PVCs... When to Get Treatment?

So I posted a while ago that in May, out of no where, I started getting PVCs at about a rate of 1 every 15 secs to 5 minutes, depending on the time of day. Nothing seems to control of affect them, i.e., electrolyte supplements (2.5 months on Jackie's Mg/K replenishment), diet watching, exercise, etc. I went to see my cardiologist who looked at the ECG, referenced my echo cardiogram I did a year ago, and several other past tests. His response was "benign" as most people have heard. Then I read this today:

PVC / AFib Article

It seems to suggest finding a doc until they do something about PVCs if you have had afib. I have had one afib attack 2 years ago that last a few hours until my potassium was brought back to normal and possibly another one that lasted 20 seconds or so a month ago.

So I am confused. Everyone says PVCs are benign if no other structural heart disease is present, but this article seems to add if you have or had afib, you best do something.

Any thoughts?

My first thought is articles like that are why I don't like Steven Ryan and a-fib.com. He reports some random guy's experiences and then says -- based on nothing -- that PVCs lead to afib. If you read the random guy's actual report, he's not so alarmist:

Quote

According to Mayo, if PVCs are over 20% of your heart beats, they are dangerous. Mayo calls that level ‘high density PVCs”. High density PVCs cause your heart muscle to weaken.

My high density PVCs were 30% of my heart beats, and my ejection fraction was down to 41%.

That sounds about right to me. You're nowhere near 30% so that's why your cardiologist said benign. It is benign. Yeah, I know it might not feel benign, but just know that it's not hurting you.

My second thought is you don't have afib. One episode two years ago when you were hypokalemic (low potassium) doesn't mean you have afib. Get anyone's potassium low enough and they'll have an afib episode. That's well known to ER docs everywhere. Fix the potassium and the afib goes away forever.

By all means look for ways to reduce your PVCs using lifestyle modifications, supplements, whatever works, but unless they become really excessive I wouldn't dream of doing an ablation or taking antiarrhythmic drugs if I were you.



Edited 1 time(s). Last edit at 08/23/2018 12:49AM by Carey.

Ditto what Carey said. That site is pretty "sketchy" and the guy there seems to be pitching a book. I'm not leveling any accusations, but I'd keep the salt shaker handy if you know what I mean.

You need in excess of 20,000 PVCs in a day before doctors will get concerned. I certainly agree they would be annoying as heck. I'd try supplementation and lifestyle adjustments before I considered anything else. AAR's would be extreme, I think. PVC ablations can be done and, from an electrical standpoint, probably easier than AF ablation because there tends to be just a single "focus" somewhere in the ventricles that's causing it. But to get an RF catheter into the ventricles you have to go past valves. which is kind of scary.

Fibbin - On the Mg and K intake. How much of each are you taking? You may need a lot more time if you are severely depleted and it may be as long as 6 months before you really start to stabilize. Also, if consider trying the topical form of magnesium either by Epsom Salts baths or the topical magnesium gel rather than ingesting supplements....since sometimes there is interference at the cell receptor sites from transfat damage, etc... and the nutrients are unable to get inside the cell. Note also that when you are too low in magnesium... adding potassium before Mg is optimized can produce more activity than prevent. It's all a ratio/balance with electrolytes... and you don't want to overdo sodium and calcium, although you do need some.

Jackie

Thanks for the feedback, all.

Jackie,

I currently take about 600-800mg of a mix of magnesium glycinate (Doctors Best) and Mg taurate. In addition I do 6 sprays of Mg oil morning and night and leave it on. K I take about 3g of KCl powder over the day with food.

I've had some bad days with 6% PVCs and 7% PACs. My EP reckoned they were annoying, but said they were not dangerous.

PVCs are awful, especially when they come in bi or trigenimi form.
I find afib less scaring, even if it's far more dangerous.

hello i am new to this blog so what i have to say is that after eating i get these heart flutters and palpitations always with no reason i dont know if its palpitations or arrhythmias i am also a diabetic and what i noticed also after injecting insulin i also get them and when i wake up in the morning i also have trouble sleeping but what i really mean that there is only one reason for that that the doctors have no clue of anything i went to a lot of doctors and they said its in my head to take zanac and zoloft that was the answer they gave me so i told them to take a walk.
so the problem is from i know is the food we eat this has the biggest impact on our health .if we understand that we can be cured not completly but part of the problem.

Hi Everyone

Can you tell me how you can differentiate between ectopics - does a PAC feel different than a PVC?

Thanks and regards all,

Anne

Hello Cosmos and welcome.

Here are some considerations:

If your heart activity is consistently occurs after meals, then you need to do a dietary assessment and attempt to target what might be causing the reaction. Being diabetic has it's own challenges but typically, the food/afib association has to do with a type of a sensitivity and/or often lack of natural stomach acid production...tracking back to lack of nutrients required for making the stomach acid. There could also be a 'filler' or additive in your insulin product to which you are sensitive.

