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Managing and Living With PACs and PVCs
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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My EP made me wear something called a Zio patch. It is like a mini EKG device that is sticks onto your chest right above your heart. Some folks prefer to stick it on themselves while I simply have the pros do it. You can't shower for the first 24 hours and it will itch a bit over the day. You wear it anywhere from 24 hours to almost two weeks. I wore on this past June and last month. It records every beat, heart rate, etc and is very sensitive.
My results were that I had normal sinus rhythm with PACs around 3.5% of total heart beats and PVCs were well less than 1%. My EP told me that there was nothing to worry about even if the PAC burden of 3.5% hit 5-8%. I guess they call a burden of 3.5% "occasional" and since they are PACs, they are not really treated.
Do u take medication for these?
Are you seeing a electrophysiologist? One thing to realize is stress and worry aggravate PVCs and PACs. Thus trying to find ways to reduce that is important and you should be getting guidance on that.
Did your EP suggest taking Magnesium? A complete blood test will reveal any electrolytes imbalance along with magnesium and potassium (which are important with having PVCs) but mine were normal after blood tests. We moved to a low dose heart rhythm medication. I have chronic PVCs (one about every 10 beats). They get better then worse. I have an ICD/Pacemaker since 2006. I have heart failure with first symptoms caused by a left bundle branch block diagnosis and low EJ over 20 years ago. I do Sprint Triathlons so not stopping me from exercise (all approved and encouraged by me doctors).
Good luck! Try to find ways to reduce stress and occupy your mind away from PVCs.
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What low dose heart rhythm med are you taking?
Timely, It is Mexiletine Hydrochlolride 150 mg. They make it in 3 doses. Low, intermediate, and high. My EP said to start with low and adjust from there. I did have a drop in number of PVCs but not drastic and was sporadic.
The only issue is that it needs to be take every 8 hours. It has a quick exit from system versus other types and thus the need to do every 8 hours.
Have a upcoming home monitoring of ICD/Pacemaker which will determine the success or need to adjust based on number of PVCs the home test will show. I have this home test (called latitude) every 3 months and this will be first 3 month period since I started medication.
It was also recommended I take Magnesium 400 mg. which I already was. I asked my EP about taking potassium but was advised my last blood work showed normal levels so no additional supplement was recommended.
What form of magnesium?
What I take is called Triple Magnesium Complex which I get from Puritan Pride vitamins and supplements.
My EP nurse said Magnesium Citrate. The recommended dose for me was 400 mg.
I would check with your EP or primary care doctor before taking any supplements. I did this with potassium being told it was good to reduce PVCs. What I got back from EP was my blood test showed I was at the upper level of normal levels of potassium and would not recommend taking additional potassium.
The citrate salt formula is the formula most easily absorbed and is probably the cheapest/most widely available. The other salts have their pluses and minuses, but you can research the question. A pharmacist uploaded a video on youtube some months ago where he explained the benefits of the various salts.
I have tried several: beta blockers, calcium channel blockers, and Flecanide. Nothing worked or the side effects were too much for me to handle (feeling tired). We are going to try a drug called Solatol later this week.
Did u try carvedilol?