off that for about 3 years and also takes the magnesium....but 400mg. per day......Our cardio wasn't too worried about the pvc's either. Hope it eases your mind a bit.

Evelyn

 

[tommy]

Thanks. Y'all have eased my mind. The dang things startled me.

Since stress appear to be a factor, feeling better about the situation may improve it. Work has been more stressful lately, and I haven't been exercising as much lately. I posted a few weeks ago about growing excuses and lack of motivation. One of the excuses is time (see comment about work). During my long distance running days, I left my stresses on the tarmac. As for motivation, I'm working on it - this didn't help.

I did some more Internet research and found an EKG example that looks similar to my waves during the echo (yes, I peeked). I want to be careful not to self-diagnose, but suffice to say, that exercise also sets my mind more at ease.

Thanks for the tips on supplements. I'll wait for test results and another doctor consult before starting anything new, but I'll ask about magnesium and amiodarone. Do either of these cause a Coumadin adjustment?

I had quit caffeine since just before AVR 5 years ago. Last year I decided to switch to the "moderation" approach (1-2 cups of coffee or diet sodas per day). I think I'll go back to abstinence except that I'll give myself permission for chocolate now and then .

Thanks again.

 

[Karlynn]

I was going to ask about stress too. That's what does it for me.

 

[Mary]

Before AVR, fluid retention and an elevated body temperature caused mine. I've had just a few since surgery.

 

[Marguerite53]

Hi Tommy. Glad you are relaxing about it. I'm still presurgery, but the PVC's were driving me crazy (couldn't sleep, even) until my atenolol got raised another notch to 50mg. At first, restraining from caffeine and chocolate did the trick. But they came on with a vengeance with my weakening heart. Now I eat chocolate and indulge in a coffee every now and again. With the beta blocker, I know they are still kind of happening, deep in there, like drunken PVC's. But they go away faster.

Stress would definitely kick them in. Especially the kind of stress where I was forgetting to breathe properly...racing around, pushing to think, etc. Try some slow deep breathing and be aware of when you are starting to get stressed and try to relax yourself.

And try not to focus on them, ignore them, like a rude person at a meeting, or something.....honest, you might be able to just will them away some!!

Good luck. Don't worry!!

Marguerite

 

[JimL]

Tom, please don't understand me to recommend amiodarone ever for anyone! That is one serious drug, with severe coumadin interactions. I had amiodarone for one month, and then switched to magnesium, which is far more mild, no side effects, and works better.

 

[tantekay]

Hi! I hope all is still going well for you. I do not have any valve issues (or at least none that I know of right now) but I do have PAC's and prone to A-fibs. I've had echo's, ekg's, and holter's. My episodes were very hard to catch. We finally went with an event monitor that I wore for 30 days. That was the best for diagnosing. I do take Toprol XL 50mg/day to help control things and that works pretty well, and only deal with the occasional overnighter when I won't convert out of A-fib after several hours. Now I don't know how existing valve issues may complicate things, but I have no major concerns or restrictions, I just cut back on the caffene and like everyone else, stress makes things worse. I also know that amiodarone is a very serious drug. My son (2 1/2) is on amiodarone and we have to go for yearly bloodwork to check liver and thyroid function as well as ekg's every 6 months to check for toxisity. Didn't mean for all that to sound too scarey, because it's much better to be on the meds if you need them than not to take them. Best of luck to you.

 

[francie12]

Hi, Tommy--Your symptoms sound exactly like mine, a non-valve person. My 24-hr. holter monitor revealed 2,000 or so pvc's, though I only actually felt a fraction of them. Since the ones I notice are brought on by eating, there's not much I can do in the way of limiting the cause! I've been assured on every side that this will not affect my health adversely in any way. I just go thumping and flopping my way through the day and think of it as a mild curiosity, if I think of it at all. Having been through all you've been through though, I'm sure you don't want to have a cavalier attitude about anything concerned with your heart. Just wanted to say that your symptoms sound just as harmless as mine and hope they turn out to be just that!

 

[tommy]

Y'all are wonderful.

Try some slow deep breathing and be aware of when you are starting to get stressed and try to relax yourself.

Easier to stay out of a hole then climb out of a hole.

Jim, don't worry, I'll see what the cardio says before I open my trap and suggest medicine.

Tantekay...wow 30 days. I think my monitor caught enough to show the doc what he needs to see.

Francie, thanks for your perspective. It helps. As for "all I've been through", I guess when you add them up, the list gets longer and longer, but I truly feel blessed. I've been very active since AVR. This forum is one of my many blessings.

Yet, I don't mess with stuff. And I don't want the list to get any longer if I can help it. I've posted before, that my biggest regret was the at age 30 I didn't recognize the bacterial endocarditis symptoms even thought they were raging.

