PVC anxiety reduction methods?

[Ix49]

My PVC burden is extremely low, but sometimes it feels like mutliple in a row happen (can't say for sure, maybe there's normal ones in there I'm not feeling?) And the ones I do get, I feel very strongly. I'm still being investigated to make sure there's nothing concerning but generally Drs are not worried. But for some reason I can't shake the anxiety. I understand everything the Drs explain about the low risk, but still when one (worse multiple) catches me off guard I feel scared I'm going to die.

I also have a bigger worry about what happens if I develop heart disease in later life. The biggest reason no one is worried is because my heart is assumed to be structurally normal based on age and previous eco's (having a new scan to confirm). My heart may be structurally normal now but it won't always be, so if the risk is structural abnormality, what happens when I inevitably develop plaque?

Has anyone ever found ways to settle anxiety about their PVCs? I don't want the stress to ruin my life but right now I'm in constant fear of them. I'd lived with them for a decade without concern but since feeling a few in a row, the spiraling has been hard to stop.

[bluemoon572]

I also have had PVCs for years but since I have developed aortic stenosis, I feel somewhat unnerved when I experience them. It's stated that even in the presence of moderately severe aortic stenosis, PVCs are not life threatening. However, I've opted to take metoprolol daily and feel it's reduced frequency of my PVCs. I would do the same if I developed coronary artery disease. Hopefully in years to come you won't develop coronary artery plaques with proper diet,statins,etc, but beta blockers may be a protective choice if you did.

[Ix49 in reply to bluemoon572]

Thanks for your reply and sorry to hear yours are giving you a tough time too. I make as many preventative choices as I can, but heart disease runs in my family from 50s onwards. It's good to know meds can help though! They did suggest beta blockers now to help my anxiety but it was decided it wasn't best with being asthmatic. Hopefully if they were needed they could maybe trial them under supervision though.

[bluemoon572 in reply to Ix49]

My son in law has had 2 episodes of paroxysmal A Fib. After the first,he was treated successfully with the beta blocker,metoprolol but it flared up his asthma. He stopped his metoprolol abrubtly and had another bout of A Fib. Was tried on the calcium channel blocker diltiazem which was unsuccessful. The more cardioselective beta blocker atenolol was successful and hasn't stirred up his asthma. Something to keep in mind.

[AAJJTt]

Hi,

I’ve put a few comments on forums regarding ectopics.

Ectopics are tough. I totally understand where you are coming from.

I started out 5 years ago with a heart attack (nstemi II ), this was my introduction to paroxysmal Afib (the root cause). Treatment - Flecainide; well controlled with no episodes for 4+ years.

In the early days, before treatment, ectopics were always the harbingers of an Afib episode and my constant nemesis since. I am very wary of them.

I did suffer badly from ‘ectopic storms’, which drove me ‘mad’, robbing me of sleep. Anxiety just enforced a negative feedback loop that descended into more ectopics. They were investigated by my cardiologist, the burden was actually not that high, less than 3% and he wasn’t overly concerned. It didn’t feel like that though! sat up and alert at 3am, slavishly watching 5+ pvcs on my Kardiamobile trace. Anxiety is definitely a catalyst and an amplifier; getting control of it, is the way forward. I turned to a course of cognitive behaviour therapy and for a period, an evening sedative. This worked for me, it broke the cycle and it all settled down.

CBT - I was always a bit sceptical about the whole area - talking therapies/mindfulness but it did help; don’t ask me how though 😀 The sessions covered how to spot unhelpful patterns of thoughts, feelings and behaviours and techniques on how to deal with them.

I still have ectopics, daily sometimes, my Afib is also vagal in nature too and I tend to pick up on ectopics after I’ve eaten. I still have runs of them as well, the beginning of the year is bad for me for some reason, I had a stint in Han/Feb. However, they just don’t bother me the same and I know I cannot let them ‘get into my head’. I literally give myself a good talking to - “ Ok, ignore it, breathe in, carry on (or in bed rollover), my heart is not going to stop.” As I mentioned previously , it just breaks the cycle of catastrophic thinking (especially at night ) which descends into anxiety and promotes more ectopics.

- Breathing - good too. LSD = long, slow deep. Inhale and exhale slowly (something like 6 a min) with slight pause before exhale. Filling your belly with air (diaphragm) not just raising your chest and shoulders. You need to persevere with this - 5mins, it’s not instant but just breathing calmly slows down you down, allowing you to relax.

At the moment, life is normal. I am currently in a good period of stability and I honestly feel that I don’t have any limitations - I regularly run, climb, cycle and travel but ectopics are ever present to some degree.

