Heart & Cardiology/PVC


Dear Dr.Richardson.

I have some questions concerning my heart. I have been a longtime sufferer from PVC's and its driving me crazy. I work as an ICU nurse and most of the time I am analyzing heart rythms so my knowledge about palpitations is somewhat extensive. I have had my palpitations off and on for years..I have taken several echos, holters, one MRI and 1 bicycle stress test. ALL OK. In the last months or so my palpitations have taken a turn for the worse...they bombard me. They used mostly to be unifocal singles, but now they come in couplets (sometimes multifocal), triplets, with compensatory pauses sometimes interpolated. Its just a big mess! (I hooked myself up to the ecg at work ). Today I tried working out on a bicycle with the same intervals as we would use on a stress test. During the test all was fine but 2-3 minutes later I was in bigeminy for about 2-3 minutes! Can you help me but some meaning to all this? Should i be concerned qnd require more tests? I am 33 years, slim, no cardiac risk profile.

Yours sincerely

Hello Daniel,

As you know, premature beats, even bigeminy and brife runs, are normal heart activity, easy to understand as normal from knowledge of the heart's electrical system and occurring in about half of us.  They don't mean you have heart disease or will in the future develop heart disease or any cardiac catastrophe.  It's common for PVCs to occur more frequently after exercise.  You don't need any more tests.

Re management:  safest of all is just ignore them.  Beta blockers reduce PVCs in some people and are very safe.  Flecainide and sotalol are more often effective and are safe in someone with a normal echo.

Please write back if this note doesn’t answer all your questions.

David Richardson  

Heart & Cardiology

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David Richardson


Adult heart function and disease. Not very good about children lesss than 12. Hypertension is o.k. Heart rhythm a special interest.


Certified in cardiology by the American Board of Internal Medicine. Was chairman of division of cardiology at the Medical College of Virginia. Am now mostly retired.

Fellow of American Heart Association and American College of Cardiology and member of American Physiological Society..

Circulation, American Heart Journal, Hypertension.

M.D. from Harvard Medical School. Residency training at Yale Uhniversity School of Medicine and Medical College of Virginia.

Awards and Honors
Gold Heartt Award from American Heart Association in 1995.

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