The first suspect would be if you use artificial sweeteners or eat "no sugar" foods and drinks containing them… as is typical for diabetics to avoid sugar intake. Here’s a list of suspects..
• Aspartame
• Acesulfame potassium
• Alitame
• Cyclamate
• Dulcin
• Equal
• Glucin
• Kaltame
• Mogrosides
• Neotame
• NutraSweet
• Nutrinova
• Phenlalanine
• Saccharin
• Splenda
• Sorbitol
• Sucralose
• Twinsweet
• Sweet ‘N Low
Some also say Xylitol – the sugar alcohol substitute.

Other common culprits might be gluten containing foods, chemical flavor enhancers such as MSG, and many other additives and preservatives in packaged, processed foods and also the preservatives sodium nitrite or sodium nitrate in sandwich meats, sausage, bacon, ham, hot dogs, etc. There are others as well.

It's important to determine if you have enough natural stomach acid production… since if not, the inability to break down food properly can create some stomach issues such as bloating and then impingement on the vagus nerve (which can cause palpitations or afib)… if your stomach bloats. If you are overweight in the midsection, that compounds the problem.

Just a few ideas. If you want help with your assessment, send me a PM. Glad to try to help.

Be well,
Jackie

FibbinAfib – Thanks for the dosing info. You should probably consider cutting back on the amount of potassium you take daily to see if that helps your extra beat activity. If we knew for sure what your intracellular magnesium-to-potassium ratio was, we could determine if your magnesium level was sufficient to support that much potassium (because you undoubtedly get some additional K from food).

We know that when IC magnesium is on the low side, then adding too much potassium will cause the extra beats… and often outright afib. Consider cutting back on the potassium by 1,000 mg for a week or so to see if anything changes.

There is always the possibility that you are still low in the magnesium. Although it would seem you are dosing generously, there is always the chance you are a Mg waster or a lot of it isn’t getting inside the cell… therefore, the potassium may be the culprit. If you are typically a high-stress individual…either emotional or physical stress demands, the Mg is quickly depleted.

Jackie

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AnneC
Can you tell me how you can differentiate between ectopics - does a PAC feel different than a PVC?

Usually, but not always and it's not the same for everyone. A PVC will usually feel more distinct, like a missed beat or an exceptionally powerful beat. PACs can feel the same, but they're usually less pronounced. For example, I used to get PACs in a bigeminal pattern that could go on continuously for weeks. So if you looked at my ECG you'd see beats occurring in pairs, with one of them being a normal beat and the other being a PAC. I couldn't tell which was which by how they felt. I just felt two beats, pause, two beats, pause. A PVC, on the other hand, is a very distinct strong beat that's unmistakable. So the answer for me is yes, I can tell them apart, but they often feel about the same for some people.

For me a PAC is a “misfire”, like an engine that’s out of tune. A PVC (of which I’ve had very few) is a nuclear depth charge going off beneath the waves!

It’s not the same for everyone, though. The only was to tell for sure is an EKG. The PAC will look like a normal QRS complex without a P-wave preceding it. A PVC will look like a very distorted QRS, often with a large negative deflection. Almost an “S” laying on its side for lack of a better description.

Jackie,

Thanks for the info. I cut back below 1g of K a day. I know I go through K fast as my blood readings are always on the low side (3.7-3.9). I was below 3.0 when I went into afib, so I have been trying to keep up with my body. All kidney function checked out OK through a huge battery of tests.

I am under high stress constantly (I am a partner of a startup company). Maybe I should up the Mg? The Mg Taurate I can take a lot of without any GI issues. The Mg Oil seems like I can use it all day too, 2 or 3 applications without any GI issues.

Fibbin - Okay... if you are monitoring the potassium and your levels are continually on the low side, then...too much is apparently not the issue for you. From past experience, I know if my K levels get much lower than 4.0, I'd be having afib or ectopy.

Your high stress is undoubtedly a prime factor for Mg depletion. You can certainly try increasing the Mg Taurate... but it may be more taurine than magnesium. However, it's not typically a problem to take high doses as it's very safe.
Here's a link to a previous report on taurine [www.afibbers.org]

When it's convenient for you to experiment with increasing your magnesium, push for even more. The bowel tolerance issue is the signal the cells are saturated.... unless, of course, as I mentioned...if the receptor sites are blocked... but you'd probably have concluded that by now when you push the overall intake.

On the Mg oil... what brand are you using?

Jackie

Quote
Carey

Can you tell me how you can differentiate between ectopics - does a PAC feel different than a PVC?

Usually, but not always and it's not the same for everyone. A PVC will usually feel more distinct, like a missed beat or an exceptionally powerful beat. PACs can feel the same, but they're usually less pronounced. For example, I used to get PACs in a bigeminal pattern that could go on continuously for weeks. So if you looked at my ECG you'd see beats occurring in pairs, with one of them being a normal beat and the other being a PAC. I couldn't tell which was which by how they felt. I just felt two beats, pause, two beats, pause. A PVC, on the other hand, is a very distinct strong beat that's unmistakable. So the answer for me is yes, I can tell them apart, but they often feel about the same for some people.

I agee. For me, PVCs create stronger beats and a very unpleasant feeling in the chest. Bigemini is felt like bradycardia with heavy beats. In trigemini form, I'm used to call it the "we will rock you" symptom.