PVC couplets and triplets - freaking out!

[CMX2013]

I'm a 34 year old active female (not athlete, but exercise regularly and have for years). In August 2013 I started experiencing palpitations that would relate to exercise (particularly during exercise and recovery). I was investigated with echo, ecg, holter (231 PVCs, feel every single one), stress test and MRI. The MRI revealed mild dilation to both ventricles, but with perfect function. Nothing else worth noting. It was suspected I might have dilated cardiomyopathy and was referred to a cardiomyopathy / sports cardiology expert, one who is world famous at that so really someone who knows what they are talking about.

To my relief, his conclusion of my situation is that I absolutely do not have dilated cardiomyopathy or any (structural) heart disease. The heart function remains perfect, the LV dilation is minimal and the VO2 max results support the fact that this physiological adaptation to exercise. Wonderful news.

However, the PVCs continue, daily. They come every time with exercise, they also come at rest. I am now on some beta blockers as they cause me great anxiety. The dose is very low as I have a very low HR (low 40s), they have taken the edge off, but the sensations have not disappeared.

I can sort of live with the bumps and thumps, but what is absolutely freaking me out is that I'm pretty sure I am also experiencing couplets and triplets. I am so worried this means that the situation is getting worse. The cardiologist didn't seem particularly worried about this, but I am. Can something like this genuinely be normal and part of the parcel of suffering with these things?

[heartfluttersflyawayplz]

Hey went saw my Cardio dr, she did a EKG, said looks like it has for last 20 years so it was good, listen to heart said sounds good,

Told her about the 7 hour run of pacs every other heart beat said yup that's normal for them, says she hears a lot about them lasting that long, told me not worry they just pacs not going kill me,

Going try a new med it's the sister med to the one I've took for 30 years timilol, not sure the name will post when I get it I think it starts with a p lol

Says if I not like it I can go back to old meds, she said I don't need med for heart , just to make me feel better and not feel as many skips

So we see start new med sat,

Guess I should feel better that Alls good but still scared when they come, and pray not hours lol,  

Ask about a echo said just had one two years ago it was good, stress test sept last year was good, 6 hours of hospital monitoring heart it was good.

So guess she happy with all of that and feels for sure it's just the pacs cat using all them flutters, guess I should be very happy, but knowing they are coming back makes me scared

[heartfluttersflyawayplz]

Wow your very lucky you can't feel them , feel Blessed

[CMX2013]

It's so strange how we all feel different things. I get a few hundred PACs a day too but since I can't feel them I don't even think about them. Go figure!

[heartfluttersflyawayplz]

wow so far I don't have that I don't think lol, I feel everyone of my pacs , I do get the burn/sorta tight feeling is that what your talking about?  than I start thinking it might be a heart attack with my pacs but so far I am still alive .

do you get them everyday to or for hours at a time like  massive beats in a row , I get them every other beat its a flutter if I am really lucky they go to every  8th beat . getting ready go to my dr will come bACk tell ya what she says got lots questions for her

[emdoss]

I guess because mine have gradually increased over the years, and they've always seemed to be in a rhythm, that I am used to them. They are bothersome, but I've been dealing with them in a consistent-like rhythm for almost 9 years, so I just feel like it's the "normal" for me. I actually wasn't even having trouble with them, until about 8 months ago. I was extremely tired all the time, and I started having episodes where my heart rate would go bizerk and I would almost pass out.

I feel for you though.. it must be difficult to have the pacs just hit you all of a sudden. I guess in a way, I'm fortunate to have so many, as I don't have to deal with the anxiety of not knowing when they're going to strike. Good luck with your dr's appt!

[emdoss]

Well in my case, my PVC's are coming from the outside of my heart, so they weren't able to access the area through the standard ablation. With an epicardial ablation, rather than going into the heart via an artery, they make a small incision under your breast bone, and they use a needle to enter the sac surrounding your heart. They then guide the catheter in, and ablate the outside of your heart. This site best describes it in detail, if you're interested.

http://stanfordhospital.org/cardiovascularhealth/arrhythmia/treatments/ablation/epicardial-ablation.html

I get that same "squeezing" feeling that you're talking about. Wish I knew how to make that stop

[CMX2013]

I haven't heard of an epicardial ablation, what is done in that procedure? Hope it goes well, best of luck!

Does anyone else get their PVCs feeling like a "squeeze" in the middle of the chest? Typically when I'm for example walking that's what I get. A sense of a squeeze in the middle of my chest. It's so awful. How can I possibly ignore that?

[heartfluttersflyawayplz]

are yours like that everyday that ryhtem, it would make me nuts GOD BLESS YOU I could not live like that lol well I guess I would if I had to. mine come and go , but when they are here they like to visit for hours like 6`10 hours at a time than they go away and come back whenever they want to ruin my day lol.


mine are pac with every test that's what they tell me.
yeah they told me the med I am on does not get used to your body, it does a great job and I hate to change I have no side affects from this one and trying to get used to a new one is yuck lol but if it will stop them from staying with me  for hours on hours I might try if it wont than I will have to learn to live with them when they visit.

I can so far I have been very lucky not to live with them everyday all day, most the time they are few here and there  but nothing to worry over. so trying stop this before it gets out of hand and its a everyday thing, hope as I get older it does not get worse.?

