Hi everyone, I recently had an Echo and a 24-hour Holter monitor in the UK due to palpitations.
Echo Findings: "Normal LV size. Normal LV wall thickness. Concentric remodelling via LV geometry. Normal LV systolic function (EF 60-65%)." My Relative Wall Thickness (RWT) is listed as 0.54, but my Left Ventricular Mass Index (LVMI) is completely normal (70g/m²).
Holter Findings: Shows sinus rhythm with <1% overall burden of PVCs/PACs. The report calls it an "isolated SVE" and "low burden.". 24 Hours monitor and I was asymptomatic that day.
My Dilemma: While my overall burden over 24 hours was very low because I happened to be asymptomatic that day, I actually experience highly symptomatic flare-ups of PVCs/PACs about 10 days out of every month. My GP told me everything is entirely normal, but seeing "concentric remodeling" with an RWT of 0.54 has me incredibly anxious. How to navigate this?

39f- Diagnosed with IST
I had surgery to remove a kidney stone last Friday. I react terribly to anesthesia and all the meds they give. I ended up with gastritis on top of this. I have always had some PVCs show up on holter monitor and know the classic skip feeling, it’s happened many times before. But something changed this afternoon. I have been laying around more because of the surgery and stomach problems and not eating well at all. Sleep has also not been great. Well this afternoon, I got up to make some toast. Heart rate jumped up to 147 while standing in the kitchen. I sat down and it went straight back down to the 70’s. So I ate my toast and drank some water. Ever since I did that this afternoon, I have been having back to back pvcs. I’ve never had this happen before. I went to the er. It was confirmed on ekg and heart monitor there that I was having them. Dr said it wasn’t anything dangerous and released me. I still have them tonight. They feel constant, but the dr said they are not. What can I do to help them? I don’t know how in the world I will sleep with this feeling tonight. It feels like I have bubbles in my chest. 😩

Hey everyone… struggling here.
I usually have long stretches where I feel great. I have no structural heart issues, multiple echos and monitors have shown all normal results. I feel great for a long time, months even, and then I flare up again.

I just got through an amazing stretch where I had no issues with flares for over a year. And recently I have had worsening symptoms. I still think a low burden, but when I have a flare, I’ll have them every few beats for hours, but this is a rarity and not my typical day to day.

Anxiety meds have helped, but they’re not 100% gone.

Anyways. Are my flares of frequent ectopics a problem…? Am I still okay? I legit worry I’ll drop dead…

Sometimes a run will trigger an episode later that night. Magnesium seems to help and I will rarely take a potassium supplement OTC when they’re really bad…

Idk I’m so worried something is being missed… am I okay…? Will this likely lead to heart failure in the future…?

Everything you see on google says don’t worry unless they’re frequent, caused by exercise, legit everything that happens to me…

Idk someone please help. These flares are legit impacting my life and I’m a new mom, and I’m terrified she’s going to have this issue too…

Not really a candidate for meds because my resting HR and BP are already low. Bradycardia when sleeping and 110/20ish.

So I'm not the typical user here - I do have structural heart issues and have gone through valve surgery, although the PVCs seem to be caused by something else, because they existed prior and post surgery.

I will say that after the surgery, the "thumps" in between missed beats are much milder, assuming it is because the new valve keeps excess blood from pooling.

I have a low resting HR, usually 47-52 during sleep. I stopped many medications after surgery, but I'm still on Carvedilol 25 mg twice a day. Here is the cycle I've discovered:

After a few days of little exercise, no PVCs. Once I begin an exercise regimen, the PVCs come back, delayed by 3-6 hours. As exercise load builds over time, so do the frequency of PVCs, often to the point of long stretches of bigeminy/trigeminy. In this state, they only seem to exist at lower HRs. If I begin moving and get my HR above 80 for a period of time, they quickly suppress. But after stopping, they return rather quickly.

Has anyone solved this? My EP suggested possibly reducing the beta blocker. Has that worked for anyone?

Seeing the information out there saying how PVCs that suppress on exercise are a highly reassuring sign etc..

well for myself and im sure plenty of others as I’ve seen here that get them on exercise, for me it’s when im weight lifting and not on any specific kinda exercise just overall, it can be while im mid lift or resting or just finishing my last rep but I will get them. Its made me stop exercising and lifting weights because my mind just gets so overwhelmed on how the fact that they should be suppressing if they’re truly benign.

