PVC - Premature Ventricular Contractions

Hi Teri, Thanks . Lets see back trouble? Try a right paracentral herniation at c5/c6 with pressure on the subarachnoid space & nerve &disc degeneration at L5/S1 and herniation& presure onthe left space& nerveso that takes care of both sides of pain i guess? I read some where that back trouble can cause stomach trouble sometimes I cant tell which one is hurting so badly. Hey if you want a giggle check out my adventure with red velvet cake on the GERD forum. I know that bloody stools are serious and I am not makeing light of that situation at all just my stupity i guess.Been eating salads & running to the bathroom. Untill Later Pat. I hope you understood my back trouble I dont (SMILE).

 Hi Teri, What I ment is that I dont understand all that medical talk for what is wrong with my back All I know is that all the surgeons say is OR now.   I have been putting it off for at least 5 yrs.I dont want to go to the O.R. I guess I am waiting for something else to be invented Ive stopped takeing my mortrin for pain because of my stomach I only take 1 tyanol(SP) a day now .I know you have a bad back? Is there anything new instead of O.R.? I feel sorry for you ! Well as someone said before me I hope everyone has a safe and painfree or close to it week ahead   Pat

PS I take Neurontin for migraines and seizure activity, but it helps with nerve pain as well. Ask your Dr. about this? :)

This is for TheDWP: I'm so glad you brought this up! See, while PVCs are generally not felt to be medically important, you and a lot of the rest of us know the flip side of that: that they can make you almost nuts sometimes. OK, so what do we do about it when that happens? First we try de-stressing and removing offending substances (til we can't move in the morning for lack of a jolt of caffeine for instance). When none of that affords the relief we need, the single most safe and effective Next Thing is taking a beta blocker - like metaprolol. Hopefully you're using a controlled-release version like Toprol XL (or its generic, which is "metaprolol" with some initials after it). The "regular" version is supposed to last 12 hours but it doesn't. Trust me on this. And although there are quite a few beta blockers to choose from (Inderal, Sectral, Atenolol, etc.), the reason for that is that some work better in some folks and others work better for others. Also, there is the asthma issue, which is why, unllike Inderal (propranolol is the generic) most of the ones prescribed now are Beta II selective which, short story, means they are less likely to case constriction of the bronchial tree and so less likely to aggravate asthma in those who have that to take into consideration.

I recently had the pleasure of illustrating to my highly esteemed (I'm serious! He's even got a phD) cardio guy just how effective metaprolol (as Toprol XL in my case) can be. I showed up for a scheduled routine nuc scan/stress test following the usual protocol, which is "stop the beta blocker 24 hours prior to the test." I've given up trying to simply tell these guys they're wrong to do that, so I hadda just show him. I came in (I already have Right Bundle Branch Block, so the EKG part alone is pretty much useless, thus the nuc scan with it) and my heart was going nuts. We couldn't even DO the stress test! I told him that if we did it the next day, with the beta blocker in me, it would all work fine. He, being a sport, agreed, so we did that. Next day I came in - ZERO PVCs and the RBBB was even gone! The test was a snap that way, and I was able to reach my theoretical maximum heart rate, which is why they tell you not to take the beta blocker first anyway - because it slows one's heart rate. BUT....metaprolol, in most people, will allow what's known as "the training effect" - the increase in heart rate during exercise, while slowing down the resting rate nicely. Since exercise often wipes out resting PVCs (and vice versa - no way this won't drive a person nuts), it all works optimally. It is very effective (not 100 per cent, but often very close to it) at managing the ectopy (PVCs, PACs, PJCs, etc.), protects heart disease patients from possible heart attack to a great degree, and generally makes everyone feel better. My MD/phD was amazed. You learn something new every day. He'd never heard about that drug and the training effect stuff! You just can't absorb everything I guess. So anyway, no surprise that you got quick and effective suppression of your ectopy (there can be breakthrough, but overall it's much better ON it that off it, wouldn't you say?) and it doesn't mean a thing so far as "needing repairs" goes. It just blocks the beta receptors in your heart's nerve endings from picking up so much adrenaline, which keeps things running much more smoothly. It works, the newer ones like metaprolol have very few annoying side effects, and for the most part it quiets the irritable heart. That's all! Doesn't really mean anything, just gets your heart off your back. I'm very grateful to Toprol XL for giving me more quiet days than not. I was having some really annoying breakthrough the past couple weeks, but I finally traced it to an indescretion of mine: caffeine after 9:00 PM. Stopped doing that and all is quiet once again. Hope yours stays that way as well, and it's just something we have in our arsenal now that we didn't before. It's also, as I said earlier, a great help for those of us who have had an MI because it does other things, too, subtly, which help protect from repeat MIs and dangerous arrhythmias. Hope this answers the question for you and that you're enjoying the peace and quiet again. :)

AJ:

Thanks for he great reply...it's always nice to hear that stuff from someone who can explain them by example...it truly is amazing how fast it stopped them and I've never heard the training effect theory before, but now that you mention it...it makes sens...when I do excert myself by walking or running, I do get a nice rythum going....I was on Toprol XL for a long time but metoprol is soooooooooo much cheaper...and it seems to work for me...thanks again for your thoughts, maybe when my stress settles a little I can pull back off but it's nice to know I can get some relief....

