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Long Term PAC and PVC Suffer. Need your support and guidance
Heart Rhythm Conditions | Last Active: 5 days ago | Replies (93)Comment receiving replies
Hello everyone!
Thank you for much for the support and posts!
A few more events and questions.
I had a really episode of palpitations last Thursday and of course, I panicked and went to my local ER. When I got there they did a quick EKG and of course, everything was normal...no palpitations at all! But while I am sitting in a chair at home or in the ER, the palps are firing off like crazy! The moment I lie down to do an EKG, they go away. Well I then had another full set of labs done and a chest Xray. All normal of course! They then did another EKG and I asked the nurse if I could maybe sit up a bit when the EKG is being done. Then she caught one PAC and another. The ER doctor told me that I am fine and my cardiologist then put me on Dilitiazem, calcium channel blocker, to take at night. I already take Amlodipine and Losartan in the morning for blood pressure and my numbers are good. I started taking the Dilitiazem on Thursday night and on Friday, I felt some relief. I am still on the medication, but I struggled all day yesterday and again this morning I am having many PACs. My cardio also ordered another chest holter monitor (A Zio Patch recorder) and I started that on Friday and I will wear it for a week. Cardio doc also wants to me restart exercising as I have been scared to do so with the PACs and PVCs.
My cardio (great person) keeps reassuring me that the PACs and PVCs are not harmful even if they hit 10,000 to 20,000 per day. I am curious to see what my new monitor says but I am sure I am having at least 5000 to 8000 per day. He also told me that his father gets up to 30,000 per day and that he is in perfect health.
I know that these will never go away, but I want them to reduce in quantity and severity. I can FEEL each one and when they hit, my anxiety just soars!
Questions:
1. Do you great folks feel more palpitations when sitting? I feel much more when sitting and they really reduce when standing up or walking around.
2. I notice a huge increase in them when I wake up in the morning? Sometimes they slow down in the afternoon and evening.
3. What have you heard about ways to reduce how many we can actually feel? I have tried Xanax, Hydroxizine, meditation, breathing exercises, distraction, etc.
4. Finally, I keep reading about how the VAGUS nerve could be responsible for causing these. However, I have three cardiologists tell me that vagus nerve is not a cause.
Thank you,
Replies to "Hello everyone! Thank you for much for the support and posts! A few more events and..."
I have a lot of PVCs and some PACs and also feel every single one. I believe it is related to the Vagus nerve being stimulated somehow. That is why for me they are worse after eating a meal, or if I have indigestion. Sometimes if I have gas, I will feel several PVCs as the digestive tract makes noise. When the gas is gone, the PVCs stop. I have a cardiologist tell me there is no proof the Vagus nerve has anything to do with it. I then had a gastroenterologist tell me that some studies have shown a connection. Who knows? And everyone is different. Some people apparently never feel these. That must be nice. Although I have no other symptoms along with them so am grateful for that. Also mine will stop if I am exercising, or even just working hard in the yard.
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A couple of thoughts:
Have you had a cardiac MRI? My EP thought my occasional AT and VT were “idiopathic”, until he got the MRI finding that my Left Ventricle was dilated and my expulsion fraction was 43%.
My background: 72yo male in good health (otherwise), developed AFIB in Nov’21, had an ablation in Nov’22 which resolved the AFIB, but have had ongoing PAC/PVC’s with a 15% burden. Like you, they made me anxious and uncomfortable. I was constantly checking my HR on my watch and keeping notes about what I ate. I completely cut out alcohol and caffeine, and tried to avoid red meat. Still they were there. Fast forward to May’23: I had an Insertable Cardiac Defibrillator (combo PaceMaker and Defribulator) installed. At the same time, my EP switched me from Metoprolol to Sotalol and stopped my Eliquis. Bingo! I feel so much better. I continue to see and feel anywhere from 5 to 15% PVC’s but they no longer bother me. It’s too soon for the ICD to be playing an active role, so I’m thinking it was either the Eliquis or the Metoprolol (or both) that somehow affected the way I was feeling. I see my EP again in 2 months at which time I expect he will “tune” the parameters on my ICD and perhaps that will calm the PVCs.