I try to keep to the mantra - calm down, they are doing me no harm but sometimes it still gets a head of me. Very recently, I had an in clinic cardiology appointment and something just tripped. While doing the ECG my heart was bouncing around like ‘a rock in a tumble dryer’. I wasn’t unduly concerned, I’m glad they got the trace too but it was really my own doing. Got a grip and an hour later and my heart was back to normal NSR - 55bpm.

I am prone to ectopics too after eating (rest and digest cycle), so I try to avoid over eating and feeling floated. When a few bumps and lumps creep in, I think, so what. If I chill and relax, and don’t fixate on it, they will filter away and they do. Don’t get me wrong, it took me a while to get here. The mind is powerful, but it is well worth investing some time on the ‘mental’ side of these conditions.

[Ix49 in reply to AAJJTt]

Thanks so much for your reply and sharing your experiences! Anxiety really is the worst cycle, I actually wasn't having many, just the odd strong one or run of a few (which terrify me) at first, but since the anxiety kicked in they're now very regular and harder to ignore.

I've never found CBT helpful unfortunately, but talking therapy helped in the past for everything, so I'm going to look into finding someone private soon I think.

It's interesting what you say about digestion, someone else mentioned this on a prior post too. Every heart condition I've had (I had successfully ablated WPW with runs of SVT too) is always made extremely worse by indigestion. I try and explain that to Drs but they sort of freeze like they don't know what I'm talking about.

Thanks for the tip about the breathing exercises, I'll look into a few as they've always been helpful at keeping asthma attacks manageable during emergencies.

Do you find Kardia helpful? My Dr suggested it, offered to read any traces from it. The issue is I have a smart watch (2 leads, so less than Kardia) but by the time I set it up, the PVCs have stopped so I assume it'd be the same problem with Kardia.

[AAJJTt in reply to Ix49]

Hi, I have find the Kardiamobile really useful, though it can addictive and so needs to be used with care. I have a 6L and have found its Afib determinations to be accurate. Along with self awareness, I would use it to determine if I need to use my PIP. Thankfully never at moment.

I also find it’s pretty easy to detect PVCs on traces too. It can get ‘fooled’ though, if there are too many PVCs (4 or 5 +)on a trace then it sometimes determines Afib (or an unclassified) incorrectly.

Sorry to hear CBT hasn’t worked out. I probably lump CBT, talking, etc into one thing actually but it all has worked. I just worry about them the same and if I don’t think about it, they usually melt away.

[Identiy]

Two things

1. the perceived threat is that you have no control over the action of your heart and that the resulting VPC's which increase with your increasing concern about them, could kill you. Talk to the fear, tell it to kill you. As you have been investigated and advised that you have a normal heart, it won't happen!!! ie try and bring on the VPCs instead of trying to stop them and worrying when the next one will come

Until you front up to the fear and overcome it with some hard evidence, the doubt will linger and you will have ongoing anxiety

2 increasing your heart rate thru exercise will eliminate VPC's .Go to a gym, sit on a stationary cycle and gradually increase your heart rate to the maximum for your age -= 220- age

As you have been assessed and advised that your heart is normal, this will not be a problem .If you are used to exercising , it will be easy. If not, gradually build up the duration and intensity of exercise.

However, the VPCs will persist until you are exercising hard, but will disappear at about 85to 90 % of maximum.

Experiencing this will give you confidence that they are not a problem as you will appreciate that it they were, common sense would say that at high exercise loads they would be worse.

If you are worried about doing this, talk to you GP and be referred to. Cardiac Rehab facility where they can monitor you.

I have a significant area of fibrosis in the left ventricle from myocarditis aged15. Started having VPCs in early 30s. Did the above, solved the problem. Still exercising hard 44 years later

[Ix49 in reply to Identiy]

Thank you! No one has spoken to me about exercise so far, I've had a few bad ones while walking so I assumed it was a trigger and to avoid. But now you mention it, when I've been in a better rhythm of exercising regularly and gradually increasing fitness over time, I don't really notice them. It's only when I try and throw myself back into it after a period of not doing much. Interesting to know they disappear better with increased heart rate, I'd worried it'd be the opposite! I'd seen the research saying they should decrease with exercise but because they'd pick up around 120 bpm I assumed it wasn't working. I tried to do more exercise when I had the halter on, and the Drs weren't worried just checked in I'd been working out and not resting for the high BPM readings.

[Choccie55]

My ectopics started in my 30s and were always worse just before my period and were horrendous during peri menopause so definitely hormone related. I was then diagnosed with SVT and take beta blockers which have really helped with my ectopics. I take Bisoprolol 2.5mg a day.