For patsprnk: Yep, metaprolol, like most beta blockers, will slow your heart rate, although with common dosing there is a theoretical limit to how slow you will get. (My normal rate is in the low 60's - high 50's without it, and with it I run 50's to sometimes low 40's, but function OK). Anway, if that is a concern there still may be a beta blocker for you! It's called acebutelol (brand name Sectral) and it has ISA - Intrinsic Sympathomimetic Activity. That means it actually stimulates your heart to speed up a little, even as it's slowing it down, so the net result is much less slowing than with the other ones. It also was the very first one (and still may be the only one, I haven't checked in a long time) that was actually approved for suppression of PVCs! So that might just work for you. Worth asking about at any rate. It's been around since the 80's and has a fine track record, so there is that. I would avoid at almost any cost any of the dedicated antiarrhythmic drugs (I spent 16 years on one and it nearly killed me). Those have been found to cause more dangerous arrythmias in people who otherwise probably would have been fine. There are a few exceptions (as there are to everything) but beta blockers aren't dedicated anti-arrhythmics but, rather, utility players that have a lot of uses, and Sectral is the big exception that proves the rule. Hope this helps. 

AJ your information is great!  Its nice to have someone posting here with so much knowledge!  I know it is helpful to the others here.

 

Just a word of caution to you all with PVC's.  Be sure that your doctor diagnoses yours as benign.  Most of them are but not all, especially if there are other heart problems.  Hugs, Pat

One more for thedwp: if the generic metaprolol works for you, I will say no more! Results are what's important - along with prices, which can be outrageous, and you're right, the MSRP on Toprol XL is an outrage - but there's a lot of that going around right now. Politics is another of my interests and this is one area of politics - the Great Medication Price Conspiracy - where I am active and doing whatever I can to break the backs of the profiteers of human suffering. But that's another story....

Thanks AJ, I

dont want to think too loud my heart hasnt been acting up too badly for a few days and I dont want it to hear me But I ll save your advice untill later. I once took Procadimine(SPELLING) Wow what a horrible reaction I had to that drug.So now I am very scarry about heart meds Teri was fussing nicely at me about not takeing my Zocor everyday Keep up the good work   Later Pat.

Hi everyone, I've been following this "conversation" and just had a few questions. I have some type of "heart palpitations", which have never been picked up on a monitor, but seem to be PVC's from the description. Just a quick hard beat, out of nowhere, usually just one or two a day, sometimes five or so in an hour, but never a "run" of them. Have had all the tests, my stress test and EKG look great, Holter normal sinus rhythym, echo showed normal structure, dye ct of chest looked great, heart labs are good. My cardiologist discharged me, telling me I had no cardiac problem, once my anxiety lowered enough that my heart rate fell from 100-120 to 70's and mostly 80's. My pcp told me a few weeks ago that I had partial right bundle branch block, which he said is nothing to worry about. (yeah, sure... tell a panic attack sufferer that!!!) BUT.. since this is one EKG out of about twenty and this is the only time it's been mentioned to me... I sometimes wonder if I even have it. I have had "bad" ekg readings in the past... I stay chilled in offices and have shivered and gotten strange readings, but on retake is fine.
So, with these PVC's, feeling that hard quick beat is totally benign and normal? If there is no underlying problem, which I have none? I used to get one and then have a "run away" heart rate that would hit 160, but once I learned coping methods for anxiety that stopped. Now I can feel one, immediately take my pulse and get a steady rhythym in the 80's and occasionally a little higher if my anxiety jumps on me.
I tried a beta blocker (inderal) to slow my heart rate when this first happened and it didn't work well for me (dropped already low bp so I stayed dizzy and stupid). But I have noticed that the more I do, the less I have. Is that typical?
This past weekend I walked four miles (up and down hills) from parking area to large fireworks show and back... best stress test I've ever had..lol. And not a glitch from my heart. Didn't feel too much of the pvc's for a day or two afterwards either. I can't exercise too much due to fibromyalgia and assorted back problems.. so that type exercise is a rarity for me.
Most of mine I feel when I have been sitting a while, is this normal?
Wow, what a ramble..sorry.
-Sarah

This is an excellent article explaining PVC's!  It explains exactly what they are and when they can be a cause for concern.  I hope this answers a few questions.  Hugs, Teri

