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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Is The Treatment For The PVCs With Heart Arrhythmia?

Heart related, PVCs since I was 15, now a 56 year old male. Benign arrhythmia comes and goes over the years. As I get older, it seems more frequent. Dec 2013, had Stress/Echo, passed. Was generating PVCs before and after treadmill, none during. Though I avoid caffeine, I had given up Chocolate for Lent 2014. Easter resumed eating chocolate, quite a few pieces over the day. Monday following Easter, woke with persistent arrhythmia. The frequency concerned me, so by 1:00 P.M. Monday went to E.R., had Frequent PVCs and PACs, 3 to 1 respectively (approximately). Discharged from E.R., and I contacted my Cardiologist who viewed the E.R. EKG, blood tests, and observations. My Cardiologist feels that there is no reason for concern. Though I mentioned it to him, with him still unconcerned, I get into bigeminy and quadrigeminy. I have no pain, no shortness of breath, no dizziness, and if I couldn t feel them I d have no diminution of activities. But they are driving me nuts. I m in bigeminy for episodes throughout the day, and when I lay down at night, it s constant quadrigeminy. In addition to this, my stomach roils, you can hear it across the room. Last year, I developed a situation that persisted for a few weeks where if I swallowed food, my heart would experience an isolated ectopic with each swallow. I m at wits end, it s hard to believe that this many is of no medical significance, but without knowing others going through the same thing, just reading the plights of others doesn t seem to help. I take Atenolol, Klonopin, Hyzaar/HCTZ, Levothroxine, Phenytoin, ASA. My anxiety level is through the roof. Traditionally, I d get many PVCs when tense, such as work meetings. Though I ve had limited bigeminy before, these episodes are protracted, but it does eventually resolve for short to moderate times. The quadrigeminy is new. I ve been told by a neurologist to consult an Autonomic Nervous System specialist for other reasons. And I ve convinced the cardiologist to do a Holter on Monday. How can I mentally survive this, the doctors are unconcerned, my brain unconvinced, and, where can I guide my doctors, test wise or medication wise.
Tue, 2 Jun 2015
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Cardiologist 's  Response
Increasing the dose of atenolol would help after ruling out reversible causes eg. , because you on thyroxine get Tsh free t3/4 checked as overdose of thyroxine can precipice or increase the frequency of your arrhythmia. Also HTZ may cause electrolytes imbalance like hypokealemia, hypomagnesemia etc. Do mail your holter for a detailed discussion
Regards Dr. Priyank Mody
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What Is The Treatment For The PVCs With Heart Arrhythmia?

Increasing the dose of atenolol would help after ruling out reversible causes eg. , because you on thyroxine get Tsh free t3/4 checked as overdose of thyroxine can precipice or increase the frequency of your arrhythmia. Also HTZ may cause electrolytes imbalance like hypokealemia, hypomagnesemia etc. Do mail your holter for a detailed discussion Regards Dr. Priyank Mody