Felt PVC's

Had the reimplant after complications on Feb 6th of this year. Initially great, two weeks in started having a lof of PVC's (900 in two weeks time), then again at six weeks, and now "again" the last two days. Sometimes the are a small flutter feeling, other times it's like a grip and squeeze sensation that lasts a whole second followed by heart rate increase and a warming sensation around my heart.
I am going to ask to wear a heart monitor so we can be sure they are PVC's or PAC's, but is there a chance they aren't? I've read about Afib, but it seems like they would feel different or at least last longer. Are there other possibilities I haven't considered? Are many of you having "felt" PVC's a year out? I know healthy people have them, but most folks feel nothing and dont know it.


11 Comments

PVCs

by Jimmy Dinfla - 2018-05-23 19:43:50

Agree with your decision to wear a monitor and asking your cardiologist to interpret results.

Recommend reading a posting by:

MARTYP, May 19, Forum: Coping

addressing PVCs, etc.

About 5 percent of my beats are PVCs.  Sometimes I feel them, but most of the time I do not.

 

???

by The real Patch - 2018-05-23 20:24:01

You're already wearing a heart monitor

Good one...

by donr - 2018-05-23 21:27:28

THIS IS ALL SCREWED UP!.  I fixed it w/ editing
...Patch!

Afib & PVC's feel nothing alike.  Afib is a faster than normal, generally uncoordinated rhythm HR that you may or may not feel.  I have them infrequently in short runs that my PM senses, but I do not.  In my dotage I mixed them up w/ A-tachy, which is a high rate that my Cardio defined as 175 BPM lasting more than 5 sec for sensing & reporting by the PM. 

OTOH, a PVC runs at your normal HR, but feels different.  There is a distinct pause in the middle of one, followed by a very strong THUMP! of a beat following the pause.  So here's what you would sense were it PVC's:  ...thump,thump,thump, thump, pause, THUMP!, thump, thump, thump...

The "unbolded" thump is a wimpy little beat that comes EARLIER THAN NORMAL, but is weaker because the ventricles are not full of blood yet because the contraction is premature.  The pause compensates for the early conraction "Earliness" to re-establish a NSR, then the THUMP! because the ventricles are now a bit fuller than usual because of the pause.  If you are feeling your pulse at the time of a PVC you can sense a very distinct pause followed by the stronger beat.

I have a reasonably decent concept of how a PVC feels - I've had several milliion of them since getting my PM in Feb 2003.  Sorry for the confusion.. .singles, runs, couplets, you name the combination, I've had it.

Hope this helps you figure it out.

Donr

Afib/Aflutter/PACs/PVCs

by AgentX86 - 2018-05-23 22:36:34

No, AFib is not anything like "NSR but faster".  AFib is usually a *very* irregular heartbeat (like constant PACs, which is more or less what it is) and, while it is usually faster than a normal heartbeat, it isn't necessarily faster.  Aflutter is usually, but not always, a very fast but regular heartbeat.  The atria beat very fast (up to 300bpm, even) but the heartbeat will be some whole number divisor of that (1/2, 1/3, 1/4, etc.), resulting in a constant heartbeat.

Your description of PVCs is just like Afib.  My Aflutter what similar, since there was no rate lock (alternated from 2:1, 3:1, 4:1 at random).

More information?

by AgentX86 - 2018-05-23 22:41:09

What sort of pacemaker do you have?  Number of leads?  Mode?  Why did you get it? Any sort of procedure (other than the implant)?

Perspective:

by Gotrhythm - 2018-05-24 14:56:29

Don't get too wrapped up in chasing down PVCs. I know 900 in two weeks sounds like a lot, but it's really not. A Holter monitor test once showed I had had 40,000 in two days. The PE found that an impressive number, but not an alarming one.

Think about it. Calculating a steady rate of 60 BPM, you have 3,600 beats per hour. That's 86,400 a day. Of course, with rate response turned on, the actual number of beats would be higher. In two weeks the number would be well over a million.

At 900 PVCs in two weeks, that's roughly 65 beats a day that weren't missed, they just weren't as efficient--see Donr's post--as all the others. Figuring 86,400 beats a day, that's a less than one hundredth of one percent*.

Think about shooting baskets and in 3600 tries and scoring better than 99.9%. That's how well your heart is doing. 

To answer you other questions, these days, almost 7 years out I still have PVCs--how many, I don't know. Some I feel, some I don't. When I do feel them, the "grip and squeeze followed by a warming sensation" is more common than the skipTHUMP that is often described. Less often I feel a sort of flutter/stutter. Still, it's all PVCs.

I don't have A-Fib.

* IF my math is correct--and that's a BIG if. Check the numbers yourself.

Thanks all

by bposter - 2018-05-24 17:38:09

Thanks all for the responses, sorry I didnt reply sooner, it's been a busy day.

