AF Association
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Normal concern or unnecessary worry?

For many years I had occasional bouts of PVCs, then during a time of great stress I was diagnosed with paroxysmal AF, but it wasn't until a year ago that I was given Flecainide twice a day, Metoprolol and Xarelto. Recently wore a 2-week Zio Patch monitor to give the cardiologist a clearer idea of how long the AFib episodes last, in order to decide whether or not it would be safe to discontinue the Xarelto for 2-3 days in order to have surgery. Last week he reported that the monitor showed that while the PVCs are now frequent and long lasting, and there are still episodes of tachycardia, the actual AF episodes are brief -- so discontinuing the blood thinner for surgery would be fine.

All well and good, except that the PVCs are worsening. I have been told that they are common and nothing to worry about, so I've never worried about them until now, when for weeks I've been I waking with them every day -- heart racing and skipping every 3rd or 4th beat -- which brings shortness of breath and sometimes a slight ache in the chest. Fortunately, over the past year the Flecainide has been effective at controlling the PVCs within an hour, but now the effect has started to wear off within a few hours, which calls for an extra dose of Flecainide -- resulting in an increase in unpleasant side effects. Even though PVCs are supposedly not dangerous in themselves, I sure hate the way they can make you feel when they show up every morning and continue for hours.

The frustrating thing is, in spite of my taking

written questions to appointments, my cardiologist has a way of taking control of the conversation, talking fast and much, and eager to leave the room. So I often come home with some of my concerns still not addressed. Last week, he indicated that perhaps I am worrying too much about these things. Perhaps I am . . . but when a condition gets worse instead of better, one does tend to wonder and even worry. Or have I become paranoid?

I welcome any comments -- gentle or brutal!

Thanks!

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Just wondering if you use any measires to reduce your anxiety., mindfulness, relaxation exercises, anxiety management with breathing exercises? It can turn into a vicious circle.

If you are concerned about stopping xarelto for surgery you can have"bridging" with low molecular weight heparin injections ( clexane or similar) which protect but don't cause issues with surgery. Most hospitals have a protocol for deciding who needs this.

Hope all goes well.

Wendy

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Wendy, thanks so much for your thoughtful response. This anxiety thing started a few years ago, during the time I was my husband's 24/7 caregiver in the heartrending final years of his life, and then 3 years ago came bereavement and all that comes with it. Since then, anxiety seems to have become an unwelcome habit (for want of a better word) even without my realizing the source, and I'm trying hard to remember the more relaxed person I used to be. So here I am, getting increased PVCs, and, as you point out, there's a vicious circle going on. To answer your question -- I have tried relaxation exercises, breathing exercises, but must confess I need more consistent practice. Starting today! I'm never quite sure what "mindfulness" involves, though I think I know -- and again I acknowledge that it's time to apply myself to these practices more consistently, in addition to taking a magnesium supplement.

I do appreciate your input!

Frances

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This reminds me of a previous conversation about overbearing and unsympathetic consultants, however it does seem you have been thoroughly checked out so Bagrat's suggestions seem helpful. I sympathise over the PVCs but I am sure anxiety makes them worse, speaking from experience 💓

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Thanks, Buffafly! Wouldn't it be nice to have a cardiologist with the empathy and patience and enthusiasm of Sanjay Gupta! My cardiologist is a pleasant enough man, but at 72 is hanging in there until retirement a year from now. Maybe he has "been there, done that" way too many times -- which would explain his attitude.

Like you, I have come to the conclusion that anxiety plays a huge role in PVCs, which I'm only just beginning to realize. It sounds as though you understand! So it's time to apply myself to conquering the anxiety.

I really appreciate your response!

Frances

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Dr Sanjay Gupta has just done a video on getting rid of ectopics you may find of help. Check out his website. I relate to what you have written and as much as I thought the ectopic beats caused anxiety it is a circle one worsening the other, break the cycle somehow. Best of luck

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Thanks, Yachtgirl! I went immediately to Sanjay Gupta's latest video and it was a big help. Very enlightening. I'm so impressed with him and his caring attitude and knowledge. Just being assured by others that the anxiety/PVCs cycle can be conquered is encouraging, so I thank you for your part! I wish you all the best!

Frances

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If you want to try mindfulness the headspace website is a good place to start. There is a free taster series of sessions. Also have a look at human givens ( google it). My anxiety was linked to when my husband had his heart attack and made a full recovery. There is a book amazon.co.uk/dp/B007ECTSNC/... which is helpful. I also had three therapy sessions which as a sceptic seemed like hocus pocus but changed my whole approach to life.

Look after yourself Wendy

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