PAC's and PVC's!

[bentley1961]

.I have been told I have PAC's and PVC's.  I have also been told I have a completely normal heart.  I get these feelings like a small jump or catch.  On occasion, about eight times in the last month, I get these sensations like I have been hit in the chest. Like my wind gets knocked out on me, briefly, and maybe one or two times consecutively.  Almost like a little seizure type feeling in my chest, that sends my into an instant panic, my heart races afterword and pounds seemingly twice as hard and I get more skips. And on one occasion, after the weird sensation for a few seconds in felt like my heart was gone, chest void and I couldn't pick up a pulse in my wrist for a few seconds.  I know there's other post on things like this, but I'm still a little lost. Are these PVC's, something worse? ANY info would be greatly appreciated! I'm so scared of doing anything these days, I get scared that the next time it happens my hearts going to stop for good!  Is is bad to have these things a couple of times a day or am I making a big deal out of nothing.  The cardiologist I saw said I was totally normal but I sure don't feel normal.
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[dave1726]

  Well, I know so much about hearts because I have the same thing you have (benign PVC's and PAC's) and like you I couldn't accept the answers so I did tons and tons of my own research back when I was getting my extensive testing done. I had to scientifically prove to myself that I did not have a myriad of different malignant conditions by reading endless medical journals and research articles about each concept. I now realize that what I sometimes feel is benign, and I sometimes come on websites like this in my spare time and try to help put other people's minds at ease by providing little tid bits of all the information I have accumulated, because for me it was scientific, medically based facts and research that did the trick and I wish someone could have just been there to answer all my questions as I had them. I try to make things easier for people who share the anxieties I have had at various points.  
     If you had an EP study and they couldn't find the spot of your PVC's and PAC's then it's probably just an autotomic issue. You see when you have adrenaline build up in the heart, but then a low heart rate working against it the imbalance of adrenaline vs. vagal tone (the vagus nerve brings down your HR) it leads to palpitations. This is why after a stressful day or a hard workout people often say they get palpitations at night while trying to relax or go to sleep. The left over adrenaline has the heart all amped up and those "back-up generator spots" might fire because they are like, woa I don't want the heart to be moving this slow, I have so much adrenaline over me right now, so they fire a PVC or something.
      Your ultrasound is an echo, the dye ultrasound is a stress echo, and you had all the EKG's and such. You have literally had almost every non-invasive heart test known to man, and one invasive one (the EP study).
       The sinus node thing, might have been a reference to "sick sinus syndrome" not "slick." This isn't a bad thing neccessarily. Sick sinus syndrome means the heart goes from slow to fast quite often and suddenly, especially with breathing in and out. True sick sinus syndrome is an old people problem, but sinus arrhythmia, which is probably what he was referring to, just means the heart rate is much higher when breathing in than when breathing out. The difference becomes less and less with aging, which means you'd have a lower "heart rate variability." But you have not lost this yet, which is very good. It's healthier to have a high heart rate variability. People with heart disease often have very flat heart rates over 24 hours, meaning the HR doesn't change much at all throughout the day no matter what they do. You seem to be the complete opposite. You probably have one of the healthiest hearts going. Most people never find out this much about their hearts but since you had the PVC's and such you took all these tests and found this out, so you can take with you the peace of mind that you have a very healthy heart.

[dave1726]

  Okay, first of all, it's important that you actually know that what you have are PVC's and PAC's. When you say you were told this is what you have I assume that means you were given a Holter monitor or Event Monitor and this is what they caught. If that is the case then at least we know what it is. If your doctor is just guessing though it would be a good idea to ask for the monitor if you have insurance because it will tell you what exactly you are having when you experience the arrhythmia sensations.
     Also, when you say you have been told your heart is normal, I assume this is because they did an echo and an EKG (and possibly other less essential tests like a stress test or cardiac MRI). Assuming you have actually had an echo and an EKG and a cardiologist said they were normal, then we truly know your heart is structurally and electrically okay.
      If all this is true, then what you are experiencing is truly benign. Here is why you feel what you feel. A PVC or PAC is when a spot in either the atriums or ventricles of the heart decides to fire off a beat prior to when it should happen. Normally the SA node in your right atrium is the natural pacemaker, but any spot in the heart can take over for the SA node just in case it goes bad. Think of it like an extensive back-up generator system. It's a good thing. However, if one of the back-up generators gets antsy it will fire off a beat before it should happen. If the antsy spot was in one of the ventricles it is a PVC and if it was in the atriums it's a PAC. One is not worse than the other. They just are what they are.
      In terms of what you feel, it's actually the beat after a PVC or PAC that people feel. You see, let's say you are sitting at 70BPM. Then all of a sudden a premature beat fires off halfway before it should. Well, this beat (the PVC or PAC) arriving 50% too soon means that the next normal beat will come 150% of the time from when each new beat normally comes. The extra time after a PVC or PAC when there is no heart beat is the pause you feel, and the hard, knock your wind out beat you feel is the next normal beat after that abnormally long pause. The reason this beat feels so hard is that it had extra time fill up with more blood. You still pump out the same percentage of end diastolic blood volume with each beat, so if you normally fill up with say 130mL, and eject out 60% of it you are used to having a "stoke volume" of 78mL. Then suddenly your heart gets 50% longer to fill up after a PVC or PAC, and it fills with 195mL, with 60% of that being 117mL. Obviously a beat that pumps out 117mL will feel more forceful than the one that pumps out 78mL. It's all relative. During exercise you pump out a far greater percentage with each beat, but it's consistent so it doesn't feel weird. After a PVC or PAC at rest it feels like a big hard shock, because you go from pumping out "X" to pumping out nearly 2X's X in one beat. This phenomenon is sometimes referred to as the Frank-Sterling law of the heart.
      Overall, assuming you have had the proper tests to rule out structural heart disease and electrical issues, this is a benign phenomenon. Taking certain  supplements helps some people, while for others avoiding certain stress triggers can help. For some people they never do find out what causes them, but you can rest assured that it is 99.99% likely that you have a completely benign condition and are going to be just fine. Even long sustained runs of VT (ventricular tachycardia) are normally benign when the heart is otherwise healthy. Palpitations are only a bad sign when there is an underlying heart disease.
      I hope this helps. Feel free to ask people on here more questions.

