Anyone else suffer with these? I've had these for years and they're bad today. What treatment are you getting? My cardio doc says mine are "normal" but they sure suck today. Crap.

I don't know what they are, but I certainly hope you get to feeling better.

pira114, thank you. Premature Ventricular Contractions (PVCs) are extra, abnormal heartbeats that begin in one of your heart's two lower pumping chambers (ventricles). These extra beats disrupt your regular heart rhythm, sometimes causing you to feel a flip-flop or skipped beat in your chest.

It feels like the heart misses a beat when in reality it is beating twice together fast. When it does it for hours, it's really annoying!

Uh, yeah. That sounds like it could drive a fella mad.

Mine went away with diet and exercise. Lost weight and started speed walking. I still do the coffee route in the morning, but don't touch the stuff the rest of the day.

Load up on natural sources of potassium. PVCs are a result of inefficient or improper transfer of electrical signals between nerve cells specializing in maintaining regularity of heartbeat. Your pathways are defective, so you want these signal transfers to operate as efficiently as possible for your defective pathways.

One thing that interferes with said efficiency is low blood potassium. Correct this with diet. Easiest way is to get yourself some cans of low sodium V-8, which is loaded with the stuff (even more so than regular V-8). Drink a can down and see if after an hour it hasn't improved. Some other good sources are bananas, salmon, avocados, mushrooms, and leafy greens. Alter your diet so you're daily consuming sources high in potassium and see if that helps.

Good luck.

If the doc said his ectopy was "normal", than I would caution against adjusting electrolytes.

Sometimes, the AV node just wants to do a cameo.

Not that diet and reducing caffeine doesn't have its benefits when dealing with PVC's, but I'd sooner leave that discussion to the guy with the M.D.

That's putting the cart before the horse, in my way of thinking, i.e., one should first apply an informed dietary alteration, and only if that doesn't work should one consult a physician who may well screw you up worse than you were when you first consulted him. The best medicine by far is a proper diet. This, in fact, was the opinion of Hippocrates, and he was correct.

Yeah, i get them too. Sometimes I get them real bad and mine seem to be worse in the Spring of the year. I had them more when I worked, so I think stress is a factor. I avoid caffeinated coffee, eat well and try to stay calm. Try square breathing, slowly take in a breath, hold it for a count of 10, slowly exhale, wait for a count of 10 before slowly inhaling again. PVC can cause anxiety and the anxiety makes it worse. Do the square breathing and remind yourself that they are nothing to worry about.

Just an FYI, there are a LOT of reasons you can have PVC's not related to serum potassium levels or "defective pathways" in the hearts electrical conduction system.

Also, trying to correct your K without knowing what your level is to start with by eating bananas or drinking V8 is a joke.

Advice on the internet is worth what you pay for it. The above post is a great example.

Sincerely,
someone with a tad bit of cardiac ICU experience.......

What, may I ask, is your experience with cardiac arrhythmias and ectopy?

Yep, the breathing exercise you describe is very effective. Breathing regularity is neurologically connected with heart regularity.

The exercise you describe is very close to that practiced during Zen meditation, by the way.

Thankfully, I quit coffee a few months ago, so my keyboard is safe.

But, seriously, I would hope someone would not disregard advice from a board-certified cardiologist and listen to some dude named The Real Hawkeye (or goalie) on an anonymous internet forum.

Most of the drama on here is just whiny BS, but bad medical advice can be dangerous. Especially when the OP has not given anyone nearly enough information to allow someone to reply with any good advice.

Heck, we don't know if the guy is already taking K every day because he's on a diuretic, or if he's already had an EP study and subsequent ablation, or if his PVC's are from an elevated potassium level (which, as I am sure Hawkeye would know, is very apparent on an EKG by the T-waves) which would make attempting to increase your K through diet a bad thing.

But, hey, it's the internet, so we're all experts.....

goalie, I realize that healthy food is quite dangerous and shouldn't be consumed without first consulting a physician.

How many folks have died from banana or V-8 consumption, after all? Must be piles of them.

That isn't really the point though, is it?

Fact: you don't have nearly enough information to give any medical advice here.

Fact: you didn't answer my question about your experience.

So, what is your cardiac experience? It must be extensive if you're giving out advice.

My advice is based on knowledge of the subject matter, and is at worst harmless. You explain to me the harm in his giving it a try. How potentially dangerous is the addition of a can of V-8 or a banana to his daily diet? Please proceed.

PS He's been to a cardiologist and clearly received no relief, regarding which I'm not the least surprised.

So, the Holiday Inn Express pic was accurate.

That's all I need to know. Thanks.

Modern doctors are the street-level pushers for the pharmaceutical industry. They are always measuring their patients up for a chronic course of some drug or other, each with at least as many downsides as up.

I'm still waiting to hear the potential downside of increasing natural dietary sources of potassium in the case under discussion. What harm can befall him from consuming a daily banana, a side of greens, or a can of V-8. Let's hear it.

FWIW, this statement, not your "drink V8" advice, is what brought me in. It is a factually incorrect statement. It demonstrates what I consider the pinnacle of dangerous in medicine: a small amount of knowledge, with the belief that said small amount is a lot.

By definition, a PVC is NOT a "pathway" issue. It is when the ventricles of your heart stimulate contraction WITHOUT stimulus going through the normal pathway (SA node to AV node to ventricles), but I'm sure you knew that. PVC's are not preceded by P waves because they do not begin up in the SA node, which happens to be in the atrium. They are PREMATURE, which means that they occur WITHOUT stimulus at all from, as you described them, "inefficient or improper" signals. They are a separate area (or areas, depending on morphology of the widened QRS, although one can have a single focal point of QRS instigation with polymorphic QRS waves if the signal is taking a different pathway each time the ventricular pacemaker fires) that is actually firing too early and independently of those "improper" electrical pathways you described.

PVC's can be related to many things not pathway related. You can have no aberrant condution issues and have massive PVC issues depending on metabolic issues, poor perfusion, etc....

Again, what is your experience? How did you come by your extensive knowledge of the cardiac electrical conduction system?

Um, for all you know his PVC's are being caused by an ELEVATED potassium related to chronic renal insufficiency.

The giving of advice without having nearly enough knowledge to form a good opinion is the whole point.

Keep digging, it makes you look smarter. Really.

If todays PVCs are different, causing more fatigue, pain, dizzyness or shortness of breath you should at least call your cardiologist and maybe even 911 if the PVCs seem to be debilitating or non-resolving. Modern paramedics can have you on a 12 lead EKG real quick. All it takes is one R on T pvc to ruin your day.

You merely used more and different words to express the same concept regarding pathways. Why do you believe that increasing pathway efficiency via dietary improvement would be dangerous? That's the critical question that needs answering here. Please proceed. Folks at the Fire are waiting with bated breath to learn of the dangers associated with a daily banana or side of greens.

If that were the case, his cardiologist would have informed him of it.

And the cardiologist also would have said it was "normal" to be having PVC's since it would be expected.

I love how you say "modern" doctors are all quacks and shills in one sentence, then act like "oh, they would have said that" in the next. Which is it?

I notice you ignored the part where I pointed out you made a factually incorrect assertion about PVC's though. I figured you would.

Keep digging. It makes you look smarter. Really, it does.

No, I didn't. I clearly pointed out that PVC's are NOT a pathway issue, they are an issue with a hyperconductive area of the ventricle (usually not associated with your "normal" electrical conduction system) firing too early.

Nah, he can take a banana. That works for R-on-T instigated V-tach, right?

I mean, I just shock people at work for that, but maybe I'll start giving them a banana.....

