PACs & PVCs at Night/Early Morning

Just wondering what your cardiologist has said to you about your issue? I want to share that I was diagnosed with A-fib a year ago in October. I had to wait for a cardioversion in Dec, then after some months of "peace" I had an outbreak of A-fib again, tried an anti-arrhthymic and opted for an ablation last November. The A-fib is "gone" but I now have intermittent Premature Supraventricular complex. I thought I had just traded one form of arrhythmia for another BUT my cardiologist just told me that I am super lucky! He explained that this "extra beat" condition is not unusual, is not really harmful (unless excessive) and is so much better than dealing A-fib! Like you, I notice the extra beats more at night or at rest; he said this is also typical since when the heart starts to slow down at rest, that is when the offending electrical site is more likely to "take over" from the AVN. I told him that on the two or three occasions when it really bothered me at night so I couldn't sleep, I took a small dose of Flecainide (had it left over from my trial on this drug) and it went away in a matter of an hour or so. It's called "a pill in a pocket." I am not suggesting this for anyone; it just worked for me. I guess my bottom line is that I left this cardiology appointment feeling very lucky and much more optimistic about the success of my ablation. I can live with these occasional extra beats but A-fib was a real downer, much more dangerous for my overall health/lifestyle and my concern that it would "spread" to a more chronic condition. Just have a real discussion with your doc if you haven't already. Sometimes having something that is slightly annoying is better than something that can't really be controlled, has long term risks and is truly ruining your lifestyle. Good luck.

@sjm46 Thank you for a very positive response! There's this thought in the back of my mind that, "this can't be good." But acceptance is key to living a healthy life, and as you said, "gratitude" is so important. It could be something more serious. Other people are living with conditions that are far worse. My late father had A-fib and eventually needed a pacemaker.

About five years ago when my symptoms where less frequent, my GP prescribed propranolol on an as needed basis. I found that it would instantly to calm down the arrhythmia and after a few days I didn't need to take the medication. It could be months, years between episodes. Currently my symptoms are stronger and more frequent (daily), however, I am unable to take a beta blocker at this point in my life due to a low heart rate. I plan to focus on healthy living and looking forward to discussing options with my Cardiologist next month.

EP told me that the complaint of being aware of irregular beats when sitting quietly or trying to fall asleep is very common. It’s not that you are having more arrhythmia than usual, it’s just that you are more aware of them when all is quiet with no other activity or noise.

Has anyone had any success taking a supplement called Berberline? I’ve read a lot of good things about it but I do have heart failure and don’t know how it might interact with my prescribed heart meds.

@torrise Good! I hope you get support and some real answers. It helps to be "listened to" and my cardiologist is truly a good guy. When I asked him why he hadn't sent me to an electrophysiologist right in the beginning when I was diagnosed with A-fib, he said that while he understood where I was coming from, he had patients that would have been totally against an ablation--"I don't want anyone poking around in my heart"--or what if he had suggested that and then the outcome had been unsuccessful or there was a complication that made things worse. This ablation for me was my choice. He had very good points; I am one that would prefer ablation treatment to meds, but that is not for everyone. Then I pointed out that from all my research, not all EPs are the same and that getting a very good one is essential. He totally agreed with me; told me he sent me to the best one in his system and that they were lucky to have snagged him from another hospital. He also told me that there were others in his system that he would never send any of his patients to! Now that is honesty and I appreciate that. As a nurse, I saw great docs and then some that were not so hot! He also doesn't blow me off because I look things up and advocate for myself. So I hope you won't hesitate to ask for helpful suggestions; you have a right to a good night's sleep!

@jimadman55
Your last sentence is what you need to focus on. I have learned to discuss taking any supplements with my medical doctors. They are the only ones who have your complete medical and mental health history and all medications you are taking.

Supplements and vitamins can affect prescribed medications. I have heard about Berberine but for me would not take it without both my EP and my heart failure doctor saying okay and verifying does not contradict other medications or my health issues.

I was given a recommendation to help with PACs and PVCs of magnesium citrate by EP. My EP did the checking for me with my heart failure doctor who said okay. If not I would have checked with all.

Have been taking magnesium for a long time now. However had some issues with non sustained Tachycardia and was put on a medication called Mexiletine by my EP. It not only almost completely stopped the tachycardia but drastically reduced the PACs and PVCs.

I see a lot of post with individuals under a lot of stress and anxiety because they are monitoring their PACs and PVCs. I know hard not to but worry about them causes more stress and anxiety which will cause more PACs and PVCs. This comes from both my EP and heart failure doctor.

So for me I was told to continue with my exercise routine (I was medically cleared to do) and it really helps reduce my anxiety and stress over my PACs and PVCs. But those who don't like to exercise I always mentioned finding a hobby you like doing. Anything your find favorable and or brings a smile to your face do it. It will really help with stress and anxiety.

One exercise though check with your doctors and let them give you acceptable levels of exercise. I have not done any Sprint Triathlons lately due to skin cancer surgeries but have done about 50 of them since 2017 and I am a heart failure patient with a ICD/Pacemaker.

@sjm46
EP are really good if you have electrical problems. The are cardiologist with special training and experience in electrical function of heart. I had a lot of test done by my EP and have had a ICD/Pacemaker since 2006.

I had on ablation done many years ago on RV and stopped PVCs there. I started having increased ones in the LV but my EP said he would rather try medications first before even considering an ablation in LV.

He first put me on 400 mg of magnesium which helped but was started to have some issues with non sustained tachycardia and PVCs were still there. So EP put me on Mexiletine which really help stop the non sustained tachycardia and also reduced my PVCs and PACs dramatically.

So they can really helped with electrical issues not just ablations but other ways to treat PVCs PACs.

You are correct but my point was that some are experienced and well-trained and provide excellent treatment. Others do "cookie cutter" ablations--like the basic procedure without carefully mapping out the areas of foci in the heart that can cause the arrhythymias. I have heard claims that ablations will only take "45 minutes to an hour or so" using pulse field ablations. Mine was almost 3 hours and it was for A-fib that was paroxysmal, not chronic. So patients need to beware. Make sure your EP is well respected and qualified. Not all docs are the same!

My EP is the director of Electrophysiology and Pace Clinic at Mayo Jacksonville.

Before I moved to Jacksonville area I was seeing local cardiologists along with my EP at Mayo. My local cardiologists would comment on my EP (Dr. Kusumoto) being an outstanding EP and they had attended his seminars and lectures. Dr. K has written books of electrophysiology and president of the Electrophysiology Society.

Hard to get him if new patient as has moved into research. His pledge to any of his existing patients was to still see them. I had 3 ICD/Pacemakers put in by him. I have been seeing him since 2006. He told me recently that I was his longest patient at Mayo Jacksonville. I think he meant politely saying I was getting old.

I have been living with the same thing sense 2011 mine started with it one night I just started to get then by the hundreds it kept happing I told my husband and the next time we went to the doctor he told on me they put me through a lot of test the doctor put me on 25 mg Toprol-XL than in 19 he changed it 50 mg then in 22 it changed I tried to tell him they had changed they were harder he said I was just hipper aware than I changed doctors the next doctor said that I needed to take a different form of the metoprol tartrate 25 mg but if the 25 did not help I could take 2 so far it has helped a lot I hope this will help you good luck