[Eric2002]

I may be unique but my PAC/PVC issues seeem to have been corrected by a Calcium supplement. I found that out on my own after more than a year since first noticed. In hindsight, being lactose intolerant I should have been taking a supplement. Instead, I scared myself for a year and tried a number of incorrect things - coffee helped but magnesium didnt. Its been a month with no problem since I started taking 1000mg of calcium every three days and it hasn't happened once. I am sure there are many possible reasons for these, but I thought I would share the simple thing that is working for me.

[svendiddie]

Growing up I thought I had a heart flutter. In the last few months it started happening daily, sometimes all day long. Went to the ER and they ran every test in the book and told me that I have PACs and PVCs. They could find no reason for this condition. I followed up with my Dr. and still no explanation. I am 47, I have no health concerns, take no medications, and eat no processed foods. My Dr. said she wished all her patients were as healthy but this still scares the bejebbers out of me sometimes! I am sorry for everyone with this issue.....but it is sure nice to know I'm not alone.

[Marianna1952]

I just went through a similar experience for 2 days straight. This experience was awful and scared the poop out of me.  I went to my cardiologist and he gave me a halter monitor for 48 hours The result of the test said I had normal sinus rhythm but experienced PVC's and PAC's.  I went to my chiropractor for a regular office visit and told him what was going on and he gave me a packet of a magnesium supplement and within 10 minutes of taking this the palpitations stopped completely!!!!.  I read up on magnesium and it's becoming a very important supplement for heart issues, ESPECIALLY heart rhythm disorders.

[Fcsilver]

I have had PACs and PVCs throughout my lifetime. Mine are directly related to hypo magnesiuma. I can usually stop them with magnesium supplementation.

[scardicat]

This is March, and in August of last year I went into hospital for irregular beats and fear.  It was awful, lasted about two/three weeks almost hourly, well, after seven days and every test they could think up, including a cardiac cath= I was told I would have to learn to live with it.  I do take meds for it, went for almost seven months with no recurrence , and as of yesterday they started up again.  Still scares daylights out of me, and I keep thinking it might be the real thing this time.  But am trying to keep positive and believe that its the same old benign thing and nerves making it seem worse than it really is.  I wonder what I could do to prevent it from happening again.

[heartfluttersflyawayplz]

hey, I get them like that to . no worries it will not kill you , its jus extra beats an it will go back to normal

[Diana1950]

I understand all of what is being said but my concern is when the PVCs or PACs come in a bunch and I get scared that my heart will not go back to a normal rythym.  I get a little light headed.  I make myself cough to stop it but am afraid it will happen when I am sleeping and I won't know it so I won't cough and my heart may not start beating normally.  Any feedback from anyone?

[ljanesyoung]

Dave1726-  Thank you for your detailed comment at the beginning of this thread.  I have never had what is going on inside of me explained so clearly.  What I am feeling now completely makes sense.  I even had my husband read your comment to help him understand what I am feeling.  Thanks for all of your research-- it is very much appreciated by people who are looking for answers!

[Aliciaporter]

I have been going threw this for years and did all tests and dr says I fine......?? Wish I had answers I usually get it couple times a week, but yesterday I got it all day. It's so scary I want answers someone help, where I live there must not be any good dr.s who even care anymore

[blake093]

Bentley this problem you are describing every single word in ur post is exactly what I am going through I go to the ER at least once a month because sometimes the skips get so bad that my heart rate jumps to 150 BPM and I still get the PVCs and PACs with a fast heart rate .. I get then even while exercizing and I feel every single heartbeat in my chest weather it is q normal beat or not I hear my heart beat too I can't fall asleep at night without t.v. or music on I usually take xanax to get me to sleep.. I've been to the cardiologist and told they were benign and it was normal for me but it certainly doesn't feel normal and never will.. just the other day I called an ambulance because my resting heart rate was 170 and I was having PVCs and PACs  its good to know I'm not alone out there as I'm typing this I'm even feeling very hard PVC beats

[kjandme]

Hi.I have had PVCS and PACS for almost 11 years now and im still not use to them. My doctor has said im fine but i still get scared when they happen. They started when i got pregnant with my last baby. I developed cardiomyathpy but my heart has came back to normal Thank the Lord.I askedhim why i still have them and he said my weight and my sleepapenea.I am trying to loose weight but im so scared of these things causing more issues.Do you have any advice for me..Thanks Patty

[Otto1950]

I'm a retired research physicist and have spent a similar amount of time and effort in attempting to understand the heart's electrics. My particular problem was Atrial Fibrillation, which was proved to be cause by premature electrical signals emanating from the pulmonary veins from the lungs into the heart.

