Why am I having pvcs, palpitations, and skipped heart beats
The title basically says it all. Briefly, I'm a 48 year old guy with a history of rare skipped heart beats. My doctor said it seemed like I was having pvcs and they weren't anything to worry about. It used it be like once a month or so. About 1 week ago I started noticing skipped heart beats a few times every minute. Sometimes it can be hours between me noticing any, but then I have times where they are 5 times in a minute. When they happen, I feel a flutter in my chest and if I'm checking my pulse at the time, there is a slight pause and then I feel the next heart beat. I'm going to call my doctor on Monday to ask about it. I don't have any chest pain, fainting, light headedness, etc. It is just the flutter in my chest. Sometimes it is a little stronger, like a soft hit to the chest. Otherwise, it is just a flutter. Does anyone know why I'd start getting these so often? I did run out of my Vitamin D supplement I take before this started, but I'm guessing that is coincidence.
After about a week, they became a lot less frequent. My doctor didn't seem too concerned but asked if I want to try an event monitor to try to catch one. I said sure.
He ordered me something called the Zio wireless patch, for seven days. I had to go to a cardiologist office and a tech applied the patch after shaving the area over my heart, cleaning the area and then using this special rough pad over the skin to make sure the patch would stick well to the area. The patch was pretty small, maybe 4-5 inches wide by 2 inches tall, with a raised button in the middle. It was flat enough that it was barely noticeable under my shirt. No one commented on it. Basically whenever I felt a skipped best or anything else odd, I pushed the button and wrote down the date and time in a book and explained what I felt in this special diary book.
While it was ordered for 7 days, the device works for up to 14 days. Just my luck, I only had one mild pvc during the 7 day period. I called the company and they said I could wear it for up to 14 days before mailing it in (they give you a special box to mail it in for analysis when done), for no extra cost, and they will analyze all of the data. I waited another 3 days and I had a few more skipped bests. Once I had a few that I was sure were similar to my symptoms, I mailed it in as per the instructions.
A week or so later, my doctor called and said that the skipped bests were in fact pvcs. He said if they aren't too frequent, I don't need to do anything. He said if I want, he could start a beta blocker to try to reduce their frequency and severity. He said it wasn't anything dangerous though. It just feels very uncomfortable, and scary when it happens at times.
So since I made the last post, the palpitations went away almost completely for a few weeks, then came back for a few days, then went away again. I do have occasional times where I may get a few palpitations over a 15 minute period. Sometimes they are stronger and sometimes really mild.
It seems like there isn't a good idea of what causes them to be more frequent at different times. I already avoid caffeine drinks, but have occasional chocolate.
Anyone else have any success dealing with pvc palpitations?
They continue to come and go. I may go weeks barely noticing a single one, and then other days I'm having 4-5 every minute. I'm getting more used to experiencing them, but they still worry me. I did some reading online (a dangerous thing - probably similar to whatever you are doing right now) and I saw that in general PVC's are not dangerous as long as the rest of the heart is normal. Normal means that everything looks okay on EKG and you don't have any other symptoms. Some studies seemed to say that in order for the heart to be called "normal" aside from PVCs, you should have an echocardiogram. I know going to see a cardiologist who specializes in this area is probably overkill, but I did ask my doctor about it and he said he will refer me to a specialist, for piece of mind if nothing else. He also said the specialist can decide whether I should get an echocardiogram or not. Unfortunately, it takes a while to get appointments with these specialists, so it'll be a few more weeks.
In the meantime, I drive myself crazy trying to figure out what is causing me to have more frequent skipped heart beats. My most recent theory is that they became more frequent when I started a new brand of meal replacement protein shakes. I made sure there is no caffeine in them, and there is no aspartame, which I've read some people get increased PVCs from. I stopped drinking them for a few days and maybe they are less frequent - but maybe it is the same. Hard to know.
I'll try to remember to post a follow-up after I see the cardiologist in about a month.
I saw the electrophysiologist cardiologist. He reviewed my event monitor and he pointed out that the 37 PVC's I had during the approximately 10 days I wore the patch amount to less than 0.01% of heart beats. I told him I understand that, but that there are times where I get about 4-5 PVCs every minute. He still didn't think it was a big deal. I'm guessing he sees this all of the time and he also deals with far more concerning heart rhythms where he needs to intervene.
In spite of the relatively infrequent PVCs on event monitor, he said I should still have an echocardiogram, given that it is non-invasive, relatively inexpensive (although he commented that they are more expensive than they should be), and it may pick up something. He didn't pick up anything unusual on physical exam, but I wasn't expecting anything there.
Because I also have pretty severe sleep apnea, he said I may have increased pressure in my pulmonary artery noted on echocardiogram. He said I shouldn't freak out if that abnormality shows up, but he said in that case, he would want to do a cardiac MRI to make sure I don't have something called pulmonary artery dysplasia or maybe he said right ventricular dysplasia. I wouldn't be surprised if I have increased pulmonary artery pressure (pulmonary hypertension) because of the sleep apnea I've had for years.
