HomeAnswersCardiologypvcMy ECG shows sinus rhythm with premature ventricular contractions. Is this a cause for concern?

What does the presence of premature ventricular contractions in my ECG indicate?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

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Published At November 26, 2023
Reviewed AtNovember 26, 2023

Patient's Query

Hi doctor,

I wonder if you can help. I have been having ECGs, and they indicate I have sinus rhythm with PVCs. I can feel my heart beating. Is this dangerous? Medications previously taken for this same issue include Sertraline and beta-blockers. I used to suffer from depression and anxiety, but I came off the tablets. I seem to be stressed currently, not sure why, and getting the PVC results.

Hi,

I am delighted to welcome you at icliniq.com.

I read your query and understand your concern.

There are many artifacts in ECG (electrocardiogram). Wearable ECG is not always correct. Even if there are PVCs (premature ventricular complex), these are not dangerous in most cases. Please have a 12-lead ECG done. Also, tell me, is there any known family history of cardiac disease?

Hope this helps you. Feel free to ask if you have any further queries.

Thank you.

Investigations to be done

The investigations that need to be conducted include an electrocardiogram (ECG), an assessment of electrolyte levels, and a thyroid-stimulating hormone (TSH) test.

Patient's Query

Hi doctor,

Thank you for the reply.

This is a 6-lead ECG. I previously underwent a 12-lead ECG, but it did not show anything because I was not experiencing stress at that time. Presently, I am under a lot of stress, my anxiety is severe, and the recent test indicates PVC (premature ventricular contractions). Why would I have PVC if I am stressed, though? Will these go away? Can they mean I am going to have a heart attack? Not that I am aware of. I had an echocardiogram three years ago, and it showed normal results. On my Holter monitor report, it mentioned that I had over 2000 PACs over a three-day period. When you mention 'artifacts,' are you suggesting that my ECG results might be inaccurate or affected in some way?

Hi,

Welcome back to icliniq.com.

Few atrial premature beats are present. These can occur due to anxiety, excessive caffeine intake, electrolyte imbalances such as low potassium and magnesium, and sometimes during fever and thyroid disorders. To address this issue, it is advisable to avoid anxiety, reduce caffeine consumption, and have your serum electrolyte levels checked. These premature beats often disappear when the heart rate increases, as in the case of exercise. Are you currently taking any over-the-counter medications for cold, cough, allergies, or asthma? These medications can also elevate heart rate and trigger premature beats. In times of stress and anxiety, stress hormones are released, which can lead to premature beats. May I inquire about your resting heart rate?

Looking forward to your response in order to help you.

Thank you.

Investigations to be done

The investigations that need to be conducted include an electrocardiogram (ECG), an assessment of electrolyte levels, and a thyroid-stimulating hormone (TSH) test.

Patient's Query

Hi doctor,

Thank you for your prompt reply.

Are they PACs or PVCs? Is this a cause for concern? I will undergo a blood test. My resting heart rate is about 68. I assume that once the stress and anxiety subside, the situation will improve. I've been experiencing PACs for years. Regarding both PVCs and PACs, does their presence increase the risk of any serious conditions?

Hi,

Welcome back to icliniq.com.

These are PACs. Both PACs (premature atrial contractions) and PVCs (premature ventricular contractions) are not dangerous by themselves. Prognosis depends upon the underlying cause. PACs are rarely serious. PVCs are also not serious in the absence of structural heart disease. Your echocardiography was normal; there was no structural heart disease. A resting heart rate of 68 is considered normal. If you experience intermittent PACs, they will likely subside once you engage in brisk walking or jogging to raise your heart rate above 100. No need to worry.

I hope this has helped you.

Thank you.

Patient's Query

Hi doctor,

Thank you again for your time; I greatly appreciate it.

So this is more than likely stress-related, which I need to control? Can you determine if there was any heart damage from this ECG? This is my latest ECG.

Hi,

Welcome back to icliniq.com.

Yes, control anxiety. In this ECG, there are APCs (premature atrial contractions) present as well. If the symptoms bother you, I suggest you take tablet Bisoprolol 2.5 mg once a day. This is a beta blocker that will suppress APCs and improve symptoms. The dose may be adjusted according to your response.

Patient's Query

Hi doctor,

Thank you for the reply.

What are APCs? Is this different from before, or are you saying it is the same as before? I have been on beta blockers previously, and they slowed down my heart rate, which was not very good. If I can control the stress, hopefully, the palpitations and PACs or PVCs will vanish. At the moment, it turns out it is happening once every 10 seconds, which is a lot, is not it? Thanks for your help. So, in the ECG I have shown you, there is no immediate threat of a heart attack or heart damage, correct?

Hi,

Welcome back to icliniq.com.

Yes, there is no immediate threat of a heart attack or damage. APCs or PACs mean atrial premature complexes. VPCs or PVCs mean ventricular premature complexes. Yes, these are frequent but not serious. Atrial premature complexes occur due to factors like fatigue, lack of sleep, anxiety, stress, alcohol, and caffeine. In your case, anxiety and stress seem to be the likely causes. Controlling them should lead to the disappearance of APCs.

I hope this information will help you. Please revert in case of further queries.

Thank you.

Patient's Query

Hi doctor,

Thank you again for your time; I greatly appreciate it.

I have atrial premature complexes (APCs), do not I, and not ventricular premature complexes (VPCs)? Since I have been stressed, which I must add, I do not know why, but this is something I will work on, I have been experiencing dizziness. Is this common? When I say 'dizzy,' I mean having a foggy head with occasional dizzy spells. I am also very argumentative and have no motivation, but I assume this can be attributed to stress and anxiety. Thanks again.

Hi,

Welcome back to icliniq.com.

Your dizziness is not due to APCs. Your heart rate is normal even with APCs. Yes, these are APCs and not VPCs. Also, check your blood pressure.

Dizziness or fogginess can occur due to fatigue and exhaustion. Engaging in regular exercise like cycling, swimming, and jogging can help decrease anxiety and stress and improve mood. Here are some steps to manage anxiety and overthinking:

  1. Reflect on good moments from the past.
  2. Spend time with close friends.
  3. Engage in constructive activities.
  4. Maintain distance from toxic individuals.
  5. Extend help to others, as this can provide a sense of satisfaction.

I hope you are satisfied with my answer. For further queries, you can consult me at icliniq.

Thank you.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Muhammad Zohaib Siddiq
Dr. Muhammad Zohaib Siddiq

Cardiology

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