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Suggest Treatment For Frequent Premature Ventricular Contractions
Question: I suffer from constant pvcs. Had echo and Ecg and no issues. On 10mg of bystolic which is doing nothing. Treatment advice needed.
Brief Answer:
Consider thyroid issues&remeron&holter monitoring
Detailed Answer:
Hi XXXX,
I have gone through your medical history carefully and noted that you have had high free T4 but now within range. This makes me think that you are having problems with hyperthyroidism which is being treated with adequate medications.
Oscillations in blood thyroid hormones (sometimes high and other times low after taking medication) would be a cause to problems with heart rate.
With regards to your pvcs, I advise to run holter monitoring testing to further evaluate your PVCS:
- if they are less than 20/hour, then, there is nothing worrisome
- otherwise, if they are more than 20/hour, I advise to start another medications (e.g. verapamil) as long as beta-blockers are not giving effect.
I have noted that you are taking Remeron (mirtazapine), most probably for any post-traumatic stress or other neurological problem. There are some studies indicating a rare effect of Remeron (mirtazapine) on heart conduction and heart rate. You can discuss with the doctor who prescribed this medication about this rare side effect in order to change therapy.
Hope it helped!
Dr.Albana
Consider thyroid issues&remeron&holter monitoring
Detailed Answer:
Hi XXXX,
I have gone through your medical history carefully and noted that you have had high free T4 but now within range. This makes me think that you are having problems with hyperthyroidism which is being treated with adequate medications.
Oscillations in blood thyroid hormones (sometimes high and other times low after taking medication) would be a cause to problems with heart rate.
With regards to your pvcs, I advise to run holter monitoring testing to further evaluate your PVCS:
- if they are less than 20/hour, then, there is nothing worrisome
- otherwise, if they are more than 20/hour, I advise to start another medications (e.g. verapamil) as long as beta-blockers are not giving effect.
I have noted that you are taking Remeron (mirtazapine), most probably for any post-traumatic stress or other neurological problem. There are some studies indicating a rare effect of Remeron (mirtazapine) on heart conduction and heart rate. You can discuss with the doctor who prescribed this medication about this rare side effect in order to change therapy.
Hope it helped!
Dr.Albana
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I was in hospital for two nights in cardiac ward. They observed hundreds of pvcs but after echo sent me on my way. Previously had holter and again despite showing pvcs it was considered unremarkable. As for remeron I have only been on it two weeks. These pvcs have lasted 3 years.
Brief Answer:
Eliminate causes that trigger PVCS as following...
Detailed Answer:
Hi back,
Thank you for providing more of your medical data.
I'd like to have any holter report in order to analyze it myself. Can you send a copy to me?
If PVCS lasted 3 years with no solution, then, verapamil is advised to try first. It is also important to keep monitoring thyroid function as it is a potential cause.
If they sent you home because reports were unremarkable, then, this is a great sign indicating nothing serious.
Try to avoid foods/drinks that might trigger pvcs:
- carbonated drinks, which might increase abdominal bloating, precipitating PVCS
- coffee/caffeinated drinks (energetic drinks)
- alcohol/smoking
- spikes in blood pressure
- have a biochemical balance to rule out hypokalemia & hypomagnesemia (low potassium and magnesium levels respectively) that might trigger PVCS
Please bare in mind that the treatment of PVCS is to:
- avoid causes that trigger PVCS (as mentioned earlier)
- relieve symptoms of heart palpitations (for which you are taking bystolic; as it is not working for you, I advise to switch to verapamil)
Hope it helped!
Dr.Albana
Eliminate causes that trigger PVCS as following...
Detailed Answer:
Hi back,
Thank you for providing more of your medical data.
I'd like to have any holter report in order to analyze it myself. Can you send a copy to me?
If PVCS lasted 3 years with no solution, then, verapamil is advised to try first. It is also important to keep monitoring thyroid function as it is a potential cause.
If they sent you home because reports were unremarkable, then, this is a great sign indicating nothing serious.
Try to avoid foods/drinks that might trigger pvcs:
- carbonated drinks, which might increase abdominal bloating, precipitating PVCS
- coffee/caffeinated drinks (energetic drinks)
- alcohol/smoking
- spikes in blood pressure
- have a biochemical balance to rule out hypokalemia & hypomagnesemia (low potassium and magnesium levels respectively) that might trigger PVCS
Please bare in mind that the treatment of PVCS is to:
- avoid causes that trigger PVCS (as mentioned earlier)
- relieve symptoms of heart palpitations (for which you are taking bystolic; as it is not working for you, I advise to switch to verapamil)
Hope it helped!
Dr.Albana
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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