Sigh. PVC’s have me desperate. How to cope?

Posted by mattb4295 @mattb4295, Oct 16, 2022

First off, thank you for reading. I know from reading posts that people have it worse than I do and I offer my utmost respect for those of you who do.

Briefly-

39 yo/m
Reasonably healthy. Non smoker. Stressful job.

So, a few years ago I started to have an occasional (painful) pvc that always got my attention. Once it hit 3-4 a day, I did like everyone else, and sound of the alarm and got the full gamut of testing.

Benign. Low dose Metoprolol.

Ok great.

Fast forward to these last two months, and the amount of PVCs I am having has increased 100 fold. They are all day. I went from a few a month to one a minute.

Panic. Doctor. Here we go again.

Once again, they are telling me that they are unifocal and harmless. These. Don’t. Feel. Harmless.

They absolutely stop me mid sentence every time. Each one is like a jump scare. My stomach drops like a roller coaster and I have a brief adrenaline shot. Like you’re scaring the heck out of me over and over. Just a Deep painful fear each time.

The doctors don’t seem very concerned. They recommended a magnesium supplement, which I am taking religiously.

No caffeine. No smoking. No alcohols.

Nothing.

This has destroyed my quality of live almost overnight. I wake up in anticipation. I go to sleep in fear.

Does it get better? Is this my life now? Even as I type this, I’m having one about every 30 seconds. I don’t want to go anywhere. I don’t want to do anything. I’m just petrified.

Wonder if switching from a beta to a calcium channel would work? Is this my life now?

The sad thing is… I “know” it’s supposed to be fine but why doesn’t it feel fine? Every shot of adrenaline warns me that I won’t be around much longer.

Just terrible.

Any input is appreciated.

Interested in more discussions like this? Go to the Heart Rhythm Conditions Support Group.

Hi Matt welcome to connect and I feel your concern. It's funny how doctors like to say it's not a problem and medically that's true. But I have also had them at different times with my heart rhythm issues. For me when it got bad I finally decided to talk to my doctors about a anti-anxiety pill.
The unfortunate part about these types of problems is anxiety can actually make the problem worse. Kind-of a catch 22. I was told to actually yell at
Myself to convince myself it was not going to hurt me. A counselor told me that once. If you would have pulled up beside me at a light you might see me all alone yelling at my self. But it did work sometimes. The other method I would use is what they actually tell people who are of risk of a heart arrhythmia or attack which I also had.
It's similar to what pregnant ladies were taught to help strengthen their pelvic floor muscles. Squeeze real hard like your going to the bathroom and keep repeating it. Also coughing very rigorously also. It acts on the heart to kind-of reset it, as funny as that sounds that actually got me out of some real issues with VT arrhythmias. So I hope maybe some of those tricks work and ask you doctors for maybe a light anti-anxiety pill I took them for a while and they do work. Let me know if any of those work.
Blessings

REPLY
@danab

Hi Matt welcome to connect and I feel your concern. It's funny how doctors like to say it's not a problem and medically that's true. But I have also had them at different times with my heart rhythm issues. For me when it got bad I finally decided to talk to my doctors about a anti-anxiety pill.
The unfortunate part about these types of problems is anxiety can actually make the problem worse. Kind-of a catch 22. I was told to actually yell at
Myself to convince myself it was not going to hurt me. A counselor told me that once. If you would have pulled up beside me at a light you might see me all alone yelling at my self. But it did work sometimes. The other method I would use is what they actually tell people who are of risk of a heart arrhythmia or attack which I also had.
It's similar to what pregnant ladies were taught to help strengthen their pelvic floor muscles. Squeeze real hard like your going to the bathroom and keep repeating it. Also coughing very rigorously also. It acts on the heart to kind-of reset it, as funny as that sounds that actually got me out of some real issues with VT arrhythmias. So I hope maybe some of those tricks work and ask you doctors for maybe a light anti-anxiety pill I took them for a while and they do work. Let me know if any of those work.
Blessings

Jump to this post

Thank you for your help! Yeah, I’m a 12-year paramedic so I know about vagal maneuvers but mine are so sporadic, I’m not sure it will help.

