Step 10 (a): Please don’t beat me up on this one.Rarely do I use an anti-arrhythmic drug, like flecainide or propafenone or sotalol. And the best part of using beta-blockers: lack of harm. Beta-blockers are also good for as-needed use, say for bad days when the PVCs are acting up. They sometimes lessen the thudding associated with the irregular beats. Right understanding of PVCs means knowing they will pass. Cutting back on caffeine and alcohol, looking critically at the dose of exercise, going to bed on time, and smiling are all great strategies for PVCs. This gets me back to the 4 legs of the table of health: good food, good exercise, good sleep and good attitude. Steps 5-8 include adjustment of lifestyle, both on a micro and macro style.Removing fear is always a good first step. It is important to understand the problem, and its benign nature. Ten treatment steps. The first step is to ask what company does the PVC keep? PVCs occurring in patients with a normal heart (by history, exam, ECG and ECHO) are almost always benign. He still rides, fast at times, but doesn’t ‘train.’ (I’m not advocating not racing it’s just an anecdote.)Ħ. Recently, a cycling friend told me his PVCs had resolved almost as soon as he stopped training for races. The theme here is that PVCs tend to cluster at times of high inflammation–be it physical, mental or emotional. The middle-aged person going through a divorce, the doctor embroiled in a lawsuit, the minister who takes care of everyone but himself, the grad student during exams.
The reason I see inflammation as the link is because PVCs often occur in patients who are exposed to stress. Of course, my theory is that PVCs associate with excess inflammation. It might happen during a big training block or immediately afterwards. Mandrola observations. PVCs might indicate training excess. The word benign means the extra beats do not indicate heart disease or predict sudden demise.ĥ. In an overwhelming majority of patients, especially those with a structurally normal heart, PVCs are benign. These patients should be referred to an electrophysiologist.Ĥ. Patients with more than 20,000 PVCs per day are at risk for developing cardiomyopathy (weak heart). The normal person has about 100,000 heartbeats per day (athletes a few fewer). Quantity of PVCs. A 24-hour-holter monitor tells us how many PVCs occur on a given day.A heart doctor should evaluate arrhythmia that gets worse with exercise. PVCs that worsen with exercise may be indicative of a heart under stress, say from a partial blockage of an artery or something else. Response to exercise. PVCs that mostly occur at times of rest and suppress with exercise are usually benign.It is worth quantifying facts about the PVCs:
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