I think I found a good Arrhythmia Specialist. This
doctor was actually an electrical engineer before
becoming a doctor. Here's what I learned.
First. his office wasn't that close and I had to get
there at 8 AM. this meant I had to drive on a fog
snarled Washington beltway, alternating between speeds
of 65 and zero as conditions prevailed. Here's the
crazy thing. I get up with my usual atrociously high
number of PVCs (5 to 20/minute). Enroute, while
negotiating the beltway traffic I happen to notice
that I'm not having PVCs. I check my pulse and get
0/minute. Apparently the stress of beltway traffic in
the fog lessened my PVCs.
Luckily (since I was going to the cardio), the PVCs
returned as soon as I relaxed in the waiting room.
This doctor seemed willing to listen and comment on
some of our PVC topics.
My PVCs are most likely caused by a group of renegade
cells in the far upper right ventricle. When my heart
rate slows down, these cells try to maintain the
higher rate. Because they aren't communicating well
with the rest of the heart's electrical signals, they
trigger out of synch beats.
He has an acquaintance that has nearly constant
bigeminy (PVC every other beat - about 43K/day). He's
had these for over eight years. When benign, they
will not kill you. Be glad they are benign.
I then went over some of the questions we've had on
this list:
* PVCs seem related to gas, and of course you get more
gas the more fruit and vegetables (healthier diet) you
eat(also the older you get). He believed there was a
connection, but the medical communnity had not
sufficiently defined the connection to allow medical
action. He didn't have any patients that benefited
from anti-gas medications. Because of the variability
of PVCs, a treatment has to have worked about a month
to be successful.
* Related to blood sugar after a meal? When you
digest a meal, a lot of complex issues occur. The one
he finds significant is the release of high levels of
serotonin which he believed was related to PVC onset.
This relationship explained why Paxil (a selective
serotonin reuptake inhibitor) might help with PVCs,
although Paxil is not usually prescribed.
* Diet (high fiber, vegetarian) or taking Lipitor for
high cholesterol? I got my PVCs 3 weeks after
starting Lipitor. He thought diet would be extremely
rare as a cause of PVCs. He also thought Lipitor was
extensively tested and not likely the cause.
This doctor does procedures to "zap" offending heart
cells. He did not recommend this for me, but just
wanted me to know there were procedures that will work
in many cases to remove the problem. He related his
experience with one young patient who decided to be
zaped (I liked his use of non medical terms) to get
rid of his PVCs. In this case they had the patient
prepared, the catheter was up to the heart and ready
to zap, but no PVCs were occurring. The patient said
he could cause PVCs to occur by thinking. In a few
minutes he was able to produce PVCs, and the operation
was successfully completed.
So some can mentally control their PVCs! Another
patient insisted he could start PVCs by eating a
turkey sandwich (turkey produces high levels of
serotonin). They had this patient in the hospital,
all instrumented, and ordered up a turkey sandwich.
The patient started having PVCs while still munching
on his turkey sandwich. In this case the doctor
thought this occurred too rapidly to be the turkey,
and rather was the patient's mental process. His use
of actual examples was nice, because I didn't feel he
was suggesting my PVCs were all in my mind, but rather
that they can sometimes be controlled by the mind.
Again using non medical terminology he described the
types of treatment. He said we give out beta blockers
like water because they are so safe. In a follow on
comment, however, he said there are withdrawal
symptoms when coming off beta blockers (including
mental states like anxiety) so you always have to
taper off them. By the way, I think I suffered some
withdrawal coming off Hawthorn Berry because it seemed
for a while my PVCs got worse than before I tried it.
I just stopped taking it, but should have tapered off.
The next drug used for PVCs is a calcium channel
blocker. These are almost as safe as water if the
patient does not have serious heart problems (heart
attack, angina, clogged arteries). They don't
decrease the heart rate as much as beta blockers, and
in my case since my resting heart rate is low (44BPM),
Verapamil is what he prescribed.
The last ditch, if you can't just accept these benign
little twitches (rhymes with), would be a procedure
to locate and zap the offending renegade cells.
I told him about Hawthorn Berry working beautifully
for two weeks. He said don't forget a lot of
medicines come from natural ingredients (foxglove,
digitalis), so it is quite possible some of these will
work. Supplements are, in a sense, just like
medicines except they are not controlled with respect
to purity and concentration. When you take any
medicine or supplement you are experimenting to find
what works for you. There's nothing wrong with
experimenting as long as you don't take ridiculous
dosages.
Other than possible drug treatment (my option) to
control the number of PVCs, what he would do is take a
good multi-vitamin (with lots of minerals - calcium,
magnesiun,...), and have a stress test every year. He
also suggested not neglecting other good medical
routines like keeping cholesterol low, and having a
flex sphig every few years, which were actually more
important to be concerned about than the PVCs.
Rob