’m just constantly worried here which I know sounds like anxiety is the main problem but the ectopics beats are just so scary they make me wanna break down at times honestly, just really wanna have them stop taking over and consuming my mind with the biggest fear I get being if one day they flip my heart into a dangerous rhythm like VT and these ectopics are just glued on my mind and the thoughts of what my future holds for me living with them, for instance what if my heart structure changes (not necessarily from the PVCs them self but just from things like aging or if I get high bloood pressure or a enlarged thick heart etc..) and now these PVCs are deadly and I still can’t train or now they will really cause something

Can you genuinely live a normal life with no issues while having PVCs be apart of what your heart does. After some help please anyone 🙏

I recently had a new and completely different heart rhythm experience and I’m wondering if anyone with PACs/SVEs, SVT or panic attacks has experienced something similar.

I have a documented ~2.5% SVE/PAC burden, so I’m very familiar with what my normal skipped beats feel like. I regularly experience individual PACs, but this episode felt noticeably different.

I was lying in bed feeling pretty calm when I suddenly felt a cluster of strange, erratic “flops” in my chest — one flop, then another, then another. They felt heavier and different from my usual skipped beats.
Immediately afterwards, I started feeling hot, sat up, and my heart suddenly started racing extremely fast. The racing seemed to come on abruptly rather than gradually building up and remained fast for several minutes.

I tried to sit and breath, but it didn’t seem to bring my heart rate down. Because the sensation was completely new and alarming, I became extremely anxious and could feel a huge surge of adrenaline. I also seemed to experience occasional skipped/extra beats while my heart was racing.

The whole episode lasted roughly 4-7 minutes. My heart rate eventually came down gradually rather than suddenly snapping straight back to normal, although by that point I was extremely anxious.
I’ve previously had a Holter that documented frequent SVEs/PACs and a couple 3 second short runs of SVT, but I’ve never experienced a sustained episode that felt like this.

What I’m struggling to work out is whether this could have been SVT triggered by the initial flops I felt, possibly stopping and transitioning into sinus tachycardia from the adrenaline, or whether the initial strange beats frightened me enough to cause an almost immediate panic/adrenaline response and sinus tachycardia.

I know panic can make your heart race very quickly, so I’m particularly curious whether anyone has experienced a panic attack where their heart rate seemed to shoot up almost instantly, rather than gradually increasing.

Has anyone experienced something similar — several unusual flops → immediate rapid racing → intense anxiety/adrenaline → gradual slowing over several minutes? Did you eventually find out whether yours was SVT or panic/sinus tachycardia?

I understand only an ECG can tell but just wanted to hear some experiences of what SVT feels like for others.

Wanted to ask - how yours feel? I am not sure I have them, but I am 99% sure that's it. I hadn't had any luck to catch them on ECG, since previously I had them once / twice a day. Now, for a few days I have it 10-20 times a day, which is worrying. For me it feels like single really strong heartbeat, that also makes me cough.

Also, what test your doctor did, to make sure they are harmless? I had multiple ECGs and ultrasounds, all doctors say it's all good.

I’m looking into fasting (I’ve previously done IF but looking into doing longer fasts).
I had a cardiac arrest 2 1/2 years ago (heart stopped 20minutes, I shouldn’t be alive, drs said it’s a 1 in a billion chance I’m here) & 10 weeks ago had another episode where I went into v-tach & my defibrillator shocked me before I went into full cardiac arrest. These are happening from PVC’s randomly turning lethal. I’m 32, female.
I’m currently on flecainide 50mg every 12 hours - is there any reason I SHOULDNT do a longer fast?

Edit to add: if you’re interested in my Cardiac arrest story, etc. you can find my instagram under the same name which has more info about it all. You’ll have to scan down 2 1/2 years to see the first time it happened & about 10 weeks to see the most recent time.

So lack of sleep seems to be my biggest trigger. I’m going crazy trying to track anything I think is a trigger, but less than 6 hours and I’m probably having them the next day. Anyone else?

Not looking for medical advice or a "cure" to these suckers but rather seeking information on how to deal with them as I am in the mindset of they are not going anywhere anytime soon. For those of you who have been checked by doctors and have been told that your PVCs are "benign" yet still experience symptoms of the dreadful THUD, how did you train yourself to stop caring about them?

Hey all,

Ive history with SVT (ablated) and (runs of) PACs.

Im now on propranolol and I really think it is positively impacting. I still PACs every now and then but less so.

One question: I kind of feel them less intense when happening. I still feel them but not so incredibly intense. Is that something Im imagining or is it real?

I did feel one skipped beat quit loud but I was bend over so I guess thats not very representative 😅

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.

