1. < Heart Rhythm Conditions

Managing and Living With PACs and PVCs

Posted by rr1967 @rr1967, Aug 14, 2023

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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rr1967 | @rr1967 | Sep 7, 2023

Hello! I have posted here several times and I appreciate all the feedback and support.
Recently, my PACs seemed to become worse, again. I can just sit in a chair and just feel the extra heartbeat 6-10 times every minute. My electrophysiologist has reviewed all of my labs, tests, etc and simply states that I have PACs and need to learn to live with them as they are benign, but worrisome.
We tried Diltiazem and that did nothing. Now we are trying Verapamil.
I know that PACs will never go away, but I am simply trying to find way to reduce their frequency or impact. Even as I type this out, I am feeling them. I ran to the ER last week and of course, all results were normal.
I am not sure what else to do and I feel like I am losing hope.

Thank you,
RR

REPLY
11 replies
rr1967 | @rr1967 | Sep 8, 2023
In reply to @rr1967 "Hello! I have posted here several times and I appreciate all the feedback and support. Recently,..." + (show)
@rr1967

Hello! I have posted here several times and I appreciate all the feedback and support.
Recently, my PACs seemed to become worse, again. I can just sit in a chair and just feel the extra heartbeat 6-10 times every minute. My electrophysiologist has reviewed all of my labs, tests, etc and simply states that I have PACs and need to learn to live with them as they are benign, but worrisome.
We tried Diltiazem and that did nothing. Now we are trying Verapamil.
I know that PACs will never go away, but I am simply trying to find way to reduce their frequency or impact. Even as I type this out, I am feeling them. I ran to the ER last week and of course, all results were normal.
I am not sure what else to do and I feel like I am losing hope.

Thank you,
RR

Jump to this post

Hello
Thank you for the advice. I am currently seeing an electrophysiologist who specializes in arrhythmia and he keeps telling me I am fine. I do not drink caffeine and I do not smoke or use any drug. It looks like at the current time, I do not qualify for an ablation and they are not 100% effective.
RR

REPLY
gloaming | @gloaming | Sep 8, 2023
In reply to @rr1967 "Hello! I have posted here several times and I appreciate all the feedback and support. Recently,..." + (show)
@rr1967

Hello! I have posted here several times and I appreciate all the feedback and support.
Recently, my PACs seemed to become worse, again. I can just sit in a chair and just feel the extra heartbeat 6-10 times every minute. My electrophysiologist has reviewed all of my labs, tests, etc and simply states that I have PACs and need to learn to live with them as they are benign, but worrisome.
We tried Diltiazem and that did nothing. Now we are trying Verapamil.
I know that PACs will never go away, but I am simply trying to find way to reduce their frequency or impact. Even as I type this out, I am feeling them. I ran to the ER last week and of course, all results were normal.
I am not sure what else to do and I feel like I am losing hope.

Thank you,
RR

Jump to this post

Ask him what your PAC burden is as measured by a 24 hour Holter Monitor where you go out and exercise like you'd like to at least once during the 24 hour period. If the burden is higher than about 10%, and he feels it's okay, hie yourself to a second opinion...but not his.

REPLY
dcw | @dcw | Sep 9, 2023
In reply to @rr1967 "Hello! I have posted here several times and I appreciate all the feedback and support. Recently,..." + (show)
@rr1967

Hello! I have posted here several times and I appreciate all the feedback and support.
Recently, my PACs seemed to become worse, again. I can just sit in a chair and just feel the extra heartbeat 6-10 times every minute. My electrophysiologist has reviewed all of my labs, tests, etc and simply states that I have PACs and need to learn to live with them as they are benign, but worrisome.
We tried Diltiazem and that did nothing. Now we are trying Verapamil.
I know that PACs will never go away, but I am simply trying to find way to reduce their frequency or impact. Even as I type this out, I am feeling them. I ran to the ER last week and of course, all results were normal.
I am not sure what else to do and I feel like I am losing hope.

Thank you,
RR

Jump to this post

Hi all,
I have a question about the definition of PACs. I have a few isolated incidents of high heart rate, very brief, a few times a day. For instance, as I start my daily walk, my heart rate might go from 70's to 115 in an instant and then return to 70 bpm. So my heart rate seems to only stays high for a brief time and then resumes rythym. Is this what would be considered a PAC or a PVC?

REPLY
gloaming | @gloaming | Sep 10, 2023
In reply to @rr1967 "Hello! I have posted here several times and I appreciate all the feedback and support. Recently,..." + (show)
@rr1967

Hello! I have posted here several times and I appreciate all the feedback and support.
Recently, my PACs seemed to become worse, again. I can just sit in a chair and just feel the extra heartbeat 6-10 times every minute. My electrophysiologist has reviewed all of my labs, tests, etc and simply states that I have PACs and need to learn to live with them as they are benign, but worrisome.
We tried Diltiazem and that did nothing. Now we are trying Verapamil.
I know that PACs will never go away, but I am simply trying to find way to reduce their frequency or impact. Even as I type this out, I am feeling them. I ran to the ER last week and of course, all results were normal.
I am not sure what else to do and I feel like I am losing hope.

