Long Term PAC and PVC Suffer. Need your support and guidance

Anxiety can be such a difficult conditon. Do you wear a watch (Fitbit/Apple etc) to measure your heart rate throughout the day? This can help determine tachycardia and how high your heart rate goes during these events.
You mention your recent flare started 2 weeks ago, did anything precede it? Some possible triggers - recent illness, recent vaccines, allergic reactions?
Have any of your doctors mentioned dysautonomia or postprandial tachycardia?

Anyone had the lariat procedure, vs the watchman.

How about this for a laugher. I went to get an ECHO to check on heart function and more specifically LBBB. Results came back and EP said my results were normal and for now I do not need a pace maker. Also my EP allowed me to start on bio-identical testosterone per my functional medicine doctor. Here is the laugher. Upon leaving the clinic the engine on my car seized up in the parking lot. Ha 87,000 miles practically new and it's shot. But hey my ECHO came back normal and my ejection fraction ratio is up to 55%.
After engine seized it had zero ejection fraction ratio. LOL!

hHeart arrhythmia is frequent for me at times, mainly PVCs. This current regime is helping. I have been walking daily for 30 minutes since December 12, 2023. Lost 13 lbs so far. Limit sodium to under 1750mg daily and liquids 64 ozs. In March I started taking Q10 100 mg, 0live leaf extract 100mg daily and K2 100mg. PVCs are down from 20 per minute to 0-2 per minute resting. The PVCs go up during exercise but now I only get about 5 per minute on the tread mill. Stopped drinking beer\wine in the evenings, or any alcohol for 3 months and now have added back one glass of white wine on some Fridays. One heart medicine: Enalapril 2.5 mg daily. (I tried 5.0Mg but it was too much for me. Extreme loose stools and venule bursts in fingers and legs.) I allergic to beta blockers except one, bisopropolol and swore it off due to the many side effects. I looked at statins and the side effects on my wonky liver would be a disaster. My career was highly stressful and when I was diagnosed in December with heart failure 35% EF and LBBB I knew I had to quit. That lack of stress may be what is keeping me alive more than anything. Still I am extremely dizzy and unsteady on my feet due to low blood flow, but the Enalipril gave me back my breathing at night, on a one to no pillow surface, and I no long feel faint all day long. If you are stressed at work I highly recommend a lower stress job.

I had a follow up with my EP today. I recently went through a 3 + month period of 22% PAC heart burden. He said ablations for PACs are all but impossible because unless they are firing very rapidly like every 2 or 3 second that cannot be found and ablated. Luckily they have really calmed down. I have considerably fewer of them and a low more normal sinus and bradycardia sinus and far far fewer possible Afib (according to the Kadia which cannot tell a PAC from Afib.
I have changed some supplements including some probiotics that affect the heart and very high doses of ubiquinol. I'll see if this keeps up. For those of you with 2% burden you have no idea what 22%. burden is like. Its freaking awful. I also had a 2% PVC burden which adds up to 1/4 of my heart beats are dysfunctional.

rr1967
Can you talk to your EP and see if they can refer you to psychiatric medication specialist. I go to Mayo Psychiatric department and see a PA who speicalizes in psychology medications. She works with my EP and heart failure doctor before prescribing any medications.

She prescribed Escitalopram 10 mg many years ago to help with my anxiety. This medication was cleared by my heart failure and my EP okay for me. It has really helped reduced my anxiety over the PVCs and PACs.

I am not familiar with the medications you were prescribed but I take my Escitalopram in morning as it meant to be an all day medication. You can always asked your EP about it. What is good for one patient may not be appropriate for another.
Good luck. Also when you get anxiety at night time have you explore doing the deep breathing technique to help reduce anxiety?

@rr1967 You did the right thing asking your EP about what to take. What will work and what is good for one individual may not be for another individual. I think that is important on MCC.

Mine wanted me to take Magnesium Citrate. I was taking another form of Magnesium and was not helping. So I switched to the citrate and wow they did not go completey away but drastically reduced. There are so many addititives to magnesium it can be confusing of what you should take and that is great you went to your EP. It is the same thing I did as the magnesium supplement I was taking was not citrate. Citrate is absorb very quickly in digestive system and is sometimes used to help with BM and constipation.

And you are right on about if it can reduse the PVCs and PACs it really affectgs your mental outlook and moods. Good luck. Sounds like you have a good EP and well up on supplements and what is best form of magnesium for you.

@chantalf
These are questions you should asked your cardiologist, EP, or PCP. They can determine if a supplement is adversary or helpful with all your medical conditions, especially your heart and what you are taking for your heart.

I know a pain but it is what I do. Most of time they say no problem but several times advised I not take that particular supplement and/or a specific form of it would be better.

@windyshores
ICD refers to Inplanted Cardiac Defibrillator.

Mine will speed up my heart when ventricles goes into tacacardia and if that does not work it will give me an electrical shock to heart. That, at least for me, has worked about a dozen times.

With changes to my pacemaker programming and new medication I have not had any shocks or even elevated pacing for over 6 months. I am knocking on wood when I write this.

@jc76 what are ICD shocks?