Athlete with healthy heart and frequent PVC's

[coloradoultrarunner]

I'm an ultrarunner and endurance athlete that went into the doctor last week with some arrhythmia concerns. When they did an EKG run, it picked up frequent PVC's happening every 3-5 beats from a single node. The doctor panicked and sent me right over to the cardiologist where they did an electrocardiogram and put me on a 48-hour Holter.

The echo came out negative with no abnormalities/thickening and great blood flow. No signs of heart disease. I don't have the Holter results back yet.

I did a couple of light 30 minute steady state workouts this week and the PVCs seemed to disappear for almost 12 hours. I also notice that the frequency of them picks up after I eat or at rest. They are particularly concerning at night as I am trying to fall asleep. It's a downward cycle that triggers panic episodes and more PVC's during those times.

Everything I am reading says not to worry about these if my echo came out healthy and shows no underlying signs of hear disease or blockages. I am still having a hard time putting my mind at ease.

I've already cancelled one race this summer due to this, but are there any cardiologists or endurance athletes on this forum that can give me some advice about working out or continuing activity with frequent PVC's.

I'm not showing any other symptoms. No shortness of breath, no tight chest and I feel perfectly normal when on my easy runs. The PVC's have been coming and going. I woke up this AM with normal rhythm, and then have had a few episodes off and on throughout the day today.

[Catherine S]

Hi and welcome. With regards to having cardiologists on the forum...not sure we do, if we do they haven't shown themselves in the years I've been here, so you might have to settle for just ordinary joes, who also suffer with this particular problem

PVCs are really common. ..scary as hell but very common as you'll see from the many posts on the subject. They are the result of the parasympathetic as well as the sympathetic nervous system which involves the Vagus nerve...you can actually Google this as it's not scary to read...we usually discourage googling symptoms for obvious reasons, but the vagus nerve information is really interesting.

If this nerve is irritated or compromised in any way then it can affect your heart rate/beats because it's responsible for helping to regulate your heartrate. Other culprits include adrenaline surges, stimulants such as caffeine, smoking legal substances as well as non legal, eating or drinking anything that might irritate your digestive system, any activity that may alter your breathing pattern...cold weather, cold showers, sex, exercise, tension, fear, anxiety and panic. The list is endless but none of it is life threatening.

There are so many of us here who suffer with these benign palpitations and flutters so you're not alone with this. My own doctor suffers too and he and I take the same medication for it, a beta blocker called Bisoprolol. It works really well for PVCs as do most beta blockers because they calm down the nervous system and this calms down the heart...it's a bit more complex than that actually but you get the basics.

We've all had the tests, the ECGS, the Echoes and the Holters and been told by cardiologists that all is well. This could be the closest you're going to get to a cardiologist here sorry, but we know our stuff if that helps.

And...If a cardiologist does pop up at this point I'd just like to ask, where the hell have you been all this time?!

ISB ☺

[Aaahhfreakout]

I am neither a cardiologist nor an endurance athlete but I have read a bit about elite athletes and arrhythmias.

Here's some random stuff I know:

A British Olympic team doctor said that the ECGs of the athletes were a nightmare of all sorts of strange but apparently harmless arrhythmias.

PACs and PVCs tend to be common the day after someone runs a marathon.

There is a paper online -- which I can't find after a brief search -- in which a cardiologist treats someone successfully who has been having a lot of PVCs by getting him to train less often.

So there you go.

You might want to get checked to see if any deficiencies are causing you problems. Some people have reported some success with magnesium supplements.

[KaylaR88]

Hey!

I don't run marathons, but I do high intensity and endurance training 6 days a week. I've had PVCs for 12 years. Annoying is an understatement. There is a correlation between athletes and arrhythmia's, especially marathoners. I imagine it has to do with the stress on the body and imbalances with electrolytes. I don't get too many of them, thankfully, but I do have days where it really acts up. I notice with some intense workouts, the frequency of them increases. I try and listen to my body if I know it isn't anxiety. I'll eat some greens, nuts and fruits, drink lots of water and then do a lighter workout. Usually I'm back to normal. I'm not sure what your diet is like now, I imagine it's good, but perhaps you're still lacking in a vitamin or mineral. I'd be curious to hear when this started and what you were doing. Maybe you were/are under more stress than usual?

[MyNameIsTerry]

There is also interesting research out there about a lack of weight training and extreme cardio may have lead to some athletes experiencing problems.

[KaylaR88]

MyNameIsTerry, that's an interesting point. I'll have to read about that. I noticed when I dropped three days of cardio and switch to high intensity weight training, the PVC's lessened.

[coloradoultrarunner]

Thanks all. Yeah, diet is good. I tend to have more frequency after eating which is interesting though. Vagus nerve seems like a potential culprit after some google searches. I may play around there. I had a blood draw and electrolytes and all other blood workup is normal. Still waiting on Holter results. I'll give an update on that once I hear back. I also have a second cardiologist/EP opinion scheduled for next week to cover all my bases.

[MyNameIsTerry]

MyNameIsTerry, that's an interesting point. I'll have to read about that. I noticed when I dropped three days of cardio and switch to high intensity weight training, the PVC's lessened.

I remember seeing it quoted in a training mag. It was something about the need for weight based exercise to prevent the issue. It was just about the types we see in the media, those rare cases.

It's an interesting observation that you've had. It would be interesting to find out more about that.

[coloradoultrarunner]

So I got my holter results back and I have benign frequent PVC's at 8.9% of my overall beats over a 48 hour period. They are sending me to a cardiologist/electrophysiologist for a follow-up, but they told me that I am okay to run since it is a 'benign' arrhythmia. While it is freaky and easy to panic, they told me to try and ignore them for now.

I wish these people could do more to help spot the 'source cause' of these things. Beta blockers are not an option for me since I'm an athlete.

[Catherine S]

Hi again (previous username I Still Believe), yes I understand what you mean re beta blockers as they can interfere with energy levels for sure. If you can't ignore the pvcs then perhaps you can try some of the natural remedies instead.

Take care