"WHAT CAUSES VENTRICULAR PREMATURE BEATS? — A number of mechanisms can be responsible for the development of VPBs. In some cases, cells in the ventricles become unusually "excitable" because of changes in the blood chemistry or elevation of adrenaline, causing them to fire and interrupt the normal sinus rhythm. In other cases, electrical impulses within the ventricle are routed in an abnormal way because of underlying disease or scarring of the muscle, causing a short circuit of the normal pathway, causing abnormal impulses to occur. In still other cases, cells in the ventricles can fire because of the effects of medication, toxins, chemical imbalance, or the strain and/or injury to the heart muscle that occurs with coronary heart disease, congenital heart disease, high blood pressure, infections of the muscle (myocarditis), or diseases of the heart muscle (cardiomyopathy)."

http://patients.uptodate.com/topic.asp?file=hrt_dis/11733

For srhpalmer: I suffered with panic disorder (in conjunction with Mitral Valve Prolapse) for 33 years, from age 16 through 49. Boy was that a drag! And of course that condition caused to be released literally gallons of adrenaline into my bloodstream over that period. I managed to function, but I also missed a lot because of it, and enjoyed a lot of things less than I would have without it. Finally, after my (totally unrelated) MI and single vessel bypass at 49, I was referred to a doctor who specialized in this sort of thing post MI. Well sonofagun! He wrote an Rx for clonazepam (Klonopin) and within two weeks I was out doing things I hadn't done since my teens! I had been a firefighter, EMT, businessman, husband and father, all the while having the occasional, totally unexpected "brainstorm" and lived with the embarassment and frustration. I even, at the age of 17 (and this is in 1962, mind you) was introduced, by well-meaning doctors, to methamphetamines and phenobarbital. That was a mess! We've come so far in our ability to chemically treat these things, but there's still a lot of controversy about the root cause of PD. I have my theories. At any rate, it is frequently seen with a mild, common and very benign form of MVP, and those of us so "blessed" can get a real sinus tach going just from thinking about caffeine - or the next panic attack. Now the Klonopin didn't cure anything - but it bought me the time, space, and peace of mind to work on the thing from the inside of my head. I am so happy to not be having that going on in addition to everything else life can throw at a person! And of course I still have PACs, PVCs, runs of stuff (god knows what - we rarely have time to catch it) and I also belong to the RBBB club! In fact, when training medical staff to do EKGs I love to be the "dummy" patient, because they are horrified when they see the messed up appearance of mine due to the Bundle Branch Block. It's really a largely irrelevant thing, it's ugly as sin, and a great teaching tool! It does make stress tests more difficult to interpret, which is why if you ever have one it should be with a nuclear scan. The RBBB makes the EKG part of the test too hard to use alone in determining if there's any heart disease. But even that has to be taken in context, because unless you have unusual shortness of breath, crushing chest pain, or any of the classic symptoms of serious heart disease, there's usually no reason to be having a stress test anyway - although I would recommend one as a baseline for anyone with a major family history or over the age of 50.

 

Premature beats are more noticeable usually when one is sitting still. Getting up and doing something then will usually make them go away. On the other hand, if they start while you are doing something, sitting down and getting quiet will usually have the same effect. Arrggghhh!

Hi Sarah,

Incomplete RBBB is really hard to pick out from a normal EKG. When my goes incomplete (which it does from time to time) I get all excited because it looks all neat and normal! Oh lord, I've lost my mind, I knew this would happen. :)

 

Wow, you just recently started having the panic attacks? That's a GOOD thing, or at least the best of a bad thing. (I know what I mean). The earlier it's recognized, the sooner it can be controlled, understood and managed. Most of us who have it are simply "wired" differently from others and need to learn how to react to our own internal perceptions. Stuff our bodies does that most people either don't feel or don't notice. It's a huge drag, but it can be fixed and, in fact, it can often be the opening for a better life in general. I know if someone said that to me 30 years ago I'd have busted him in the snout, but a lot has happened since then. It's actually a great time to be alive. We're learning more about medical stuff all the time, making incredible leaps forward. I'm very optimistic about PD and MVP and dysautonomia, etc. Now my project is to convince my youngest daughter (who has MVP, dysautonomia, panic attacks/focal seizures and migraines) that it's all OK and going to get better. She functions on a very high level, but not without a lot of anxiety about what's going to happen next. She was "cured" of SVT by means of an RF ablation when she was 15 and right now is winding up a six month stint in England, on loan from our DOD to their intelligence service. Clearly she is a lot stronger than she perceives herself to be.

 

Oddly, GERD is also seen in conjunction with these other things that we've been discussing. There seems to be this "package" deal available to some of us lucky people. Just take one thing at a time and break it down, then move on to the next. I've found that meditation is almost as important as medication in managing this stuff.