PVCs during "recovery" phase of exercise--when does "recovery" start?

[JamesAA]

I can get PVCs at rest.  But during my 30 second, hard sprints I will often (but not always) get them immediately after stopping---I'll throw 2, 3 or 4 (not consecutive but like every other or every third beat).  My HR is still very high, and after a few seconds, when my HR begins to slow down, the PVCs go away.   Interestingly enough the HR actually still climbs or maintains a high rate in those couple seconds after stopping the run.  

So I'm confused.  Are these happening during my "recovery" phase or "exercise" phase?

Again, they usually do not occur while I'm running, but only immediately after stopping.  But then they go away after a few seconds, when the HR comes back down.  And even this pattern isn't the way it always is.  I can do 10 of these sprints and not throw one PVC.  

[lgrass94]

if this post is still watched then i cannot believe how similar you guys are to me! WOW, ive found someone with the same questions as me.

i have exactly the same!

i will train heavy weights 4 or 5 times a week and perhaps get the odd one due to the postition of the movement of weight lift.

then i start abruptly skipping for say 10 or 12 minutes, and when i drop the rope, maybe 20 or 30 seconds later i get a funny out of place rhythm that makes me a little breathless. If i was asked to explain the feeling i would say pvc's in a row or run, for around 7 or 8 seconds, and if i cough or bend down i could bet my life it would correct itself. instead i get very anxious and my heart rate increases a little before cooling down and the sensations gone!

what is this? is this dangerous? does this bare the hallmarks of NSVT or ARVD?

[jzinckgra]

I cycle a fair at high intensity and get pvcs and more recently pacs. Interestingly, most of my pvcs up until recently were during rest (laying on the couch, falling asleep) and harly ever during excersice. Now the trend seems reversed where I get them more on on my rides, usually with HR's above 140. On an 90min ride this past week I counted 5-6 pacs and other rides about the same number of pvcs.

I had 2 stress tests within the last 3yrs and passed without issue. Max HR 181. One pvc noted after stopping. I also, get the occasional pvc after immediatly stopping intense exercise. I've had event monitors and have captured some of these events on my bike and at rest and was told nothing to worry about. Howver, the recent pacs while cycling have me thinking about requesting a 24 or 48hr holter. I'd really like have my cardiologist see all the events at intense exercise. It *****, cause I can go about a year or so with these, then start feeling something new may be evolving and feel the need to go back to doc for reassurance.

[Sagitarius88]

My recovery skipped beats mostly happens after if I done something needed more energy from my body hmm for example if I'm constipated and sitting in toilet and straining my skipped beats start after a row of fast heart beat that really makes me worries because i want one more child and during labour u have to push very hard if after every push my heart will behave like this will I survive?
I have done a electrocardiogram back in 2012 do I need another one?
My skipped beats always feels different at different times
I'm seeing a electro physician soon so I hope he have answers for me

[pvctom]

i had a an E.P. study done in '98 due to a positive test for late potentials - this concerned the EP, so I was scheduled to have it done. The E.P. study proved negative... I still get many pvcs, and sometimes they are very bothersome, but I have to remember what the Cardiologists have always said, they are benign. I really like what everyone has said, and always learn something from this forum.

[JamesAA]

Guys, read this, re: recovery PVCs.  This may ease some of your fears.  I pulled this off a cardiologists website.  It seems that the recovery PVCs are ONLY worrisome in the presence of already detected CAD.  Here's his quote:

In that study, published in 2008, recovery PVCs were related to coronary artery disease (CAD) and evidence of cardiac ischemia (insufficient blood supply). If your heart has checked out OK, you are not at risk.
"... everyone with recovery pvcs has, or is at risk for heart disease..." thus only applies to patients with coronary artery disease who have recovery PVCs, not the other way around (PVCs do not mean you have CAD). Other than that, anyone with new PVCs or other arrhythmias should be checked out for a host of potential other problems and thus may require extensive testing

[hefner33]

Well said Artaud.

I think a Dr your confident in and can show that goes a lonnng way

[Artaud]

That's the problem with the internet, too much info, too little understanding (and I don't profess to understand, but mine is from experience).

I have gone to the National Institutes of Health and found studies, published just as prestigiously, that have findings that are 180 degrees apart, literally coming to opposite conclusions.

I have always had tons of PVCs after a stress test, but none during. Every cardiologist I have ever had claimed that there is no problem with the PVCs as your heart slows down. If you're still hooked to the EKG and they observe the PVCs occurring, I would imagine if the occurrence of the PVCs signified ischemia that changes on the EKG would be noted and addressed.

One of the sites where I read the article addressed above, a commenter suggested that there may be a differentiation between people that are plagued by PVCs before the test vs people that have no history of PVCs before the test, that don't experience them during, but do during the recovery phase. Based on my own experience with Stress Tests and recovery phase PVCs, and the doctor's complete disinterest in them, I believe there is a difference between PVC afflicted people vs people that are free of PVCs before the test. I get them just waiting for the test to start because I'm nervous.