Pills are out, although I’m curious about swapping from BB to CCB.

I’ve run the gamut of possibilities but this has gotten out of hand. Ugh!!!

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Matt, First, know you are not alone. I have had a-fib and PVCs for years. (My PVCs sometimes just trigger me, and sometimes they trigger an episode of a-fib, so there's that...)
I and so many others know the feeling you get when you wonder if the runs of PVCs will ever abate and give you a break. I know that feeling of - hard delay...THUMP! - in your chest that is massively distracting to whatever you are doing.
Fortunately for me I don't have the sensation that many others have, that I might die in that moment. I get the adrenaline rush and the anxiety, but not the fear. I am thankful for that.

There are a few things you can do and it sounds like you are doing many of them. First of all, just shake your head at any medical professional who just tells you it's benign and that you should just live with it. It may not be on track to kill you, but it's NOT benign to your life or spirit. Those who have not struggled with this do not know how disabling and troubling this can be to a person's life. Seek out others who do know and can empathize.

Watch your intake of food and drinks carefully to try and tease out any triggers. Caffeine has never been a trigger for me, so I still drink it. Alcohol is, and I mostly avoid. Through a naturopathic physician's testing I found out I had a sensitivity to gluten and wheat, which I never knew because I did not have the digestive symptoms that others have. I dropped gluten from my diet, and my PVC episodes were noticeably less frequent. Get a sleep test and find out if you could benefit from a CPAP machine if you have apnea. I sleep better now and believe that helps my heart, too.

I won't suggest medications - you can get good advice from your doctors, and just keep trying different dosages, combinations, and timing until you notice any changes. You can also get an ablation if things are truly unbearable for you and your PVC daily load approaches or exceeds 20%. I believe that's the threshold for ablation, but ask your doctor. I have had several ablations for my a-fib and can attest that they do help - at least for awhile.

But mostly? Remember - you are not alone in some arrhythmia hellscape. Sometimes that's the thing that can help the most. Good luck to you and have no fear - everything changes, and this will too. Yell that one out loud!

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Thanks for the replies. I’m thinking my next step has to be a food test. I don’t know what else to do. Every little thumb comes with an adrenaline dump. Even if I’m physically active, it’s strong enough to be noticed.

So distraction/exercise isn’t a viable solution. I can’t believe these came so fast. Within two months I’ve gone from 1-2 a day to 1-2 a min. That’s an astronomical increase and I can’t live like this 😩

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Hi Matt. Welcome. Those of us with PVCs feel your concern. You've already had an ear-full of the "take this supplement", no caffeine, no alcohol, no sodium, reduce stress, etc so I will not preach to the choir ad-nauseum on these. Here's some nuggets of PVC wisdom that hopefully will help...

A few PVCs are generally of low concern. However, high PVC burdens can lead to a host of other problems such as PVC induced cardiomyopathy. What is considered a high burden varies but in the order of 10,000+ PVCs/day or greater than 10-20% of all heartbeats are the typical levels considered high burden.

Sure, all of that advice is great but what does one do when their PVCs are symptomatic even at a low burden like yours? Getting to the bottom of the PVC problem requires knowledge, professional help from physicians and emotional support.

The best answer/advice is to be honest and straight forward with your doctor about the severity of your symptoms, your treatment goals and expectations. If your physician is unable, unwilling or completely dismissive of the above, it's time to find a different physician who will take your concerns seriously. Don't go fishing for procedures like cardiac ablation on the advice of Dr. Google. Educate yourself on the subject so you can have a meaningful technically correct discussion with your physicians. A physician that might normally be dismissive might take you more seriously when you genuinely know what you're talking about. The Mayo Clinic web site, NIH/Pubmed studies, American Heart Association "Circulation", etc, are great places to start. BEWARE the monetized Youtube channels but look for the conferences by doctors for doctors. A great example is Dr. Fermin Garcia's talk on "PVCs: The Good, The Bad and The Ugly" on youtube.