Actually, a better question is why you are giving medical advice when, in regards to cardiac electrophysiology, you clearly couldn't find your ass with two hands if I gave you a map and a one-hand head-start.

Depends on where you "give" it to them I guess.....

It's called tossing a bone to your side of the argument for the sake of discussion. In other words, from your perspective, doctors can and will evaluate all relevant factors and come to correct conclusions. That being the case, from your worldview, the doctor can be assumed to have determined said condition not to be present.

Personally, I have less confidence in this by far, which is why I recommend a dietary improvement prior to a visit to a doctor for a chronic complaint like this. Worst case scenario, the person has improved his diet, and will see a doctor the following week because symptoms haven't subsided. Best case scenario, symptoms subside, and no doctor visit is required.

Going to the doctor (apart from emergency medicine) is one of the most dangerous things you can do these days, and should be avoided to the extent possible, particularly regarding apparently chronic, and not immediately life-threatening, conditions.

Just had to quote this little gem.

and you already edited it. Well met

Gee, you know what's funny? You are talking about one area of medicine where the doctors have actually embraced moving AWAY from just throwing meds at a problem.

Fifteen years ago we would start a lido gtt for frequent PVC's, THEN call the doctor. It was protocol. I have not seen a lido gtt other than in a code for years.

ACLS is about a zillion times more simple than it used to be. Now you just give epi. (I kid, I kid, but it's close) We used to have a dozen ACLS meds we cycled through in a code. Now, other than the electrolytes (calcium, mag) it is basically epi and amio.

You crack me up.

And that's not a pathway inefficiency???

One of your exalted high priests has already evaluated him, no?

Nope. But, since you don't actually understand what the hell I am talking about, it may seem like it is to you. If anything, the PREMATURE part would indicate to an intelligent individual that something might be TOO efficient.

Hint

You keep digging. I'm off to spin class. I'll eat a banana after to ensure I am heart-healthy.

Nothing I said in that regard was inaccurate. You may choose to misconstrue it if you like, however, by copious application of technojargon.

The reason for the PVC is that the normal pathway isn't being followed, or at least not with enough efficiency as to preclude the PVC. Thus the issue.

I get them and have a friend who gets them real bad. I think the most important thing is that it has been established that they are in fact PVC's. In this case, the OP has been informed that's what they are by his doctor and told they are harmless. However, they can be very annoying and it's just real easy to feel anxious when you feel your heart beating irregularly. My friend gets them so bad that sometimes it impedes the oxygen to his brain to the point he feels like passing out.

Beta blocks often help. They can reduce the frequency. And if nothing else, because they reduce the force with which the heart beats, you are likely to no longer feel them (unless you take your pulse). I am now on a beta blocker and this is true for me. I don't feel them like I used to and I have them less often. At their high point I was up to about 8 to 10 per minute.

Before I went on a beta blocker I tried a magnesium supplement. I had researched PVC's a fair amount and found that many people found relief through magnesium supplements. They helped quite a bit and by the way, I did not go on the beta blocker for the PVC's - it was for elevated blood pressure. I remain on magnesium and the beta blocker.

Regarding beta blockers for PVC's, one line of thinking is that why go on a medication for something that is harmless? My own opinion on the matter is that if it significantly impacts your quality of life, it may be something to pursue with your doctor. On the other hand, if your blood pressure readings are in the borderline high range, it starts to make more sense.

The friend I referred to earlier sought out a consult with one of the top cardiologists in the country. He traveled half-way across the country to see this guy. The doctor recommended he stay on his beta blocker and suggested he add magnesium. My friend tried about every form of magnesium supplement out there but could not tolerate any of them (IIRC it was stomach upset that just wouldn't go away).

A lot of people get PVC's. In some cases, people are subjectively unaware of them. They are thought to be harmless and from what I've read, won't do long-term damage to your heart.

What I have learned in my research is that everyone is different. For example, there are some people who have started a magnesium supplement and had their PVC's completely vanish within a day. For others, it is of no help at all. I would see sampling a can of V-8 juice or popping a magnesium supplement as a very low risk. If you want to play it safe, run it by your doctor. I mentioned to my doctor I was going to try the magnesium and he saw no issue and felt no need to check the magnesium level in my blood. By the way, I'm not suggesting mega-dosing any supplement. I take 250 mg. of magnesium per day - which I believe is the smallest dose available.

Other people find relief through meditation, reducing the stress in their life, diet changes, exercise and so on.

Hope it works out.

Be sure to consume lots of starches while you're at it. It should form the foundation for your diet, while avoiding fats and oils wherever possible. Isn't that what your brotherhood has been telling Americans these last fifty years, resulting in skyrocketing obesity, heart disease, and type II diabetes? Sure, I want to follow your advice.

Hawke, have you made it to China yet?

You are one dense dude. STFU already. You are way out of your league trying to compete with goalie on this. And yet, you still continue to argue with someone who has BTDT.

You are a fricking idiot to the hilt. Good God man, stop.


Clyde

I have offended one of your exalted high priests, haven't I? Shame on me. What's the procedure for obtaining absolution?

Self-immolation

I'll begin immediately by consuming several cans of GMO corn.

Is there anyone you are NOT afraid of?

I say afraid and not wary, as your post suggest you must be a hermit.

Cops,crazed negores, an now doctors. It must suck to even walk out of your house.

And you teach kids!!!

Clyde

You are factually incorrect. Ignorance can be cured with education, but stupid is forever......

You see it as wrong only because not stated in the official language of your exalted church, but rather in plain English. In point of fact, there are no errors in what I stated regarding inefficient or defective neural pathways being a cause of PVCs.

Hawk, the language is precise because the electrical conduction system of the heart is complex.........and tells an educated person a LOT.

I will respond more at home later, but, yes, you are factually incorrect, or, in your terms, wrong.

Yes, exalted one.

Mostly I agree with Hawk on this.

Go into a doc with some heart rhyhm ailment and they'll slap you on a beta blocker or some such poison, and never even attempt to find out the cause.
Btdt.

Too much pill pushin' and not enough doctoring going on these days.

Don't be a hater because one of us can look at a 12-lead and read it, and one of us could look at one and not see an MI, let alone know what coronary vessel and part of the heart is likely involved.

I am one of the few "regular" RNs that can give morphine without an MD order based upon my assessment of an ekg and the patient, yet you want to act like I am the one here that doesn't have a clue.

You are pretty funny, keep digging and talking about things you don't understand. It makes you look reasonable AND smart......

Your doctor (s) suck. Find a new one.

Doctors are all satan worshipers.

Thanks for the input guys. I've been on high blood pressure meds for years, taking Losartan {Hyzaar} with HCTZ, 100-12.5 now along with Zetia, 10 mg for high triglycerides. High BP runs in the family. My Dad had a pacemaker but not till he was in his 80's. He had no other real health problems. He's gone 3 years now. Damn. But I digress...

I, too, have read a lot about magnesium but haven't tried it yet. I had a hiatal hernia repair with a vagotomy years ago and my stomach is very sensitive to a lot of food, bananas included.

I've been disabled for 18 years from a low back injury. I take 7.5 mg of oxycodone 4x daily, along with whatever muscle relaxer is the flavor of the day, but that may change today when I see the back doc later this morning. It's just not working like it used to. I've tried Morphine and Fentanyl and all the other usual crap. I know, I know. So exercise is a very difficult thing for me. I try to ride my bike {low impact} but...pain, lots of pain. I know, it's a cycle...

I actually got some sleep last night, but the PVC's are frequent again today. I also use a CPAP, been diagnosed with moderate apnea, was waking in the night with a start like something stopped working, i.e. heart or lungs. Not sure the CPAP is really helping. I don't snore now...