Likely, the stress of the test releases Adrenaline and other Catecholomines and those of us with an irritable focus or foci experience exacerbation of same as the heart's natural pacemaker no longer fires faster than the irritable cells.

Those of us that believe we consult competent doctors can leave those concerns to them.

[hefner33]

Hey. Sorry I didnt mean to scare with link. They do use a quite scary title. But the more I read these paticular studies the more I come to the conclusion these individuals had underlying heart conditions which if you wrre tested is what your dr rules out.

What your describing is what they call positional pvcs or pacs. For ex I can be laying on the couch and jump up off and get a few.

[tom_h]

If you're referring to positional related skips,or PVC's, this is a well documented phenomonon and in most cases in benign.  I don't practice yoga, but unless you get your heart rate really crankin' at a rate seen when you're flat out running, I think you're experiencing something that all of us feel occasionally.  
Check this thread in Medhelp.....  http://www.medhelp.org/posts/Heart-Rhythm/Positional-Causes-to-Abnormal-Beats/show/2209608

[Sagitarius88]

This post is really scaring me a lot
I m having same symptoms when I do certain postures of yoga my skipped beats occurs or when I do a class of body balance i really don't understand what is wrong i really think I m gonna die one day with this problem
I have saved the linked Hefner shared so I show to my electro physician when I see him this time

[hefner33]

Thanks Tom

"Whereas exercise PVCs were related to the heart rate increase with exercise, recovery PVCs were related to coronary disease (previous myocardial infarction, coronary revascularization procedure, or pathological Q waves on resting electrocardiogram) and ST-segment depression."

So I'm assuming that all the ones that had recovery PVCs had one of the coronary diseases listed? So I'm assuming if you have them and dont have the listed that you cause is something other than coronary disease.

It does state "We studied 1847 heart failure–free patients" but you would think they would take in the fact that they had other underlying heart problems or maybe I'm interpereting it wrong

[tom_h]

I believe the original article written by Dr Frederick E Dewey  is available in the January 28, 2008 issue of the Archives of Internal Medicine. Google this info, and you'll find it.  The PDF is a free download.  There's a lot of physician-speak in the article, but you'll get the gist of it.

[hefner33]

Also I think they mention that the use of "frequent" was having 6 or more per min so im assuming 18+ per 3 mins. Im almost assuming they are talking only pvcs and not pacs which pacs are supposedly more common with exercise

[hefner33]

Heres the article I read

http://www.nejm.org/doi/full/10.1056/NEJMoa022353#results

Yeah its all confusing to me as well. For a while exercise was a relief of my premature beats so I would go run to get a days relief from them. The started getting them during and then after I stop. They dont seem to get worse but they are basically how they were before I started exercising. Ive never had these caught on a stress test though

[JamesAA]

So I wonder what category I'm in??  Most moderate to medium exercises will not cause me to throw any PVCs after I stop.  But sometimes (about 50% of the time) I will throw a few RIGHT after I stop abruptly during a high intensity drill (sprints, etc), but only in the first 5-7 seconds.  Basically none after 10 seconds.  

In other words only 50% of the time, when the exercise is intense, and only in the first 5-7 seconds.  I wonder if they would categorize that as "recovery PVCs".  

[hefner33]

I read this report too and if I remember correctly from reading the study side notes, the recovery period was the first 3mins after stopping exercise. They also mentioned they allowed certain %s to cool down and others had to abruptly just stop

[JamesAA]

Thanks Tom.  I read that one too, just last night as a matter of fact.  I further read a cardiologist talking about that specific mortality being higher for people with already known heart disease.  I wish I bookmarked it.  

But I'm a little fuzzy as to what is "recovery".  For instance my PVCs will often happen the second I stop sprinting REALLY hard, while my HR is still high and sometimes it even gets a beat or 2 higher in the few seconds immediately after I stop running.  After 10 seconds the PVCs typically totally dissipate.  So I'm not sure if these studies mean the several minutes after working out as "recovery"---cause if that's the case I get next to no PVCs in that time.  It's only immediately after a VERY HARD run.  Simple mild or even moderate exertion will not do it.  I need to get my HR up there for this pattern to occur.  

[tom_h]

James, there is a study report, and I hasten to add ONE study report that indicated that recovery PVC's are associated with higher mortality rates than those that experience ventricular ectopics during exercise.

"..."Recovery premature ventricular complexes [PVCs] seem to be more significant than PVCs that occur during exercise testing. They seem to have some prognostic significance, so that there appears to be additional risk stratification provided by arrhythmias during recovery," he noted. In contrast, PVCs occurring solely during exercise have limited prognostic significance, he said......"

My post is certainly not to frighten you, but to make you aware of this study and that perhaps it's something you might want to mention to your cardiologist.