From personal experience, the cardiologist I was referred to was just another pig at the trough of the Canadian health care system. Ultimately after almost a year of chasing the pig in circles, I found a really good internist (he's like a really friendly Dr. House) that has kick started proper care for me. The ideal credential would be to find a good eletrophysiologist but don't discount other good physicians as there might be something else going on. For example, sleep apnea and oxygen de-saturation can be the source and/or contribute to PVCs.

Lastly, keep a log of pertinent data such as blood pressure, ECG rhythm strips, when you felt bad, medications, etc. My doctors really appreciate the rhythm strips from the Kardia 6L, pulse oximetry data (O2 ring) and CPAP data (OSCAR software reads the SD card from my Resmed). This data will help guide your physician in a "where there's smoke there's fire" kind of way. Don't be discouraged if physicians want to also do their own tests on top of your data. The "bad" cardiologist I had absolutely REFUSED to look at ANY of the data I gathered but my good internist looks at and wants copies of everything.

Wishing you all the best and a speedy recovery!

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Hello there. Thanks for reading again.

I previously made a post about four or five months ago, discussing my sudden onset of PVCs. They were very upsetting and troubling, and honestly felt like they were on the road to ruining my life. I realize that many people here would probably love to be in my shoes because I had a relatively low burden of around 500 a day but they were symptomatic and the ones I was having were quite distressing.

Please understand I mean no disrespect and completely empathize with those of you who have it way worse than me. My heart and thoughts are with you.

Anyhow, I had a gamut of testing, including Holter monitor stress, test bloodwork CT

All of it.

The doctor says I’m perfectly fine have no structural abnormalities and just suggested I continue on a magnesium supplement

Things had seemed to subside, and I feel like for a short time I have gotten my life back, but just the other night, at 8 o’clock at night, I felt “full“ like I needed to belch. It wasn’t an uncommon sensation, but I definitely felt that acid and burp type of feeling. Funny enough, I hadn’t eaten in 8 hours. Well, lo and behold, when I sat down and bent over to grab something off the floor, I started having consistent PVCs

I called my wife in the room and said watch this, using my Apple Watch to show her that bending over and straining would cause a bigeminal rhythm with PVCs every other beat and as soon as I would stop and sit up, they would stop

Of course, it was extremely upsetting, because I have never seen myself in that type of rhythm. I have no other symptoms. I did not get weak for lightheaded or have chest pain although I’m sure some of that might have come along if I had continued for more than about 30 seconds.

I tested this hypothesis three or four times with the same result each time and immediate alleviation upon sitting up. Of course, two hours later, when I no longer felt full, I could not reproduce this.

I sent a message to my electrophysiologist, and he basically just said yeah you are irritating something in there but it’s no big deal. I’m not sure that I want it to be my final answer. If something is being irritated, who’s to say it won’t get worse? If something is being irritated, isn’t there a way to stop irritating it?

I found an article about a surgeon who had positional PVC stimulation when operating in a certain body position, and he eventually had to have an ablation. Has anyone else had experience with this positional stimulation?

I am going to attach two strips that were taken just a minute or two apart

Thanks again.

REPLY
@mattb4295

Hello there. Thanks for reading again.

I previously made a post about four or five months ago, discussing my sudden onset of PVCs. They were very upsetting and troubling, and honestly felt like they were on the road to ruining my life. I realize that many people here would probably love to be in my shoes because I had a relatively low burden of around 500 a day but they were symptomatic and the ones I was having were quite distressing.

Please understand I mean no disrespect and completely empathize with those of you who have it way worse than me. My heart and thoughts are with you.

Anyhow, I had a gamut of testing, including Holter monitor stress, test bloodwork CT

All of it.

