thatoneguy01, I have an ICD/Pacemaker and my device is remotely monitored every 3 months. It allows my EP (who reads the report) to have the number of PVCs and PACs.

I see you mentioned the PVCs in a row. I had about 20 of them over a 3 month period that were 3 in a row. These like you I feel more as it feels like a fast flutter. It is those that bother me the most like you. However after being on a new medication it feels like the PVCs are stronger feeling that before. I have hundreds of thousands of PVCs over a 3 month period.

Regarding PACs I have several episodes of AFIB but they are listed as non sustained meaning they last only a few seconds and reset back to normal. I think I feel this but does not last long enough to really bother me.

Basically I am a mess but have been dealing with this for decades. One thing I read over and over is the stress of the PVCs and PACs. My cardiologist, heart failure doctor, and EP all concur that the stress caused by the PVCs and PACs can lead to more PVCs and PACs thus the stress needs to be treated as well. I do take a low dose anxiety medication and I think it really helps.

I am an avid exerciser and that helps also. I think exercise and the endorphons produced allow you do deal better with the stress the PVCs and PACs. I pushed my EP do to another Ablation but he told me that it would NOT stop PVCs as they are normal and will continue but not as many.

I have a pacemaker so the PVCs interrupt the pacing of my heart. They want my heart paces at 98% and with the PVCs I get only 92%. But it has no impact yet on my exercise abilities so they are reluctant to do ablation. I am on Mexiletine which is suppose to help reduce the PVCs. Don't think that is happening but unless my pacing % goes down will not up the dosage. What bothers me more than the amount of PVCs is that some of them seem to be stronger and I feel them more.

I was not given any recommendation by EP for metropolol (have seen the name though a lot) just to try Mexiletine low dose and if needed can up the dosage.

My EP (Mayo Jacksonville) recommends the Mexiletine as it a short lived medicine in your body and does not have the similar toxic affects of some other heart rhythm drugs. I have to take it every 8 hours though because of it not staying in body nor building up like other medications.
Good luck!