Aa
Frequencies of PVCs
I have always experienced the occasional thumping PVC throughout my life - sometimes aftera a hard workout, sometimes with an intense emotion such as I just got scared or upset, but never lasted.
A month ago out of the blue I started experiencing runs of PVCs so suddenly and frequently throughout the day, and after day 4 of this, ran to the MD. I had 2 EKGs, ultrasound, and wore a 24 hr halter (the halter detected 170 within that time frame) and was diagnosed with "just PVCs." (all tests showed them) After a month of being on metoprolol 25mg and propranolol 10mg q8hr prn, I seemed to experience some relief, and in fact would have a couple of days w/out any PVCs at all. My MD didn't seem worried about anything at all, even though I experience several PVCs in a row. I have learned more on the internet reading about triplets, couplets, etc, than I have learned with my MD - And I definitely have several runs of those at a time. But now the last couple days I have experienced up to 14 PVCs in a row (not every other heartbeat, but EVERY)- and tons and tons throughout the day (yesterday I know I probably made my first 1000+ PVC day). The prn med didn't really seem to help anything other than soften the hardness of the "thump." I don't get lightheaded or chest pain with the several consecutive PVCs, and yesterday just worked my day through, but when I get so many PVCs in a row, is there really a worry? My MD doesn't seem to want to bother with me, he said everything else looks good, but is there a danger in having so many PVCs back to back to back, and if so, what should I look for if otherwise I am asymptomatic (other than anxiety?) Should I see a different doctor?
A month ago out of the blue I started experiencing runs of PVCs so suddenly and frequently throughout the day, and after day 4 of this, ran to the MD. I had 2 EKGs, ultrasound, and wore a 24 hr halter (the halter detected 170 within that time frame) and was diagnosed with "just PVCs." (all tests showed them) After a month of being on metoprolol 25mg and propranolol 10mg q8hr prn, I seemed to experience some relief, and in fact would have a couple of days w/out any PVCs at all. My MD didn't seem worried about anything at all, even though I experience several PVCs in a row. I have learned more on the internet reading about triplets, couplets, etc, than I have learned with my MD - And I definitely have several runs of those at a time. But now the last couple days I have experienced up to 14 PVCs in a row (not every other heartbeat, but EVERY)- and tons and tons throughout the day (yesterday I know I probably made my first 1000+ PVC day). The prn med didn't really seem to help anything other than soften the hardness of the "thump." I don't get lightheaded or chest pain with the several consecutive PVCs, and yesterday just worked my day through, but when I get so many PVCs in a row, is there really a worry? My MD doesn't seem to want to bother with me, he said everything else looks good, but is there a danger in having so many PVCs back to back to back, and if so, what should I look for if otherwise I am asymptomatic (other than anxiety?) Should I see a different doctor?
sorry to confuse you about some things...here's a website I'm a member of that has a heart term glossary that explains things very simply - skipping hearts you can google it or just do it as a web address: http://www.skippinghearts.com/articles/category/glossary/letter-A/
nsvt is non sustained ventricular tachycardia; and if you look in the glossary under V it gives a great explanation in layman's terms or you can search up top here and put in whatever term you want and look for the glossary terms also
http://www.medhelp.org/medical-information/show/808/Ventricular-tachycardia
I did find an interesting fact here - Ventricular tachycardia (VT) occurs in approximately 2 out of 10,000 people
it's a good start with stress test; probably echo and blood tests would be good also they may need to do a 30 day monitor to see if they can find those 15 beat runs you're having - find exactly how many per day and if they can tell where they're originating.
I've had 3700+ per hour for months on end, non stop - which is no fun to deal with. Last time I checked in Dec 09; I had roughly 10,000 again, which is nothing like my 50,000+ but still enough to warrant treatment and possibly another ablation.
I personally will not take Flacainide but others here do take it. I've read it has too many side effects and I have cardiomyopathy so no way I even want to take any meds, unless necessary.
If they give you twilight sedation during an ablation you really don't remember much and not in any discomfort. I think the worst part was afterwards taking the cather out and having to hold pressure on it for 30 min - that's the part that hurt me.
There is much debate on what's considered "frequent" pvc's and what requires meds or surgery. Typically dr's medicate anything between 6,000 - 8,000 pvc's daily and will look at surgery when you're around 15% of pvc's in a 24 hour total heartbeats.