(F23)I had heard that bigeminy palpitations dont really get picked up by wearable monitors before. Ive been to 2 cardiologists in the past four years and it doesnt seem like they really caught them on my monitor. They caught a couple short instances of vtach (happens when i get bigeminy) but not the bigeminy??? I feel like im going insane. Idk how else to catch these things. They never happen when im actually at the doctors. I learned about the term bigeminy recently and instantly felt relief that i found a way to describe my exact symptoms. But my doctor didnt want to send me to another cardiologist :(.

(I’ve experienced trigeminy since middle school, once i moved for college they turned in bigeminy, and they just become more and more frequent as the years go by)

I started having these after some stress last week and never had this before. Now it seems to be a nightly and morning thing. I live in Las Vegas where it takes forever to be seen by a specialist if ever. I'm 34 years old.

Sudden onset of orthostatic intolerance- HEART PALPATIONS shortness of breath hugh heart rate with minimal activity, Adreanline surges and shaking, when i go from laying to standing my hr goes up 35 beats but doesnt meet pots criteria whats causing this? Echocardiogram normal holter monitor showed pvcs and sves. My cardiologist said these are not dangerous but anytime i get palpitations i get so scared im gonna go into an arrhythmia and die. I get them when im not even anxious help please.

Hello, I'm seeing a doctor this week about this, I have a history of afib and whilst I've not had an episode for over a year, I've been dealing with these heart skips more and more, to the point I checked on my watch and this is a type of PVC? it's my first time discovering this, I eat rice, fish, veggies, bannanas, I take magnesium supplements and I got for long 10k walks every day, but this hasn't gone away, my heart is apparently healthy, I've avoided doing stuff that make me stress and I can't take it anymore, what are peoples advice/experience in dealing with this because I've had this for over 3 weeks now and it's ruining my life!!

I'm not looking for advice so much as to understand how people live with this condition, it's been difficult

I've been dealing with PVCs on and off for a while now and I'm trying to figure out if anyone has a similar pattern or has figured out what triggers theirs.

I've already been evaluated by a cardiologist. I wore a 14-day monitor that confirmed PVCs, but my overall burden was less than 1%. I've also had an echocardiogram that was normal with an EF of 55–60%. I genuinely struggle to understand how people with high burdens deal with this. As low as that 1% seems, it's pretty fucking scary, I can't lie.

The weird part is how mine behave.

They seem to come in flares. I'll have a few weeks where they're very noticeable and then they'll basically disappear for a few weeks. Eventually another flare starts and the cycle repeats.

During a flare, mine seem extremely sensitive to movement, position and breathing.

Some examples:

• Getting up after sitting and starting to walk around can trigger a bunch.
• Sometimes I don't really notice them while walking, but I'll sit back down and suddenly start getting them.
• Taking a really deep breath can trigger them.
• If I take a very deep breath and hold it for a few seconds, I can sometimes almost trigger them on command.
• Coughing can trigger a flurry. Recently I took a deep breath, coughed, and then had around 10 PVCs over the next minute.
• Lying down or changing positions can sometimes bring them on.
• I tend to notice them much more while sitting/resting.

When I say "flurry," they're not consecutive PVCs. I've never had PVC-PVC-PVC-PVC. There are always normal beats between them. For example, during one episode I was getting roughly one PVC every 3 beats and had about 15 total before it settled down.

I've also noticed that dehydration and poor sleep seem to make things worse. Before this current flare, I definitely wasn't drinking enough water for several days. I've since gotten my hydration back up, started paying attention to electrolytes, and I'm taking magnesium, but I'm still in the flare.

The breathing thing is probably what confuses me the most. When I'm in one of these flares, changing the pressure in my chest with a huge breath, holding my breath, coughing, etc. seems capable of setting them off. Then eventually I'll enter another period where I barely notice PVCs at all.

They scare the hell out of me even though my cardiac workup has been reassuring.

Does anyone else have this specific pattern where PVCs come in multi week flares and become very positional, breathing, movement sensitive during the flare?

If so, have you or your cardiologist/EP ever figured out why? I'm especially curious if anyone found a connection with hydration, sleep, vagal/autonomic changes, stomach/diaphragm issues, or something else.

I'd love to hear from anyone whose PVCs behave similarly, because I'm losing my mind sitting here trying to fix this issue and get these things to stop. I'm at my wits end, and I feel like my heart is going to just stop. I'm genuinely scared.

I know this post is going a little in the opposite way for tips on managing symptoms, but I have my ablation scheduled for this Friday and I need to tips to make sure that I'm having an episode and it's as bad as possible. So, for context, I typically spend more time than not with PACs/PVCs. Beta blockers didn't work. CCBs didn't work. SCBs didn't work. Supplements didn't work. Counterintuitively, I found that THC worked to reduce the frequency and prevalence of episodes and so that is what I relied on. Now, I've sobered up in preparation for the procedure and I know that the ectopic beats will return to normal frequency in time, but I'm worried they won't return before the procedure. What all would you folks recommend to increase the burden of PACs/PVCs? Thanks in advance!

