Palpitations: Is It Ventricular Premature Contraction?

Palpitations

Hello Dr.
Lee: I previously consulted you about my palpitations and took your advice to record the occurrence times and seek medical attention.
Thank you for your guidance.
I have been experiencing irregular heartbeats for about a year, and in the past couple of months, they have become particularly frequent.
Sometimes, the intense and irregular heartbeats prevent me from sleeping.
During these episodes, I measured my pulse and noticed that it would skip a beat simultaneously.
When I sought medical attention, I underwent an electrocardiogram (ECG), and the doctor informed me that it was a ventricular issue.
He mentioned that this phenomenon occurs in everyone daily, but normal individuals experience it fewer than 30 times a day, whereas I have about 2000 occurrences daily.
The doctor did not specify what condition I have, but after reading about the symptoms and ECG examples of ventricular premature contractions, I feel that they closely resemble my ECG and symptoms.
Therefore, I would like to ask you, Dr.
Lee: Is my condition likely ventricular premature contractions? Is this situation dangerous?

Xiao Qian, 20~29 year old female. Ask Date: 2000/12/27

Dr. Li Huixiong reply Internal Medicine

If your palpitations are clearly reflected as abnormalities on the electrocardiogram (ECG), and the frequency can reach over 2000 times a day, along with associated discomfort symptoms, this indicates a condition that requires treatment.
Since I cannot see your ECG records, I cannot specify the type of abnormality.
I recommend discussing this with your primary physician.

Reply Date: 2000/12/27

More Info

Palpitations, or the sensation of an irregular heartbeat, can be concerning, especially when they become frequent or intense enough to disrupt daily activities or sleep. Based on your description, it seems that you are experiencing a significant number of premature ventricular contractions (PVCs), which are a common type of arrhythmia.
PVCs occur when the ventricles of the heart contract prematurely, leading to a feeling of a skipped beat or a fluttering sensation in the chest. This can be accompanied by a pulse that feels irregular or less frequent, as you have noted. While PVCs are common and can occur in healthy individuals, the frequency and intensity of your symptoms warrant further discussion.

Your doctor’s observation that you have PVCs occurring around 2000 times a day is notable. For context, while it is normal for people to experience occasional PVCs—often fewer than 30 per day—frequent PVCs can sometimes indicate an underlying issue, especially if they are associated with other symptoms such as dizziness, chest pain, or shortness of breath.

In terms of risk, PVCs are generally considered benign in healthy individuals without underlying heart disease. However, in some cases, frequent PVCs can lead to complications such as cardiomyopathy or may be indicative of other heart conditions. It is essential to assess the overall context of your heart health, including any structural heart issues, electrolyte imbalances, or other factors that could contribute to the frequency of your PVCs.

To further evaluate your condition, your healthcare provider may recommend additional tests, such as:
1. Holter Monitor: This is a portable device that records your heart's rhythm over 24-48 hours, providing a more comprehensive view of your PVC frequency and patterns throughout your daily activities.

2. Echocardiogram: An ultrasound of the heart can help assess the structure and function of your heart, ensuring there are no underlying issues contributing to your symptoms.

3. Electrophysiological Study (EPS): In some cases, if PVCs are frequent and symptomatic, an EPS may be performed to map the electrical activity of your heart and determine the best course of action.

4. Blood Tests: Checking for electrolyte imbalances, thyroid function, and other metabolic factors can help identify any contributing issues.

If your PVCs are confirmed and deemed benign, management may include lifestyle modifications such as reducing caffeine and alcohol intake, managing stress, and ensuring adequate sleep. In some cases, if PVCs are significantly affecting your quality of life or if they are associated with heart disease, medications or procedures like catheter ablation may be considered.

In conclusion, while your symptoms may suggest PVCs, it is crucial to work closely with your healthcare provider to monitor your condition and determine the best approach for management. Regular follow-ups and open communication about your symptoms will help ensure that any potential risks are addressed promptly. If you experience any new or worsening symptoms, such as chest pain, severe dizziness, or fainting, seek medical attention immediately.

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