Increase in PVC's with exertion

Long time reader, occasional poster...

Currently 56 and have had PAC/PVC's and very occasional AFIB since 06(6 episodes total, last in 2019 and 5/6 cardioverted). Largely handled with diet suggestions from this board and I am very thankful for this. Developed gastro pain in October and this has continued...all the tests have been done including scans, blood, colon0scopy, upper GI, etc...all negative. Managing now with Prilosec. In addition I take metoprolol(50mg) and atorvastatin(70mg) daily. Statin is due to a high calcium score in 2018...I largely eat like a goose with occasional slip ups at Italian restaurants...and I do like my wine and beer on the weekend.

My concern...this summer I have started having short runs of PVC's, some painful, after exertion but not in recovery. Usually brought on by walking uphill for extended time...3-5 PVC's about 2-3 seconds apart and then stop when I stop. This has increased and now occurs when walking...sometimes on flat surfaces such as parking lots.

It has been such a long time since I have had to deal with this that I am now quite anxious again. I am also concerned that this could be related to CAD as I had the calcium score in 2018. I largely control my LDL with diet and the statin...I get very little exercise other than occasional walks and yardwork.

I do have appt with my GP on Tuesday but I feel I should go directly to cardio for stress test...as always, your thoughts/observations are appreciated.

Thank you in advance.



Edited 1 time(s). Last edit at 08/18/2023 10:04AM by shca67.

I think the cardiologist would be a good idea. PVCs shouldn't be painful.

Interesting that I have always had some painful PVC's...there just seems to be more now and with 3 to 4 two to three seconds apart.

How do you know they're PVCs?

They studied various factors for both PVCs and SPVCs (PACs) in this study. Here is the Discussion.

Results of our exploratory observational study suggest that lifestyle, eating habits, and body adiposity are significantly associated with cardiac ectopic beats and HRV.

Consistently with previous findings [26], the results of our study pointed out the close relationship between body composition and the outcomes of interest. The univariable analysis showed that waist circumference was significantly associated with both PVCs and SVPCs, in accordance with the growing body of literature which supports the relevant role played by the waist and hip circumference in cardiac risk predictive models [27]. Conversely to what is documented in the literature [28], our study showed no significant results regarding the effect of BMI on cardiac ectopic beats. In contrast from BMI, MBF (mass of body fat) resulted to be significantly directly associated to PVCs. This is consistent with evidence reported in the literature; a recent review documented the role of adipose tissue on cardiac arrhythmias, and in particular on ventricular rhythm disorders [29].

Regarding food intake, we found out that higher fruit consumption had a significant impact on the improvement of HRV and in reduced occurrence of PVCs. Despite the limited availability of evidence regarding potential associations between fruit intake and HRV and ectopic beats, the beneficial role of fruit in improving cardiac autonomic function has been documented [30].

Upon multivariable analysis, age was found to be associated with SVPCs and PVCs, but not with HRV; this finding is only partially consistent with literature in the field [31]. Regarding dietary patterns, our study showed a significant association between higher intake of snacks and sweets, sugars, and grain products with PVCs. To our knowledge, this is the first study in which the consumption of such food products has been investigated regarding its linkage to cardiac ectopic beats and HRV. Despite the lack of evidence regarding cardiac rhythm, studies have reported the potential risk of refined carbohydrates and simple sugars in facilitating weight gain [32], thus increasing cardiovascular risk. To reduce such risk, evidence suggests limiting the consumption of refined grains and to prefer low energy carbohydrates, such as whole grain cereals, fruit, vegetables, and legumes.

Regarding the consumption of protein, the present study suggested that protein intake was inversely associated with SVPCs. However, no specifications were made as to protein type (animal vs. plant). In the literature, limited evidence is available regarding the association between protein food and cardiac electrical activity, since previous studies have concentrated mainly on fish intake and cardiac rhythm, not on another type of protein food. Results of such studies suggested a beneficial role of omega-3 PUFA in fish against cardiac arrhythmias [33].

Together with dietary intake, lifestyle habits also appeared to be significantly associated with outcomes of interest. Consistently with recent publications, our study showed that physical activity was significantly associated with higher HRV (by reducing sympathetic activation [15]). Sleep hours also resulted in a significant relationship with HRV and SVPCs; sleep hours had a direct relationship with HRV and an inverse relationship with SVPCs. The effect on HRV is physiological, since it is well known that longer sleep time results in higher HRV, while poor sleeping or sleep deprivation can adversely affect HRV [34]. Conversely, no significant effects of sleep hours on PVCs were observed, whereas recent research has pointed out higher PVCs as a consequence of sleep disruption in hospitalized patients [35].

Some differences between this study and previous findings may be due to different data collection methods, especially regarding the 24 h recall. Generally, previous studies employed only FFQ to estimate the effect of food consumption on cardiac rhythm.

Despite the fact that this was an exploratory study and significant results should be researched further by independent labs in a more targeted research design, these findings provide new insights to improve the management of patients attending cardiac rhythm labs.

Holter monitoring is a clinical investigation that helps medical doctors to assess cardiac function, especially if a standard electrocardiogram does not give enough information about heart electrical activity. This instrumental examination generally falls under a set of clinical tests intended to be used for differential diagnosis. As a result, data from the Holter monitor are often underused, especially in the research context. Conversely, the findings of the present study provide new insights into the usefulness of such clinical examination. If lifestyle and dietary patterns influence the onset (and/or the severity) of cardiac rhythm disorders, clearly, Holter monitor parameters may support clinicians in the development of ad hoc strategies (modification of lifestyle and eating habits) based on Holter parameters to improve cardiac electrical function, reducing the risk of more severe, life-threating, cardiac arrhythmias.

