How many PACs or PVCs are considered too many to require treatment?

800 per day is nothing, if heart beats approx 100000 times per day, your PVC load is less than 1%.
Mine is 15%, 15000 per day....now on meds for it....
Talk to your doc, maybe try magnesium
Good luck

Nash, curious...what medication are you on for the PVCs?
I have been on amiodarone for a long time for atrial fibrillation, which brings my heartrate down; it's my belief that the lowered heart rate creates favorable conditions for PVCs. My load is around 10%. I am seeking the right combination of medication for these two conditions and it feels really daunting. The PVCs disrupt my sleep and cause extreme anxiety.

Anyone out there with similar experiences?
Jennifer

Have a regular heartbeat most of my life and I'm 62 years old. Some days I feel like every 10th beat is a regular heartbeat. I feel like I wasted my time for 4 years with this loop recorder in my chest and I would transmit several recordings every day of my heart fluttering and jumping and skipping beats yet the loop recorder never red flagged any of it and always said my heart was in a normal heart rhythm during all the times I transmitted recordings. My doctors had me on metoprolol for about 20 years and I'm beginning to think this metaprolol is causing my heart to have more irregular heartbeats

I have a rare heart birth defect, for which my Electrophysologist
implanted a special $25,000 loop heart recorder. From what you’ve described it sounds like you have a faulty SA Node which is your heart’s natural pacemaker. I get all kinds of symptoms like yours but are not recorded by my loop recorder either. My recorder is set to map out my defect which is a 1 in a million birth defect. Your doctor must have your recorder programmed for something he is looking for, like mine is. So that any symptoms you spoke of are not needed. Your symptoms indicate your SA Node is faulty and most likely you’ll end up with a implanted pacemaker/ defibrillator. The pacemaker will set for a normal heart rate. The defibrillator will shock the heart into rhythm and the pacemaker will take over. I’m not a doctor but have a faulty SA Node myself from my birth defect. Hope this information helps you because stress and anxiety are the key to your symptoms.
@becky1024

Wondering if anxiety, adrenal, causes snowball effect..at least, this is my theory...You always see anxiety listed right...so, when the PVC's start up, noticable, first response is in my case, kinda a mini panic attack, I get anxious about them, and bam...of course, more follow..Vicious cycle..Anyone with same theory? ( Also have BP issues, so they say that contributes overall)...and of course, then you read, some of the BP drugs can cause heart irregularities!!!

I have an advanced case of Cardiac Sarcoidosis. I have experienced it all (sustained VTach/Vfib/Cardioversion) take 1 amiodarone 100mg/day, but still have 20,000 PVCs a day. They just added mexiletine and it seems to help some. I have had two ablations and they say we're running out of options. The last holter monitor showed the PVCs originate from all over my heart. Transplant has always been said to be in my future. Seems like it's coming sooner rather than later - but not today!

In the past year I have had 3 different episodes of frequent PAC’S for a week. During that week I have a couple of days where I estimate I have up to 20,000. Asymptomatic, but very worrisome. Most of the remaining days I have just below 10,000. Then they disappear like they never happened. I have figured out the trigger of fatigue and sleep disorder with moderate alcohol use. I am fortunate as taking melatonin, doing yoga and decrease alcohol use to less than 5 drinks per week work to get rid of them. I was wondering if these episodes are a predictor for Afib? Also should I get treatment if theygo over 10,000 per day and are asymptomatic or wait the week out to see if they go away.

I am struggling with PACs myself. The answer to your question may be what is you total burden? That burden would be listed as a % of total beats in a 24 hour period that are PACs. My burden was listed at 22% PACs and 2% PVCs. That means nearly 1/4-25% of my heart beats in a 24 period are aberrant. That is consider high. My resting HR is 50 beats a minute. So you have to take you resting HR and find the total beats for a 24 hour period. The amount of PACs you report for a 24 hour period is then divided by that number of total beats 24 hour period. You really need a monitor to get it correctly. So for example if your resting HR is 75 BPM and you experienced 20,000 PACs in a 24 hour period that would equal a burden of 18-19 % if my math is correct. My EP recently said it is nearly impossible to do ablations on PACs. He claimed that you have to literally be looking at the heart at the right place at the precise time it is creating a PAC in order to ablate it. Yet I read plenty of articles discussing ablation of PACs. So if mine continue I will push the discussion with him about an ablation. It negatively affects my quality of life especially resulting in poor perfusion resulting in making me tired and on edge.

Have you discussed this again with your EP? My last few 24 hour monitors showed 31,000 and 43,000 PACs per day with an average burden of around 26%. It is horrible! My EP is willing to do an ablation but I know it can be very difficult to map them and I am trying to decide what to do. It is a terrible way to life, though. If I can make it until Fall, I will probably either go back for another ablation, or go to Rochester for a second opinion.

I have discussed it with him and he said PACs are to hard to map. This is the head EP at a large university based medical center that has all the toys for latest diagnostics and generally staffed with a good set of skilled EP surgeons. Ironically I have also been having trouble with Afib returning after 5 years since an Afib ablation. So I have averaged about one event usually lasting around 36 hours every month or so and then I self convert. I am now scheduled for an Afib ablation Sept 25th. As for the PACs it seems I have been getting breaks from them. They stop for a few days or even a week and then when they return they haven't been as consistently intense recently. Especially so at night. So that is my saving grace for now. I also have a Kardia device and can read them and somehow I translate that into understating what they are and I try to rationalize it. But if you are not getting any breaks and it is continuous that must be hard. I try to use self-hypnosis originally learned from a great clinician for pain mangement and that helps blocking out the mental part. I still find them physically fatiguing when they get going and do not stop. We have been having a lot of very hot weather which makes it worse. That said overall recently since I last posted it has improved.