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Saturday, September 14, 2013

The PVC/SVT Adrenaline Connection

These past two months I have been under an extremely high amount of stress.

We have been living in a rental home owned by friends of ours for the last two years, while we were hoping to implement our plans to build our dream home.  Then I got sick with my gallbladder and had it removed, and then my husband ended up with his two heart surgeries last year, so the building plans were put on hold.

This last spring we asked our friends to extend our lease to November so we could finally go ahead with our building plans.  They agreed and signed the lease extension.

One month later they decided to put the house on the market, and we soon found ourselves in a quandary of what to do, whether to go ahead and build, stay in the house until November and hope to find temporary housing for two months, or to break the lease, lose our deposit, put ourselves in jeopardy for a potential lawsuit for breaking the lease early so we could find a longer term temporary housing, or find an existing home to buy and try to talk the landlord into shortening the lease a couple months while we waited through our escrow process.

Because they had the house on the market, it turned out they really needed us out because a home with a tenant in it is far less desirable because the buyer has to honor the lease, so they agreed to shorten our lease to September while we look for an existing home.  We decided to keep life simple and buy an existing home.

It is all good because what we bought was our dream home, bigger than what we could build with a paradise backyard.

But the strain put on the friendship, and the process for improving and cleaning a home you don't own, that you are being forced to move from, is extremely upsetting.

Since the process began in June, I have had a major ramp up of my PVC's and SVT episodes, and because of this, I now know that stress plays a major factor in my heart rhythm problems.

Am I glad I am in this situation?  Well, yes and no.  Yes, because I did get the home of my dreams for less money than it would have cost to build it, and yes because I learned more about my body during this stressful period of time, but no, because a friendship has been strained as I have learned more about our friends and their integrity and value of relationships over financial gain.  Financial gain or, perhaps, preservation of financial status won.

This realization has caused many feelings for hurt, anxiety, worry, fear, and sometimes anger.

But, my heart has taken the role of regulator over my response to that anger.

With each period of anger has come either a bigeminy rhythm of my PVC's or an SVT.  I went from January to July not having any SVT's at all, and since July I have had three, and two of them in the last three weeks while we have been at the head of our stress, moving, and cleaning and preparing the rental.

Last night my anger was at the height and I suffered from bigimeny for the first time since I performed a piano solo in last April's talent show at church.

Bigeminy rhythm, to me is as scary as an SVT because the thuds in the chest are so strong.  Last night's episode, however, taught me that I MUST  regulate my anger.  As soon as I felt the PVC's turn bigeminy, I told myself, "Let it go!  You have to let it go!"  and my heart quickly went into regular rhythm when I said that to myself.

Upon researching this phenomenon further, I came across this excellent explanation of how this happens in a forum about PVC's on this web site.  This is a great discussion and I'm copying and pasting the post here for those of you who can benefit from this great explanation.  I know it will help me a great deal and I hope it helps others too......

 Nov 03, 2008
To: steph4501I can hear the frustration and fear in your post and I wanted to come and offer some information that may help empower you if nothing else. 
Doctors indeed do know what causes PVC's, the problem is that they don't know what initiates the reaction.  Every cell in your heart has the capability of initiating a contraction.  Most don't, and that "chore" is relegated to the SA node or your "natural pacemaker."  These specialty cells begin an electrical signal that causes all of the cells in your atria to contract, and the electrical signal reaches your ventricles which then contract a fraction of a second later.  Adrenaline and other chemicals are part of the endocrine system, and their job is to increase heart rate when you are afraid (fight or flight).  This chemical causes the SA node to fire more frequently increasing heart rate.  SOMETIMES, regular cells in your heart can become sensitive to adrenaline and others and they sort of try to "help out."  Thus, initiating a contraction that is "out of sync" with the others.  In the case of PVC's the source of these ectopic beats are cells in the ventricular area, with PAC's they are in the atria.   
One common denominator in ectopic beats is the adrenaline response.  That is why cardiologists often prescribe beta blockers as a first step in helping to alleviate symptoms.  The beta blocker "blocks" some of the adrenaline from being detected by the cardiac cells and therefore decreases the number or at least the force of the ectopic beats making them less noticeable.  Interestingly enough this sets up a negative feedback loop.  Your heart beat does not frighten you as much, you don't produce as much adrenaline AND what you are producing is still somewhat "blocked."  So, your heart beat calms...and you worry even less, which is less adrenaline and so on and so forth.  Sometimesdoctors will pair a prescription of Beta Blockers and an SSRI (Paxil or Prozac as examples) in low doses to lower the anxiety levels of those experiencing the ectopics.  This is not because the PVC's are in your head, or because you are weak, or because you imagine them or are crazy.  This is purely to reduce the effects of the positive feedback loop that feeds ectopic beats.  If you worry, you become anxious, if you are anxious, your body produces and releases adrenaline...which increases ectopics, which increases worry.  It is biological. 
As for "how do they know it won't kill you."  Well, no-one knows when their time will come.  All of us are living on borrowed time, we just don't know how much time we have.  However, in the case of PVC's and PAC's research has shown that people who experience these beats are statistically NO MORE LIKELY to die of sudden heart attack, heart failure or other cardiac causes at an early age.  There is a SLIGHT, but negligable, association of persistant ectopics (upwards of 10-25,000/day) causing cardiomyopathy.  This is not a common situation however, and if you are under the care of a cardiologist who will check on your symptoms usually annually, this is unlikely and if it does happen is treatable.  So...statistically speaking, hundreds of thousands of people experience PVC's (most with absolutely NO sensation of having them) and their cardiac induced mortality is no more than those who do not have the ectopics. 
While I totally understand your desire to remain "drug free" you may consider going on a very low dose of beta blockers (I only take 12.5mg/day or 1/4 tablet) to help reverse the positive feedback loop.  Once your PVC's begin to calm down, you may even get permission to only use the BB's when you "need" to.  Mostly I use them when it is the week before my period or when I'm ill--both of which increase adrenaline levels.  (FYI the female menstrual cycle often results in mild anemia which is a trigger for adrenaline induced increases inheart rate--and illness increases heart rate to amp up the immune response). 
I hope I did not bore you.  For me, knowledge is empowering.   
Take care..."

I'm so very grateful to others who have taken the time to help people like me manage this condition.  I know I must learn to control my anger, to not be so fearful, and worrisome, and even consider medications if I find that the mental energy I'm putting into calming down doesn't work.  

So far, I have been able to control the last three SVT episodes by laying down and distracting my thoughts, and last night I flipped back out of bigeminy also by controling my thoughts, so hopefully, I am on to something here.  

I would love to hear other's experiences from those who have made discoveries on how to manage these benign and annoying heart rhythms through biofeedback and care of mental health.

1 comment:

  1. Good post. I agree completely. So much power in the mind! All the best.