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GeorgeN
adiposity
.

just learned a new word!

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GeorgeN


Regarding food intake, we found out that higher fruit consumption had a significant impact on the improvement of HRV and in reduced occurrence of PVCs. Despite the limited availability of evidence regarding potential associations between fruit intake and HRV and ectopic beats, the beneficial role of fruit in improving cardiac autonomic function has been documented [30].

That is so interesting. I would not have thought that because well.. sugar.. I do love my fruit in the summer.

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GeorgeN

Regarding dietary patterns, our study showed a significant association between higher intake of snacks and sweets, sugars, and grain products with PVCs. To our knowledge, this is the first study in which the consumption of such food products has been investigated regarding its linkage to cardiac ectopic beats and HRV. Despite the lack of evidence regarding cardiac rhythm, studies have reported the potential risk of refined carbohydrates and simple sugars in facilitating weight gain [32], thus increasing cardiovascular risk. To reduce such risk, evidence suggests limiting the consumption of refined grains and to prefer low energy carbohydrates, such as whole grain cereals, fruit, vegetables, and legumes.

Regarding the consumption of protein, the present study suggested that protein intake was inversely associated with SVPCs. However, no specifications were made as to protein type (animal vs. plant). In the literature, limited evidence is available regarding the association between protein food and cardiac electrical activity, since previous studies have concentrated mainly on fish intake and cardiac rhythm, not on another type of protein food. Results of such studies suggested a beneficial role of omega-3 PUFA in fish against cardiac arrhythmias [33]

Although this is PVCs.. I experience this with PACs. I even made a doc appt because so many PACs and I just slowed down on any sugar and it helped like crazy. In fact today I had some Zucchini bread.. aka CAKE (its flour.. and sugar.. and oil).. and PACs came on. not fun..anecdotal but still. I am doing some rehab and they even mentioned "go eat some protein." I wonder about the omega 3s and blood thinning. I sure would like to start them but I am on Elequis. Going to ask them next week.

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bettylou4488
Although this is PVCs.. I experience this with PACs. I even made a doc appt because so many PACs and I just slowed down on any sugar and it helped like crazy. In fact today I had some Zucchini bread.. aka CAKE (its flour.. and sugar.. and oil).. and PACs came on. not fun..anecdotal but still. I am doing some rehab and they even mentioned "go eat some protein."

I've posted before, I have a friend who is a Wolff Parkinson White (WPW) ablatee (WPW is an issue with multiple bi-directional pathways in the AV node). WPW's are more susceptible to afib. WPW is genetic. She's 72 and had her ablation around 2008. She gets huge quantities of PACs when she consumes many carbs. She does much better on keto with respect to PACs.

Quote
GeorgeN

Although this is PVCs.. I experience this with PACs. I even made a doc appt because so many PACs and I just slowed down on any sugar and it helped like crazy. In fact today I had some Zucchini bread.. aka CAKE (its flour.. and sugar.. and oil).. and PACs came on. not fun..anecdotal but still. I am doing some rehab and they even mentioned "go eat some protein."

I've posted before, I have a friend who is a Wolff Parkinson White (WPW) ablatee (WPW is an issue with multiple bi-directional pathways in the AV node). WPW's are more susceptible to afib. WPW is genetic. She's 72 and had her ablation around 2008. She gets huge quantities of PACs when she consumes many carbs. She does much better on keto with respect to PACs.

Yes I do recall that. And other times you have mentioned it and I definitely have gone less carbs overall (not even close to Keto) but it helps just doing that. I am finding I have to consider digestive enzymes though- the meats don't seem to digest as well for some reason. But overall I feel better when I am closer to lower carb than not. Whole30-ish eating...



Edited 1 time(s). Last edit at 08/18/2023 10:20PM by bettylou4488.

Interesting information...I am a large consumer of sugar via fruits and fruit juinces. To answer Carey's question, they typically feel like a "thump" for an instant...I have had them on and off for years and previous stress and holter monitor tests pointed to PVC's. Compared to PAC's and AFIB (much softer "thump" and more of a fluttering, lighter misbeat) the PVC's are a more solid, single thump...may be followed by 2-3-4 more but separated by a beat or two.

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shca67
Interesting information...I am a large consumer of sugar via fruits and fruit juinces. To answer Carey's question, they typically feel like a "thump" for an instant...I have had them on and off for years and previous stress and holter monitor tests pointed to PVC's. Compared to PAC's and AFIB (much softer "thump" and more of a fluttering, lighter misbeat) the PVC's are a more solid, single thump...may be followed by 2-3-4 more but separated by a beat or two.

Yep, that sounds like PVCs. Okay, so you meant they feel like a more pronounced thump rather than actual pain. Is that right? If so, then no worries. I was just concerned with you saying they were painful.

Follow up cardio visit and stress test showed benign PVC's with occasional bigeminy...guess it had just been too long since my last period of increased PVC's and it became anxiety provoking...at any rate, she asked me how I was doing with the four primary triggers....caffeine, alcohol, stress and lack of sleep. I failed on three of the four. So a week later, after I learned/confirmed what they were...dealing with it just fine.