Heart Rhythm Disorders: Insights on VPCs and Autonomic Dysfunction

Arrhythmia issues?

Hello Doctor: I experienced chest tightness and a sensation of a foreign body in my throat around 34 months ago, and sometimes my heart would beat strongly.
Later, I visited a psychiatrist and was diagnosed with autonomic nervous system dysfunction.
To be cautious, I also consulted a cardiologist, and the examination results were as follows: 1.
Sinus rhythm with a rate of 47-116/min and a mean of 65/min.
2.
Rare atrial premature contractions (APCs) totaling 8.
3.
Frequent ventricular premature contractions (VPCs) totaling 2873, with multiform, bigeminy, trigeminy, and quadrigeminy patterns.
4.
No pauses.
5.
Non-specific ST-T changes.
6.
Total of 2 events: both events were sinus rhythm with VPCs.
NOTE: Three channels (MV5, MV1, lead III).
The doctor told me that having over two thousand VPCs is not serious and that we would only be concerned if it reached ten thousand.
He prescribed medication for me to take if I feel very uncomfortable, but I see many online users with only a few hundred VPCs.
Is having over two thousand VPCs really not a concern? Additionally, is there a connection between this and autonomic nervous system dysfunction? Since both occurred almost simultaneously, but the doctor also mentioned it is not entirely the main cause.
Is there a need for catheter ablation treatment? I am inquiring because I have been taking an SNRI for four months, but the heart rate issue still persists.
PS: I have not taken the medication prescribed by the cardiologist because I thought that if I treat the autonomic nervous system dysfunction, the heart issue might improve as well.
I am not experiencing severe discomfort, just a feeling of tightness.

Dan, 30~39 year old female. Ask Date: 2021/08/06

Dr. He Dongjin reply Cardiology

Hello, having over 2000 VPCs is really not serious, and it's okay.
If you feel uncomfortable, just take your medication.
It might be related to autonomic nervous system dysregulation.
There's no need for electrical ablation treatment; if the autonomic nervous system improves, will the VPCs also improve? It's hard to say, so let's just stick to taking the medication for now.
Changhua Hospital cares about you.

Reply Date: 2021/08/06

More Info

Understanding heart rhythm disorders, particularly concerning ventricular premature contractions (VPCs) and autonomic dysfunction, is crucial for managing symptoms and ensuring cardiovascular health. Your situation, involving frequent VPCs and a diagnosis of autonomic nervous system dysfunction, raises several important points worth discussing.

Firstly, it’s essential to clarify what VPCs are. Ventricular premature contractions are early heartbeats originating from the ventricles, which can disrupt the normal heart rhythm. While having a high number of VPCs, such as the 2,873 you mentioned, can be concerning, it does not automatically indicate a severe health risk. Many individuals can have a significant number of VPCs without experiencing serious complications. Your cardiologist's reassurance that 2,000 VPCs are not severe and that intervention is typically considered at around 10,000 VPCs is consistent with clinical practice. The context of these VPCs, including their frequency, pattern, and the presence of symptoms, is crucial in determining their significance.

The relationship between VPCs and autonomic dysfunction is also noteworthy. The autonomic nervous system regulates involuntary bodily functions, including heart rate and rhythm. Stress, anxiety, and other psychological factors can exacerbate autonomic dysfunction, potentially leading to increased VPCs. In your case, the simultaneous onset of symptoms related to both conditions suggests a possible interplay. While your cardiologist indicated that autonomic dysfunction may not be the primary cause of your VPCs, it can certainly influence their frequency and perception.

Regarding treatment, the decision to initiate medication or consider procedures like catheter ablation (often referred to as "electric burning") depends on several factors, including the severity of symptoms, the frequency of VPCs, and their impact on your quality of life. If you are not experiencing significant discomfort or complications, your cardiologist may recommend a conservative approach, focusing on lifestyle modifications, stress management, and possibly medication if symptoms worsen.

It’s also worth noting that lifestyle factors, such as exercise, diet, and stress management, can significantly impact both autonomic function and heart rhythm. Regular physical activity, adequate sleep, and stress-reduction techniques (like mindfulness or yoga) can help improve autonomic balance and potentially reduce the frequency of VPCs.

If you are hesitant about taking the medication prescribed by your cardiologist, it’s important to communicate this with them. They can provide guidance on the necessity of the medication and discuss alternative strategies if you prefer to manage your symptoms through lifestyle changes. However, it’s crucial to monitor your symptoms closely, as untreated autonomic dysfunction can lead to other complications.

In summary, while having a high number of VPCs can be concerning, it does not necessarily indicate an immediate danger, especially if you are not experiencing severe symptoms. The relationship between VPCs and autonomic dysfunction is complex, and managing both conditions through lifestyle changes and, if necessary, medication can lead to improved outcomes. Always consult with your healthcare provider before making any changes to your treatment plan, and ensure you have open communication regarding your concerns and preferences.

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