This picture says it all. This is how I feel some days when I’m “under attack” by PVCs and PACs. More on that in a minute.
It’s been a while since I posted about my one year anniversary of being free of afib so I thought I’d provide an update.
The great news is I continue to be free of atrial fibrillation and for that I’m so happy and grateful for. After being afib-free now for over 15 months I’m almost to the point where I don’t worry about having another episode. I said “almost” because that dark cloud still lingers over my head. I don’t suppose that will ever go away completely until they find a true cure for afib.
As those of you who are enjoying a life free of afib because of a successful ablation know, we are essentially in a period of remission. We pray to God that it will be in remission for good but like a cancer patient in remission, there is always the chance our condition can come roaring back to haunt us. I’ve always said if I can buy at least five years of afib freedom from my first ablation I’ll be thrilled so we shall see what happens. For now I just enjoy each and every day I’m blessed without afib (and without having to take drugs either)!
Those Nasty PVCs and PACs
I’ve posted in the past (here and here) the battles I’ve had with PVCs and PACs since my ablation. Well, today the battle continues. I have a string of really bad days and then I’ll have a few decent days and sometimes I’ll even have days where I don’t have any PVCs and PACs; or at least I don’t feel them. Those days are far and few between but they are glorious!
On the bad days it’s hell. It’s almost as bad as being in afib. I just feel like crap all day and it really gets me down mentally. I do my best to stay positive but it isn’t easy. I just pray during those times and try to have total faith in God that I’ll be o.k. and that someday He’ll cure me of these palpitations.
I honestly don’t know why I have them. I don’t know if they are some kind of side effect of the ablation or if they’re just yet another heart issue I have to deal with. I tend to think it’s more of the latter. It’s easy to point to the ablation as the culprit since I never had nagging PVCs and PACs before the ablation but I’m just not convinced the two are connected.
I didn’t have any PVCs or PACs immediately after my ablation. They didn’t kick in until about four months after my ablation. Furthermore, they seem to have only gotten worse over time, which provides further evidence these aren’t likely connected to my ablation but who knows.
Even if they are, it’s water under the bridge at this point. What’s done is done and I wouldn’t do anything different. I’d gladly exchange a life free of afib (and drugs) for nagging PVCs and PACs – so long as they aren’t so bad they lead to heart failure!
PVCs, PACs and Heart Failure
If 20% of your heart beats are consistently (and that is the key) PVCs and/or PACs, this is when doctors start to get concerned. At 20%, you run the serious risk of heart failure. Usually at this point doctors will intervene with drugs or an ablation.
Fortunately, I’m not there. I use my AliveCor monitor regularly on my “nasty days” and I’ll have anywhere from 6-9 PVCs/PACs per minute. With my resting heart rate of 60 beats per minute that puts me around 13-15%. Yes that’s high, but not at the 20% threshold. And even on my nasty days I don’t think I’m having that many every single minute for hours on end.
If I start having a lot more nasty days than o.k. days, or if on my nasty days I start approaching 20%, I’ll definitely be calling my doctor to get a 30-day monitor so we can see exactly how bad they are and come up with an appropriate game plan. For now, I’m just trying to ignore them and live my life.
I’m going to continue to try to pin point what might be triggering these PVCs and PACs. I don’t know if it’s the supplements I’m taking, my diet, or if they’re just random like my afib was leading up to my ablation.
If they continue to get worse, as I mentioned I’ll be making a call to my local EP to get a 30-day monitor so we can see what is going on. Hopefully it doesn’t come to that but if it does it does. I’m confident that these will either settle down themselves or I’ll find a way to defeat them…or just live with them.
I hope everyone reading this is doing well. Feel free to reach out to me if you have any questions about your afib or just want to connect with a fellow afibber. Take care and God Bless!
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I have been reading through the internet trying to find a solution to my case. It’s long story but I will try to make it very short.
I studied to be a pilot in 2007 and I got my license in 2009. I have been searching for a job since but have had no luck.
