When to worry about PACs/PVCs?

[is_something_wrong]

Hello :-)

I've been experiencing a flare-up in my ectopics recently.

My heart is healthy (I had an EKG and an echo done two months ago when my ectopics started to bother me again). I don't know if what I'm experiencing now is PACs or PVCs (none were found on my EKG) but earlier I had only PACs. I would assume that most of my ectopics are PACs.

I know that stress and anxiety is a major trigger, and what often happens is that I'm having one ectopic, I'm trying not to worry about it, then I have another one and I get a major rush of adrenaline, which makes the ectopics go wild and I'm having 5-15 a minute for a while (15-20 minutes) and suddenly they just go away.

The sensation is quite variable from event to event, sometimes I get the throat fullness sensation followed by a thump, sometimes it feels like my heart stops and then a thump, sometimes I just feel some fluttering in my chest for a second or two. I'm worrying about the latter as I fear it's a run of ectopics.

The problem is, I KNOW that premature beats are benign but still I can't stop worrying. It's like a fear of fear, because I fear that the ectopics will ruin my life.

I'm taking 100 mg Metoprolol (and some Propranolol as needed) and it takes the edge off my ectopics, but it's not a cure. Also, I'm on Zoloft for my anxiety.

Test results:
EKG: Normal sinus rhythm, 64/min, normal.
Echo: All normal.
BP: 115/75 at doctor's office.

At what point should I worry about ectopics (how many)? Is it common to have a fluttering sensation even with a single PAC or PVC? Is it normal to get those flare-ups where you feel ectopics several times a minute?

[JosephCacciatore]

I suffered PACs and PVCs for about 3 years about a couple of years ago. I quit smoking and cut back on drinking and stop caffeine but I was still having any where between 5000 to 10000 episodes a day. All my electrolytes checked normal my heart was fine according to all the cardiologist tests. I started to take magnesium supplement and with in a few weeks they were completely gone. I took magnesium with calcium with a 2:1 calcium to magnesium ratio along with vitamin D. The amount that I took was 800 mg or calcium and 400 mg or magnesium and 400 ius of vitiman D. This got rid of them and I still talk this supplement every day. I have few here and there maybe less then 10 episodes and most days none. Even if your blood results check normal for magnesium it doesn't mean it's not low. Because magnesium is mostly stored in the muscle and skeletal tissue and in the heart. Try it out I am telling you this worked for me and was about to go have an ablation done because I was so tired of having PACs and PVCs. If it works for you, please share this to other sufferers.

[RubyWitch]

Hi everyone. New to this community and am desperately seeking some reassurance.
I am 63 and have had what I use to call, and what my doctors called, "palpitations" since I was a teenager.They were very infrequent, never more than a few flutters, then they'd go away, often for months. I described them to my doctors as feeling like my heart did a quick flip-flop. I never got used to them and they always scared me to death. I have panic disorder, so I'm sure I don't need to tell anyone here that does NOT help the situation at all. Fast forward MANY years to last November and I began to have them more frequently and they would last longer. I began to feel my pulse while they were happening, which I never did before because they would always stop before I even thought to check my pulse. Feeling my heart "skipping" beats in a really erratic rhythm terrified me and I'd end up having a panic attack on top of the PVC's.........it wasn't.......and isn't fun.
I did some research on the net about PVC's (I know, I know.....bad idea, but I went to reputable sites.....The Cleveland Clinic and Johns Hopkins only) and was quite reassured that PVC's were benign and harmless.....UNLESS YOU HAD UNDERLYING HEART DISEASE. Well, guess what? I have CAD (coronary artery disease) and have two cardiac stents due, obviously, to plaque build-up. I have hyperlipidemia, which means my body produces way too much cholesterol, and that was the main culprit as I eat a very low cholesterol diet and take a statin, but I've had the HL my whole life, so add 2 + 2. I did NOT have a heart attack, thank God, as the problem was discovered in time. So, while I am packing around some space junk in my heart, my heart is essentially sound. My cholesterol readings are excellent. But, I am still left with the "underlying heart disease" label, and THAT is what scares the daylights out of me when I have an episode of PVC's. My cardiologist has tried numerous times to reassure me, but with the panic, I just can't seem to not freak out. After reading that itdood has had as many as 6K in a 24 hour period, I feel very foolish to tell you that while I don't know the exact numbers, the longest episode (I guess they are called "runs?") has only been about 2 hours. And that has only happened twice. All my other "runs" have lasted maybe 10-15 minutes. Then I may not have any for weeks, possibly months. (Although I DO occasionally feel a "fish flop") If I had 6k, I honestly believe I'd go insane! I don't know how you live with that many.
One of the things about these PVC's that I don't understand is WHEN they happen. I can be working my butt off in the yard, or stressing about life and I don't have a single "flop." Then I sit down and eat dinner and later, while I'm relaxing reading a book or watching TV, THEN they start! Virtually ALL my episodes/runs have happened at night when I'm relaxed and not feeling anxious at all. What's up with THAT? My cardio has told me I'm probably just not aware of them during the day, but I am SO "heart phobic," I honestly don't believe there is any way I wouldn't be aware of my heart going wacky. I see you guys talking about "R on T ectopics" and I don't have a clue what you're talking about. Or the "long QT." I see my cardio for regular check ups and he always does an ECG or is it an EKG? They are always normal. I recently had surgery for an abdominal aortic aneurysm and they had me hooked up to a heart monitor as well as doing EKG/ECG's (?) every day. I'm assuming they all must have been fine because nobody said anything to me. (And now I have a THIRD stent!) I have a note to get through airport security! LOL
I am really, really sorry about the length and rant style of writing this. I just have so many questions and fears and know so little about what the hell is going on. I keep trying to reassure myself that if anything was really wrong my cardiologist would be doing something, but he certainly seems unconcerned.........so I try to be unconcerned too, but it's not working!
I live in fear of these things happening, just like I used to live in fear of having a panic attack until I got on the right meds for those. I do take BP meds........atenolol and amlodipine. My cardio did say I could take 1/2 of an amlodipine if the PVC's lasted more than 2 hours, but he also said the reason he told me that was because they scared me, not because 2 hours meant anything dangerous. He told me I could also do some fairly rigorous exercise and that will often stop the run. There have been a few nights when you'll find me outside at 1 am race walking around the house with my flashlight and my dog wondering what the hell I'm doing. Sometimes doing something physical DOES make them stop, other times they'll stop, but return when I relax.
Again, I apologize for such a long winded and disjointed post. I obviously need some advice and I hope one of you can pick through all of this and toss me a bone...........I'd be ever so grateful.
Thanks so much
      
