PVC's

Hi Everyone - I am sure this subject has been discussed many times. Anyways, I had dual ventricular pacemake implanted in August - 2009. It went fairly well and I am back to running full time for recreation. About January of this year, I notice like a tremble or shutter in my chest. Nothing really at first, it just happened occasionally. I didnt know what it was at first. About a month later, it continued and picked up with them happening more frequently. I went into my doctors office and they read my data from my pacemaker. I was having early beats or PVC's. This never happened before my pacemaker....although I had other issues. So, they put me on a supplement of magnesium oxide. Well, about a month later, I am having these PVC's approximately 200 plus times a day. They are really annoying and can happen any time whether I am sitting relaxing, working, or running. They actually increase when I get them because I get anxiety from them and they feed on themselves. Nothing really has changed in my life to cause them - no additional stress, change in diet, etc. I have read up on them and cut way down on my caffeine and carbs. But to no avail, they continue. Any opinions or suggestions??? I would really appreciate it.

9 Comments

Thanks Frank

by TLRun - 2010-04-01 01:04:45

Thanks Frank on the info on PVC's. Yes, they are really annoying. Like you stated as you have them, they cause stress and pickup further.....they feed on themselves. I am still puzzled why they started as nothing really changed in my life. I find it kind of ironic that I never had them before the pacemaker or I didnt notice them. I am going to get the issue check out about the ventricular pacing voltage. Also, like you, I am not into being put into a zombie state from meds to slow them down. The trade off is worse.

PVC's

by ElectricFrank - 2010-04-01 01:04:53

The only good thing about PVC's is that they aren't medically serious. They seem to be related to heart tissue irritiability which initiates the premature beat. I've had spells where I had as many as 2500/day for a month or so. They generally disappear during exercise like running and then show up near the end of cooling down. You mention not having any new stress, but the PVC's themselves can be a stressor.

The only pacemaker related issue that I suspect is the ventricular pacing voltage. Some of the worst I've had were when my voltage was set high to handle a loss of pacing.

I also suspect viruses, alergies, and ....

I've turned down offers of meds for them even when they were the worst. The side effects of the meds aren't much of a tradeoff. Same with ablations.

frank

Mayo Article

by ElectricFrank - 2010-04-01 11:04:37

Here is the jist of the Mayo article:

"Rarely, when accompanied by underlying heart disease, frequent premature contractions can lead to chaotic, dangerous heart rhythms and possibly sudden cardiac death."

Note the word RARELY. Actually, you could say that normal heart rhythms rarely can lead to sudden cardiac death. In fact the single most common factor for sudden death is being alive.

We are seeing the beginnings of the next money maker in the cardiac business..ablations, meds, and pacemakers.

frank

PVC"s

by lenora - 2010-04-02 01:04:12

Yes indeed PVC"s can be dangerous and life threatening depending on the frequency and where they land in the cardiac cycle and can be damaging to the myocardium over time. Discuss this issue with your cardiologist and don't allow the advice to strangers to influence your medical care.

Renee

by ElectricFrank - 2010-04-02 02:04:09

I wasn't accusing Mayo of using PVC's to enhance money making. Actually, their article is well balanced gives some guidelines as to when PVC's may need to be followed up in more detail. I just went back and reviewed the article and the part I clipped is the only place where sudden death is mentioned. In your original post you stated that "they can be very dangerous and, in some cases, lead to serious arrythemias and sudden death" and suggested reading the Mayo article so I clipped the part relevant to your warning.

As for my comments about money-making, I have seen an increasing number of posts on this forum by people who have had AV ablations plus pacemakers to treat the resultant AV block. Many are very unhappy with the outcome.

frank

Another opinion

by ElectricFrank - 2010-04-02 02:04:24

I clipped this from the University of Iowa Medical Clinic site for what it is worth. It gives some history of current thinking about PVC's