Last year I got the chance to apply and I passed everything so it came to the final stage where I have to do my pre-employment medical check and guess what – apart of that I was scared not to have this job and so on I was thinking too much about my future.
The doctor said all the blood tests and other things were fine and normal except that I have PVCs on my ECG. He made me do an echo and stress ECG and a few more tests and all came back normal except PVCs.
I also did a holter monitor for 24 hours and it showed 4,200 PVCs a day. They didn’t know the cause of them. I don’t drink but I do smoke and use a ventolin inhaler.
The doctor told me to take Concor 2.5 with Cordarone 200 once a day and come back to check.
I went to so many doctors in another hospital to check what other options I have and most of them told me not to take Cordarone as it is very toxic. Since that time when I start to feel the PVCs in my chest 2 months ago and it’s in my head no matter what I do. I still think about it.
Anyway, I took Concor 2.5 one pill in the morning and one at night for 8 days and I went to do an ECG and the PVCs were sill there. The doctor said Cordarone 200 is very effective so I am on it for 6 days now, one pill a day and I still feel the PVCs.
I don’t know what to do as I have a short time to make them disappear before I go for the job check again.
Otherwise my job doctor told me if I take the medication and I still have PVCs after one month they might consider doing an ablation for me as they don’t know the cause of the PVCs.
I am very worried rather than scared. I just want them to disappear so I can get the job of my dreams. Should I give meds more time to work?
Even though I tried all sort of things I gave up smoking, caffeine – you name it – and I walk 1 hour a day but still they are there. I am having another Holter after 2 days to see what will happen.
Please, can any one help and tell me what to do?
Sorry to hear about this. These PVCs can be nasty and troublesome for sure. Are they giving you the Cordarone specifically for the PVCs? If so, that doesn’t sound right. I’ve never heard of a doctor prescribing amiodarone (Cordarone) for PVCs. As you’ve noted, that medication is very toxic and stays in the body for several months after you stop taking it. It’s usually a drug of last resort for any heart-related condition.
PVCs, while very troublesome at times, are usually benign. Doctors don’t get concerned about them until 20% or more of your total heartbeats are PVCs. You are well under that threshold.
It’s possible the inhaler you’re taking is contributing to your PVCs. Side effects of these inhalers include irregular heartbeat and/or rapid heartbeat. You might want to discuss this with your doctor.
Believe it or not, but sometimes the very drugs they prescribe to treat heart conditions can cause heart conditions like PVCs and PACs! You’re taking a couple different drugs, one of which is very powerful and toxic, so it’s possible these drugs are contributing to them. However, it sounds like you had PVCs before going on these drugs so it’s less likely that these drugs are contributing but they clearly aren’t helping either.
Some people are able to control their PVCs through a variety of natural remedies including stress reduction, improved sleep, taking certain supplements such as potassium and magnesium, and improving their diet.
If I were you I don’t know that I’d jump straight to an ablation at this point. While you’re having a fair amount of PVCs, you’re not having anywhere near the 20% threshold. PVC ablations are very difficult to do so it takes a highly skilled ablationist and even then they aren’t always successful.
I wish you the best!
thank you for your reply thank god someone there.
now the cordarone i am taking on the 11th day now and i just removed my holter yesterday and the pbcs went down from 4200 to 700 per 24 hrs so the med is working i guess and doctot said i can stop it whenever i want but the thing is at the moment my biggest concern is how to pass another ECG without PVCs.
what i have to do now is going to the company doctor and do ECG and he said if there are no PVCs shows i will sign you as fit to fly and you go to the course and sign you contract and if otherwise he will have to do ablation.
they seems like they have to treat everything you have before they sign you off but now i am happy that PVCs went down to 700 and scared at the same time that one of them will show there.
so i thought i will take cordarone another week or so and then i will go to do ECG and see what will happen.
and as of the inhaler yes i just found out recently that they cause PVCs but i found out something that before when i smoke i need to use the inhaler once or twice a day just to make the wizzing disappear but when i gave up smomking 3 weeks ago i didnt need to use the inhaler not even once and i thought about everthing i do and i tried to stop everything that might cause them but PVCs are still there so i dont what is the cause.
as for the cordarone i am not taking it for long term. the doctor suggested this as a fast option to make them disappear in one month then i give it up and it will just make me pass the job ECG and once that passed no need for me to take it anymore.
so what do you suggest and what is your opinion about my case.
and thank you very much for your time writing to me.