Dude, they're doctors, not Masons.

Thanks for clearing that up. I thought you had some PVC piping in your heart. Hope you are better soon.

Like I'm gonna believe you.

My potassium was 4.3 last time it was checked, but it's been awhile.

Perhaps your Vegus nerve acting up is responsible for your arrhythmia. Google it. Be a detective.

270 -

Do you feel the PVC easily? I would think your BP meds would reduce the force. As far as your apnea, time for another sleep study? Another possibility is your Doctor could order a Holter monitor and that might reveal (or at least rule out) what is giving you that start that wakes you up.

Between the hypertension and chronic pain, I'm not surprised your doc would indicate the PVC's were normal, if not expected. The pain meds also may have a cardiac side effect, direct or compensatory.

Good thing you didn't have a banana.

So, your K is perfect. So much for fixing it with a banana and a salad....

How long have you been on a statin for your cholesterol? Long-term, they can be nasty.

If I have 1 PVC during the day, or every few hours, no biggie, but I do feel it. But, like these last 2 days, when I can't go more than 5-10 minutes without having one, and they occur as multiples, {1 normal beat then a PVC then 3-100 beats then another PVC} then yes, they are very noticeable. Especially every 3-5 beats for minutes at a time. Gonna pick the back doctors brain about pain meds and PVC's today. And more internet reading, of course.

Really?

http://en.wikipedia.org/wiki/Vasovagal_response

Because a common thing like that, which SLOWS the HR (and, FWIW, is one of our most common rapid-response team calls when patients faint) is going to be responsible for the ventricles of the heart contracting PREMATURELY.

Very long term statin use. Decades. Yeah I wondered about that.

Google is your friend. There's a 1000 pages addressing what I suggested could be 270s trigger.

So, to be clear, you are having them every few MINUTES? No wonder the cardiologist said it was normal. Most people have that many if they drink a cup of coffee, they just don't feel them.

I assume you've been checked out where they hooked you up to the monitor and watched/counted them, right? It is odd that you would feel them if they are that infrequent. Most people notice something like an SVT or a new a-fib with RVR, but not infrequent individual PVCs.

Good luck with the pain. I broke my T5 rock climbing in WY in 1993. It sucks, and, if I don't stay in really good shape, I am pretty much an invalid.

So, you've dealt with people fainting from that often? Or are you just being TRH jr?

We have that many threads addressing why the 30-06 is better than a 270...

Google may be your friend. I like a heart rhythm monitor and and EKG to interpret when dealing with cardiac rhythm issues. Labs are also welcome.

Then again, I didn't get my training/education from google, I got it in college, then, more so, in a hospital working ER and ICU.

I am aware of some people who have thousands, many thousands during the course of a day - and are still considered normal (i.e. not harmful). And in some cases, they don't feel them. I am also aware of others who have one now and then and they are very troubled by it. My friend who nearly passes out from them at times, he has long strings of them. Sometimes, being told it is, "normal" only goes so far to managing the corresponding anxiety.

I am 60 years old, has always been active and healthy. About 3 years ago, I started feeling a skipped heart beat. I went to my doctor and he put me on an EKG in the office and didn't see anything, then gave me a Holter monitor to wear for 24 hours. When the results came back, he said it was nothing to worry about, go on with your life. I somewhat felt at ease, but it continued. About 4 months later, I had a mini physical for a CDL drivers license. We were almost thru the exam, when she put a stethoscope on my chest, and her eyes got big, and said "You have a heart murmur". I then went to a cardiologist, and got an ultrasound of the heart chambers. They said my mitral valve was leaking and would only get worse. I had it repaired at U of M in Ann Arbor , Michigan. I'm good to go now!
So! Dont believe your regular doctor , if its not his specialty. I still notice a PVC once in a while, but not like before.

His doctors are typical.

Long stings of PVC's are referred to as ventricular tachycardia. We shock that. It's considered a lethal rhythm. Your definition of "long" may be different than what I consider long though. 10-15 beat runs are not a "big deal" but, then again, I am not usually more than a 5-second run from a Lifepak 20.

Couplets common. Triplets concerning. Long strings bad.

Damned right. Few foods more dangerous. I have that on good medical authority by the name of goalie.

Damn! We agree on something. I'll have to reevaluate my whole worldview now.

Did your original doctor, the one who actually ordered a Holter Monitor, not listen to your heart?

While I disagree with TRH's opinion that the vast majority of MDs are worthless, ignorant hacks, they do call the one's who graduate in last place "doctor" just like the one's who graduate top of the class.

You guys make me glad I work somewhere where we have a decent heart-failure program, do heart transplants and VADs, and generally don't freak out too much when we have to do "stuff" like emergently place a pericardial window in the ICU room.

Not dissing you at all but an EKG or a monitor will tell you almost nothing about the root cause of the malady. They simply record the event. A little detective work done by the patient to try and find out 'why' it's happening can't cause any harm, can it?

Ease your sarcasm, dillweed. The OP said in a prior post that his stomach is sensitive to bananas.

You definitely need to supplement with CoQ10. I hope your doctor told you that years ago.

Nah, just promise me that, if you ever have an episode of chest pain, diaphoresis, a feeling of impending doom, etc... that you ask to be evaluated without a 12-lead EKG, because the people who read those don't know a damn thing about the heart anyhow.

Anyone that thinks that they can significantly raise their serum potassium level by eating bananas is an idiot or ignorant. You claim to not be ignorant.

(I know it's the logical fallacy of the false dichotomy, but I couldn't resist)

FWIW, I will go to work Tuesday, and the odds are that, at some time in my 12-hour shift, I will be called to assess a patient for chest pain that, based upon my assessment and ability to read an EKG, will be in the cath lab with a needle-stick time of less than 20 minutes from when I was paged.

As Travis would say, GFY

You clearly don't know what you're talking about if you believe low blood potassium levels aren't significantly amenable by dietary alteration.

I say just go in and get it checked. Without an updated EKG you don't know what your rhythm is. Maybe it is PVC's, maybe not. Maybe you're throwing PAC's, maybe a 2nd degree AVB or new onset of AFIB. You won't know unless you get it checked. Your past EKG with your cardiologist is in the past and is not your current condition. You'll probably get a new prescription, whether or not you take it is up to you.

Really? What, pray tell, is the leading cause of low potassium in cardiac patients there Hawk? How many bananas do you have to eat to make up for that K lost because you're on 40 of lasix BID? I specifically said bananas, not diet. People like you seem to think that one can significantly alter their K by eating a banana a day, you can't. You'd have to eat bushels of them.

Again, your ignorance of what I am talking about sure doesn't stop you from chiming in, but you may want to reconsider. That whole "better to be thought a fool than open your mouth and remove all doubt" thing you know.....

To tell you the truth, I dont think he did! His nurse was in there for a while, but he is always busy. I dont trust him as much as I used to.

Don't be interjecting into this with logic and reason. Plus, a 2nd degree type two block never lead to anything bad.....

But, you hit on my original point: get CURRENT data. Nobody on here, myself included, had anything other than a WAG as to what the OP should do. We simply don't have the data, and giving advice without even knowing what is going on is just plain stupid.

I wouldn't trust a cardiologist that didn't listen to my heart any more than I would trust Hawkeye to read my EKG. You don't just hear a "murmur" you hear something that tells you very specific data, such as is the murmur systolic or diastolic?

And, IMO, listening to the heart isn't like taking vital signs. Unless the nurse knows what the hell he/she is doing and has good experience, the odds of them hearing and charting a murmur correctly are likely close to the odds of raising your potassium from 2 to 4 by eating bananas.....