Here's just one thread and the answer from a doctor here from Cleveland Clinic; but they answer tons of these questions monthly with basically the same answers - it deals with VT but it's the same thing with pvc's:
http://www.medhelp.org/posts/Heart-Disease/Idiopathic-Ventricular-Tachycardia-Ablation/show/1327314
"If your heart function is normal...The only thing worth assessing is the number of PVC's in a 24 hour period. If it's greater than 15% of all the heart beats than there is a small risk of developing a PVC induced cardiomyopathy."
"We typically don't ablate PVC's unless they are symptomatic or if they are very numerous (great than 15%). The VT isn't ablated unless it's sustained or very symptomatic with episodes of passing out or nearly passing out. Sometimes it's difficult to induce the Vt in the lab but becasue the PVCs typically look like the VT we sometimes go after them" ...
nsvt is non sustained ventricular tachycardia; and if you look in the glossary under V it gives a great explanation in layman's terms or you can search up top here and put in whatever term you want and look for the glossary terms also
http://www.medhelp.org/medical-information/show/808/Ventricular-tachycardia
I did find an interesting fact here - Ventricular tachycardia (VT) occurs in approximately 2 out of 10,000 people
it's a good start with stress test; probably echo and blood tests would be good also they may need to do a 30 day monitor to see if they can find those 15 beat runs you're having - find exactly how many per day and if they can tell where they're originating.
I've had 3700+ per hour for months on end, non stop - which is no fun to deal with. Last time I checked in Dec 09; I had roughly 10,000 again, which is nothing like my 50,000+ but still enough to warrant treatment and possibly another ablation.
I personally will not take Flacainide but others here do take it. I've read it has too many side effects and I have cardiomyopathy so no way I even want to take any meds, unless necessary.
If they give you twilight sedation during an ablation you really don't remember much and not in any discomfort. I think the worst part was afterwards taking the cather out and having to hold pressure on it for 30 min - that's the part that hurt me.
There is much debate on what's considered "frequent" pvc's and what requires meds or surgery. Typically dr's medicate anything between 6,000 - 8,000 pvc's daily and will look at surgery when you're around 15% of pvc's in a 24 hour total heartbeats.
Here's just one thread and the answer from a doctor here from Cleveland Clinic; but they answer tons of these questions monthly with basically the same answers - it deals with VT but it's the same thing with pvc's:
http://www.medhelp.org/posts/Heart-Disease/Idiopathic-Ventricular-Tachycardia-Ablation/show/1327314
"If your heart function is normal...The only thing worth assessing is the number of PVC's in a 24 hour period. If it's greater than 15% of all the heart beats than there is a small risk of developing a PVC induced cardiomyopathy."
"We typically don't ablate PVC's unless they are symptomatic or if they are very numerous (great than 15%). The VT isn't ablated unless it's sustained or very symptomatic with episodes of passing out or nearly passing out. Sometimes it's difficult to induce the Vt in the lab but becasue the PVCs typically look like the VT we sometimes go after them" ...
Thanks cindy707 - I have actually had the opportunity to email back and forth with my MD, and he's turned out to be very helpful. He's a new doc, and I think the day I was in to actually see him he had so much going on and I didn't feel satisfied in his office, but he has taken extensive time and detail in answering every single email question I've sent him. Tomorrow morning I am scheduled for a stress test.
Has anyone been on Flacainide 50mg? Last week Tues/Wed I had such a rough couple of days w/PVCs I told him my heart felt like it would get "stuck" in a rythm of up to 15 in a row - so he switched me from 25mg of metoprolol straight into flacainide 50mg x a day. Well the side effects look so scarey to me I told him I wasn't going to start it until the day before the stress test (today). But he seems like he went straight in for the kill with the treatment.
As for Vtach or SVT, well as I mentioned, my heart rate (beats) ever really increases, it's a steady beatTHUMP, pause, beatTHUMP, pause (thump being the reset) so hopefully I'm not experiencing that, but I do get several in a row.
And an ablation? Is that a painful proceedure? Is it a day thing, and I hear a lot of people don't get relief from ablations, but some days sounds tempting.
Has anyone been on Flacainide 50mg? Last week Tues/Wed I had such a rough couple of days w/PVCs I told him my heart felt like it would get "stuck" in a rythm of up to 15 in a row - so he switched me from 25mg of metoprolol straight into flacainide 50mg x a day. Well the side effects look so scarey to me I told him I wasn't going to start it until the day before the stress test (today). But he seems like he went straight in for the kill with the treatment.
As for Vtach or SVT, well as I mentioned, my heart rate (beats) ever really increases, it's a steady beatTHUMP, pause, beatTHUMP, pause (thump being the reset) so hopefully I'm not experiencing that, but I do get several in a row.