Your blog is great! Thanks for all the info and insights that you share here.
Can you point me to any websites that discuss the problems associated with frequent PACs (>20% of beats)?
I’m a 50 y/o woman and started having palpitations 8 months ago; was diagnosed with AF by cardiologist, started on propafenone, and sent to an EP; told by the EP that I didn’t have AF and to stop taking med; had renewed palpitations and told by cardiologist to get back on med. I’ve been back on the propafenone for over a month now (and overall feeling much better on it), and I’m having frequent episodes of frequent PACs: 20 per minute at a heart rate of 80 for an hour or two at a time (my resting heart rate is 60) occurring every other day or every few days now, plus fewer random PACs throughout the day everyday.
My Kardia (OMG I love that thing!) tags these episodes as AF. I sent the recording to my cardiologist and got two sentences back saying that they are PACs not AF, but they cause symptoms. I know she’s busy, but I’m concerned because my symptoms are a problem: fatigue, dizziness, shortness of breath, exercise intolerance. I had near faints before the AF diagnosis, and I don’t want to pass out while I’m driving or take a tumble and get hurt. I’m also concerned that these PACs might indicate that I’m headed to AF again, if that’s what I actually had to begin with.
I’ve made an appointment with a new EP, but the soonest I can get in is a month from now. Any info you can share regarding frequent PACs would be appreciated.
Sorry to hear about all your struggles with PACs. I don’t have them as bad as you but I can fully appreciate how crummy you must feel at times when you get them. They can be horrible!
I can only tell you what I’ve learned and what I’ve been told by various experienced EP’s. PAC’s and PVC’s are usually benign. My doctors have always told me they don’t get too concerned until 20% or more of your heart beats are PVCs or PACs. Even then they would monitor things to see how often they occur at that rate and what damage, if any, they are having to the heart. 20% of your heart beats might be in PAC’s or PVC’s but if it’s “only” that bad a few hours every other day or your heart still looks healthy, they will likely just tell you to live with them.
You can have an ablation for these if they get that bad, however. And you can take drugs such as flecainide and propafenone to help tame them. Again, that’s what my doctors have always told me.
Aside from ablations and drugs, sometimes you can find relief with supplements and changes in your diet. You might want to look into magnesium for starters. As for diet, the Paleo diet is one that is always recommended for afibbers. I’m not on that diet myself but if my PVCs and PACs don’t settle down soon I might give it a try for a while.
If you have any specific questions, fire away. I wish you well and I sincerely hope you find relief. I know they are miserable.
I believe you must hope and pray for a total “healing” of your PAC’s and PVC’s, just as you were healed from the AFIB.
My short story: Got afib when I was 24, then lots of meds. 5 cardio versions and an Ablation in 2003 (In Pretoria South Africa).
After the ablation, my heart went into afib 3 times. Got it back in sinus once with prayer (pastor prayed for me). My doctor would maybe say it was the meds because I was put on a drip with I think cordarone/amiodarone and the other 2 times with cardio version.
The last 2 times I went into afib I believe it was dehydration mixed with exercise and drinking alcohol the previous night (yes I know I should have known better), and the other time was taking a caffeine drink during a long cycle training ride.
I am now AFIB free for nearly 3 years and it is wonderful!
Keep the good faith, you can overcome!
Three years and afib-free…that’s so awesome to hear!! Congrats! I wish you many more years of NSR, my friend. Thanks for sharing your story.
My afib started in Jan of 15 with a really erratic heartbeat that took me to the hospital. They gave me something to slow it down and it went into normal sinus rhythm within 30 hrs. I then had one on July 15th but my heart wasn’t so rapid. I went to the hospital and they gave me an I.V. and I went home with the afib. I think that one lasted 4 days.