I have mocked your statements for being ignorant and factually incorrect, and I stand by that. I have not lied about what you've said, I've simply quoted it and shown it to be untrue. I've made fun of you for arguing so passionately about something you know so little about.

But can you at least refrain from misrepresenting what I said?

"Bananas are not going to help" is NOT the same as saying "Bananas are one of the most dangerous foods known to man." Granted, when you asked HOW they COULD be dangerous, and I pointed out a common scenario with cardiac patients (elevated K due to renal insufficiency/failure), you simply said "but the doctor would have told him that" and moved on, like that statement coupled with your obvious disdain for modern medicine and those who practice it doesn't make you a world-class hypocrite.....

You are doing something wrong if you need to lie about what the other person's position is in a debate.

I just came in from a 4 mile cross-country ski with my weimaraner loping along and having a great time. This whole thread has absolutely cracked me up. TRH - sometime you've got know when to remove your hands from the keyboard. goalie - you're cracking me up over here. This is like the guy at the coffee shop trying to tell me about playing the saxophone when all he's ever done is watched Slick Willy Clinton play it on TV.
FWIW I suffer from myasthenia gravis. My docs want me to maintain a good diet and exercise so that my heart and lungs are as healthy as possible so the MG won't manifest or progress in those organs when I have an attack. Some days I have the juice to exercise like I want, other days I can't. What I DO know is that without "modern quack doctors" (my sister being among them who guessed my diagnosis over the phone), I wouldn't be here typing right now because I would have died during my first MG attack. I like doctors. I'm not a fan of taking the pills I have to take, but I'm a fan of living. Some things can't be corrected by changing diet. I lowered my cholesterol and triglycerides with diet change, lost 30 pounds (some of which I've gained as I take prednisone on a weekly basis) and overall I'm in better physical condition now than I've ever been. Thanks doc. And goalie - as a pastor that sees the work of your colleagues firsthand - thank you for taking good care of your patients.

My cardiologist was great! It was my private doctor, who didn't listen to my heart or missed it. The nurse, who heard it while giving me a CDL physical, was experienced and knew something was wrong. I am thankful for her!

No doubt you're knowledgeable in your field. But so were your brothers in medicine who for fifty years recommended the modern American diet that resulted in skyrocketing Type II diabetes, obesity, and heart disease, while those who continued to regularly consume eggs, whole milk, beef, and the like (i.e., the recommended healthy diet pre-1965) remained lean and healthy till ripe old ages. On questions of diet, therefore, you will excuse me if I don't bow to your authority.

Your doctor practices the modern medical model, i.e., the conveyor-belt assembly-line model of medical practice, the traditional model having been made impracticable by the advent of HMOs.

I am going to type this really slow, so even you will understand:

We are discussing the electro-physiology of the heart. It is a much more exact topic in terms of what is known and what are actual facts than the "diet" stuff you keep referring to, which, for the record, I have not opined about.

You have made false statements. That is not opinion. We are not talking about the sun revolving around the earth here, we are talking about a tracing representing the electrical activity in the heart that can be very specific. How specific one may ask? Well, while the EKG, like an X-ray or CT etc... should never be used alone to diagnose without assessing the patient, I have yet to page out a level one to our cardiology group after seeing acute and significant EKG changes and have the patient not have some issue requiring intervention either in surgery or the cath lab. Ever. Not once. Granted, I refer to a cardiologist on the "iffy" ones while alerting the cath lab and let the cardiologist make the call, and some of those EKG's are not representative of blocked vessel, tamponade, etc..., but I am batting 100% on the "obvious" ones.

Usually, before they go to the cath lab, I am pretty sure of what part of the heart is being deprived of oxygen because of which of the 12-leads are showing significant Q waves or S-T elevation, or the presence of a new RBBB.

There is an awful lot that can be discerned from a properly obtained 12-lead EKG, and the terminology is quite specific for a reason.

You said the cause of PVC's was the OP's electrical conduction system pathways in his heart. Specifically, you stated that they were, to quote: "inefficient." I stated that you are wrong.

There are many reasons one can have PVC's. I'll try to name a few here:

caffeine
cocaine
alcohol
cardiomyopathy
hypoxia
deep suctioning that stimulates the carina (we mess with new ICU nurses by doing this on vented patients then acting alarmed)
thyroid issues
valve issues
ischemia of cardiac tissue
psych medications (tricyclics IIRC, but could be wrong on type)

But, I'm sure you already knew all that. Just like you keep trying to act like something being hyper-efficient is the same as it being inefficient. Inefficiency in the cardiac conduction system would be anything from a common elongated P-R interval (1st degree block) to a complete A-V disassociation (3rd degree block) and they are usually manifested by delayed or slowed beats, not faster ones, you know, like PVC's.

So, again, keep digging. It makes you look reasonable, intelligent, and capable of learning. Really, it does. Honest.

How many times has Hawkeye told us that his father is a physician?

I wonder if he makes a habit of telling his dad that the old man is a danger to his patients.

Oooh, that would explain the little knowledge, but thinks he knows a lot thing.

And after stating that I was wrong, you went on to describe in detail an inefficient and/or defective electrical conduction system pathway as the cause of PVC, only using different language. You're so accustomed to the sacred language that you no longer recognize the same meanings when communicated in standard English.

I'm told I have them. I don't feel anything from them. Cardio doc told me to switch to decaf coffee. Didn't say a word but thought "isn't that like drinking beer without alcohol?". I only drink one cup of regular coffee most days and 2 glasses of iced tea with supper.

Jeez dude, a PVC has NOTHING to do with the regular pathway electric impulses usually follow in the heart.

http://www.bostonscientific.com/lifebeat-online/heart-smart/electrical-system.html

The reason they are wider on the EKG strip is that they are originating below the SA and the AV node, and not traveling through the bundles to the Purkinje fibers.

As an added bonus to make you look stupid, we are talking about PREMATURE beats, which would be the opposite of an INEFFICIENT system.

The best part is that, unlike some conduction issues, PVC's are one that can occur in people who have a perfectly normal pathway and conduction system all the way from the SA node to the aforementioned Purkinje fibers.

It has nothing to do with me being accustomed to "sacred" language and everything to do with you not knowing WTF you are talking about.

Keep digging, it makes you look smart. Really. It does.

Hint: it actually makes you look like some gun-control advocate that ignores reality and rabidly clings to his/her preconceived notion of what "is" in an orgy of purposeful ignorance.

We used to call PVC's with a different shape "Multi-Focal" PVC's and it was assumed that, since they displayed as a different shape on the EKG strip, indicating different pathways through the ventricles of the heart, that they originated in different places of the ventricles.

It turns out that quite often, one focal are of the ventricle is responsible for the PVC's despite the different shape on the EKG strip, it is just that, since they are completely removed from the normal conduction system pathway of the heart, it is not uncommon for the impulse starting at the same place to take a different route for each impulse.

We now call them mono-morphic (same shape) or poly-morphic (different shape) PVC's, since the previous wording was (like you) often factually incorrect.

Language matters. If you don't know the language, you probably shouldn't try to speak it.

I wish you luck man. I only see the bad cases (vent dependent crisis) of that in the ICU, and it scares the crap out of me.

I sincerely hope you never have to see me in the hospital.

The only problem with switching to decaf coffee is that most often the process used to remove the caffeine involves the use of toxic chemicals that are worse for you than the caffeine, and which can also cause heart beat irregularity.

I sense a little bit of parsing in your language there. The pathways associated with PVCs are neither normal or efficient.

