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Brian
climber
Cali
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Procrastinating now, so can't give the full story.
Short story is, ended up in the ER about 5 years ago with full on atrial fibrillation. Docs converted me back to sinus rhythm with some meds, kept me fore a few days of observations and let me go.
Lots of anxiety to be sure, both about 1 young kid at home and another on the way, and about my ability to continue an active life.
Since then I have had the "million dollar workup" (nuclear imaging of the heart under stress, echo, sonograms, etc., etc.) I've gotten third and fourth opinions, from teams of specialists at UCLA, and everyone has said the same thing: there is nothing wrong, keep living your life.
I know the anxiety is hard to deal with, as several folks have said. My climbing partners will attest that I still have a habit of checking my pulse pretty regularly on long slogs at altitude. However, I think this is some of the best advice you could get: "Personally, I've found having a person obtain a clear understanding of what is going on, HUGELY reduces the anxiety of the experience...which is one of the things that keeps the whole thing going on." At this stage you, and I, have had the docs check things out. There are no guarantees in life, but if the doctors (the experts in this case) tell me to keep climbing, I'm going climbing.
Yes, I still get PVCs with some regularity--as said above, everyone gets them, but it is just stress buckets like you and me that feel them and fixate on them--but I just remind myself that everything has been checked out, a dozen times.
I still see a cardiologist once or twice a year for a holter monitor, and I am on 325mg of aspirin as a precaution, but since the initial event I've run an half Ironman, climbed big walls, spent a season in Chamonix, led some of my hardest old-school mixed nasties, made a (failed) free attempt on Moonlight, etc., etc.
I know it is scary, but if the best experts tell you to keep living, keep living. Good luck getting used to it. I know it can be hard, but you will get there.
Brian
PS--I'm 41 now, so the initial event happened around 36! Totally blew me away given my cardiovascular fitness, but there you go, life surprises you sometimes.
PPS--I'm also off coffee, which I still miss after 5 years (although I do treat myself to small amounts very, very rarely). Fecking peppermint tea is no substitute at 3:30am alpine starts... !
PM me if you want more information or someone to relate to.
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Ed Hartouni
Trad climber
Livermore, CA
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I'm 55 and was diagnosed with "ectopic hearbeat" at 28...
haven't really done anything about it in that time... still here... good to be vigilant but most likely not a problem.
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doc bs
Social climber
Northwest
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Dr KenM is right.
PVCs are normal. We all have them and three per minute is the ussual. You can check you friends and family members and they will likely have some too, sit still and feel there pulse for 1-10minutes.
In fact "AV block" can be normal too (someone else worried about that too). AV block is normal in resting atheletes whose resting heart rate is in 40s or 50s. If you do pushups or jog to get your heart rate over 60, the block goes away!
When I am anxious, I like to go out a play or run for an hour. When I get my runners high, I am not so anxious. Climbing is even better for this:)
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Paul_in_Van
Trad climber
Near Squampton
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MH,
What you are describing is called cardiac ablation. Used to treat AF in either intermittent or chronic situations. Neat tech.
Interesting note, in about 1% of cases people retain water, which can collect in the lungs and cause complications. Not sure how often this potential issue is discussed. I've got two close family members who had this in a week and half last month (the ablation, only one of them had water retention issues).
PVCs are thankfully way less worrisome.
Cheers
P
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Beatrix Kiddo
Mountain climber
Littleton
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Topic Author's Reply - Oct 8, 2009 - 10:30am PT
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Hey thanks everyone. My doctor did perform the EKG but really did not go into any detail about what is happening. I learned more here. This sensation that I'm feeling as I type I believe is driving the anxiety. Gonna dive into work to take my mind off of this and then go climbing after work. I'm so thankful for those of you who have given me advice here, offered me some peace of mind and insight.