And an ablation? Is that a painful proceedure? Is it a day thing, and I hear a lot of people don't get relief from ablations, but some days sounds tempting.
Okay i'll add to the mix here...i agree with itdood on this that you need to find a doc that is willing to listen to your concerns and get proactive w. your episodes. I would not even ever go into the V Tach arena unless it has been confirmed thru extensive testing by your heart doc...V Tach is a world away from PVC's, You could put this into perspective in that on any day our hearts beat over 100,000 times in a 24 hour period so you can kind of do the math. Alot of docs like yours call PVC's benign even tho we all know it doesn't feel like that at all. I had a pretty tough time of it with my PVC's a couple of years ago and chose to go for the cure and not the treatment and opted for an ablation which was 100% successful for the PVC's and have never had to feel another one since the procedure. I also had the ablation for a couple of other things but i think if it is really wearing on you and worrying you that you should try to find a doc that you bond with and talk to him/her about your options. I don't know how i feel about taking a beta blocker PRN because they take weeks to saturate our tissues for max benefit..i took antenolol for mine daily and it worked and then after the ablation chose to stay on it as a safety net at a super low dose and am glad i made that choice...don't get disheartened...just get busy....find yourself a doc that works for you...maybe you could post the area you live in and members could toss in their two cents worth of who may see a doc in your area and that they love them...good luck
Wow, 50,000??????? I am still learning the lingo (and th threats behind it). What are vtach runs? I am having SOME sort of runs....my heart will do that weird bmp-THUMP..pause for about 15 beats in a row, then all sporadic, sometimes up to 30 or so irregular bmp-THUMP..pause beats in a minute! eek. My md seems SO uninterested!
And Bayleaf, you make me feel better too.......the sensation I think is 15 PVCs in a row will halt by itself, but sometimes I feel like if I hit my chest with my fist and cough it helps too. My pulse is always very slow...usually around 60 bpm, even when the PVCs are happening. I will get SEVERAL in a row, then will change to every other beat, then sporadic. Sometimes I feel it softly (sometimes behind my sternum, sometimes in my neck) but I never feel a vibration, and my HR never increases by much.
Trying to figure out how to navigate this forum, I found some people who responded, THANK YOU TO ALL! Actually, as of this morning from about 6am until about 9am I had about 600 PVCs - well, that extra "thump" you feel when your heart beats, then pauses. My heartrate is always around 60 or so, but it will get "stuck" in the "bmp-THUMP...PAUSE, bmp-THUMP...PAUSE, bmp-THUMP...pause..for up to 15 beats in a row. No lightheadedness or anything,but it's SO hard to deal with. I have NO idea why I am getting these out of the blue. Some days GREAT, and other days (like the last 3) were just AWFUL. Like I said, on an average day I probaby experience 300-400, but will get an hour of them straight, then a couple hours "break", then will kick in again. Other days I have none at all, but like I said yesterday I KNOW I had my first 1000+ day. Was very miserable. This forum definitely helps me calm down, but when my heart gets "stuck" in that rythm for up to 14 or 15 beats in a row, it makes me wonder if it's stuck in a danger zone!!! not sure what PACs are and the other terms are for having more than 4 in a row............just trying to learn since my MD is too busy and unconcerned to sit and answer all my "am I dying" questions! lol!
I think you should contact your doctor and tell him things have escalated and you would like to come in and see him again. You will not know what your heart is doing until you actually catch it on a monitor. I had to really push to get a 30 day monitor, in fact, I ended up changing doctors. I have had so much of mine either caught in the ER or on monitor I am able most of the time to tell the difference between a PVC and a PAC by the way they feel.
bayleaf do you also suffer pvc's? I know you've been a GREAT help to me, but I have been asked many many times by doctor's - EP's & Cardiologists if I "feel" my pvc's when I've had testing done or wearing monitors - so maybe they mean something different than what you're saying? I usually laugh and say yes I feel them.
I feel pvc's but not pac's and dr's have tested me on that while hooked up to monitors :P I told them when I was in the hospital if one more dr came to watch my monitor I was going to charge admission LOL can you explain a bit better about what you mean? because I'm really confused
newtopvc's - I've been known to "throw" ? I think is right word; 50,000 some odd pvc's daily caught on monitors, some vtach runs and crazy other stuff - just take it all with a grain of salt and enjoy life to it's fullest - the only med I've found so far that has helped me with no major side effect is Inderal.