Yesterday I had about 30 strong clench and squeeze PVC's along with a lot of flutters and a few thumpers, I called up to the hospital and the doc decided I should wear a monitor for 30 days so we can see what they are exactly. We both think it's likely they are PVC's, but the guessing is what's hard. I think I could easily deal with the occasional flutter, but these strong clenchers often stop me in my tracks and worry the people around me. I had two the other day while mowing, they were strong enough that I stopped walking involuntarily. Those...those I dont like. It feels like something is really wrong, and it's hard to convince the emotional portion of my brain that there is not. What makes it worse is that before the pacer and the weeks between the replacement I had 'zero' felt PVCs, not even flutters.

I wish I knew more about them, the why, and I wish I could know for sure they werent dangerous. The two docs I've seen both say "they 'shouldnt' be" but they refuse to day 'they 'cant' be', I'm sure for liability reasons. I dont love wearing the monitor, and wish I had kept the under-skin loop recorder I had in when all this started. I mistakenly assumed the pacer would do exactly what the loop recorder did and more. The pacer (Boston Sci L331, dual chamber) counts PVC's, but doesnt record the ekg for minutes before and after an event, which is exactly what the loop recorder did. Lesson learned.

Like everyone else here I just want to express my appreciation for you all. Even though we dont always have resolution we do have shared experience and a safe place to say "this sucks!" and "it gets better". Hopefully these 'are' just PVC's (doesnt sound like afib, thanks for explaining) and I learn to live with them.

I used to drink two Monster energy drinks a day just because I liked them, now 10mg of caffeine with almost guarantee 2-3 strong PVC's within 20-30 minutes. That amount should do nothing but it's too consistent for me to ignore. I am beginning to wonder if I have other sensativities that I havent recognized yet.
If there is anything besides caffeine on the "strictly avoid" list please share. Thanks again

Besides caffeine

by AgentX86 - 2018-05-25 00:03:09

Alcohol.  Some have sensitivities to rich food, too.

Is the monitor an "event monitor" with a cell phone connection?  That's what they gave me.  It only took three days for them to give me the "get the to the ER" phone call (at 3:00AM).

 

My First PVC...

by donr - 2018-05-25 02:11:22

...hit me at 9:20 PM. 15 March, 1977.  I was standing in a kitchen I shared with another officer at Aberdeen, MD, a US Army base.  I was drinking a can of Coke.  At the time I had zero idea what a PVC was.  Never heard of one - except as water pipe that came in 10 ft lengths.  Now, was that dramatic?  I still can recall it plain as if it were yesterday.  I thought my heart had actually stopped & I kinda slumped onto the counter top briefly.  Was I scared - you betcha!  Now we al sense these things differently - you call it squeezing - others call it "Flip-flopping."  Now fast fwd to Feb, 2003, when I got my PM implanted.  I'd had arrhythmias for several weeks, always feeling rotten.  I was having runs of PVC's, but did NOT recognize them as the same things as that dramatic event of 26 yrs before.  I wound up in the ER, then into the Hosp & 3 days later was sporting th scar where the PM went in.  For some reason, I did not have as many PVC's after implant as I did before.  But have them, I did & they disturbed me.  I'd complain to my Cardio & he'd say "Those are PVC's.  they won't kill you."  His head nurse said the same thing.  His companion EP & his nurse said the same thing.  Four yrs later, his new EP associate said he same thing.  After another couple yrs, I finally believed them - I was still alive - & forgot them.  I no longer sense singles, & not many short runs - but a multi-second run can get my attention. 

ACtually, they can kill you - too may long runs can morph into VTach, then to V Fib.  What is too many?  I approached that limit in Jan 2018 when I had the beginnings of a heart attack that involved a lot of PVC's - but I'd been having a lot of runs for some nearly 5 months.

Hope youcan get a handle on this problem.

Donr

 

PVCs

by The real Patch - 2018-05-25 17:10:18

Look, we all react to stimuli differently. I have no issue with caffiene or alcohol in moderation but other things can trigger various arrhythmias I enjoy and frankly I can't really tell them apart. What you have to do is experiment. If you stop coffee and the problem diminishes quite a bit, good chance that's a trigger for you. Delete one thing at a time, don't drop everything as you'll never really know the problem source. Now I'm not saying eat drink and be merry but use some common sense and if you slowly weed things out you'll find the root cause if indeed it's even due to food or beverage.

I have PVC, SVT, PAC, VT, V-Fib, palpitations, and atrial flutter, honest, I can't really tell them apart and most often don't even feel them. They tell me about it when I have an interrogation. That's why my device is there, to take care of and manage those issues. My Dr and I don't even discuss how many I have, what's the point? Oh and I'm 11.5 years out.

Here's my point, you'll drive yourself crazy if you worry over every little thing and by the way stress is a trigger for arrhythmias. Relax and enjoy life, if all you do is worry about dying, you really aren't living.

...

by bposter - 2018-05-27 22:16:40

I appreciate the feedback everybody. Truly. Hoping these settle down soon. I could live with the little ones, but arrhythmias that stop me mid-stride are hard to ignore. I've had a dozen today that hit hard enough they startled me when my heart kept beating, was sure each time something serious was happening. It's crazy to think some of you have these daily for years. I went a whole month without this, hopeful my body finds its way back there.

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