This tickle, or bubble popping sensation that I keep feeling (even right now) in the upper part of my chest is still making me want to run out of the door of my office, jump in my Jeep and speed to the hospital. I hope this stops soon. Not my heart but the palps. :-)
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leinosaur
Trad climber
burns flat, ok
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I wonder if someone with a resting HR as low as yours is more likely to be aware of the PVCs since your compensatory pause as described above might be nearly 2 seconds : 47 bpm = 1.23 sec/beat X 1.5 = ca. 1.9 sec - with low "normal" HR being 60-100 your pauses are longer than "usual". Ken?
Congrats on your outstanding cardio fitness and good luck with this issue - I bet you'll make peace with it pretty quick.
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shellon copeland
Social climber
reston, virginia
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Hi I am and RN and worked in CCU (coronary care unit/intensive care) and you should probably see a specialist called an Electrophysiologist this is a cardiologist who went further and spent like 3-5 years just studying and practicing the electrical parts of the heart. If you look up on google for electrophysiology of the heart it will show you the pathways etc. You sound like you are in great shape and also probably need an echo to see if there are any structural changes to the heart. But dont be very nervous many many people have this and is very very treatable. good luck and let us know how you are doing.
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Ken M
Mountain climber
Los Angeles, Ca
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//"I wonder if someone with a resting HR as low as yours is more likely to be aware of the PVCs since your compensatory pause as described above might be nearly 2 seconds : 47 bpm = 1.23 sec/beat X 1.5 = ca. 1.9 sec - with low "normal" HR being 60-100 your pauses are longer than "usual". Ken?"//
I would think that to be the case, although I'm personally not aware of any studies on the matter.
one of the things that drives the people with this sort of thing crazy, is the ambiguous things they hear:
Sounds like standard PVC's, nothing to be worried about---better see a doc
Doc checked it out, it's ok----better see a cardiologist
Cardio checked it out, it's ok---better see an electrophysiologist
EP checked it out, it's ok---better get another opinion
2nd EP checks it out, it's ok---better go to Mayo
The first step is the correct step. No one else here has seen you, or your EKG. If you don't trust your doc, you have a bigger problem, but easy to solve. If you trust your doc, then trust them, and follow their advice. We have all the time in the world to give lengthy explanations, but they know YOU.
And think about your asthma medicines........(palpitations are the most common reason for people discontinuing albuterol, in my experience)
Regarding compensatory pauses, I may not have been clear in the significance: If a compensatory pause is reliably present with the ectopic beat, it is a PVC. The point is, it is a definitional thing...if one can define a person's ectopy as a unifocal PVC at a rate of <10/min, then one has defined the situation and the severity, and the diagnostic job is just about done. What they have is no longer in question, the cause and the possible treatment are left, but the issue of danger is settled.
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Jaybro
Social climber
Wolf City, Wyoming
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I have an irregular heartbeat I have two different drummers, one only supplies intermitant contributions, lots of people are like that. It's cool, doesn't get in the way. i've run 48 Marathons and ultras.
A resting pulse of 48 is not unusual for a runner.
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GOclimb
Trad climber
Boston, MA
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Radical wrote: I don't think a PVC should be that noticeable personally although I guess some notice them.
I don't know if they all present this way (or if this is what Beatrix feels) but with me, what was most noticeable was not the pause, but the early beat. And the reason it was so noticeable was the POWER of it. It felt like all of a sudden I had a heartbeat that felt twice as hard as a normal one. It took my GF lying on my chest listening to figure out what it was. It sounded like:
lub-dub.....lub-dub.....lub-dub-LUB!........................lub-dub.....lub-dub
GO
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Beatrix Kiddo
Mountain climber
Littleton
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Topic Author's Reply - Oct 8, 2009 - 01:56pm PT
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Yes GO! Exactly. I believe the early beat is that pounding, fluttery feeling that I feel. When I check my pulse as this happens, that is also when I feel the pause. It's calming down as the day progresses. YAY!
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Beatrix Kiddo
Mountain climber
Littleton
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Topic Author's Reply - Oct 8, 2009 - 04:39pm PT
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YIKES!!!!!!!!
