PVC, PAC, What The Hey!

Hi All,

What is the deal with these ectopics? Are they harmful or benign? Are they indicative of an impending afib episode? Why have many cardiologists maintained that they are harmless and "normal". While others have stated that they are in fact precursors of an afib event?
What is the science on this?

I do take the "tamers", mag, K and taurine, which do help, but do not eliminate. I am one of the "difficult cases" due to being in the "long standing, persistent afib" group. Thankfully, I have been under the care of Dr. Natale and have had 2 ablations with him, the most recent being done in August of this year. I am in nsr but do have ectopics everyday more some days than others. I am taking 10,000 units of D-3, do not eat processed foods, eat lots of greens, other veggies, low on grains, not much meat and follow most of the Strategy protocol.

But, that said, I am mostly seeking information on the status of the present science on ectopics.

Thanks,
John

John,

Isolated PAC's & PVC's are, benign, as I understand.

PAC runs can presage afib, however if you are ablated, I believe this is less likely to happen. When I did not have my electrolytes managed well (too much Ca++), the very vagal time after orgasm was a trigger. I did not need a monitor to feel the PAC runs. I could usually stave off an episode by changing my autonomic tone (ANS) - sitting up, standing up, moving around. Happily this is no longer an issue or trigger. Eleven years ago, I was working on developing software/hardware to see these runs and give myself enough warning to change my ANS to ward off afib. It was difficult and I never succeeded - fortunately electrolyte balancing (really slamming my system with mag) made this a moot point.

I think there are data about frequent PVC's not being a good thing.

Unless you are monitoring, probably hard to tell the difference.

The chest strap for my old Polar S810 monitor did not "see" the malformed QRS waveform of a PVC hence they present as a beat that takes twice as long or half as fast. Since I've switched to a Polar H7 strap with an iPhone app, I do not see this presentation. I have a hard time believing that my PVC's are completely gone. Perhaps it is because the newer straps "see" the PVC's. In this case they would look like a PAC.

Unless you are having a lot of ectopics all the time, they are unlikely to show up meaningfully on an AliveCor 30 second strip - I can run the Polar monitors for hours or overnight.

For the truly curious, you can purchase Chinese holter monitors on eBay (with software) for $600-$800. Ten years ago, several posters here did buy their own holters (at many times this cost).

George

I don't know about the science and stats, but for me, a cluster of them is a precursor of an event.

I most commonly have an isolated "blurp" (I don't know how to describe it better; that's what it feels like) that doesn't lead to more, but if it is more than a few, an episode is sure to follow, especially if accompanied by pressure (vague, I know, but that's what it feels like). I also have what feels like a "hum", which I think is a pause .

I'm fortunate that I only have a few episodes a year, now, but I almost always can tell when one is looming. Ativan is a help, but getting the docs to prescribe it is like pulling teeth. It does work, but evidently, they think that more than a couple of doses a month is going to end the world as we know it.

lisa
__________________________

So much of medicine is looking solely down the wrong end of the gun barrel, and that is really a pity for all of us---Shannon



Edited 1 time(s). Last edit at 10/08/2015 11:14PM by lisa s.

PAC's are benign, unless they happen at the same time as 2-3 other things, then you get an AFIB episode.
PAC's are one of the things needed to start an episode, but they are benign if the overall condition of the Heart is not conducive to AFIB.

John - as you know, after an ablation...for as long as 6 months or more, it's not uncommon to have PACs or PVCs.

However, if you are low in the minerals/electrolytes -- magnesium and potassium, and as George indicates ... higher in calcium, you may trend toward more frequent activity. While you are taking them, it may not be enough. What are your typical doses of each?

After my last Natale ablation (April 2015), for a couple months, when I'd send in the weekly heart monitor recordings, the report back was "isolated PVCs".... At times I felt them; most of the time, I did not. But what I did do was increase my supplements of magnesium and potassium. That eliminated the PVCs. I also increased my daily dosing of CoQ10, carnitine and Ribose (as outlined in Cardiologist, Stephen Sinatra's book - Metabolic Cardiology). It's logical that post-ablation, heart tissue and the mitochondria need extra support and that certainly seems to have been useful for me.

I don't have various gadgets to monitor my heart daily as I am not inclined to want to obsess over every little errant beat, but I have sent in weekly recordings via the HeartTrak monitoring device provided by St. Davids.

I use L-theanine for times of stress and also adrenal support nutrients that help manage stress-related cortisol surges.

Jackie

John - I should have also inquired if you are tested regularly for your vitamin D levels and if you really do need 10,000 daily. Vitamin D helps the body to absorb calcium from food efficiently. Those writing about vitamin D3 supplementation always mention that it is important to also use Vitamin K2 in the Menaquinone 7 form... (K2MK7) to help direct circulating calcium into bones where it belongs and not into soft tissue such as arteries, brain, joint spaces, forming bone spurs or in other soft tissues.

