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

Hi RR- at this point I can only sympathize with you. This is my 1st time on this forum but my situation almost mirrors yours: 60 years old, super fit all my life (worked out just about every day), good BP (110/70), good resting HR (65BPM sitting, 55BPM sleeping), no medications, no alcohol, low fat/low sugar diet. I had the stress echo and 48 hr holter monitor, but came back OK (only observed 4% PVCs but no other issues; PVCs went to zero at max HR and during recovery period, but were frequent prior to the treadmill while at rest). I feel lot of PVCs most often with any physical activity (like you), even walking up the stairs or watering the garden. Some days are terrible where I am not moving much at all. Other days I can at least walk 20 min. I have unfortunately cut out all exercise, which is against my entire upbringing. I did cardio, weights and yoga 40+ years. I am now concerned I have some form of exercise intolerance. I have a CT Angiogram next week as a final check for blockage (have heart disease in family history). Of course all of this is compounded by anxiety too, so hard to separate that out. I will take 1/2 Xanax once in a while if PVCs and shortness of breath are bad. I also have chest pressure, restricted airway, lightheadedness and weakness when I feel bad. For now, I can't provide anything useful to you except know that there are others out there experiencing something similar, same struggle to figure it out and find a solution. Best of luck to you and will check back in later. SM63

@jwooders3 I use low sodium V-8 for potassium. It has a lot. V-8 uses it instead of salt in the low sodium version.

I started to have an arrythmia today and took a Gas X and sat up straight. I burped and my heart went back to normal!

I agree deep breathing helps calm the strong beats. Found out my potassium levels are low; they increased the dosage to two 20 mecg twice a day a month ago… waiting to see if it’s still low. Laying on my right side to sleep also seems to help.
A nurse tech suggested this may be caused by the position of the lead in the ventrical and it’s proximity to the phrenic nerve.

Hello
I am following up from my original post on being a long term PVC and PAC sufferer. After a really bad episode about two weeks ago, my EP put me on 120mg of Diltiazem, a calcium channel blocker and I take it at night along with .5mg of Clonazepam. I do seem to tolerate the Diltiazem well. The EP suggested that I could go to 240mg but that made me way too tired and lowered my heart rate again. The 120mg at night is just right for me. These drugs due to take about a week to two weeks to fully work.
My pacs and pvcs seemed to have reduced along with my anxiety. Now last night, my wife and I decided to unload some stress and ate some rich food and had too much sugar and drinks. My palps are back today but not in full force as they were in the past two weeks. I guess I have to be very careful going forward. The cardiologist and other doctors have told me that lack of sleep, sugar, especially chocolate, and of course any type of alcohol are all triggers for PACs and PVCs. I pretty much only drink micro brews these days and it had been several weeks since my last beer. I figure a few beers once or twice a month can't be too bad.
I did notice the past few times I have exercised that the palps did not appear but they were present after...I guess this is due the adrenaline still being in my system. My cardio doc still wants me to exercise. I am waiting on the results of my Zio patch heart monitor and it may be another week.

This is a great support group and I will keep posting updates. Your posts have made a difference in my life and thank you!

Oh that’s so so frustrating!! I’ve been down the road you are on and have done everything you have done . I’m not on any heart ♥️ RX now as it lowered my BP too low .
I feel each one as well when I have them . I also have Chronic gastrointestinal disorders daily that can trigger them .
I have to tell you , last night at 2 am , I was asleep and woke up to really crazy sporadic fast heart ♥️ beats .
It wasn’t pvcs or PAC’s … it was something I never really felt before .
I put on my Apple 🍎 watch and did several ecg ( like ekg ) on it .
Omg just watching the screen and what my heart my doing was so crazy . Sure enough my heart rate was 145 and I was in A- Fib for 1.5 hrs .
I got up walked around , did deep breathing exercises. I took my Triple magnesium supplement called Heart Calm by Vital Biologics w/ an xtra potassium. I took 3 , usually w/ in 20 min my pvcs would go away . Not last night w/ this A-Fib .
I finally feel back asleep 💤 and woke an hour later and my heart was in sinus rhythm.
I always have the 1000’s of deep belching and churning gut day and night . This was just so horrific.
Try the product I mentioned. It’s $30 made in USA and free shipping in USA .
It’s 3 diff magnesium’s combined with Q-10 and a small amount of potassium.
It’s saved me many trips to ER .
I pray you start getting relief .
I’m on a 10 yr journey with Gastro cardiac syndrome and 6 Gastros later , a couple of cardiologists. Still I suffer .
God Bless .. Rosemary