He said everyone has PVCs and I said they won't bother me nearly as much if they are not going to affect my lifespan. He said they don't unless they start to become around 20% or more of your total heart beats.
I asked him about the triplet (3 consecutive PVCs) and he did say that is not very common. He said that if the echo is normal, even if I had a run of 20 or even 40 PVCs, he would not treat it. I was surprised by that and it does lead me to believe that runs of PVCs are probably not as big of a deal as I thought.
So, to summarize, he said that if my echo is normal, I'm good to go but he would still recommend a repeat event monitor in 1-5 years and every so often after that to see if anything changes.
I asked him if the meal replacement shakes I drank could have contributed and he said that there is no information to support that foods can cause PVCs, but he said that everyone is different and may be more sensitive to some of the ingredients in the supplements. The ones I'm taking had no caffeine or other stimulants as far as I could tell. It does have Stevia and erythritol. I had taken other supplement shakes that had Stevia and didn't seem to have any issues, so perhaps it is the erythritol or any one of the many other ingredients.
I've been without any PVCs for a few days, so perhaps at some point I will try to the supplement shakes again, just to see if there is a clear correlation. I'd also like to not waste the giant canisters of powder.
He did also say that if the PVCs are bothersome, he would recommend a beta blocker. He said they are fairly benign with many people not having any side effects and those that do are usually mild (potential depression or sexual dysfunction). Interestingly he said that for most people the beta blockers do not reduce the frequency of PVCs. He said they really only reduce the symptoms associated with the PVCs. I hadn't heard that before.
So, that is my update. I'm schedule for the echocardiogram in a few weeks. I'll post an update once I get those results.
Anyone else who wants to share their experiences would be greatly appreciated. I get a sense this is a very common issue and it is very bothersome to many people who experience symptomatic PVCs.
I had my echocardiogram. Everything was normal, which is reassuring. The PVC's come and go and can vary a huge amount from week to week. Fortunately, most weeks they are absent now. I can't help but associate them with various dietary changes, but I don't think there is a clear correlation. I was drinking some high protein, high fiber, shakes that had some different types of non sugar sweeteners in it when they first seemed bad. I've since cut them out. I did have a few days where they were occurring but now they seem to have mostly stopped for the past few weeks. When they are gone, I feel pretty good. When they are present, it is highly annoying, and definitely makes my anxiety worse, even though I know they are not a dangerous kind of PVC.
At this point, I guess it is just a tolerate it sort of thing. The cardiologist suggested I do get a repeat event monitor in a few years. It'll be interesting to see if they become more frequent as I get older, and as my body continues to deteriorate. Who knows if it is related to inflammation, diet, or just luck of the draw. If I find out anything new or different, I'll do my best to post it here.
It has been almost a year since I had my echocardiogram. I'd say that over the following month or so, the PVCs gradually reduced in frequency where I would only get them every few weeks, and maybe one at a time. Just enough to know they were there, but they did not bother me at all. I have no idea what caused the increase during the few months they were frequent.
Last night, however, after a particularly big meal, I started having them again. I've gotten much more used to them, so they don't bother me quite as much when they are happening, but they still are unpleasant enough that I wish they would go away for good. I've had occasional PVCs today - a few periods where they were more frequent but most of the day they weren't noticeable. Hopefully they go away for a long time again.
I'll have to see if they come back after my next big meal. Maybe it was just coincidence - but it seems to be human nature to try to make associations between events, even if there is no connection.
I've had heart rhythm issues for years, in part due to a malformed valve. When I started to get chest pains and worsening rhythm problems along with symptoms of "pre-diabetes", I stopped eating carbohydrates and went on a ketogenic diet. It's made a big difference: most pains have alleviated and the rhythm has normed out. However, I've noticed the PVCs returned recently (with a touch of angina) when I drank a lot of hydrating beverage sweetened with erythritol. Big meals of carbs with sugary deserts used to do the same thing. When I cut out the erythritol, the PVCs mostly went away. I take a bit of magnesium citrate and sea salt in water to stay hydrated now.
BTW: I've refused all the heart drugs---they all have side effects---I'm pretty sure statins are poison (profitable poison for pharma and cardiologists), and I'm getting more exercise now that I've lost 40 lbs on the keto diet. Good luck. PVCs are very uncomfortable.
I totally agree that erythritol causes a significant increase in the amount of palpitations I receive
I have the same reaction to erythritol. I’ve been doing process of elimination and every time I cut out erythritol the pvcs go away. They only return after a big meal filled with carbs. But every time I have something containing erythritol they come back strong. Very strange and what’s more strange is the fact that there’s not much info about this correlation.
Although I would say that many people have reported having pvcs while being on keto which I what I was on. Perhaps it’s not keto that causes them but rather the sweeteners. I do think more research and info needs to be available about erythritol and pvcs whether on or off keto.
I totally agree that erythritol causes a significant increase