If you are not using the MK7 and have excess circulating calcium, it may account for your PAC/PVC activity since calcium is excitatory to heart cells and is dominant over the calming mineral, magnesium (inside the cell). .

Standard MK7 dosing is around 220 mcg daily. Some practitioners use more in specific situations.

Life Extension has a combination product, "Super K with Advanced K2 Complex" that provides 220 mcg of MK7 along with other vitamin K forms as well.

Jackie

Thank You all for the excellent contributions to my "reducing ectopics education".

Jackie,

Magnesium: I have recently increased my intake of mag glycinate up to 1000 mg/day. So far ectopics are down, yes. I have found a product: KAL Magnesium Glycinate that seems to agree with me, with no bowel issues. I also use topical mag oil on a portion of my skin, inside elbows and knees as well as in chest area, also making my own Waller Water and drinking about a liter a day. I think that the increased mag glycinate has helped reduce ectopics.

Potassium: I eat natural source K from bananas and avocados every day, lots of green leafy veggies, as well as supplimental K gluconate in tablets. I probably average around 3-4 gms./day

Taurine: 3 gm./day

Ubiquinol CoQ10: 300 mg./day

Carnitine: 2,000 mg./day

K2 menaquinone-7: presently taking a product that only provided 100 mcg. I will look for one with greater potency up to the 220 mcg level.

Ribose: 10-15 gms./day

L-theanine: Don't know much about this one. What is the story and the dosage for this.

Vit. D3: Last blood test showed a little low. I was already taking 5000 iu/day, so I increased it to 10,000 iu/day.

I take no supplemental calcium, but I do have some fermented and raw milk products regularly, but not every day.

John

Hi John - Finally... sorry for the delayed response. Too many things on my plate at the moment.

Your supplement regimen looks good... I still want to know what your vitamin D test level was that was considered "low"...

Great that you are getting good potassium-containing foods... now do you know what your sodium intake is?

The L-theanine dosing recommended by Michael T. Murray, N. D... is this:


L-theanine has been approved for use in Japan as an aid to conquer stress and promote relaxation. It is a very is a popular ingredient in function foods and beverages as well as dietary supplements designed to produce mental and physical relaxation, without inducing drowsiness. L-theanine is fast-acting. Generally, the effects are felt within the first 30 minutes, and have been shown to last up to 8 to 12 hours. Based on the results of clinical studies, it has been established that L-theanine is effective in the range of 50 - 200 mg. If a person has higher levels of stress it is often recommended that they take at least 100 to 200 mg one to three times daily. Although L-theanine is completely safe and without any known adverse drug interaction, as a general guideline it is recommended to take no more than 600 mg within a 6 hour period and no more than 1,200 mg within a 24 hour period.


At typical dosages, e.g., 100-200 mg L-theanine does not act as a sedative, but it does significantly improve sleep quality. It is also an excellent synergist to melatonin and 5-HTP (5-hydroxytryptophan) in promoting sleep. On its own, L-theanine at a dosage of 200 mg was shown in a double-blind trial to produce statistically significant improvements in sleep efficiency, an index of actual sleep time enjoyed between the time of falling asleep and nighttime awakenings.

Source: Dr. Michael Murray's Source for Natural Living - September 2006

The entire report is reproduced here at this website: [integrative-energetics.com]

You asked if I could explain how to change or improve "beat fluctuations" as related to my comment on Heart Rate Variability. The HRV works with balancing the Sympathetic Nervous System and the Parasympathetic Nervous System (both parts of the Autonomic Nervous System) so that neither are predominantly working 'full time' but they work in relative concert. The Sympathetic or "fight or flight mode" obviously isn't a healthy situation for anyone's body and it was designed only to aid escape from the saber tooth tiger... but these days, at every turn, there are tigers.

People with high stress are sympathetic dominant and the challenge is to reverse that with stress management and reduce stress influences from all sources. Since you've had a very recent ablation, it is normal to be more sympathetic dominant but the goal should be to reduce or manage that stress when possible....so try to relax and not worry about every little blip your heart makes while you are in the blanking period. There are also a lot of internal stressors at work that you aren't even aware of, but for the external stressors... you can definitely recognize and try to eliminate, manage or reduce when possible and obvious. I'd say for now, just give the 'insult' of the ablation procedure time to drift into the background while you work on managing the external excesses that you may not realize are stressors, but in reality, actually are. The theanine will help tremendously. Others like PharmaGaba "Stress Relax" by Natural Factors. The theanine label should indicate the Suntheanine (R) in small print so you know you're getting a reliable material. I've used both Natural Factors and Jarrow successfully and would never want to be without a supply.

Best to you,
Jackie

I have ordered some Theanine and look forward to evaluating it.



Edited 1 time(s). Last edit at 10/28/2015 09:53PM by JohnB.