"Premature ventricular complexes (PVC) mean that the extra beats originate from the lower pumping chamber called the ventricle. There has been much discussion over the last 10 years or so of the significance of PVCs. Early studies have demonstrated that patients in the first hours of a heart attack who have PVCs in the critical care unit (CCU) may be at slightly increased risk of having cardiac arrest as a complication of their heart attack. Unfortunately, that observation became more generalized to PVCs that occur in otherwise healthy people. This led to treatment with powerful heart rhythm medications in people who did not have a life-threatening heart rhythm disorder. In some cases, these powerful heart rhythm medications can create heart rhythm problems that they were meant to eliminate, and patients with a low risk of sudden death or cardiac arrest actually experienced cardiac arrest because of the heart medications. One famous study in patients following a heart attack with PVCs showed that the patients treated with placebos, or sugar pills, had a better survival rate than patients treated with powerful heart rhythm medications, even though the heart rhythm medications completely eliminated PVCs. In my own practice, if the PVCs are so symptomatic as to be disruptive, I make sure that I've eliminated all of the factors such as caffeine, certain foods, stress, before I consider any treatment with medications. When I do treat with medications, I try to use simple medications such as beta-blockers. Very frequently, this is enough to improve patients' symptoms. In summary, PVCs are common. In the vast majority of cases, they are of no prognostic significance and frequently go away on their own without any treatment beyond being reassured by your doctor."

From my perspective creating more fear about PVC's just increases their likelyhood in many people. Anxiety is near the top of the list as a possible cause in most of the articles.

fraNK

PVC's..continued

by jm - 2010-04-02 02:04:47

I have a Medtronic pacemaker which was implanted in January/2010. I have gone to the Heart Clinic twice due to racing heartbeats, heart flutters, and SOB. Was told that I was having PVC's but not to worry as they are not life threatening. I don't notice them if I am still, but if I walk a short distance or DRIVE ( I know this sounds crazy) they start up. At first I thought it was anxiety attacks, but I really think it is related to a setting in my pacemaker. I mentioned this to my Ep and she informed me that was not so....I have also been coughing more and I do not have a cold or allergies. I was told that some folks cough when their pacemaker is pacing. It just seems that when my heart rate gets too fast and the pacer kicks in it is a vicious cycle to get back in sync....I mentioned turning off the Rate Response but I swear I was really given a very strange look and told NO.

My Status

by TLRun - 2010-04-02 08:04:26

Here is my status on the PVC's. About two years ago, I had an ablation done for a-fib. Before that was even diagnosed, they had diagnosed me with advanced stage of Wenke Bach - Stage 3 with a very low heart rate. What is all strange about this and things that dont make sense and not fair in life ( I am well beyond all that) is that I am a distance runner. I have ran Ultramarathons up to 100 Miles at a time. So, I thought it was kind of ironic that someone who basically took care of themself, would have all these issues. But that is life, it was going to happen no matter what, it was in my genes as the doctors have explained.....lucky me and lucky fellow pace maker co-horts.
I had a download of my pacemaker two days ago. It picked up the PVC's. The Nurse Practicioner states they are benign. But if I want to put on medication they will. I am not crazy about it but at this point, something has to give. I am having them constantly. I barely remember my doctor telling me right after surgery that my third lead might have to be adjusted or turned off as its laying down the middle of my heart and very close to one of the other leads....thus it would cause fluttering or interference as he said. Anyways, trying to see him is like trying to book an appointment to see the President of the US to discuss this. So, around and around the circle of calls and phone tag I continue to get to the bottom of this. Anyways, I do appreciate all the advice and articles mentioned. I do read this stuff and very much appreciate it. Thank You!!! - Tom

Tom and jm

by ElectricFrank - 2010-04-04 01:04:42

It's really a matter of personal decisions what you are comfortable with.

The responses both of you are getting from your doctor/cardiologist would not be satisfactory to me. They don't make sense.

First off, I never accept that strange look.It is common and is a ploy to get you out of the office. You have two choices accept it or take action. There may be a good reason that the Rate Response is needed, but at least you deserve an explanation.

As to the story about the third lead being too close to another lead it is just that..a story. The only way that lead could cause problems is if it has a defective shield which lets current escape from it. In that case it needs to be replaced. There was a reason they specified a 3 lead pacer in the first place so to just be cavalier and turn one off doesn't make sense. The best way I have found to get an appt is to go by the office and make one at the desk. That heads off the phone tag. Don't take no for an answer. Another is to write a letter stating the problem and request a response in writing stating the diagnosis of the lead problem. Most doc don't want to put a bogus diagnosis in writing.

All I'm saying is that there are proactive steps that you can take to get a calm reasonable response to your issues, but they require becoming assertive and sticking with it. The other alternative is to leave it up to your doctor.

best of luck,

frank

You know you're wired when...

You play MP3 files on your pacer.

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