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Forum Name: Arrhythmias

Question: Many PVCs in a row

stevie13wonder - Wed Jun 06, 2007 7:04 pm

I recently had a holter test done and my EP said that I have PVCs throughout most of the day. I get a Shortness of breath sensation with them and sometimes I get 4 or more in a row and I feel like I can't catch my breath. There is also a feeling of discomfort when my heart starts beating regular again. This can go on for hours at a time. I do feel them all day but sometimes they are much worse. My EP told me to restrict my caffeine intake, I don't drink coffee but drink a can of diet pepsi every morning to get me going. He said that PVCs are usually not harmful but in people with Long QT Syndrome like myself they can pose a problem if they occur to much. He is away for the next month and I am wondering if what I am feeling is normal for PVCs or if I should get it checked out in the meantime. Thank you Stevie

stevie13wonder - Wed Jun 06, 2007 7:12 pm

I guess I should have mentioned that I am a 42 year old woman in relatively good physical condition and not overweight. I have had an Echo and my heart is healthy other than the LQTS. I have suspected Type 2 with T wave notching in all leads. We have not been genetically tested yet. I am on 50mg Atenolol and do not have an ICD at this time. I have not had any symptoms since my teens. I was diagnosed after my oldest son had a cardiac arrrest. My 10 year old son and 18 year old daughter also have LQTS. Stevie

John Kenyon, CNA - Mon Jun 11, 2007 6:53 am

Hello Stevie- Normally a young, healthy person can tolerate a 4-beat run of V-tach (3-5 PVCs in a row is arbitrarily considered a run of V-tach, although this is a controversial measurement). However, in someone with LQTS it becomes more problematic and while a Beta blocker is sometimes effective in preventing these runs, it is of more concern in your case, especially since your son has established, with you, a familial pattern of LQTS, meaning it isn't just acquired due to use of some offensive medication. While the PVC activity you are experiencing would be perfectly acceptable (if terribly annoying) in most healthy people, the fact that you have a familial pattern-based LQTS leaves me feeling that you should be followed more closely, and if your EP knows about this and has taken off for a month then there should be someone covering for him and you definitely shold be in touch with whoever that may be, as it would seem appropriate to consider what more can be done to manage what is a potentially very serious problem. Many people are subject to increased PVCs and other Arrhythmias following ingestion of caffeine, whether contained in coffee or a cola drink, and many of those are willing to put up with the annoyance of the ectopy that usually follows. Caffeine alone will not cause a dangerous Arrhythmia in the absence of any abnormality. LQTS is a distinctive and unique abnormality, however, and since you are aware of frequent and complex PVCs (and probably PACs as well) during the day, given the presence of LQTS, it may be appropriate to seek a second opinion as to the current management plan. The Atenolol may confer adequate protection, but caffeine aside, it doesn't seem to be doing an adequate job of suppressing the PVCs. It is my personal opinion that getting this checked out in the absence of your EP would be appropriate. Please do stay in touch and let us know if anything new develops.

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