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

Posted by rr1967 @rr1967, May 23, 2023

Hello everyone. Thank you for reading this below is my story:

I have been dealing with PVCs and PACs for almost 20 years. They flare up once per year usually. I have had Zio Patch monitors, tons of EKGs, a stress echo four years ago, two heart CT scans two decades ago, many ER visits, etc, etc. All results were normal with the exception of showing PACs and PVC. My burden has always been below 2% when they flare up.
25-e some stats:
1. I am 55 and in good health
2. Borderline blood pressure: usually around 120-130/75-85 most normal days.
3. Borderline type 2 diabetic.
4. I do suffer from chronic anxiety and depression. Twenty years ago I suffered many panic attacks for the course of a year. But they have gone away. Mostly I deal with almost daily anxiety and worry.
5. Non smoker, no drugs
6. I do drink alcohol ( wine or beer) on weekends with my wife, only at night.
7. I am at a healthy weight. Cholesterol and Triglycerides all normal.
8. Resting heart rate: 50-60. Cardio doc states that this heart rate is normal for me.

Well my most recent flare up started two weeks ago and they seem worse. I feel the extra beat the moment I wake up they go on all day until I go to bed. I went to the ER and they did another EKG and ran a bunch of blood work. Of course...all normal. Diagnosis: PACs. Electrolytes also all normal.

In the last week, I have noticed my skipped beats increasing when I move around, go grab groceries, go for a walk, even exercise. This has me more scared than ever. My regular doctor told me not to worry, but I am seeing an electrophysiologist (EP) tomorrow. I did see an EP two years ago and he told me I was fine and prescribed Flecianide to take as needed. I saw the side effects and they scared me off so I never tried them. Eventually, the extra beats went away.

I have also tried Metropolol and they did not work. They also made my heart rate slower so my cardio doc told me to stop taking them.

But as stated, they extra beats are back and I am more scared then ever, especially with them increasing with movement or exercise. I have never fainted or felt dizzy from these. I only catch my breath and feel extra alerted.

Finally, my palpitations also seem to increase considerably after I eat a meal. Is this normal?

Any advice, recommendations, encouragement, support please.

Thank you and my apologies for any typos or writing errors.

Interested in more discussions like this? Go to the Heart Rhythm Conditions Support Group.

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.


Hello JC76. Yes my EP did discuss the mental health part of it. I met with a therapist and now I take a low dose of Remeron and Hydroxyzine at night. Along with CBT, my mood has improved and my anxiety has reduced. However these all day PVCs simply shatter my existence and I become terrified and sad all day long.

Jump to this post

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?


Hello jc76.
My EP recommended that I simply start taking a basic magnesium supplement at 400mg daily instead of the Heart Calm. So I started yesterday and I take it with dinner. The brand is Natural Factors which was recommended by on LPs and it is called Magenesium Bisglycinate which is supposed to absorb well and be easier on the digestive system. I am hoping that this and the low dose of Metropolol will help reduce the frequency of my PVCs and PACs. I know that they will never go away, but a reduction would really help my mood and fear level.
Thank you,

Jump to this post

@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.


Can I take Heart Calm if I am already taking a beta blocker for PVCs

Jump to this post

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.


@jc76 what are ICD shocks?

Jump to this post

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.


Has your PCP or EP referred you to psyhcology division? I see a PA at Mayo Jacksonville Physchology Division. She is excellent and works with my EP, PCP, and heart failure doctors.

She prescribed escitalopram which is for anxiety. It has really helped. Years ago I was getting ICD shocks. I developed severe PTSD. I was put on Xanac, and Trazodone to be able to sleep at night and the excitalopram. I have come off the Xanac and Trazodone over a year now but she wants me to stay on the escitalopram for my anxiety over the PVCs and PACs.

My heart failure, EP, PCP, and PA at phsychiatric division have all worked together with medications, life style, etc. and my (knock on wood) ICD shocks have not happened. The pace clinic has adjusted my pacemaker and is working fine along with some new medications.

There is nothing wrong with asking about mental health and other medications to help cope with PACs, and PVCs and can medication help.

I will say again that all physicians should be addressing mental health along with physical health as they interact together. Mental health and coping with high stress medical issues affects quality of life and should be just as much priority as physical health.

Jump to this post

@jc76 what are ICD shocks?

Please sign in or register to post a reply.