One question on this PVC will or can it make your blood pressure have high and low swings ?

I'll defer to our resident Florence Nightingale.

Yeah, done a few of those too. If it's witnessed, a hospital/PM can deal but if he gets it unattended or alone it could ruin his day.
I think he needs to see a doc asap.

Someone's having a Lee24 moment...

Kent

Gee, that's all you've got? I love how people on the internet seem to be allergic to just saying "damn, I didn't know that" or "I was wrong, thanks for telling me how it is" and just ignore the facts and throw insults.

But, since you deferred, singular PVC's, even if their stroke volume is significantly less than it is with the usual atrial "kick" you get from the atrium of the heart contracting slightly before the ventricles (due to the AV node slowing down the electrical impulse) with normal sinus rhythm, should not have anywhere near enough impact on one's cardiac output to by symptomatic in terms of blood pressure dropping.

A run of non-perfusing ventricular beats, as I stated earlier in the thread, will get you shocked in the ICU pretty quickly. We're usually nice enough to wait until you pass out before we do it, but sometimes there's a newbie who gets a little excited....

Now, if you looked at my (very) partial list of PVC causes, now, some of those things will have a profound effect on your BP.

"A run of non-perfusing ventricular beats, as I stated earlier in the thread, will get you shocked in the ICU pretty quickly."

Or the back of the Medic unit.

Apparently it hurts...that's what one of our medics told us after we did it to him when he was "running" in v-tac. Done it enough to others to know that I don't want it; I also don't want the alternative.

I sense a whole lot of ignorance in your language.

The normal pathways used by the heart to conduct electricity have nothing to do with PVC's. Considering all of the EP issues that DO have to do with the "normal" conduction system, that is a subtle, but significant, fact.

Think WPW issues. Think re-entry pathway SVT's. Think 1st, 2nd, and third degree AV blocks. Think the most common dysrhythmia of them all: A-fib. I could go on, but you get the point.

As for the PVC pathways not being efficient, you are kind of correct, since, well, they DON'T USE THE PATHWAY AT ALL. Often, as I demonstrated earlier in our terminology lesson (you flunked, by the way) the PVCs don't even use the same route through the ventricle on subsequent PVC's.

This is fun, keep it coming.

Precisely my point. They don't use the normal path, thus it's a defective path, thus inefficient.

Why can't you simply admit that you didn't read my statement carefully to start with and call it good? Answer: your ego won't permit it.

That is too funny.

Back in the 90's I had a patient go into V-tach in our cardiac ICU. Back then, we had paddles at each bedside. Not the modern Lifepak type units, just paddles. I quickly checked two leads and the guy rode the lightning.

Well, about three seconds after the scream, the charge nurse strolls on in and pointed out to me that, while shocking V-fib ASAP is a good idea, people can have perfusing V-tach that lasts for hours, and it is probably a good idea to wait until they at least feel dizzy before delivering 200j to them.

Burning chest hair smells NASTY.

And, as in the case of the OP, a singular PVC every ten minutes isn't going to get anyone in the ER very excited, or in his doctor's office for that matter. As the OP has more going on than just PVC's, updated evaluation/data makes sense.

Plain old PVC's that have been worked up and deemed a non-issue cause havoc in a lot of people's lives. But it is their psychological effect vs. physical effect that is the problem.

I have them and have empathy for the OP and anyone else who struggles with them. In fact, I've been lurking for a while but it was this thread that prompted me to register and come out of lurker mode.

For me, when they were at their worst, I purchased one of these back massage vibrating cushions and rested my back against it while I watched a movie. The cushion caused enough vibration that I couldn't feel the PVC's and it was worth it to get a couple hour break from them.

You have a problem with the founder of your profession??

You are obtuse, are you not?

This is what you said:


I highlighted the parts that are so completely wrong it is laughable. PVC's are not a result of the pathway that they take after they occur. I listed a bunch of their causes, but the pathway that they will take AFTER THE ELECTRICAL IMPULSE IS INSTIGATED damn sure ain't one of them.

Also, neither the SA or the AV node (you know, those parts that, how did you put it? "specializing in maintaining regularity of heartbeat") are involved with a PVC in any way.

A little knowledge is a dangerous thing. I wish you luck in life if you always act in this manner, because, while amusing, it is precisely the attitude we try to weed out of candidates for our rapid team.

If it makes you feel any better, I rarely make it through a shift where I don't have to tell some nurse paging me for help that "I DON'T KNOW." Granted, I usually do know who to call that does, but there is just too much to know across all the specialties these days.

You just happened to pick something I have a lot of experience with. Ego has nothing to do with it. I routinely have cardiologists look at an EKG and make observations that make me feel like a rookie.

Ya gotta know your limitations.

Yup. She died from VD. She provided a level of "total care" I never will.....

LOL....

Our protocol at the time, as I remember (for v-tac) was 100 joules. 200 was where we started for manual d-fib. I got little personal experience with the new Lifepacks'.

And you intentionally misconstrue my words. What's up with that? Chip on your shoulder?

Shame on you. You should hang her picture over your desk. Be proud, man. Take that gigantic chip off your shoulder. Life's better that way.

No, I quoted them exactly as typed by you.

Are you now going to tell me that "caused by" somehow means something other than, well, caused by?????

Caused by means caused by. Absent nonstandard (i.e., defective) pathways, PVCs don't occur.

I think you're getting caught up on the word pathway, believing that it only refers to the normal pathway. Not so, at least not as I used it. Alternative pathways are also pathways, just defective and less efficient ones.

A PVC is somewhere in the ventricle of the heart that suddenly, for one of many reasons cited earlier, decides to play pacemaker and INSTIGATES AN ELECTRICAL IMPULSE.

How that impulse travels has nothing to do with why the impulse was created by that hyperactive tissue in the ventricle.


The best is that, again, you threw me a bone. I highlighted the funny part. PVC's are one of the few conduction issues that can occur in people with 100% normal conduction "pathway" in their heart, all the way from the SA node to the tippy-tip-tip of the Purkinje fibers.

This is fun, keep it up. Every time I think you can't do it again, well, here we are.

The nervous impulse causing the PVC is certainly not normal. Again, it appears your problem is that you associate the word pathway with normal pathway. Don't be so anal.

Again, the "nervous" impulse that initiates the PVC HAS NOTHING TO DO WITH THE PATHWAY THAT ELECTRICITY TAKES AFTER IT FIRES OFF THE ELECTRICITY. Period.

That electrical impulse has many potential causes. One of them is not the pathway that it will take AFTER it is created. (And, no, an impulse is not a pathway, even in TRH la-la land)

You must not have taken a logic class in school, eh? I'm pretty sure the result of something being created cannot have caused the original thing to be created.

You might as well be talking to a wall...

You're too much, my friend. Keep misconstruing. Has that tactic ever actually worked for you before? You seem so heavily committed to it that one has to wonder.

PS I want you to tell me that you've placed a picture of the mother of your profession over your desk next week. Nothing to be ashamed of. Be proud. I will always think fondly of nurses.

I know, but it is amusing, in a car-wreck kind of way, to see how far he will go to defend his original, absurdly false statement.

We've moved the goalposts a few times already. Now, apparently, it's all my fault for being anal about terminology in a subject that, by it's very nature, begs one to be as precise as possible in terminology.

It's you who's been parsing, as I've already pointed out.

Can you please specifically describe what I am "misconstruing?"

Or, are you trying to argue that the words "caused by" mean something other than, well, caused by??????

I've quoted your original statement many times. I've linked stuff to allow you to educate yourself on the topic before continuing to type stuff and display your ignorance.

