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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Dana, Volunteer Mentor | @danab | Oct 27, 2023

In reply to @rr1967 "Hello, I just met with my EP. From all the tests they have done, I simply..." + (show)

@rr1967

Hello,
I just met with my EP. From all the tests they have done, I simply have occasional PACs and very few PVCs. At this point, my EP stated they cannot do anything else. According to my EP and cardiologist, my heart is healthy and I need to deal with the mental health part of the problem (anxiety, depression, PTSD) to help reduce the impact of PACs. I am going to see a psychiatrist in the next month or so and discuss an anti anxiety medication that will calm my nerves which would in turn reduce my anxiety over the PACs and maybe even help them subside a bit. I think it is matter of working through the emotional/mental issues and attempt to quit worrying about every PAC that I have. The EP and cardio have assured me that PACs do no damage to my heart and will not lead to any other cardiac issues.
He did one more EKG today and stated everything was okay. I have a slower heart rate than most people, but my cardio says it is because I am good health. Finally, my EP did suggest that I could try something called Solatol that might reduce the PACs. I am not ready to try another medicine when the others have failed. He also stated I could try a low dose magnesium supplement and see if that helps..again it may or may not.
My blood pressure was again good today and I will continue the treatment with Losartan and Amlodopine each morning. They work and I have no side effects from them.
I think daily local and global events of the past few years and now have also taken their mental health toll on me with constant worry, fear, and anxiety. I have all but shut myself off from society in general with the rare exception of groceries, a few restaurant meals (either on a outdoor patio or in my car), and some shopping. I need to simply start living life again....this would make my amazing and long suffering wife very happy.
Thank you and I really appreciate your comments and support and look forward to reading more.
RR1967

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@rr1967 Sounds Like you had a great visit with your Doctor. I can relate also as our world is getting more complex these days. I myself now 64 sure miss the seeming easy tranquil life of my youth. But your right we try to protect ourselves from things that we really can't control. So I hope you can find a way to relax, and I also found that stress seemed to make the PVCs more noticeable. I myself find a lot of relaxing comfort in walks in our nearby park. Listening to the Birds, and just walking thru the trees brings me a sense of peace.
Blessings I send for some relief from the PVC's

jc76 | @jc76 | Oct 28, 2023

In reply to @rr1967 "Hello, I just met with my EP. From all the tests they have done, I simply..." + (show)

@rr1967

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I think in the medical field the mental side of PAC and PVCs are not addressed enough. Saying we should address them is not enough. There should be referrals to mental health professtionals. This is not to day for all but those of us that state the stress seems to cause more and more problems.

I know my EP said the PAC biggest problem is strokes because of blood clotting not the issue of PVCs on heart. PVCs are more troublesome if interfere with those of us that have pacemakers.

713j | @713j | Oct 28, 2023

Has any one tried hypnosis so you don't feel the pvc,pacs?

Colleen Young, Connect Director | @colleenyoung | Oct 28, 2023

In reply to @713j "Has any one tried hypnosis so you don't feel the pvc,pacs?" + (show)

@713j, using hypnosis to manage premature ventricular contractions (PVCs) and premature atrial contractions (PACs) is an interesting question. I moved your question to this existing discussion to connect with other members who may have experience with hypnosis:
- Managing and Living With PACs and PVCs https://connect.mayoclinic.org/discussion/living-with-pacs-and-pvcs/

According to Mayo Clinic (https://www.mayoclinic.org/diseases-conditions/premature-ventricular-contractions/diagnosis-treatment/drc-20376762) managing stress helps manage PVCs and PACs, such as finding ways to help reduce emotional stress. Getting more exercise, practicing mindfulness and connecting with others in support groups are some ways to tame stress.

Hypnosis is a changed state of awareness and increased relaxation that allows for improved focus and concentration. Has hypnotherapy been suggested to you by your doctor?

713j | @713j | Oct 28, 2023

In reply to @colleenyoung "@713j, using hypnosis to manage premature ventricular contractions (PVCs) and premature atrial contractions (PACs) is an..." + (show)

No I was just thinking about hypnosis. Because when I don't feel them pvc,pac I feel fine. Again has anyone used hypnosis???

jlchasse | @jlchasse | Oct 28, 2023

I’m new here and am about at my wits end. My story began with afib a year ago. I had the ablation and the afib is controlled but recently, a month ago, I started have extra beats. They started out slowly where the first day they only lasted an hour but have gradually increased. Last week I was hospitalized for diverticulitis and an irregular heart rhythm. I was released after 4 days but the PACs are horrible. I have them about every 5-10 beats and they last for hours on end to the point where I have them more often than not. I don’t see my EP until 12/26 but I’m about ready to lose my shot. I don’t know if I can continue like this. Anyone else have them this bad?

jlchasse | @jlchasse | Oct 28, 2023

I have them daily almost all day long and I feel like they control my life. I had afib a year ago and had an ablation but then the PACs started and they have been getting worse and worse. It’s easy for the docs to say don’t worry about them because they don’t feel them. They exhaust me and totally disrupt my life

jlchasse | @jlchasse | Oct 28, 2023

In reply to @mjj151 "I'm a male an have a similar PAC/PVC burden, around 15% overall. So far I've been..." + (show)

How do you determine your PAC/PVC burden?

gloaming | @gloaming | Oct 28, 2023

They have to be found using a credible measuring device that records your heart rate and rhythm for at least 18 hours, although some people need several days to get a veridical burden calculation. So, we are usually talking about a Holter Monitor. A physician will ask for one for you from a local lab and you'll go pick it up at an appointed time. From there, follow instructions...carefully.

Essentially, it is the total number of discernible ectopic beats in an hour, averaged over the numbers of beats. Burdens greater than about 5%, with some saying anything over 3% , is a 'high' burden, and it should be controlled.

mjj151 | @mjj151 | Oct 29, 2023

In reply to @jlchasse "How do you determine your PAC/PVC burden?" + (show)

From a Holter Monitor / recording device -- that records every PAC/PVC you have over the duration of wearing the device. I have constant PAC/PVCs and first tried taking Albuterol but that had no impact. Recently I was prescribed a low dose of Flecainide and seems to be cutting the PAC/PVSs by 50%-75% and haven't had any side effects.

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