So at times I may be (okay I am ) a cry baby and go to the doc needlessly. I have no shame in that. I'll do it again in a heartbeat (if I can find it ). I truly hope that this is one of those times.

 

[tobagotwo]

I haven't posted, because I think you're all right, Tommy. Walking is good, too. We all struggle with that motivation demon.

Best wishes,

 

[Ron]

Let me quickly throw my 2 cents in, Tommy. Our situations sound very similar, although you're a good ways out of surgery. I had mitral valve repair on Jan 27th and experienced three episodes of A-fib. With meds, I eventually converted in the hospital. I had experieced several bouts with A-fib prior to the surgery, so this wasn't unexpected.

Upon release, I had acouple of a-fib episodes, but I'm on 100mg of Toprol and that seemed to help 95% of the time.

Over the last week or so, I've had numerous episodes that I thought was a-fib because I couldn't get a good pulse rate because of the 'jumping', but am becoming convinced that its mainly PVC's that are the cause. It's not continuous, but will notice irregularities for an hour or so several times a day. I'm really not sure if this is preferable to being in a-fib or not. This was confirmed while on the monitor at Cardiac Rehab. They really do not restrict my activities.

So, I go to the "electricity" doc next week and am not sure what he'll say. Hopefully these issues will go away on their own since I'm just 5 weeks out of surgery and my heart is still recovering from trauma. Had to respond since your post made me feel much better about what I'm going through right now.

Also a basketball fan, but NOT a Texas fan. Go Aggies.

Ron

 

[tommy]

Well, it's been a good week. The echo came back fine. The holter monitor came back fine. I don't have details yet, but the cardio did say not to be concerned at all.

Those pesky beats still feel funny, but I get past them. They seem to go away over night with a steady, regular beat before I get out of bed.

This was my best exercise week since New Years. Swim bike run walk. Got in all of my workouts, although scaled back and lower intensity. Very satisying. I feel good, and very fortunate.

Thanks y'all.

 

[M&M]

Hi tommy, I just read your post and I suffered from pac's, pvc's for years. It really drives a person crazy to begin with. I had a previous heart attack and I damaged my electrical system from the heart attack and that's why my electrical system is such a mess.

But if you can still do what you want to do and don't forget to keep them monitored from time to time with your doctor - then - that's about all you can really do. I think the key thing is to get them checked on a holter monitor from time to time. Its the smart way to go and then just go out and live life. Other than that - I don't have any great advice..

M&M

 

[ks1490]

quick question

quick question

could someone please explain to a newbie to this site (and this condition) what PVCs and PACs are? Thanks!

 

[Phyllis]

Here's a pretty good explanation posted by Bob H on a previous thread:

The key isn't really whether you have them, but what kind they are. Often, when a valve is getting closer to needing replacement, the growth of the left ventricle can affect how smoothly the electrical impulses pass through the growing muscle tissue and how precisely the tissue responds to them. The same happens when the heart remodels (shrinks back to its normal size) after surgery.

Palpitations generally refer to PACs and PVCs (Premature Atrial or Ventricular Contractions), which are extra beats, named for their points of origin. They are referred to as being benign, as they cause no apparent damage and affect the bloodflow in only the most minimal amount.

PVCs and PACs are noticed more often by valve patients because of our coronary hyperaesthesia. We are extremely aware of everything going on with our hearts. As you point out, they are very common in - if less noticed by - non-heart patients as well.

In any description of PVCs and PACs, you will find cardiac valvular issues listed as a primary cause.

If you have excessively long bouts of them, or they are accompanied by dizziness or pain, or you're just plain getting worried about them, you can ask your cardiologist to put you on a Holter monitor overnight, to determine what type they are. At least then you can sleep peacefully, knowing what they are.

Best wishes,
__________________
Bob H

 

[tantekay]

Tommy....

Tommy....

Glad things are going well and hope that trend continues. Take care.

 

[tommy]

Yup, PVC's

Yup, PVC's

Thanks, everyone for your input and advice. I had a nice long chat with the cardio nurse today. I wanted some more information about the echo and holter other than "normal".

In the case of the echo,"normal" not only means "within normal limits", but also "no significant change from last time". I'm happy about that.

In the case of the holter monitor, these are PVC's. I believe that they happened less frequently during the test, but enough for the doctor to evaluate.

The rhythm is normal, in that the overall cadence is constant, just syncopated sometimes (sometimes frequently). It's like marching left-right-left-right, but the "right' comes early.

No known reason for them to start up. Work-related stress is highest on the list of likely factors. Also, I'm switching caffeine strategy from moderation back to abstinence.

I definitely feel better when I don't think about them. When I pay attention and anticipate them, they oblige by showing up, like self-fullfilling prophecy. So, they are stress related, and stressing about them make them worse. That spiral was not very much fun.

I am feeling better and notice them less. Is that self-fulfilling? Probably. I'm going to keep working on it.