Then on March 9th 2016 I had one and it lasted 6 days but I didn’t go to the hospital. Then on May 8th I had another one and it lasted 7 days without going to the hospital.
My question is this. If my heart is beating erratically, but not rapid (not over 90), is that still considered afib? I will be 73 this month and I’m starting to feel like I’m on borrowed time. They say my heart is healthy except for the afib. I have been on blood pressure pills since the age of 55 and I’m on thyroid (mine was removed) and warfarin.
There are a lot of things on the blog that I might try. Low sodium V8 for one, but are they any that seem to be more successful that others? Also, do you think the vagus nerve has a lot to do with it? I have had vaso vaso vagal attacks years ago just out of the blue for no reason. I’m starting to think it may have a lot to do with it.
Thanks for any info you may give!
For starters, you’re only on “borrowed time” if you don’t take action and get your atrial fibrillation addressed. If you just let it go unchecked you run the risk of stroke and potential heart failure. It sounds like you’re fairly early in the process so there is plenty of time to get this under control so you have many GOOD years ahead of you!
To answer your question, how rapid your heart beats has nothing to do with whether or not you’re in afib. Atrial fibrillation has a distinct arrhythmia but how rapid your heart beats during that arrhythmia will vary from person to person.
If you were my relative, here is what I would tell you to do:
1. Start learning as much about afib as you can. Knowledge is power.
2. Seek out the best possible EP you can find and make an appointment.
3. The EP is likely going to tell you you’re too old for an ablation, which is just hogwash. If you go to a highly qualified EP they can do ablations for people even in their 90’s!
4. Again if you were my relative I would tell you to seriously consider an ablation but if you insisted against one I’d tell you your only option is drugs to control the afib. They may or may not work and they may or may not have side effects. And if you go the drug route you’ll likely need to be on a blood thinner as well (depending how many episodes you’re having).
If you have specific questions, feel free to contact me directly via my contact page.
I wish you well and God bless!
Have you noticed any correlation with hydration? It’s getting warmer now, outdoor activity is increasing and so is fluid loss. I can easily provoke PAC’s and even had some weird breakthrough “fib-ish-ness” after working outdoors on a garden shed over the past few weekends. Dehydration causes fluid shifts inside your cells and along with that electrolyte shifts. It doesn’t matter if you’re supplementing – if the fluid balance isn’t right the electrolytes won’t be in the right places. It can get things out of whack in a hurry.
There has been no correlation. During that week when I wrote this blog post I wasn’t having any issues with hydration as it was cool here and I wasn’t doing much (physically) other than my morning 30-minute power walks/light jogs. I also drink plenty of water.
You bring up an excellent point, however, so I thanks for bringing it up. It’s absolutely critical to be well hydrated for optimal “heart performance.”
Yes, hydration is key. It can be tough especially with the oral mag supplements causing loose stools (more dehydration). I’m going to switch oral mag from the citrate to the chelated glycinate from iHerb and see if it gets better. I’ve been having these stupid PACs all this week for no reason I can figure. Probably only a dozen or so per day (tough to count them while asleep!) but they are, as you say, DARN annoying!
Switching from citrate to glycinate will definitely help with the loose stools issue. I also recommend you look into ReMag and Ease magnesium spray. I talked about these products in this blog post:
I can take as much of these products as I want and they have zero impact on my bowel movements. I take 750 – 1,000 mg per day of these products with no side effects at all!
I’m watching your blog closely and I care a lot about your condition since my own condition is quite similar with yours. I am living in Romania now (age 50) and I’m fighting the same beast for almost 5 years. When the beast appeared first, it came from nowhere since I was a very healthy person (and apparently still am), practicing a lot soccer and other sports, no smoking (ever), moderate drinker and low fat/salt diet.
