Aa
Aa
A
A
A
Close
Avatar universal

24000 PVCS daily - 25% cardiac output - advice

Hi, my story is quite long but i'll try make an abbreviated version:

In Feb 2014 i woke up one morning (after a very late night of work stress) with very frequent PVCS. I've had two seperate 1-week episodes of very frequent non-stop PVCS a year or so previously; both times in parallel to a viral chest infection and disappearing as the infection cleared up. I figured this episode was bought on by the late night+stress and would clear up in a day or two. It didnt!

Basically the very frequent PVCS hasn't stopped since February and has in fact increased from around 10k, to 15k to now 24k a day - broken down per hour, its 1000 an hour, regardless if i'm awake, sleeping, whatever. In general they are more frequent at rest and disappear with exertion, but ive noticed that any time the heart rate levels out (even during excercise) they start to come back.

AT first i was really sick - with some undiagnosed chronic illness. But now, 10 months later i'm apparently healthy, yet the PVCS continue to increase.

The start of all this in February, was preceded by 3 weeks of bad stomach pains. Long story short; over a period of about 4 months of atrocious, convulsive PVCS, excessive fatigue and confusion, manic insomnia (waking every 1-2 hours during the night with racing thoughts), it was discovered that my Thyroid was under-functioning, which turned out to be from iodine, iron and vitamin d deficiences, which turned out to be from a gut parasite infection with Blastocystis. Eradicating the Blasto and treating the deficiences returned my Thyroid and other levels to normal. They've been stable for the last 6 months or so and i feel pretty much 'normal'.

All the doctors treating me thought that the heart palptiations would soon clear up as i had continued to have good health.

This hasnt happened. What has happened is that the quality of the palpitations has changed dramatically; when i had the mineral deficiences and hypothyroid they used to be violent and terrifying spasms; both my heart and also my abdomen convulsing and very symptomatic (dizzy, breathless). But now they are more like small blips in the flow of my regular heartbeat and dont sem to have any impact on me and for the last 5 months or so, i've had no anxiety related to the PVCS, they just are.

However, i still suffer from fatigue. Not crushing, world-melting fatigue like before, but i do not notice that i have an intolerance to excercise - for the last 6 months or so i ONLY walk and do light stretching, relaxation yoga etc. If i jog at all, or do anything more strenuous i really suffer with fatigue which makes the PVCs worse and a tired anxiousness - as well as more frequent waking in the night. It's like i need to keep my adrenaline/stress at almost zero, because as soon as i hype up in any way - even doing enjoyable activities - going out with friends more often - it's way too much for me.  

The million dollar question for me right now is; are the heart palpitations causing this tiredness and activity intolerance? Or are both the tiredness and heart palpitations the symptoms of something else - like Adrenal issues, overactive sympathetic nervous system etc? - Or could the PVCs actually be driving adrenal/nervouse system problems themselves - as they seem to trigger little surges of adrenaline at times?

What do you guys think?

I need to decide if i go ahead with an ablation in the next month or so. My gut feeling is that this will only be treating the symptom and that the fatigue etc will remain. In which case it would be way better to not risk an ablation and adding damage to my current 'benign' condition.

Or am i being stupid and after i have the ablation, i will realise just how much these things were dragging me down physically??

I've had echos, holter montiors and most recently an MRI of the heart. Nothing abnormal found. I've been following the lifestyle recomendations for adrenal fatigue all year; which stops it from getting worse; but doesnt seem to help it get better. My Potassium level is fine - consistently middle of normal range, my Magnesium levels are consistently on the very lowest end of normal (around .70 to .80 ) despite supplementing with Magnesium Taurate all year (ca. 350mg daily - about to try bumping that up to 500mg for the next month). During the MRI (where i was in quadrigimeny) the injected me with Adenosine which dialled my PVCS up to a level i'd never thought possible - just constant explosive out of control convulsions and also triggered the  stomach convulsions i had at the start of the year.

This made me think that adrenaline is a major factor for me.. Day-to-day i have a very simple, non-stressful existence at the moment. I am not working and dont need to for the next couple of months. I eat really well, walk half an hour outside in a massive park every day. Sleep early, wake when i want. I'm not consciously stressed in any way i can notice, yet perhaps the chronic illness over the last year or so has put my body in a chronic stress state; kind of stuck in a loop, which keeps getting fed by these PVCs?

Oh - and i'm 35 years old, female and no other medical conditions.

Sorry - this is super long!
4 Responses
Sort by: Helpful Oldest Newest
Avatar universal
Hi-
Thank you so much. My EP is so confident that my ablation will be successful and that I'll be cured but then my "regular" cardio really put doubt into my head by claiming he has "many" patients with my level of PVCs who were fine, but he'd previously told me several times he had a single patient with 40,000 that he was seriously worried about developing cardiomyopathy so he echoes him frequently. And he also told me to go against the EP's strict instructions to stop the beta blocker 3 days before the ablation. Although the BB definitely doesn't get rid of the PVCs, it sometimes can calm them considerably for a few hours at a time. During an ablation is the only time you want lots of PVCs! I think there is some serious professional jealousy or something which has actually made this dr behave unethically. Undermining the success of an ablation seems like it's well beyond having a different opinion.

Thank you so much for your kind and thoughtful words- seems like we are both experts in something unpleasant and not very common.
I hope your gastritis is better soon and that your lingering fatigue and the PVCs clear up soon too.

Please message me anytime if you have any more questions or thoughts about ablation. Mine is in a week!