Heck, I've been downright helpful.

You, well, not so much. It's cool though. I find your willingness to so passionately defend an opinion founded on ignorance simply amazing. It's like watching a gun-control thread on DU or something. I especially like how you have tried to act as if a metric ass-ton of real-world experience with cardiac rhythms is somehow a reason to disregard my opinion out of hand.

Keep digging. China isn't far away.

Your whole argument is that the "pathway" CAUSES premature ventricular contractions. That is not true.

Well 270, I guess you have had an eyeful of cardiac physiology by now along with lessons in precipitating agents, cardiac muscle conductivity, nomenclature including that of other rhythm disturbances that would buy you a hard, white bed in a heavily wired room. At the end, if your cardiologist is a good one and you trust him, relax.

Aside from dizzy spells, or passing out--serious--your only symptom seems to be "feeling them" and while that is truly a symptom, it is not a threatening one. But you can probably relax. I've had them for thirty years starting with the death of a younger brother in a Third World country. I've had them worked up, down, and sideways and the bottom line at The Mayo in Rochester, MN was..stress management and less caffeine. Stress is not my heart's friend. A long day with coffee and many hard cases makes my heart do flip-flops including short runs of V-tach.

I've given anesthesia to apparently ASA Class l patients ( very healthy) that threw jumbo
QRSs at more than ten a minute-- my threshold for treating while in my care although probably not necessary especially if those beats are perfusing. I've seen 20 y/o somethings for c-sections in bigeminy (every other beat is a wide jumbo) and they were totally unaware. Many agents, and conditions can cause these and some can be malignant but you've taken the right step and seen your cardio doc.

Now,..relax.

Thanks. Last episode I had was when we started dropping my prednisone dose. Couldn't breathe. Always fun to go home for the weekend with the instructions of "If it gets ANY worse, call 911. We'll leave instructions with the ER and ambulance team to induce coma, intubate, and fly you to HCMC. Otherwise, the IVIG treatment will be in Monday morning." We got away with it, I hope to never see another ICU unless I'm wearing my clerical collar visiting a parishioner. It scares the crap out of me too.

And I just got back from a wedding rehearsal - this thread is STILL entertaining!

Again, you misconstrue. Defective alternative pathways (not the normal ones, in other words) result in (if you prefer that to causes) PVCs. Or do you suggest that the circuit traveled by the PVC-triggering-impulse is normal?

PS I won't let that last question go unanswered by you, so don't try ignoring it as you have been doing. It will just come up again and again till answered.

Do you remember that kid in the first grade who was always saying "I know you are, but what am I?"

You just met him again.

You said the "circuit traveled by the PVC" CAUSES the PVC.

The PVC triggering impulse doesn't travel anywhere until it is created. Then, after it is created, it travels through the ventricles, sometimes causing contraction, sometimes not.

You claim expertise. Where does that impulse originate? Are you asserting that it follows a "pathway" or "circuit" or something TO the place the PVC originates????

Are you an MDA or CRNA?

But it's not normal, right??? Would you go so far as to say that it's defective and inefficient??

Keep going. We're almost there.

Not really. Unless you are changing your assertion that the pathway that the electrical impulse takes AFTER it is created CAUSES the impulse to happen in the first place.

Maybe he is a "TRH" just kidding, could not resist, the internet truly can be a dangerous place and this topic is surely pointing that out.
Along with "a little knowledge is a dangerous thing"
Got that drummed into me a lot while growing up.

CRNA MS FAAPM

Like I said previously, I often have a cardiologist point something out on an EKG, that later turns out to be exactly what they said, which makes me feel like a complete rookie.....

.......despite the fact that, if I want to, I can put RN, CCRN, ACLS, PALS and TNCC after my name on my e-mail signature at work.

That's all you, my friend. My statements were very straightforward.

PS Are you saying that the course of the PVC impulse is normal, non-defective, and efficient??? Please answer this without being coy.

Cool. Sometimes (when my CPA wife took off THREE YEARS when we had a baby) I wish I would have gone to the Minneapolis VA's program when I had no kids and the chance, but I work 12 hour shifts, .75 (10 days a month) no weekends, so I guess it is all good.

Where in Iowa are you? My wife went to Luther in Decorah and drags me down there sometimes for Nordic Fest.

OK, so, to be clear and concise, your position is that, somehow, the pathway a PVC travels in the ventricles of the heart AFTER it is created somehow CAUSES the PVC.

You are wrong.

Do you want me to list the actual CAUSES of PVC's again. I could be nice and do a quick google-fu and make the list more comprehensive. Regardless, the pathway they travel after they are created isn't gonna be on the list.....just like it wasn't on the list earlier today.

Are you saying that the course of the PVC impulse is normal, non-defective, and efficient??? Please answer this without being coy.

I just thought I would quote this again from page one and ask you (again) if PVC's are a problem of inefficient electrical conduction?

I mean, wouldn't making them conduct more efficiently also make them more common?????

Wouldn't one want to make the heart tissue LESS efficient/excitable if one was suffering from frequent PVC's?????



(hint, PVC's are the result of tissue in the ventricle being waaaaaay TOO efficient and actually creating an electrical impulse out of nothing)

No, I never said that. YOU said that the course of the PVC CAUSED the PVC though......

Heck, I just quoted you saying it again on this page.

The NW corner sixty miles from Sioux Falls, SD. Small regional hospital in a Orange City.

I don't understand how anyone having multiple PVC's in a few minutes time can NOT notice them. I very much notice mine. It creates a very noticeable "sinking" feeling in my chest and it feel like my heart shuts "off" for a second. When I have 3 or 4 normal beats then a PVC, then 3 or 4 normal beats then a PVC etc for half an hour or more, it is very "draining". I feel tired and wore out when my beats return to normal.

My 21 year old son started having them and it got bad one night so he went in to the ER and was diagnosed with PVC's. He cut out energy drinks and soda and finally {yaaaay!!!} quit smoking cigarettes and he hardly has any now. I don't drink coffee or soda or smoke. I do enjoy expensive dark chocolate more than I should though.

Uncontrolled diabetics can have a massive MI without any pain at all. Of course, they can't feel their toes either....neuropathy sucks.

In the end, it all depends on the person. Unfortunately for youl your family obviously feels them all.

That is the issue with acronyms. Poly vinyl chlorides?

I'd find an abundance of today's TV adds a bit more informative if they's move out of the acronyms and tell me what their pills will cure.

I can have several in a minute and not (or mostly not notice them). However this was not true before I went on the beta blocker. The beta blocker reduces the force of the contraction hence I don't feel it as strongly. But yes, before the beta blocker, I was feeling something similar to what you describe. Also, I see I had misunderstood what you are saying about the frequency. I had thought you were getting one every ten minutes. It sounds like you can get between 10 to 15 in a minute. This is fatiguing, and demoralizing. Particularly when you feel them strongly. I think there is a fair bit of variability in how much people feel a PVC. Hang in there - you are in my thoughts.

I've endured PVC issues for years, I read the posting here and was stunned to read the v8 comments. My heart beat problems began in 2004 and I believe v8 had a lot to do with it.
I was drinking a can a day at lunch, after several weeks I noticed that I was suffering from terrible heart rthym problems, so bad I sought MD help that was inconclusive, I did wear a halter monitor for some time. Nothing else had changed in my life, and I was a skookum hard core sheep hunter in Alaska at the time.

Ultimately I cut out all caffiene, chocolate, excessive salt, store-bought meat and sugar. It took months to regain good heart beat health.

I still experience issues, but it isn't constant like at that time.

Potassium can be an issue if it is high OR low. Did they ever tell you what yours was?