First I did have 2 cardioversions (1 failed) and then my cardiologist put me on amiodarone, which was a bad decision, because after 1.5 years I developed a strong hyperthyroidism, which finally brought me again in Afib. At that time in Romania, an ablation seemed to me something exotic and unusual and somehow scary so I wasted precious time. It took me another year to deal with my thyroid condition, time I was in permanent Afib and when I fixed the thyroid problem I had another cardioversion.
Off course after that cardioversion the beast showed again at a rate of 1 afib episode/month. After several months I had my first PVI ablation in December 2014 in a private clinic in Bucharest done by a Romanian EP, a very skillful and experienced one but by far non comparable with the great ones in US or western Europe. At that time I had a moderate enlarged atria, but besides rhythm problem, the heart was generally in a very good condition.
They first isolated my PV and since I still was in Afib they burned the atrium wall to the moment Afib stopped during the procedure. After only 2 months I was again in paroxysmal Afib and had ablation #2 in April 2015 with PV isolation only without atria.
Now I am for 13 months in constant NSR, no Afib episodes, but I’m experiencing just like you many extra beats, not as many like you, around 30-40/24 hours and it feels really scary and the perception is that the beast is watching me and sooner or later is gonna come after me again. The idea is that even free of Afib, electrical storms are happening all the time in my heart,I can feel every micro volt of abnormal electricity in my heart. I’m living with fear and sometimes it gets really difficult.
I think I developed a strange bond with the beast. I know her and she knows me. We are now in a kind of status quo or a mutual modus vivendi and only God knows for how long. Anyway, looking back, I was a complete idiot I hadn’t the guts to have an ablation in the very first stage of this ordeal. If it comes again, I wouldn’t hesitate a second having the third one. So be aware that somewhere about 10.000 km away from you, someone else is experiencing the very similar sensations, fears, hopes, anxiety and symptoms.
Afib is a terrible condition, far more difficult than common public perception and here in Romania the lack of information and empathy and the complete ignorance from the part of public state health system are simply disgusting and hopeless.
Regarding your condition, knowing how mind-numbing are these PACs, have you considered the possibility of just having another ablation? I mean that thinking about the great Andrea Natale and of course the last techniques and advances in practice of ablations and tools available in US, I’m 100% sure that the beast is going to leave you alone, if not for good, for many years sure.
I’m not quite the sunny confident and optimist guy. I’m rather the pessimistic one and I really don’t want to blow your moral (in fact I keep cross-fingers for you and I wish you to kill the beast for good), but my approach is that every common symptom of afib, PAC, PVC etc. are fatally leading to Afib sooner or later. Oh how I wish I was wrong!
Glad to share this with you, wishing you and the other mates on this blog only NSR. I salute you.
PS Sorry for my written English. I really speak better than writing :)
Thanks for sharing your story! And your English is just fine by the way. Congrats on the 2nd ablation. I wish you many years of NSR.
I encourage you to try to be as positive as you can. Having PVCs and PACs doesn’t mean you’re eventually going to have afib again. In most cases, the two are very separate issues. I know many people who are free of atrial fibrillation because of a successful ablation but they continue to battle PVCs and PACs (yet never have issues with afib). Heck, I’m one of those guys! So keep your chin up and just be thankful you don’t have afib! We can deal with PVCs and PACs no matter how burdensome they are. And they don’t require drugs or blood thinners to cope with so there’s lots to be thankful for.
You have no idea when (or if) your atrial fibrillation will return so just enjoy each and every day you have NSR. You may go another 20 years without dealing with afib. Why spend those years worrying and being anxious? Enjoy all the days you’re blessed with NSR!
As to your suggestion for me to have an ablation for these PVCs and PACs, I won’t hesitate for a minute to have one. Fortunately, they aren’t so bad that an ablation is necessary. As I stated in my post and in my comments here, my bad days are usually followed by good days. Guess what? I’ve had ZERO PVCs and PACs now for the past 5 days straight! Go figure. But if it ever comes to the point where I never have good days and these PVCs and PACs take over my life, I’ll be heading straight for the operation table:)
Have a great day and God bless!
