A little confused, any help is appreciated

[ks1982]

So, I have PVC's and PAC's, usually not that big of a deal.   I have in the past had several of them in a row along with a very rapid heart rate.   My heart is structurally normal, I've had nearly every test in the book, so I'm not too worried but I am a little confused.  
I've read that runs of PVC's with no normal beat in between (pretty sure I was having at least a couple of normal beats in between during my run) that last at least 30 secs. or something is considered Vtach.  Then I've heard that it's not considered Vtach, that Vtach is a completely seperate entity.   I've heard that PVC's are in no way related to Vtach and are not considered a risk factor for Vtach or Vfib or sudden death and that Vtach etc. is all based on ejection fraction.   So my question is, which is it?   Does anybody know the current thinking on this?   Are PVC's related to Vtach when coming in runs lasting at least 30 secs or are they not related at all?  

Just trying to satisfy curiousity, thanks for any help.

[ks1982]

Thanks that does help

[Momto3]

I'm glad to hear you have had a cardiac workup and that everything looks great!!  YEAH!!  

A "run" of PVCs is generally considered at least 3 PVCs in a row, with NO regular beats in between.  It can be referred to as non-sustained ventricular tachycardia (NSVT).  If the run lasts at least 30 seconds (no regular beats), it is referred to as ventricular tachycardia (VT).  Some doctors will say that a run of 3 or more PVCs is also VT, but the actual definition stipulates a run of at least 30 seconds.  I have NSVT and when I asked my doctor if I have VT, she said, "no, not techincally".  I'm guessing it's because the NSVT is for less than 30 seconds.

It is my understanding that in patients with a structurally normal heart, the chances of NSVT turning into something serious are very minimal.  There are rare occasions where a "benign" rhythm can become dangerous, but in the VAST majority of people (with a structurally normal heart), there is not reason to suspect NSVT will lead to a serious rhythm disorder.

A worsening ejection fraction would warrant further investigation since the heart is not functioning normally.  

If you are having a regular beat every other beat, that is bigeminy.  Trigeminy is a normal beat every 3rd beat and quadrigeminy is a normal beat every 4th beat.  A couplet is when you have 2 PVCs in a row.

Hope that helps.