  

[branjie]

Your test results are reassuring. You've probably already looked into this but have you found that there are things like coffee, alcohol, smoking, hormones, being unwell with a cold etc. which might be increasing your episodes?

[is_something_wrong]

Thank you.

Yes, I would assume that (irrational) anxiety is the root of my ectopics. For some reason I worry about R on T ectopics, even though I know that even R on T is not dangerous without a heart attack or long QT.

[itdood]

During my worst episode I was getting about 6k PVCs per 24 hours.  You could see my chest move.  I remember getting a PVC storm while going to see the cardiologist, i will never forget the looks on technicians' faces.  They went completely silent and ran out to get the doc.  I scared the staff!

Yea man, it was a bad period.  Things settle down, then flare up, then settle down.  I can't put a reason towards it.  Hang in there, things constantly change.

[MichelleP_3811]

My EP told me there is generally only a concern once the number reaches 20,000 a day though they would treat with beta blockers if they were making me feel ill.  I decided not to want to deal with the meds.  I would say if you are having trouble breathing, having severe chest pain or passing out, basically having difficulty functioning, those are good reasons to become concerned but if your heart is otherwise healthy then they are more a distraction than anything else.  The idea being to try and not let the distraction cause your mind to race.  Do whatever you can to get your mind off of what is going on and you will feel better, less stressed and likely will have less ectopics.  I would also evaluate how your stomach is doing.  I seem to get them a lot more the more acid reflux I am having or if I eat large meals.  I wish you much strength to get past this recent bout and the anxiety it is causing you .  Take care and feel better soon.

[achillea]

Isn't it dreadful to have a flareup of ectopics?  It just drives a person nuts.

Everything I've read indicates that most cardiologists think that anything under 10,000 ectopics per day is not worth worrying about, when the heart is structurally normal.  

As I recall, one poster here some time ago wrote that she did get some left ventricular enlargement after years and years and years with a similar number of ectopics.  But since your latest outbreak is recent, and you heart was checked out only two months ago, you probably don't have to worry about that.

For people who feel their ectopics--and I am one of them--I think it is normal to feel them rather intensely, and to have several a minute when the adrenaline really kicks in.

Like you, I am taking Zoloft, and it works well for me.  Apparently it helps you a little, but there is a rule about medication that includes this:  If it's not working, it's the wrong drug or the wrong dose of the right drug.

In your situation, I'd return to the shrink (you have talked with a shrink?) who prescribed Zoloft and talk this over.  It's possible you need a different med, because one size does not fit all, as you know.  Also, if you haven't tried it, I understand that with anxiety, a therapeutic approach that *combines* medication with cognitive-behavioral therapy is the most effective of all.

[heartfluttersflyawayplz]

hey , sorry your having a flare up, i to have pac, they have been on monitors every time , very little pvc

mine always feel like flutters and they can come at any time, they can last for 24 hours straight with every other beat a flutter , many in a row , yes very scary but harmless

i would not worry about them even when they are 20 thousand a day all they do is try to burn the lead, but even at that many they are not going kill you,

its very scary as i woke up to beat,beat,beat,beat and it would keep going but i cough and it went back to normal. I've had nothing since, so hate waking up like that

mine don't seem to come with anxiety , because i have it and no flutters, they just come out of blue when they feel like it, and they go away for months at a time sometimes 6 months so who knows

i to just had a echo, stress test because of them and a few chest pains they say alls good so we will see lol, got to believe your dr or you will forever be running from dr to dt

hope you have a better day and try not to worry, you just had good test results and have had these before so do as i do just keep pushing forward and they will go away at some point