Wishing you much peace and health.
Helpful - 0
Avatar universal
hi thanks so much for your considered response. it's really good to get advice from someone with your unusual level of experience - given your extreme case. It must be terrifying for you - i cant imagine how that must feel moment to moment - must be a real struggle for your sanity. The times ive had Bigemeny that persisted throughout the day, despite my activity level, were hellish, dizzy and exhausting.

As far as i know, PVC-induced cardiomyopathy is only a temporary effect of the heavy PVC burden - and not permanent damage, or actual heart disease. According to all the research i've read the ablation should absolutely reverse it. Fingers crossed for you x

About the viral connection: Yes, the first time i ever had a bout of constant PVCs for a week was when i had a double viral infection: norovirus and viral bronchitis at the same time. It was hardcore and totally screwed me up. The palpitations lasted the week it was really bad and then cleared magically - in that way they do, from one second to another just stopping!

Since then they have seemed to be a marker of viral infection for me, but like i said nonstop for 10 months now and getting worse instead of better as my health improves? Doctors here seem to agree that its common for these to be triggered initially by a viral infection - some damage is done that makes the cells in the heart more irritable. But dont seem to think its evidence of an ongoing infection in my case.

I do wish there was some kind of blood test they could do to rule out any undiagnosed chronic viral infection in the body?? I tried to ask my doctors about this several times, but got nowhere. I also wonder about post-viral syndrome or something similar..

I had been taking ashwaganda for a short while, and considering starting it again - and also was keen on starting astragalus at some point - i'll look into it again now, thanks for the reminder.

I recently had an extreme bout of gastritis so right now i'm a bit wary of adding any herbs that might irritate my sensitive stomach - I was taking potassium pills for the last couple months for my heart, without any idea that they can damage the stomach really badly - learnt that the hard way and ended up in hospital for it.

I really hope your procedure goes well - it will be so interesting to see what effect the ablation has on your overall wellbeing and feeling of health. Having such frequent PVCs you definitely learn to accept a different version of normal and i think over time its hard to keep track of what the 'real' normal should feel like and what you've just learnt to cope with. In your case it will be a dramatic change i'm sure!
Helpful - 0
Avatar universal
Hi again- wanted to talk about some of your other concerns. Did any of your doctors think that perhaps your virus/chronic illness had affected your heart? I've read that up to 80% of our typical colds/virus/flus actually affect our hearts and don't cause major symptoms like a true myocarditis, but they do affect the heart muscle and it just clears up with the rest of the symptoms and there's no damage done. Now as your illness lingered, I wonder if it's possible you just had some lingering cardiac effects (the PVCs), and they too will just totally resolve soon and it won't happen again. Very good news that your scans are all ok- means there's no damage and at this point, the PVCs haven't weakened your heart at all.

In some of my episodes, which all seemed to be emotional/stress related, the situation would clear up, I would be less stressed, but the PVCs would continue for a while after, and then I'd be vigilant about them for a while after that even when they weren't there.

My guess is that if your life continues to be relatively stress-free and you continue to feel better, that your PVCs will probably just stop and you'll be ok. However... after being told that my PVCs were benign for so many years and then ending up with PVC-induced cardiomyopathy, I certainly wish my doctors had taken them more seriously and that I had done something about them before this happened. The thing is that high-frequency PVCs seem to cause damage over time- so the months of 10,000-15,000 I was having didn't seem to cause me any damage. Now at 60,000, the damage seemed to have happened within a few months, but that probably combined with years and years of pretty frequent PVCs. The thing that is a little concerning about your PVC level is that 25,000 PVCs/per day is where most doctors say you are at a real risk for cardiomyopathy. I've read that it can be as low as 4,000 a day, but 25,000 a day is hard on the heart. If you've been having that many for 10 months, and it isn't going away, then I would probably seek the ablation to stop it now, and avoid future episodes. The only truly effective meds for PVCs like amiodarone can be quite toxic in other ways when used long-term.

The great news is that you don't have any heart damage from PVCs so for you an ablation would simply prevent that from happening. AND I think the PVCs are contributing to your fatigue and definitely affecting adrenaline/catecholamine. While I don't experience fatigue with my PVCs, I experience a lot of anxiety which keeps me less active. And when you read people's reporting of their experiences with PVCs, so many feel that fatigue, shortness of breath, anxiety, and exercise intolerance.

It sounds like you are still healing, and sounds like you're otherwise healthy and will hopefully be yourself soon. Have you tried anything herbal like astragalus or rhodiola for the fatigue?

Good luck and keep us updated!

Helpful - 0
Avatar universal
forgot to mention: tired Bisoprolol early on but discontinued due to low blood pressure and anyway didnt do very much. But have been considering trialling a super low dose (half a tablet / every second day?) now that i'm 'healthy' and seeing what happens - could be a good test for the adrenaline response?
My cholesterol, blood pressure are both fine.

Basically my doctors here in Germany say there is nothing more to test (although seems like in the USA they are more comprehensive? Would be impossible to get a complete nutrient blood test here) and no other next step aside from do nothing or ablate..

Thanks.

Helpful - 0
Have an Answer?

You are reading content posted in the Heart Rhythm Community

Top Arrhythmias Answerers
1807132 tn?1318743597
Chicago, IL
1423357 tn?1511085442
Central, MA
Learn About Top Answerers
Didn't find the answer you were looking for?
Ask a question
Popular Resources
Are there grounds to recommend coffee consumption? Recent studies perk interest.
Salt in food can hurt your heart.
Get answers to your top questions about this common — but scary — symptom
How to know when chest pain may be a sign of something else
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.