Hello
Thank you for information. Both my cardiologist and EP feel that no additional imaging is needed. I have never had Afib and my full stress echo showed completely normal results including the ejection fraction. According to several doctors and cardiologists, any serious heart issues have been ruled out.
Yes, I am always checking my heart rate and sadly, I can feel almost every PAC and PVC. With my diet, I am a vegetarian, never drink coffee (only a cup or two of decaf), and have quit drinking alcohol. I was told today the Diltiazem may take several days to a week to work. I am fine with the PACs and PVCs never fully going way and I can deal with one to three per minute. It is when they go in runs or start hitting hard (almost 10 per minute) is when my anxiety takes over and I become very scared. I can't go on any beta blocker...it simply slows my heart rate too much. I am normally between 50-60 resting and the beta blockers brings it even lower. My cardio and regular doc tell me that my current heart rate is fine and it shows good health.

A couple of thoughts:
Have you had a cardiac MRI? My EP thought my occasional AT and VT were “idiopathic”, until he got the MRI finding that my Left Ventricle was dilated and my expulsion fraction was 43%.
My background: 72yo male in good health (otherwise), developed AFIB in Nov’21, had an ablation in Nov’22 which resolved the AFIB, but have had ongoing PAC/PVC’s with a 15% burden. Like you, they made me anxious and uncomfortable. I was constantly checking my HR on my watch and keeping notes about what I ate. I completely cut out alcohol and caffeine, and tried to avoid red meat. Still they were there. Fast forward to May’23: I had an Insertable Cardiac Defibrillator (combo PaceMaker and Defribulator) installed. At the same time, my EP switched me from Metoprolol to Sotalol and stopped my Eliquis. Bingo! I feel so much better. I continue to see and feel anywhere from 5 to 15% PVC’s but they no longer bother me. It’s too soon for the ICD to be playing an active role, so I’m thinking it was either the Eliquis or the Metoprolol (or both) that somehow affected the way I was feeling. I see my EP again in 2 months at which time I expect he will “tune” the parameters on my ICD and perhaps that will calm the PVCs.

Hello everyone!
Thank you for much for the support and posts!
A few more events and questions.

I had a really episode of palpitations last Thursday and of course, I panicked and went to my local ER. When I got there they did a quick EKG and of course, everything was normal...no palpitations at all! But while I am sitting in a chair at home or in the ER, the palps are firing off like crazy! The moment I lie down to do an EKG, they go away. Well I then had another full set of labs done and a chest Xray. All normal of course! They then did another EKG and I asked the nurse if I could maybe sit up a bit when the EKG is being done. Then she caught one PAC and another. The ER doctor told me that I am fine and my cardiologist then put me on Dilitiazem, calcium channel blocker, to take at night. I already take Amlodipine and Losartan in the morning for blood pressure and my numbers are good. I started taking the Dilitiazem on Thursday night and on Friday, I felt some relief. I am still on the medication, but I struggled all day yesterday and again this morning I am having many PACs. My cardio also ordered another chest holter monitor (A Zio Patch recorder) and I started that on Friday and I will wear it for a week. Cardio doc also wants to me restart exercising as I have been scared to do so with the PACs and PVCs.

My cardio (great person) keeps reassuring me that the PACs and PVCs are not harmful even if they hit 10,000 to 20,000 per day. I am curious to see what my new monitor says but I am sure I am having at least 5000 to 8000 per day. He also told me that his father gets up to 30,000 per day and that he is in perfect health.

I know that these will never go away, but I want them to reduce in quantity and severity. I can FEEL each one and when they hit, my anxiety just soars!

Questions:
1. Do you great folks feel more palpitations when sitting? I feel much more when sitting and they really reduce when standing up or walking around.

2. I notice a huge increase in them when I wake up in the morning? Sometimes they slow down in the afternoon and evening.

3. What have you heard about ways to reduce how many we can actually feel? I have tried Xanax, Hydroxizine, meditation, breathing exercises, distraction, etc.

4. Finally, I keep reading about how the VAGUS nerve could be responsible for causing these. However, I have three cardiologists tell me that vagus nerve is not a cause.

Thank you,

I hear you! I have had SVT for years. They finally put me on a Beta Blocker and it seems to help. Glad the med. is working for you.🙂

I hear you! I have had SVT for years. They finally put me on a Beta Blocker and it seems to help. Glad the med. is working for you.