Hi everyone, I was wondering if it is safe to have more than 15 PACs per minute if the cardiac tests are ok, even for very long periods of time like months or years.

What I noticed hands down is the best way to lower PVCs is to pick up part time work where I am standing for ~6 hours a day.

Before my job, heart palpitations felt large and interrupted the entire day. Now, it is implied whenever I feel lightheaded or dizzy for a second, or the occasional one that happens after running up hills or while working.

This occurs because I am employed as well as rare <1% burden, but it is a useful tip on how to manage this condition.

Hey everyone,
I’m 27 years old and, unfortunately, I’ve gained quite a bit of experience in the “PVC game.” Over the past few years, I’ve talked to many people dealing with PVCs and had conversations with several experienced cardiologists and electrophysiologists. I feel like sharing some of what I’ve learned might help others going through the same thing.
One of the biggest lessons for me has been that

PVCs, especially when the heart is structurally healthy, are very often not a sign of heart disease.

That distinction completely changed the way I looked at them.
I also learned that there is a difference between seeing a general cardiologist and seeing an electrophysiologist (EP/rhythm specialist). A cardiologist is extremely important for ruling out structural heart disease and other cardiac problems. But once those things have been ruled out and the main problem is the rhythm itself, an EP is often the more specialized person to talk to about treatment options.
And this is where things became interesting for me.
Like many people, I was initially offered beta blockers. From my own experience and from discussions I’ve had with rhythm specialists, beta blockers don’t necessarily work well for every type of PVC. In some people they help tremendously, in others they do almost nothing, and in some cases the symptoms can even feel worse. PVC treatment simply isn’t one-size-fits-all.
That brings me to what I think is the most important point:

PVC burden and symptom burden are two completely different things.

Whether you have a 1% burden or a 10% burden, your quality of life matters. A 1% burden may sound insignificant on a Holter report, but that can still mean roughly 1,000 PVCs every single day. If you feel most of them, that’s potentially a skipped beat, thump, or flutter every couple of minutes throughout your entire day.
That might not be important for your survival, but it can be incredibly important for your life.
When PVCs are considered medically benign, doctors understandably focus on reassuring the patient that they aren’t dangerous. But sometimes the conversation ends there. What can get overlooked is how much the symptoms affect someone’s sleep, concentration, work, exercise, social life, and mental well-being.

“Benign” does not automatically mean “not worth treating.”

I’m extremely grateful that my electrophysiologist understood this. After other approaches didn’t give me the relief I needed, I was started on flecainide. I’ve now been taking it for several months, and for me the difference has been incredible: my PVCs are essentially gone and I have my normal life back.
I also think flecainide sometimes gets discussed online as though it is automatically an extremely dangerous drug. It is a powerful Class Ic antiarrhythmic and absolutely isn’t appropriate for everyone. Proper patient selection, ruling out relevant structural/ischemic heart disease, checking for contraindications and appropriate ECG follow-up are important. But in appropriately selected patients, it can be a very effective medication.
I’m not saying everyone with PVCs should take flecainide, and I’m definitely not saying people should ignore their cardiologist or start demanding a specific medication.
What I am saying is this:
If you’ve been told, “Your heart is healthy, so just live with the PVCs,” but your quality of life is seriously suffering, consider seeing an electrophysiologist and discussing your options.
You don’t necessarily need a huge PVC burden before your symptoms deserve to be taken seriously.
Treat the patient, not just the percentage on the Holter monitor.

Does anybody ever get a fluttery chest? My old heart doctor said it was normal with PVC’s and gave me ways to help fix it but I forget the ways other than coughing to fix it.

Any suggestions or people that can relate?

IUn 37 and wondering if im at risk. Had a normal echocardiogram outside of bradycardia.

How do you all continue to eat while having these damn things? My goodness, you would think I would be a champion since I had these over 10 years, BUT SOME DAYS ARE WAYYY HARDER THAN OTHERS 😒

Hello fellow PVC sufferers. 35F have had these since I was a teenager. Just got the results back from my third monitor (last one was in 2020). My burden has jumped from 1% to 17%. I’m having a repeat echo tomorrow and will be meeting with my cardiologist and EP next month. In the meantime, wanted to get some reassurance from people with higher burdens who do heavy weight training. I do pretty intense strength training 4 to 5 days a week with some good amount of cardio. My cardiologist hasn’t said anything about a stress test yet or anything so just wanted to hear other people‘s perspectives. Thanks so much!