PVCs how many is too many

Hi everyone. I had an ablation a year ago. No afib since then. Male, 68.

most of the time I feel okay I guess, for someone my age. I walk every other day for 4.2 miles around the lake here. Sometimes I'll go many days in a row. Occasionally i'll got a week or more without walking if the weather isn't good.

My complaint is PVCs. I have them every day. Most of the time when I get them it's from a posture change, like when I lie down for the night (the head of my bed is raised a little), and again when I get up in the morning. But I can also get them at any time. I'll get one every 15-20 beats for 5-10 minutes until it settles down again. They seem to be sneaking up on me and increasing in frequency. They are annoying and uncomfortable and for the most part i just figure they go with the territory, but i wanted to ask if they are something to be concerned about and to watch out for.

Luckily your burden is low. I would keep an eye on it. My burden went to 42-43% and I got heart failure. I’m on brand Tenormin which stopped it but if I get stressed I get some beats and when I take my next dose I’m ok back in nsr. Magnesium helps. I just mailed in a holter and am curious on my burden %.

Tenormin helped me in 2020, 2022 and now. Tenormin is brand for atenolol which didn’t help because there is a 17% formulation difference and apparently I’m need brand. You can consult your EP to see if Tenormin is for you.

Do you know for sure what you're feeling are PVCs rather than PACs? PACs are more likely in someone with afib. You would need to capture them on an ECG to know the difference. A Kardia device is your cheapest and most accurate option.

Good question. My GP said I had PVCs according to a Holter readout, that's what I assumed they were. It's the first thump that's speeded up; if the atria are the first thump then they're PACs.

Also if I get a lot of sugar then they can wake me up with a very high HR. I fall off the wagon every so often I'm ashamed to say.

Buy a Kardia and find out. But as a general rule most EPs won't treat either one until you're in the neighborhood of 20K per day, which is about 13 per minute all day and all night. See Susan's post above why you don't want to let it go that far.

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Shiny Sleeves
Also if I get a lot of sugar then they can wake me up with a very high HR. I fall off the wagon every so often I'm ashamed to say.

Everyone is different, but if I drink or consume a sugary anything, my PVCs are going to rise significantly. It’s not worth it. Tape a picture of an oxygen concentrator and compression stockings to your fridge to motivate you if you fall off the wagon. I’m not joking.

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Shiny Sleeves

My complaint is PVCs. I have them every day. Most of the time when I get them it's from a posture change, like when I lie down for the night (the head of my bed is raised a little), and again when I get up in the morning.

For what’s it’s worth, get out of bed very SLOWLY. I found it’s helpful to first turn to your side and slowly drop a leg over, then slowly sit up, wait 10 seconds to acclimate and don’t jump out of bed.

I was in communication with a friend who also gets it like us when she wakes up and gets out of bed.

It must be more common than we think.

FWIW
I went thru insane PACs when I got the Norovirus in January. I self diagnosed as PACs after getting a Kardia. I tried Taurine and it really helped. I took 2g Taurine and 2g L'Arginine a day and felt better within a half hour; placebo effect?

"Elimination of cardiac arrhythmias using oral taurine with l-arginine with case histories"

Link

Youtuber

FWIW, Every cardiologist has their own opinion, but at Cedar Sinai Barbara Streisand Center, I was told to stop L'Arginine because studies found it lead to a higher risk of death in women. Below is the study my cardiologist quoted:
[www.health.harvard.edu]

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MikeN
I went thru insane PACs when I got the Norovirus in January. I self diagnosed as PACs after getting a Kardia. I tried Taurine and it really helped. I took 2g Taurine and 2g L'Arginine a day and felt better within a half hour; placebo effect?

"Elimination of cardiac arrhythmias using oral taurine with l-arginine with case histories"

One of my friends had excellent success with 4 g of taurine (as powder) per day with his ectopics.

The author of your linked article, George Eby, was a member here when that was published. See this from our Conference Room: [www.afibbers.org]

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susan.d
FWIW, Every cardiologist has their own opinion, but at Cedar Sinai Barbara Streisand Center, I was told to stop L'Arginine because studies found it lead to a higher risk of death in women. Below is the study my cardiologist quoted:
[www.health.harvard.edu]

From the article: "L-arginine may make blood pressure dip too low if you're already taking medications to treat the condition. If you're taking blood thinners, it may increase the risk for bleeding. And if you're taking ACE inhibitors, it might cause your potassium levels to spike."

My interpretation is that it is a warning for those on these meds, not a general one.

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Carey
Buy a Kardia and find out. But as a general rule most EPs won't treat either one until you're in the neighborhood of 20K per day, which is about 13 per minute all day and all night. See Susan's post above why you don't want to let it go that far.

So PACs/PVCs lead to HF but afib doesn't? I do have PACs... but if I keep up with my cardizem it isn't often. It stinks when it does happen though. (I take 30 mg 4X a day of the cardizem which I have found to be a lot better for me than the 120. I was taking it 3X a day- doc said it was OK but increase when needed. I also increase to taking 60 some times as well. ). Anyway I was curious.

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bettylou4488
So PACs/PVCs lead to HF but afib doesn't?

I didn't say that. Afib can definitely lead to HF if the rate is uncontrolled and remains above 100 for prolonged periods of time (weeks, months). A high burden of PVCs/PACs seem to have the same effect, as Susan found out. But if you keep your heart rate under control and your PAC/PVC burden well under 20K per day, you should be fine. It's the long-term burden that does the harm.