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GOclimb
Trad climber
Boston, MA
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I have had my hand on some hearts, even literally around some hearts, where the PVC doesn't produce a pulse.
That's fascinating! I didn't know that could be the case. As for me, I can actually feel the PVC pulse in my wrist or neck. I can't actually feel the three parts like my GF could hear in my chest, but it just feels like a stronger/harder pulse, followed by a longer pause, followed by a regular pulse.
When it was at its worst, that feeling of the stronger/harder pulse would literally vibrate my body a little, and wake me up as I was falling asleep. Now I just ignore it, and it seems fairly uncommon anyway.
GO
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GOclimb
Trad climber
Boston, MA
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Radical - my apologies, I actually mis-remembered things a bit. Last night, as I was falling asleep, I paid attention, and managed to catch a couple.
So it's *not* the way I described. Rather it feels like:
beat... beat... beat... b(weird flutter).......BEAT!... beat... beat
And sounds like:
lubdub... lubdub... lubdub... lubdublub....... LUBdub... lubdub
It wasn't the beat before the pause that was the strong one - it was the one AFTER it.
GO
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Tradmedic
Ice climber
Thunder Bay, Ontario
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Oct 11, 2009 - 10:59pm PT
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Beatrix
Sounds like there are some well informed replies to this thread. One thing that I have seen mentioned that may be playing an effect is the medication you may be on for your asthma. Ventolin, or salbutamol usually has a very minimal side-effect profile, but it does play a little with your electrolytes (it's what plants crave, heh heh heh). It can lower your potassium, usually a healthy diet will more than compensate for this but with increased activity, diarrhea, vomitting (more indirectly) may help push you into decreased potassium levels.
PVC's can often be benign, keep your doc in the loop, and watch for whatever may provoke them and/or when they aren't as predominant.
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Gimp
Trad climber
Grand Junction
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Oct 12, 2009 - 10:34am PT
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Do not like giving out medical advice over phone or net since you never really know the details but do have one comment in regard to the problem you posted.
Based on the performance level you describe PVC's would not be unusual. However, you can put your mind a lot more at ease by talking to your doctor about getting an echocardiogram/ultrasound of the heart. If your ejection fraction is normal then you (no such thing as 100% in this world) probably have no worries.
SLP
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Jaybro
Social climber
Wolf City, Wyoming
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Oct 12, 2009 - 11:33am PT
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Maybe it stems from guilt for murdering your boy friemd?
I have a very similar heartbeat pattern to what Go climb describes.
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leinosaur
Trad climber
burns flat, ok
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Oct 23, 2009 - 11:42pm PT
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radical - interesting perspectival analysis; this thread has been a fun adjunct to some rhythm reviews for my PALS certification today - best of luck with your 23:59 center - yet another reason the change of nomenclature to ED from ER is appropriate - the truly acute stuff definitely merits a whole Department. Too bad about the "other ED" co-opting the initials.
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Omot
Trad climber
The here and now
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Oct 24, 2009 - 03:20am PT
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Interesting topic. Sounds like a lot of progress has been made in understanding arrhythmia since I was diagnosed with PVC 30 years ago (I'm 48 now). They first appeared when I was running a lot and had my resting pulse down under 50 bpm. The doc said it was my slow pulse that made them more prevalent, and that they were no worry. Sounds like a similar situation to yours.
They are definitely stress related with me. I'm not in the shape I was 30 years ago, but I still get them from time-to-time (once every 1-2 weeks?). They really increased (more frequent and longer duration) when I got laid-off, and I went back to see a doctor just in case. An EKG and ECG showed I was ok, and since then I became one with my unemployment and really relaxed, like more relaxed since I've been probably since grade school, and they went away for the most part.
When they happen though, they do take my breath away, as they are very noticeable. Anyway, I'm one more data point that these things won't kill you. Don't let it keep you from getting out!
Enjoy,
Tomo
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