[Liv_l_k]

Try magnesium taurate and do a full blood panel. The cause of mine was extremely low ferritin and iron

[emdoss]

I have pvc triplets, and have them constantly. My rhythm (without medicine) is somewhat like *normal beat* *normal beat*  *pvc**pvc**pvc*. I also get runs of tachycardia for no apparent reason. My beta blocker makes me very fatigued as well, but I have to say for the most part is controls the pvcs. I'm not sure if it's 100% true, but I've read that after a period of time, your body can become immune to the medicine, and the effectiveness of it can decrease. A new medicine may bring you some relief. It's worth bringing up to your doctor. Hopefully she will have some answers for you!

[heartfluttersflyawayplz]

hi, good luck on going to dr and prayers it works for you , I have not had caffeine in years, nothing not even choc that has it in it, am so careful about that but I still get them, I can be so stressed and not get a one, I can be so calm enjoying my life and I get hours of them, just lost with it,  I used to get them here and there , now I get them for hours and like everyother heart beat, so so scary . do you get them like that?

I take timolol but it does not stop the flutters just the fast racing heart.  its a very old drug, been on it for 30 years lol , maybe time to try another one, but when I do they make me very very tired . and takes my heart beat down in 40

going to my dr today at 2:45 see what she says no flips in last two days but they will be back, they hiding behind heart just waiting for me to be having a good day so they can jump out and ruin it lol

[emdoss]

I've noticed for me personally, that If have too much caffeine during the day, it will make my PVC's worse at night. Same goes with alcohol. If I have a few drinks at night, the next morning my heart is going crazy. Hope you find a way to manage your PVC's, I know it's so frustrating.

[emdoss]

I am currently on flecainide 50mg which helps with the constant runs of PVC's. I still have bursts of vtach, and the medicine starts to wear off a couple of hours before my next dose is due. But I don't want to up my dose- The side effects are no fun. I had an attempted ablation in November, which was unsuccessful. I'm going in 3 weeks for an epicardial ablation (outside of the heart). I'm praying it will work! It would be a wonderful thing to stop these PVC's for good!

[heartfluttersflyawayplz]

Hey I just had a terrible night with them, felt great all day, had sister over played cards just a fun day, went to bed Bam, many many of them every other Herat beat at times, so scary lasted for 7 hours, no sleep, help why do they come like this, so scared to

[CMX2013]

Oh wow, 50,000 is quite a few! Do you have a "management" plan, ie medication, planned ablation?

[emdoss]

They are benign, but they can be frightening. It seems like you've had all the necessary tests done, and from the way you speak of your cardiologist, you seem like you trust him. The best thing to do is to try to live your life. I've read that certain things can trigger the pvcs, such as stress or caffeine. See what works for you. I would make sure to follow up on them regularly with your cardiologist though. When I was 15 I was diagnosed with benign pvc's (12,000/day), my doc told me I had nothing to worry about and that I didn't need to followup with him again. 8 years later  I am having constant runs of triplets, over 50,000/day. It's such a high number that it's starting to lower my ejection fraction.  Not trying to scare you by any means, and it seems like right now your pvcs are, while a nuisance, manageable. But I would reccomend you followup in a year or two to make sure nothing has changed.

[CMX2013]

I'm having such a hard time believing this can be benign.  Can it really be so?? The PVCs feel absolutely horrible and often for me they feel like by chest is being squeezed. I am so sick of being scared all the time, but just can't stop.

[FLIPPINPATTY]

Yes, I started getting 12 a minute about a year and a half ago & that was freaking me out! I had been getting some for several years & I was taking a very low dose BB but that made my HR go into the 40's most of the time. Having a low HR gives more time for these extra beats to pop in. I see a cardiologist and EP doctor at Texas Heart. I was scheduled for ablation of unifocal pvc's, but he rx me verapamil er 120 X 2 and it has really helped. I still get them, but not like I was. The ablation is put off for now.

I have documented couplets and I believe triplets, which might be NSVT. In a structurally normal heart, these are benign. You've been checked out by a good cardiologist. Now you just have to trust him & get your anxiety level down. Anxiety only makes them worse. I know it's hard. I've been dealing with them for a long time. Sometimes I have to take a small dose of xanax or ativan when they get really bad.

[CMX2013]

Hey, thank you for your response. Sorry to hear you are also a fellow sufferer of these wretched things.

Do you also get couplets / triplets / other runs? If so, have your doctors determined they are also benign?

[Kennspinn]

Well the good news is your heart is structurally normal and working good. With that being said than the PVCs are benign but they are very hard to live with mentally. I have them 8 to 10 a min. almost all day and understand your frustration. It really is tough and I still have hard times with it. My doctor actually prescribed me to a ANTI Arrhythmic drug called Flecinide. This medicine is a high risk drug and most people would freak out if they read all the information on the internet about it but my doctor thought that it would be a good drug for me. This drug worked for me for 2 straight years with 0 extra beats and I felt like I had my life back. The drug eventually started to either ware off or my body started to get use to it where the PVCs came back. So of course they gave me more of it and they went away again but anytime I get on any kind of antibiotic or medicine for whatever the Flecinide seems to not work.

So the reason for the long story is there are medicines and procedures (ablation) that you could try if it is something you just cannot get your head around but those things have risks as well. This is something your doctor and you need to discuses.

I personally hate the things but I am learning to live with them and hopefully one day I will be able to ignore them. By the way I have seen three different doctors and they all say that they are benign. So there is really no one else to go to but God for these things. :) Wish you well