I feel pvc's but not pac's and dr's have tested me on that while hooked up to monitors :P I told them when I was in the hospital if one more dr came to watch my monitor I was going to charge admission LOL can you explain a bit better about what you mean? because I'm really confused
newtopvc's - I've been known to "throw" ? I think is right word; 50,000 some odd pvc's daily caught on monitors, some vtach runs and crazy other stuff - just take it all with a grain of salt and enjoy life to it's fullest - the only med I've found so far that has helped me with no major side effect is Inderal.
Without catching the "runs" on an EKG I don't think much can be gained by speculating on what happened or speculating on what should be done. If you are still having these runs of what you think is nsvt, you should go back to your cardiologist and escalate the issue. If it were me I'd ask for a 14 day or 30 day event monitor instead of a 24 hour holter. If you're not comfy with going back to the same cardiologist or pcp, seek out a new doc and have your file transferred.
I had a similar ramp up and escalation of PVCs. I ended up finding a new set of docs that got me on a holter monitor.
I'm like you, I can distinguish PVCs by feeling alone. I've gotten them enough on documented EKGs to know and I was also formally diagnosed like you were.
I had a similar ramp up and escalation of PVCs. I ended up finding a new set of docs that got me on a holter monitor.
I'm like you, I can distinguish PVCs by feeling alone. I've gotten them enough on documented EKGs to know and I was also formally diagnosed like you were.
once you have 3 PVCs in a row, they're no longer considered PVCs, but rather a ventricular rhythm depending on the rate ("ventricular tachycardia" or "V tach" if fast enough). If you have self terminating runs (you have 5 or 6 beats but then it quits) a lot of physicians won't do anything about it. Long, persistent runs require ablations. Some physicians may refer you to get an ICD placed in case you ever have a run that doesn't want to terminate.
Also, palpitations and PVCs are not the same thing. You cannot truly feel a "PVC". You feel a palpitation, and you're assuming your palpitations are caused by PVCs. If your palpitations are slow enough to count (you said you had 14 beats in a row) than they're probably benign. If it was V tach, they would be at a rate of at least 120 (often more like 150 or 160), meaning 2-3 beats per second. Stay on the metoprolol, you may need a larger dose. But it sounds to me like your physician is appropriately treating your condition.
Also, palpitations and PVCs are not the same thing. You cannot truly feel a "PVC". You feel a palpitation, and you're assuming your palpitations are caused by PVCs. If your palpitations are slow enough to count (you said you had 14 beats in a row) than they're probably benign. If it was V tach, they would be at a rate of at least 120 (often more like 150 or 160), meaning 2-3 beats per second. Stay on the metoprolol, you may need a larger dose. But it sounds to me like your physician is appropriately treating your condition.
hi..and welcome to this forum. I have had PVCs and PACs for 17 years..so Ive been through ( and are still going thru) what you are. By all means, iam in no way putting yours down as insignificant, because to me--even 1 palpitation is one too many, ya know? But for example, I wore a 24 hour holter 2 months ago. I had 4,300 mostly PACs in about a 12 hour time span. That seems like alot, right? My cardiologist...brushed it off as totally NOTHING. There are people that post on here, that have 15,000 a DAY..some more than that. So, knowing that, if you had 170 in 24 hours...thats a pretty small amount. But...like me, the holter may have caught yours on a "good day". I know, that I have days where mine far far exceed the 4300 that I had on that holter. For the past 4 days now....its been miserable. I dont think Im having bigemy, or anything like that. But ....Ive timed it...and I will have sometimes 15-20 in a ONE minute period, on a very bad day. I have to give my cardiologist credit....hes told me over and over that they are NOT life threatening...that I need to go about my day...hes got me on potassium supplement because my potass was a bit on the low side...hes got me, now, on 200 mg of Metoprolol per day...wow! He insists that i not stop working out ( I am quite overweight but started a workout at the local fitness center where they monitor people in March and have lost weight AND strengthened my heart) on days when the palps are bad...god its hard to make myself get on that treadmill when my heart is jumping and thumping!!!! So...im kinda like you. My Dr has told me and told me everything looks good...go on with life (ya..easy for him to say)....and whether they are back to back (which mine usually are) or sporadic...they are harmless!!! I do have Xanax for anxiety...love it....but other than that....all I can say is maybe trust your Dr ....and its very very hard to do! You have come to a good place here, though...everyone is really nice and helpful!!
Have an Answer?
You are reading content posted in the Heart Rhythm Community
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.
