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Managing and Living With PACs and PVCs
Hello all. I have posted in this forum before and I thank you for your advice. I appreciate more support please.
I am about to turn 56 and I have dealt with PACs and PVCs for the past 20 years. The come and go and now they seem to be getting worse. My cardio, regular doc, and electrophysiologist all say that I am fine and that I have too much stress and anxiety (which I do..I suffer from GAD and depression.) They all say that PACs are benign and that most PVCs are benign.
I had an exercise stress echo in 2019 (all normal). Several EKGs this year...all normal. Another Zio Patch Heart Monitor that I wore for a week. Normal sinus rhythm with PACs. My PAC/PVC burden hovers between 1.5 to 1.8 percent. I have had a recent chest xray and plenty of blood work. All normal. I am borderline type 2 diabetic and my cholesterol and triglycerides are all normal. I do take blood pressure meds and it is well controlled. I try to be active almost every day and I do practice CBT for my anxiety. My resting heart rate is about 55 and my cardio says that is normal.
What else can I do to reduce the PACs and PVCs or manage them? Some days they are fast and furious and some days they simply come and ago. But they are ruining my daily life and causing more depression and fear. They are awful in the morning, reduce a bit in the afternoon, and reduce a bit more in the evening.
My cardio again states that they are fine and to not worry.
I have tried a beta blocker (made my heart rate too low and I was too tired) and a pill called Diltiazem. Really had no effect and made me too tired. I don't qualify for any procedure and the one pill they are still offering me is Flecianide but that one has WAY too many side effects and I have had at least two cardiologists warn me from taking it.
What are you experiences, advice, etc?
Thank you!
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@megansims what side affects did you have on flecanine? I’ve been on it for 5 weeks and haven’t noticed anything. I’m also taking metoprolol but neither is calming my PAC’s. If I get too much metoprolol it lowers my heart rate into the 60’s and then I get PVC’s. My burden is great and only get a few hours during the day of few. I’m awake until 3 or so every morning because the burden is so great. I try to go on and not let them bother me but it’s getting harder. I had an ablation 6 weeks ago so I’ve been trying to be patient since my heart is still healing.
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1 ReactionI have been on and off Flecainide for more than twenty years. It works for me to tamp down both a-fib and ectopics (though I definitely still have both at different times.) The only side effect I ever had from Flecainide was during my first year or so of taking it; I would turn my head or shift my eyes and get a slight visual effect, like a blur. Visual effects are fairly common, I am told, and it wasn't unpleasant, just noticeable.
Give yourself some more time for your heart structures to heal from the ablation. It might be close to three months before you will know exactly how it worked.
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1 Reaction@jenrev Agreed, the 'blanking period' is usually around 10-12 weeks, after which a Holter or other assessment is made of the heart's current rhythm. And for 75% of all patients ablated, that's about all they need and they soon learn that the Holter shows them in NSR or in an(other) arrhythmia such as flutter, a common occurrence after an ablation for AF. Happens surprisingly often, but an ablation for AFL has a very high chance of success...thankfully.
However, some patients report an elevated HR, sometimes in the high 80's even, for months following the Holter, even up to a full year. Almost always it eventually comes down. If it doesn't, and it is concerning, the electrophysiologist should take another look.