Next time, have a banana and skip the doctor......

Goalie, At the time I finally sought help my numbers were fine.
My wife is a dietitian and we live very clean, but heart rhthym problems are hereditary so I err on the side of caution, my father had a stroke due to afib.

Bananas, oranges and limes are a big part of my heart health at this point...

An active lifestyle is your best friend. It sounds like you're doing that.

Genetics are either awesome or they suck. Sorry about your family history.

He carefully avoided stating his dad's profession here, because he knew it would precipitate faster "ass handed to him" status.

Likewise, resulted to the uber sarcasm, regarding goalie, a tasteless ad hominem attack which he accuses all others of using to degrade debate.

And can edit a post twice after hitting submit, almost before someone can quote it, and then tell them they didn't see what they thought.

Good case study here, and not in cardiology.

Thanks, and yes, my day starts with the running shoes and treadmill or trail.

Goalie, you stated that you are an RN. Most RN's are lard-azzes. Are you a lard azz?

Subing for TRH?

Web, are you a fat-azz as well?

I remember a year or so ago TRH said something really stupid and I called him on it but didn't quote... he edited and hit the non-notification box then called me a liar... coleyounger jumped in on me having no idea who was correct.

Thanks for proving my point from so long ago...

And Lee24 had nothing on TRH when it came to defending bullchit...

Kent

Nostalgiafan; I appreciate your kind words. Demoralizing is a good word for it. Thank you sir.

I too can appreciate your plight, feeling your heart bounce around is very unnerving. Hang tough....

Most nurses are fat azzes.

A scant 4minutes went by in between hackleeye posting:



Then when I hit quote, it read:



I wasn't taken aback, really, as it's not the first time he's changed his post, so I'm used to it.

Luckily, I just used the back arrow to get to the cached page, and cut and pasted what was there originally.

And in that amount of time, he changed it again to:



He's quite the prestidigitator, our TRH.

Had it not been for goalie quoting the same original text in his subsequent reply, I'm sure I would have been accused of editing, or even worse, cherry picking, another one of his projected complaints against others.

You left out "or improper." I wonder why? Parsing again?

Not so. I said that PVCs are a result of inefficient or improper transfer of electrical signals between nerve cells specializing in maintaining regularity of heartbeat and that his pathways are defective (i.e., don't follow the normal course). Were the neural pathways in his heart normal, the PVCs wouldn't occur.

Why do you feel the need to misconstrue what someone says in order to win an argument?

Try cutting out the chocolate and see if it helps. Very often, diet is a causal factor in these things.

But not diet, right?? You're a typical product of the modern medical profession.

My practice is to check for typos immediately after posting. No, I don't bother leaving an explanation when my correction was for a mere typo, which generally occurs within seconds after the initial posting.

Any substantive changes I make (very rare) are accompanied by an explanatory note.

And the bolded portion is merely a lie.

Still entertaining...keep it up guys. Oh, and TRH - you're not winning the debate.

I'll make a note of that. You know I give great weight to your opinions, right?

Just from your edits in this thread... your definition of typo and subjective change is questionable. Didn't see any explanatory note with the addition of full sentences.

Kent

I play goalie for the Minnesota NHL Alumni. Did the Madison Ironman in a decent time a few years ago, and bike to work year-round.

I got out of the marines in 1992 and can still wear my dress blues.

Are you?

That's about how I had it figured.

You've combined two separate posts.

You did the Madison Ironman a few years back? So did you go ahead and complete the men's PT requirements when you were in the service or just do the women's?

Genius irony...

Kent

First off, debating cardiac electrophysiology with someone who refers to the electrical conduction system of the heart as "neural pathways" is amusing. The nervous system is not the same as the heart's electrical conduction system.

This:

http://emedicine.medscape.com/article/1923077-overview

is NOT this:

http://www.bostonscientific.com/lifebeat-online/heart-smart/electrical-system.html

Once again, you demonstrate why, if you don't know the language, you should probably not try to speak it.

Anyhow, I quoted exactly what you said many times. You are wrong. Despite me giving you all the information you need, you are obviously blessed with an inability to go learn more to understand why you are wrong.

Once again, you say I'm wrong based on semantics rather than substance.

Gee, I got 300 points most times I did the PT test, but I don't remember if it was the men's or women's. Which one requires 20 pull ups and the three mile run in under 18 minutes? That's the one I did.

Oh...my bad, you're a male. You were talking about being a nurse and I knew there were male nurses, but you know, being a sexist pig like I am I just thought...you know, you were like, a chick.

Actually, you're wrong on both.

Hint: when you admit you don't know what the hell you are talking about, and don't understand the language experts use when they talk about it, maybe you should listen instead of throwing insults at people who understand the subject matter in detail.

PVC's occur in people with perfectly normal electrical conduction systems in their heart. That is the crux of it all.

You not only have repeatedly asserted that that is not true, but you also have asserted that the way the electricity travels AFTER a PVC is initiated is somehow responsible for it existing.

Have you even read the stuff I liked for you? Learning about what you're trying to pretend to be an expert about wouldn't be a bad thing.

No biggie.



I would make a really ugly chick.....

This is the fattest I've been in a while. Too much beer and grill'n last summer (the pontoon has a grill )

I was still running 7 minute miles for my daily run though.



I do love the attempted personal attacks from the peanut gallery though. One of the smartest RN's I work with is obese. It doesn't change the fact that she's forgotten more about cardiology that Hawk and I combined will ever know.

This is on its face wrong, unless you're suggesting that there is no basis for PVCs related to neural conduction. In that case, you'd be an idiot.

But she's too stupid to eat correctly.

Ever since I cut out the fluoridated water, stopped getting annual flu shots, quit the masons, and started sporting a shower gun while bathing, my life has changed.

No more PVC and my gold losses are still above 50%.

Thanks TRH!

Can't hide from Chemtrails...

Kent

You're welcome, but don't miss this buying opportunity in gold. It won't last forever.

You're a dick Goalie. You're just like a lard-azz CRNA I had to deal with on a hospital rotation one time.

"How does this patient score on the Mallampati Scoring System?"

The big bitch was fairly certain I couldn't answer the question and she reveled in embarrasing a male Green Beret in front of her peers.

Another CRNA who wasn't a fat biatch and an anesthesiologist got me schooled up PDQ.

No one really gives a schidt whether or not you can read a 12-lead. TRH is absolutely correct that the majority of health issues are caused by diet. You yourself listed causes of PVC's which consisted of mostly [bleep] you swallow.

Just goes to show you can read a 12-lead and still be a dumbschidt.

Did it really take 5 pages for TAK to come on here and mention he was spec ops?

There's a lot of biatches like that around. How does it apply to the OP?

TAK, it must just kill you that I ain't a softy. Sorry to dissapoint you there Sally.




FWIW, my issue with TRH is his arguing from ignorance, not the diet part. I mostly agree about diet being top-O-the-heap for fixing issues with health.

Yes, back to the OP. What the OP is experiencing truly does suck. I know this because I have them too. I am having them as I write this. He is mainly asking for input from other people who have them. Specifically what has worked to treat them. In my case, beta blockers and magnesium (along with a low-sodium diet) are things I have tried and have helped. Surely it would have been preferable if the 20 pages of this thread had a lot more input from other sufferers reporting on successful things that had tried.

Oh, and TAK, it sounds like your issue, just like Hawk's, was an acute lack of knowledge. At least it sounds like you found a way to rectify it.

One other observation: from what you just showed me, it sounds like the "fat bitch" CRNA was giving you some payback for your quite obvious disdain for fatties. Live and learn......

