[Rittgil]

I've been diagnosed with PACs and told they were benign. The doctor called them "infrequent," but they sure don't feel that way to me.) I've had several EKG's, an office exam by a cardiologist, had a 24 hour Holter monitor and a thallium stress test.

My bp and cholesterol are fine. But the PACs started about the same time I began menopause, and they've seemed to increase in frequency over the last several years. I've been told that it's almost expected that they increase in number as I get older, but they still make me nervous. I've taken antidepressants, anxiolytics, and am now on a low dose of atenolol twice a day, plus .25 mg of Klonopin twice a day. For a while, this seemed to work fine, but now my PAC's are back, not as severe, but seemingly more frequent. I know the vicious cycle PVC/PAC and anxiety - you have one, you get anxious, adrenalin rushes through your body, you have more PACs, it makes you more nervous, you get more palps, and so on.

Here's one question I have: what about posture changes? I seem to have more PAC's if I'm sitting slumped back in a chair than when I'm upright. Is this postural change more PAC's, or am I just likely to feel them more? Am I putting pressure on my vagus nerve and that might be contributing to the problem? My last cardiac checkup was only three months ago, and the doc gave me a clean bill of health, as far as my heart is concerned.

[Jeff]

Rittgil,

I've run across all kinds of people that have positional or postural triggers. Me included. After eating a big meal, every time I bend over I'll get a PVC. Sometimes after laying in bed 10-20 minutes I'll get a few. I know some people get them when they lay on their left side - when it comes to PVC's I think I'm ambidextrous (or something), because I get them no matter which side I lay on. Switching from one side to the other sometimes helps for a little while (hopefully enough that I can drift off to sleep).

So yeah - it ahppens to me, too.

[Susie]

They happen to me when I slouch in a chair, lay down after eating a big or small meal, and also after drinking liquid. Ugh, when don't they come? My doctor told me one reason is due to the fact I have a hiatal hernia and as it pushes up through the diaphragm, it pushes against the vagus nerve and causes this reaction. I hate them, and even though all my tests say I am OK, I get scared, and then it is a vicious circle, the more anxious I get, the more PAC's, the PAC's, the more anxious. Oh my.

Thank God for places like this to come and share our concerns.

Susie

[jkfrench]

ahh yes, those positional PVC's...
mine are worse when I lie on my back. And you know what is really wierd...that yoga breathing...if I try it...breath in ...breath out... it makes them WORSE! Also when I slouch after drinking water..they seem to worsen and I have to stand up to make them go away. Don't worry....this is a commen problem and is totally benign.
Frenchie

[Rittgil]

Ok, I'm back again and hoping I can get some words of reassurance. I've been under stress lately and and really need to be able to get certain things done, but this increase in PAC's are making it so that I can barely function. I'm afraid to get out of bed in the morning. I try to just work through it anyway but I feel like I'm at the end of my rope.

Please help.

[SamiP]

Hi,
I'm new here, but found the site to be so helpful. I've already had a nuclear stress test, echo stress, EKG, echo cardiogram, blood work and 24 hour halter monitor. Nothing conclusive showed up, only 3 extra beats on the 24 hour monitor. The palps are getting worse and Wednesday I go to have the 14 day loop event monitor put on. I'm a wreck and I know the vicious cycle..you get palps, you get nervous/anxious, and they get worse. I'm taking Xanax but will see my doctor after this last test is done to try antidepressants. Mine seem to be worse when I'm doing thing, I'm fine sitting or laying down, it's when I get up and start moving around that I can feel them. Like you, I hate to get out of bed in the morning, never knowing what to expect for the day and I'm at the end of a very fragile rope myself.

[Jeff]

Hi Sami,

I was thinking about you and your event monitor so I posted in my journal about my experience with the event monitor (here). Like you, I was very stressed before, and I was stressed during, too. Even after I got the good results, it took me a few weeks before they really sunk in. But I'm in a much better place mentally now, and have the energy back that I used to have.

Here's wishing you an event monitor that captures your worst, but the cardios tell you you're fine.

[jkfrench]

sami
keep us updated. Any information we can absorb through others personal experiences helps us keep "peace of mind".
Thanks
Jodie

[SamiP]

Thank you, and yes will definitely keep you posted. I know how "anxious" we can get. Jeff, I did read about your bout with the monitor, and I think the one I'm getting is slightly different. This one doesn't record all the time, I need to press a button whenever I have a palpitation. Actually, I will know more tomorrow when I'm "installed" with my closest friend for the next 2 weeks. More to come tomorrow..today is my lazy day. I took off work, I have a great boss (me), who decided I should just relax today.
Samp

[momof3]

positional PVCs ,PVCs from indigestion or from gas building up in the GI tract, PVCs when I haven't eaten for a while - i work 12 hour shifts and sometimes can't get a minute to eat so i notice them then, PVCs when stressed at work (nurse), PVCs after exercise and sometimes during - the good thing; there is somebody out there that has the same PVCs - many in fact - i'm new to the PVC thing so i'm still actively trying to accept cardio's dx that they r benign

the last 2 days were much better because work was not too stressful yet i was busy enough not to think about the PVCs - in fact i may have felt less than 5 yesterday, 1 today

saw cardio today for follow up - he said he doesn't have to see me anymore unless they become unbearable -echo, stress, holter all normal - i had a few ques for him
1) some PVCs during exercise, more during recovery as well as occasionally during day, is that ok - answer, yes
2) my daughter has PVCs too, can it be genetic - answer, NO
3) HR during holter went down to 48 for more than 15 min, is that OK - answer, yes ( it's good, heart works less to oxygenate)
4) my LDL 135, answer, i don't give a sh__!

i know it is hard to accept that they are benign, but i am convinced that thinking and waiting for them brings them on

i'm going for a calcium score screening ( CT scan ) insurance won't pay b/c still experimental in their eyes - but it will make me feel better - there is still a part of me that worries that the PVCs r due to early CAD, and another part of me worries that it is a rhythm disorder like long QT - i can make myself crazy - but it will pass, if i can only use the advice i give my patients, think only good thoughts and you'll enjoy today, and remember when tomorrow comes it will be today again.

good luck and keep writing

kris