Thank you,
RR

Jump to this post

No. PACs and PVCs are often felt through the chest wall as thumps because they are extra beats. Their timing can be irregular, but it is often just an inserted extra beat. Runs of faster beats are tachycardia. Tachycardia includes atrial and ventricular tachycardia, but it also includes supraventricular tachycardia, of which flutter and fibrillation are examples. Supraventricular means 'above, or higher, than the ventricles'. So those would involve only the two atria, and NOT the ventricles. Ventricular tachycardia means fast heart rate driven by a disordered ventricle...only.

You would need a 12 lead ECG, usually in a cardiologist's offices, or at an ER if you end up there, to determine why your heart has runs of high rate after which it settles down to something more representative of your needed cardiac output. At the very least, you would want a prescription to wear a Holter Monitor for at least 20 hours, but three or more days would be ideal. During that time, you would want to stress your heart in a way that you know is likely to bring on the rapid rate. Nothing crazy, just your normal high rate of demand on your heart, such as when running, playing sports, gardening, arguing.....

REPLY
mjj151 | @mjj151 | Sep 14, 2023

I'm a male an have a similar PAC/PVC burden, around 15% overall. So far I've been prescribed Acebutolol but that has not made any impact. Cardiologist told me to follow-up in six months and seemed less concerned with the high burden. I'm going to see another cardiologist on Monday so see if they can prescribe anything else. My resting pulse is in the low 50s and noticed a slightly decrease from there when I began taking Acebutolol.

REPLY
1 reply
rr1967 | @rr1967 | Sep 15, 2023

Hello mjj151.
Thank you for sharing your information. 15%..wow... I think I am at 10% now, but my cardio keeps telling me I am fine. We have tried beta blockers and calcium channel blockers...no help at all. Now he wants me to try Flecanide which is very scary medication. Not sure what to do anymore as I am tormented every day and evening with them. I have seen a cardiologist and two different electrophysiologists and they all say I am fine. No...I am not fine...

REPLY
2 replies
Garygirl | @taftst1 | Sep 16, 2023

Have PAC and PVC 35?plus years. Now tachycardia per 2 monitors. Tried Flecainide, raised Bp. Plus black box warning. Taking cardizem, tried 30 mg. Pill 2x a day, knocked me out. Tried 30 ER was ok for a week then exhausted and muscles ache. Plus the anxiety. Can’t take digoxin made me feel awful. 35 years ago was my pill in pocket, Xanax. Stopped it immediately. Still take it at night. Been through so much. I start feeling awful at 1:30 pm till 8 pm. This morning my Bp was low, so skipped the ER Dilitizem it’s all good for a week. Now this. New cardio FINALLY stated POTS. But did not check out as well that day since I was on the heart meds. But thinks it’s it. Take Bp sitting, then standing. If it drops standing by 30 pts or so, pots. Going for 3 rd monitor in OCTOBER!!!! I do know Goli. Ashwagandha helps a bit. It’s melatonin. The sleep one will certainly allow you a good night sleep. Wish you the best. Frustration is a big factor. You want to say, you really went to school for this??? Lol.

REPLY
dcw | @dcw | Oct 6, 2023
In reply to @rr1967 "Hello! I have posted here several times and I appreciate all the feedback and support. Recently,..." + (show)
@rr1967

Hello! I have posted here several times and I appreciate all the feedback and support.
Recently, my PACs seemed to become worse, again. I can just sit in a chair and just feel the extra heartbeat 6-10 times every minute. My electrophysiologist has reviewed all of my labs, tests, etc and simply states that I have PACs and need to learn to live with them as they are benign, but worrisome.
We tried Diltiazem and that did nothing. Now we are trying Verapamil.
I know that PACs will never go away, but I am simply trying to find way to reduce their frequency or impact. Even as I type this out, I am feeling them. I ran to the ER last week and of course, all results were normal.
I am not sure what else to do and I feel like I am losing hope.

Thank you,
RR

Jump to this post

@gloaming,
Thank you for the reply. I did a holter a few times over the past few years and these heart beats were present. Cardiologist didn't seemed too concerned but did start me on Metoprolol in addition to long standing BP meds. I was just never clear on what type of arrhythmia I have. Thanks.

REPLY
che1 | @che1 | Oct 11, 2023
In reply to @rr1967 "Hello! I have posted here several times and I appreciate all the feedback and support. Recently,..." + (show)
@rr1967

Hello! I have posted here several times and I appreciate all the feedback and support.
Recently, my PACs seemed to become worse, again. I can just sit in a chair and just feel the extra heartbeat 6-10 times every minute. My electrophysiologist has reviewed all of my labs, tests, etc and simply states that I have PACs and need to learn to live with them as they are benign, but worrisome.
We tried Diltiazem and that did nothing. Now we are trying Verapamil.
I know that PACs will never go away, but I am simply trying to find way to reduce their frequency or impact. Even as I type this out, I am feeling them. I ran to the ER last week and of course, all results were normal.
I am not sure what else to do and I feel like I am losing hope.

Thank you,
RR

Jump to this post

Sorry I can offer no help except to commiserate. I have pvcs. Had an ablation about 2 months ago for svt. No frequent episodes of svt now but the pvcs are so frequent. Back on diltiazem er 120/day today. Not helping yet. It is such a drag feeling your heart constantly.

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