Travis, good to see you’re in NSR but sorry to hear you’re battling those pesky pacs. Of course this leads to another condition that worsens everything – worrying. I’ve dealt with PACs over the last 2 years. No Afib since 2014 and very few blips, unless I stop taking large doses of Vitamin C, 4-6 grams per day. Usually right after a large meal they start, but no where near the amount of yours.
Taking supplements is akin to meds, without the side effects. We still aren’t getting to the ROOT cause. Speaking of roots, I have a root canal that is my “heart” tooth and one dentist has said it’s leaching poison into my system. It’s coming out this summer, but I’m not happy about having partials. So it seems that Vitamin C is countering the effects for now. My afib started one year after my root canal. Coincidence?
Your ablation stopped the signal from reaching your heart and is preventing Afib, however, obviously that signal is still being sent from a source that is causing PACs. Dental device absolutely. Refuse that ridiculous mask. That is a medical mask like a med. Forcing air into your lungs at that rate is ignoring once again root causes, such as insufficient oxygen levels in your blood, or several other issues. The dental device is most likely the least intrusive, however, still not getting to the root cause. I know several with apnea and no afib. I don’t believe that apnea is a sole cause for afib, but a warning of something else going on in our bodies. Just like cancer, if we don’t find the cause, we cant find the cure. Regards.
Hey James. Thanks for your comments. I haven’t considered Vitamin C as something to combat palpitations with. I do take 2 grams of vitamin C a day already but perhaps I should consider increasing my dose.
I agree with you completely that medications and vitamins in most cases probably tackle the symptoms and not the cause. Although I would argue that in some cases a lack of vitamins or minerals may be the cause. For example, most afibbers are magnesium wasters. That is to say, they either don’t have enough or what they have doesn’t get used. Replenishing magnesium in these situations probably does tackle the cause.
As for your comments about sleep apnea, I honestly have no idea. Fortunately, my sleep study revealed I don’t have sleep apnea so I don’t have to deal with it. And while not everyone who has apnea has afib, a large percentage of those that have afib do have apnea so that leads me to believe there is some kind of connection. What it is exactly, I’m not sure.
Be well, my friend, and take care.
The reason I asked whether you had symptoms with the ectopic beats is because you said in your blog that you “feel like crap all day and almost as bad as afib when you have them”, but if you don’t have symptoms when you have them, may I ask why they make you feel so bad? in no way I am belittling your suffering by them.
Good catch. I didn’t answer your question accurately. I meant to reply that I don’t have dizziness or fatigue or anything like that. I definitely have symptoms, however. Like my afib episodes, when I have these PVCs and PACs I’m highly symptomatic. It feels like a big fish flipping and flopping uncontrollably in my heart. They drive me crazy. So while I don’t get tired or dizzy or anything like that, I just feel awful as I go through the day like there is some crazy fish trying to burst out of my chest. That’s the extent of the physical symptoms.
Mentally, however, is where they really take their toll. It’s impossible not to constantly think about them or obsess about them when they feel like they do. I just keep wondering and worrying, “are these going to kick into full fledged atrial fibrillation or some other arrhythmia?” or “Am I going to have heart failure with my heart functioning like this?” Those kind of thoughts start weighing on your mind so mentally it’s taxing. I wish I had the will power to just ignore them or at least not worry about them but it’s tough – even though my doctor insists they are benign still at this point.
But oddly enough I get random relief from them. I spent 6 straight days with these palpitations but suddenly in the past 48 hours they have completely disappeared. Go figure. But this is how it has always been. I’ll have a string of bad days followed by a string of decent/great days so right now I’m in the decent/great days part of the cycle…lol.
good to hear from you again Travis, I am sorry those ectopic beats make you feel bad, do you have any other physical symptoms like dizziness or fatigue when you have them?
No other physical symptoms (thankfully). They’re really random too. I’ll go 3-5 days straight with horrible palpitations and then I’ll have 3-4 days in a row right after that where I’ll have very little if any palpitations.
I hope all is well!
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