The doctor says I’m perfectly fine have no structural abnormalities and just suggested I continue on a magnesium supplement

Things had seemed to subside, and I feel like for a short time I have gotten my life back, but just the other night, at 8 o’clock at night, I felt “full“ like I needed to belch. It wasn’t an uncommon sensation, but I definitely felt that acid and burp type of feeling. Funny enough, I hadn’t eaten in 8 hours. Well, lo and behold, when I sat down and bent over to grab something off the floor, I started having consistent PVCs

I called my wife in the room and said watch this, using my Apple Watch to show her that bending over and straining would cause a bigeminal rhythm with PVCs every other beat and as soon as I would stop and sit up, they would stop

Of course, it was extremely upsetting, because I have never seen myself in that type of rhythm. I have no other symptoms. I did not get weak for lightheaded or have chest pain although I’m sure some of that might have come along if I had continued for more than about 30 seconds.

I tested this hypothesis three or four times with the same result each time and immediate alleviation upon sitting up. Of course, two hours later, when I no longer felt full, I could not reproduce this.

I sent a message to my electrophysiologist, and he basically just said yeah you are irritating something in there but it’s no big deal. I’m not sure that I want it to be my final answer. If something is being irritated, who’s to say it won’t get worse? If something is being irritated, isn’t there a way to stop irritating it?

I found an article about a surgeon who had positional PVC stimulation when operating in a certain body position, and he eventually had to have an ablation. Has anyone else had experience with this positional stimulation?

I am going to attach two strips that were taken just a minute or two apart

Thanks again.

Jump to this post

Leaning forward and straining

REPLY
@mattb4295

Leaning forward and straining

Jump to this post

Sitting normally

REPLY

(cross posting this in other topics) Four months after an ablation, I'm experiencing a high rate (20-30%) of PVC's. My EP has ordered an MRI. He already has results of CT-scan and echocardiogram . Have others had the MRI, and what was the result?

REPLY
@mattb4295

Hello there. Thanks for reading again.

I previously made a post about four or five months ago, discussing my sudden onset of PVCs. They were very upsetting and troubling, and honestly felt like they were on the road to ruining my life. I realize that many people here would probably love to be in my shoes because I had a relatively low burden of around 500 a day but they were symptomatic and the ones I was having were quite distressing.

Please understand I mean no disrespect and completely empathize with those of you who have it way worse than me. My heart and thoughts are with you.

Anyhow, I had a gamut of testing, including Holter monitor stress, test bloodwork CT

All of it.

The doctor says I’m perfectly fine have no structural abnormalities and just suggested I continue on a magnesium supplement

Things had seemed to subside, and I feel like for a short time I have gotten my life back, but just the other night, at 8 o’clock at night, I felt “full“ like I needed to belch. It wasn’t an uncommon sensation, but I definitely felt that acid and burp type of feeling. Funny enough, I hadn’t eaten in 8 hours. Well, lo and behold, when I sat down and bent over to grab something off the floor, I started having consistent PVCs

I called my wife in the room and said watch this, using my Apple Watch to show her that bending over and straining would cause a bigeminal rhythm with PVCs every other beat and as soon as I would stop and sit up, they would stop

Of course, it was extremely upsetting, because I have never seen myself in that type of rhythm. I have no other symptoms. I did not get weak for lightheaded or have chest pain although I’m sure some of that might have come along if I had continued for more than about 30 seconds.

I tested this hypothesis three or four times with the same result each time and immediate alleviation upon sitting up. Of course, two hours later, when I no longer felt full, I could not reproduce this.

I sent a message to my electrophysiologist, and he basically just said yeah you are irritating something in there but it’s no big deal. I’m not sure that I want it to be my final answer. If something is being irritated, who’s to say it won’t get worse? If something is being irritated, isn’t there a way to stop irritating it?

I found an article about a surgeon who had positional PVC stimulation when operating in a certain body position, and he eventually had to have an ablation. Has anyone else had experience with this positional stimulation?

I am going to attach two strips that were taken just a minute or two apart

Thanks again.

Jump to this post

Hello
Iam going through the same thing ?
How are your pvc now ?

REPLY
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