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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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carbcounter | @carbcounter | Nov 6, 2025
In reply to @sandrah2024 "@gloaming yes have used the vagus nerve maneuver but need to look at it more in..." + (show)
Profile picture for sandrah2024 @sandrah2024

@gloaming yes have used the vagus nerve maneuver but need to look at it more in depth and learn the techniques
I truly wish that all of us who suffer from arrhythmias in all their forms could live without the constant fear that something is going terribly wrong. I appreciate this forum so much it gives me a bit of comfort. Good day all!

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@sandrah2024 said:
"I truly wish that all of us who suffer from arrhythmias in all their forms could live without the constant fear that something is going terribly wrong."

Well, I was pretty terrified at first, and doctor after doctor astounded me by just shrugging it off, but that was ten years ago now and I've got the symptoms greatly reduced and figured hey, maybe they were right after all, LOL.

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sunnyguy53 | @sunnyguy53 | Nov 21, 2025
In reply to @megansims "I have had PACs for years as well and finally flipped into Atrial Tachycardia (SVT) and..." + (show)
Profile picture for megansims @megansims

I have had PACs for years as well and finally flipped into Atrial Tachycardia (SVT) and had an ablation. Unfortunately, they returned a year and a half later and my burden was 18-26% depending in the day. They tried another ablation but was unsuccessful, so I also began the med path. Everything so far has caused side effects. Have you tried Propranolol? That was okay for me but it doesn't work for me any more. Flecainide was horrible. I am about to try Norpace. I did finally meet with a Naturopath and she had me take Magnesium, and Heart Health. She checked my cortisol. Nothing really helped significantly. There is some evidence that Arginine and Taurine can help, but I had no luck with that either. If you haven't, ask about Propranolol (it also helps with anxiety) and if not better, see if they would consider an EP study/ablation for quality of life.

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@megansims Have you tried L-Carnitine-Tartrate or Fumarate? The Tartrate was a miracle when I started having arrythmia (PACs, I believe).

There are long-term concerns with TMAO levels -- but I didn't care at that point.

Good luck.

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jallis | @jallis | Nov 21, 2025
In reply to @dnk1kinney "Hello, I have been on the roller-coaster of PVC's for the last year. I have had..." + (show)
Profile picture for dnk1kinney @dnk1kinney

Hello,
I have been on the roller-coaster of PVC's for the last year. I have had two ablations and trialed several beta blockers. I am currently on 100mg of Flecainide twice daily. The side effects for me is fatigue and it governs my HR to 150, no where near it needs to be for the cycling I love so much. I have questioned the hormone connection and will be going for a consultation with the menopause women's clinic in November. I also get extreme headaches and neck pressure on the left side only when they hit frequently. They have said PVC's won't cause that unless there is possibly a narrowing so neurologist consult is in Sept. Unfortunately, my condition increased with each ablation and I don't tolerate the medications well. Good luck with your treatment. 🙏

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Have you ever been on Verapamil?. It works for me, treats both the PVC/'s nd blood pressure, to a degee that doesn't through you into very low. I have beenon that or Veralin for years. Both in ER capsules taked once a day.

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jacerg | @jacerg | Jan 27 11:32am
In reply to @janets "For all of you who have experienced difficulty with PVCs and PACs, I have been able..." + (show)
Profile picture for jan76 @janets

For all of you who have experienced difficulty with PVCs and PACs, I have been able to relate to your experiences. I have had PVCs, and PACs, off and on since I was 20 yrs old. Sometimes the episodes would be very bad. About 3 years ago I developed Afib. Tried a couple of meds which work for a while, also had an ablation that failed. Ended up going on dofetilide, which controlled the Afib, but my PVCs and PACs were out of control and I could barely function (I think that previously the flecainide had helped to control them). I found that deep breathing and meditation helped my anxiety and worked a little with the PVCs and PACs. The doctors had me try three different beta blockers and I reacted terribly to all of them. Then they had me try Acebutolol (a beta blocker that works in a different way than most of them). It is time released, so I reluctantly took the chance and tried 200 mg a day (very low dose). It has worked really well to keep the number and intensity of PVCs and PACs under control and with very few side effects compared to the other beta blockers. For any of you who have not tried Acebutolol, you may want to talk to your cardiologist about it. Good luck. I understand your misery!!!

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@janets I know this is an older post but just wanted to chime in.

I’m in my 60s and this past year, have been having all sorts of issues with my heart - which I chalked up to stress. Lots of PVCs/PACs, fast heart, etc. I started with a very low dose of propranolol (20 - 30 mg a day) which I did pretty well with BUT I was out of breath a lot. Propranolol works on other things besides the heart - like the brain for migraines and the lungs. So i decided to switch to Acebutolol based on the fabulous reviews. It does NOT affect anything else but the heart. I just started 6 days ago and so far - so good. I’m on 200 mg a day - but supposed to up it to 400mg. Not sure if I want to do that. No out of breath issues and I can tell my “flutters” are much better. The only negative I’ve seen so far - is the COST. These are double the price of my propranolol. Folks need to check out this beta blocker!

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