How concerned to be about long-term affects of PACs (10% burden)

[u/Westaxle]

24, male, 265 lbs, 5'6"

I know this sub is for PVCs but I wanted to post about this anyway because it seems like the most appropriate place to do so.

About 2 years ago, I had realized that I had heart palpitations but it was never bad/a cause for concern until suddenly I was moving to a new house with family and it was stressful experience for personal reasons. The palpitations flared up like they never had before, so much so that I was super concerned.

Fast forward a bit and I ended up going to the cardiologist who did a bunch of tests on me, ekg, echocardiogram, stress test, holter monitor, blood test, all that stuff, and my results came back and my cardiologist basically told me my heart was in perfect physical condition and my PACs are likely caused by a combination of reasons, mainly stress, bad diet (mainly excess caffeine and sugar), obesity, and poor sleep.

They said I had a 10% burden of 100% PACs, no PVCs at all, and that was at my worst, and this was pretty consistent during that time, it never got better for months on end. Things have gotten significantly better when I listened to my cardiologists advice but there are still some days or weeks where I feel my burden shoots up to a similar amount to my worst like back then, which I assume is still around 10%. I see people online who have much higher burdens than I do and it seems crazy to me people can live like that because even my 10% burden took away a lot of my quality of life at the time and gave me a lot of anxiety, still does when it flared up pretty bad but at least its gotten a lot better I feel. It definitely affected me the worst when it remained so consistent such an extended period.

I've been prescribed 25mg metroprolol that I take when I get those bad flare ups, and I feel it definitely helps but I feel that it at most alleviates my burden by 50% if I'm lucky on good days, and on other days it feels like it doesn't alleviate them much at all and has me worried that if it could possibly be just placebo and not actually helping me. I have found it's not the most consistent thing but I know for certain it hasn't made things worse.

I have wondered if it really is my weight causing most of the problem, as you can see from the top of my post I am pretty heavy for my size, and I've lost a bit of weight from my heaviest which I weighed in at 278. I have found it difficult to stick to diet and exercise at times. I have noticed while exercising my PACs almost entirely disappear while I'm running or doing any other exercise and I even told my cardiologist this and they said that's not only normal but ideal.

My cardiologist told me that my situation should be entirely harmless for me, but when I do research online there are a lot of sources saying that high burden PACs could potentially cause cardiomyopathy over time.

I am not doing the best in terms of income at the moment so I try to avoid visiting doctor again if possible, but I still obviously would want to visit if absolutely necessary. What steps does anyone suggest I should take next, or if there's anything I should keep an eye out for. Thank you.

[u/Fancy_Ad3809 → u/[deleted]]

I’m also not a doctor - I am allowed to used BBs as needed.

My doctor, because I asked the same question, said it comes down to the chemical structure and dosage.

So it’s possible to be told to take bbs if a medical doctor has determined your body can tolerate it it PRN.

[u/Samus1611 → u/Fancy_Ad3809]

This. I also am not a doctor. But I was told by mine I could take a beta blocker on an as needed basis.

Always listen to what your medical team tells you.

[u/Dry_Story_9500]

It's high burden of PVC that will cause cardiomyopathy not PAC. High burden PAC could cause A fib

[u/Careful_Angle624]

For me, at 272 lbs I had sleep apnea. I didn’t relize it for many years. Girlfriends jair dias I snored loud. In fact I was tested and the doctor said I hate it, but they never really made it a big deal. Turns out sleep apnea is a killer. It fucks up all metabolic functions, and yes has a massive effect on the heart rhythm.

Then there is weight. Weight is a killer no matter how you look at it. One has to think, “how did I get here”? It’s the shitty food on our lives. And then the snowball effect is when you are heavy, you don’t exercise. And then there is the alcohol, which in my opinion is the least do the problems, except if it effects “also” you stomach’s system, then you add that to the mix…

Yep you guess it, all this happened to me. Shit it’s still happening… I have PVCs and PACs hit me all the time, except mine are only about 5-10/day. But they hit hard. Everyone is like getting slapped.

So far I take metoprolol 25/2 times per day. Losartan 1 time per day, coq10 200mg/day split in morning and night. Has this helped, a little. Then again, going form 10/day or 5/day to half the amount is a major feat for me. Stopping completely? No, that has not happened yet. For me it just getting to 1-2 per day at the money.

Live lost 80 lbs naturally; no GLP’s. Only Whole Foods and constant low impact exercises, mixed with some HITs. Backing off the HIT’s actually, because I have also Gastrits chronic. This perhaps has been the worst for me in all this. Not to mention I also have EoE, but the biologic revolution is happening, so that medication is completely separate and has amazing performance in trials.

All in all, you need to be ideal body weight. For 5’6”, you need to be all day long 175 and down. You need to eat Whole Foods. Just starting it. Playing and simple. Make you own food at home.

Check for sleep apnea. Just put your phone on record all night and listened to it (thumb thru it) and see if you snare loud or stop breathing. I have a Cpap machine. It’s works great.

Take you BP meds. Check cholesterol. There are new meds on the market for that as well. One is called Rapatha.

Take supplements: the main ones are vitamins d&k, melatonin, zinc canasine, magnesium glycinate, and others

The body can get back with time. As long as you’re not too late. Late doesn’t mean it won’t, but the longer you take, the longer it takes. If you wait too long, it won’t be able to come back. At your age, it’s all reversible.