This was knocked on the head 18 months ago with a catheter cryo-ablation which works by interrupting the electrical path so that the signals just don't get through any more. Whilst in there they performed an angiogram, and discovered some early signs of CAD which have now been stented - some 5-10 years before they'd have caused trouble (apparently).

My reason for posting is that since coming off statins due to myalgia, PVCs and PACs have re-appeared. To my astonishment, I find that a 10mg daily dose of Pravachol banishes them completely.

Any thoughts as to why ?

[ailyn29]

im goin crazy with all theses pvc pac today i starting having then that i got so scare my heart was racing crazy an making pauses help:( that i call 911 when they came my heart rate was fast and i was having a lot of pvc pac my blood pressure was normal . they did a ekg show etopic beat but they wsnt concern my pottasium was normal they send me home i feel they didnt care:(

[bentley1961]

Wow this is great you know so much!!!!  I don't think for sure I have WPW.  I'm sure they would have picked on something like that.  They just said everything looks good and don't sweat it about the irregular beats.  Well too late!  I totally sweat it.  I just sit waiting for the next one to hit me.  I know that is so crazy but they scare me so much that that is all I think about.  I just read these things that say everyone has PAC's and PVC's during the day but I don't know one person who has them.  I ask all sorts of people and they look at me like I am crazy and say don't feel a thing.  I think if they actually had these huge thumps etc that I have that they would feel them.  I don't think a person can actually be that tuned out!

[tom_h]

Dave, I had AVRT with extremely high rates, 300+ as a kid.  As an adult, I would peak out at around 260 if I went into SVT during (what I would consider to be) extreme physical output levels.  However, my PR interval was never questioned, so I assume that it was within acceptable limits.  After ablation it was measured at 142ms.

[dave1726]

  The condition being referred to is WPW. If you have a copy of your EKG's I would look to see a number called the PR interval. If it is below 120ms this could be a case of WPW (Wolf Parkinson White Syndrome). This is where the AV node receives the signal from the SA node too quickly. It's known as a "pre-excitation" syndrome because it happens before ventricular depolarization normally occurs. This is a generally benign condition but should be treated with an ablation (which is highly effective), because in very rare circumstances it can create some problems. This might be what he meant by "slick." However, if it was a reference to the SA node and not the AV node this was probably not the case. I don't think this is what you have because your EP would have told you such, as it's pretty easily identifiable. But it's very treatable and may be the cause of your palpitations. One of my coaches actually had this and had an ablation for it and never had palpitations again. His HR used to get up to 250BPM during his boubts of tachycardia which is why they made him do the ablation. I really doubt this is what is happening with you. Please do not worry. Lots of us have premature beats, it will not hurt you.

[bentley1961]

YIKES!!!!  I didn't know that!  I thought it meant it was a good thing!  

[tom_h]

As you may already know, the term "slick sinus node" describes a atrioventricular condition that is characterized by a shorter-than-normal conduction delay in the AV node. This allows the electrical impulses to travel on to the ventricles before the atria have fully contracted.

[bentley1961]

Wow did you two ever put my mind at ease!

I know for the the EP doctor said that I have a "slick sinus node".  I actually asked him if he meant "sick" and he said no.  He said my heart was completely healthy and it was a "great" sinus node (I guess as far as great sinus nodes get).  

I feel so much better after reading both of your posts!

[updownleftright]

If you've had your heart checked by a cardiologists than you don't need to give these "sensations" you're experiencing a second thought. PVC's or PAC's are both very very common and will not harm you. They might pose a threat to individuals with heart disease ,cardiomyopathy, or brugada syndrome, but in healthy individuals they are of no concern at all. They feel strange, and different from time to time, but you'll be fine.

[bentley1961]

I keep on thinking of other things now that you mention them.  I have had a dye stress test (I think it was called that), an ultrasound, tons of ECG's and I even went for an EP study years ago because of my insistance that something was wrong.  They couldn't find one thing!!!!!  I just remember the EP doc saying I had a slick sinus node.  He said it was the sinus node of a 20 year old and I was 40 so that was all good!  I just don't understand why I get these and feel them SO much!!!!

[bentley1961]

Hey Dave....yes I have had a TON of testing but I guess I just don't believe them!  I find it hard to believe that when my heart is skipping around like crazy that it is normal.  I don't know anyone else that feels their heart doing strange things!

How do you know so much about hearts?  You seem very knowledgeable.