So, going from this:

to this:


is not substantive, just a mere typo?

Shirley, you jest.

liar.

As for me, that was correct. I unphucked myself. TRH, however, is dead-nuts accurate.

That really bugs your lame azz, don't it? GFY.

I'm honored. And I'm enjoying both of you working yourselves up a little bit over being right. It's like people-watching in a mall during Christmas season.

Ok, this has gone on long enough.

Hawk, the central nervous system and the electrical conduction system of the heart are not the same thing. Excitibility of the NERVOUS system can result in the initiation of electrical impulses being generated in the ventricles of the heart. The pathways those impulses take have nothing to do with the CNS stimulation or hyper-excitibility at the cellular level that initiate those impulses.

Your assertion that "inefficient" pathways CAUSE premature ventricular contractions is false.

TAK, if you think he is correct, you did NOT un-[bleep] yourself at all, and need some remedial training.......lots of it.

Okay, that right there is funny. Nice advantage on semantics. Well played.

I stopped reading here, because you've already fabricated a straw man, and the rest of your post will merely comprise tearing it down, and a waste of my time reading it. I've never stated anything of the sort. Nervous impulses don't only travel through the CNS (how absurd). You can't win an argument by randomly making things up about your opponent's stated positions.

I laughed pretty hard at that one too. Wait, I'm supposed to get mad.....nah, it was pretty funny.

The reason you always misquote me on this point is obvious. Were you to correctly quote me, you'd look like a fool disagreeing, as you have likely now figured out, thus the constant misquotes.

The accurate quote is this: "PVCs are a result of inefficient or improper transfer of electrical signals between nerve cells specializing in maintaining regularity of heartbeat. Your pathways are defective ..."

All I did was clearly explain how a PVC comes to be. It has nothing to do with what you said happens. It isn't how you said it happens. It isn't even close. "Pathways" have nothing to do with why a person has a part of the ventricle "fire" and initiate a PVC. Period.

That is all.

Hint: You should read it and tell me how what I wrote is wrong, because what I wrote isn't compatible with what YOU said initiates a PVC impulse.

Truth be told, you shed a tear.

The straw man is all you've got, isn't it?

-Inefficient is wrong. If anything, the impulse are TOO efficient.

-The cells that normally maintain a regular heartbeat are NOT involved with the initiation of the PVC. In fact, they are not even in the same part of the heart. Unless you know something about the SA node that nobody else in the world does.....

-One can have perfectly normal conduction system pathway (no aberrant conduction, no re-entry pathways, etc...) in their heart and have PVCs.

-The nervous system stimulation that initiates a PVC can be functioning perfectly normal, and be reacting to one of the many stimuli I posted previously.


How about this, I posted how a PVC is initiated. You do the same thing. Be specific. Explain in detail what happens, OK?

Any system that's not functioning correctly is functioning inefficiently in the larger scope. But I notice that you again left off the key words "or improper." The addition of those two words covers a whole lot of ground, thus your choice to leave them off.

No, it's all covered by the part where you reference the cells that usually regulate the heartbeat. You know, the one's that ARE NOT INVOLVED AT ALL WITH A PVC.

That alone makes your statement hilarious. And wrong.

Or, are you asserting that the cells that usually regulate the heart-rate in a person ARE involved in a PVC, either in one's initiation or conduction? Because, if you're not, you're whole statement is hooey.

You missed the response to this part, so, again, your assertion that the SA node, you know, that part of the heart in the artium that regulates a person's HR, is involved in the initiation of a PVC is completely false.

Or do you have other special cells you want to tell us about. I have some researchers that would love to talk to you I'm sure....

The correctly functioning heart (which means, for one thing, no PVCs) occurs when the entire electrical system of the heart is functioning properly and efficiently. It's a system, and all impulses in the heart are interconnected to one extent or another. If there wasn't something wrong with the proper impulse pathways, improper impulses wouldn't occur. The latter are programmed "efforts" on the part of the heart to compensate for inadequacy in the proper impulse pathways.

You're an idiot. "Efficiency" implies work, in this case, blood pumped, with minimal expenditure of ATP. A PVC is anything but. Maybe you're a lot less smart than you pretend.

T-A-Knee, you're in health care? What do you do?

Goalie, TRH, contrary to the subscriptions of some here, is not stupid, rarely (as in I've not read it) says something stupid, and as you can see, is dogged (TRH, where do you get the time?).

And, while you are probably an excellent and knowledgable ICU nurse, your judgement on when to "call it a game" needs...refinement.

I haven't weighed in on the technical aspects as I don't have much to offer. I am curious whether certain hearts that throw PVC's are technically abnormal. I am referring to those hearts that only throw PVC's when a certain food or chemical is introduced. Let's say caffeine for example. If your heart doesn't throw a PVC unless it is triggered by caffeine, is it an abnormal heart? Of course, we also know that many to most hearts throw PVC's once in a while, and this is considered, "normal."

On the face of this question and excepting all other conditions and agents, IMHO, no. You have defined maybe 99% of human hearts, the variable being, the amount of caffeine to reach the threshold of resultant ectopy (PVCs) in any individual.

Certain foods that I usually avoid but eat occasionally will almost always give me 'odd knocks' I call them.
Eating shrimp, dark chocolate or drinking coffee with cause my heart to throw an arrhythmic sequence and it is (thankfully) usually short-lived (a few seconds.)

Also, when in the sheep, goat mountains I'm careful to not drink too much water without including electrolytes.

And for the record, some of you guys need to f*cking grow up. We can't have a conversation without this sh*t ongoing?

Goalie, your thoughts are appreciated here in spite of what some have added.
T A K, I'd like to think that you're a decent guy, I dunno, but the way it reads you need the sh*t beat out of you, once or ten times; grow the hell up.

That was always what those with far more training in cardiology told me. I'm an old SF Medic George (MOS 18D) I've passed ACLS, old and new countless times, as well as ATLS several times. I even passed the Flight Paramedic exam a couple of years ago. I'm well aware that Goalie isn't stupid, he's just a hair-splittin' showboatin' dick, like my fat CRNA biatch-buddy.

TRH catches all manner of grief for his observations on diet. I have yet to see him post anything on the subject that anyone with a clue as to what the current science points towards.

So speaks the voice of fairness and the even hand.

You and my wife should have a beer together. You should thank TRH as well.

... would find fault with?

May I add a little theology here without anybody here going into V-fib? . Don't "A & E me" either; this is in the Bible. Take it up with HIM.

We (a "collective we") were once perfect. But the Fall of a historic and once perfect Adam and Eve in a once perfect home, sentenced them (and us) to a physical death. Since then God has intermittently stepped-down our longevity from eight, nine hundred years (imagine the hunting a guy could do; true, with sticks and stones but..) to what now? Eighty years maybe with seventy allowing only some a measure of fitness to do anything physical.

Not only us but all of creation groans with all kinds of disruptions and aberrancy. I think the TRH is right about all kinds of "foodstuff" substances (including highly processed foods which are some of the most enjoyable) in our diet contributing to many physical problems, including common things like caffeine and situational stress, making our hearts "wobble".

If your cardio- doc has cleared you of malignant PVCs, you'd best relax cause you have other things that are more pressing or will be. We don't have that much time here.

Wisdom. Sage advice.

Certainly is.

So, according to you, the presence of a few PVC's after a cup of coffee are a positive indicator of heart dysfunction.

Wrong.



Another factually incorrect statement. 3rd degree heart block is the state where the impulses from the top of the heart are completely blocked from the bottom, which results in a junctional or other escape pacemaker to take over. The P waves march out perfectly, and the QRS complexes usually do as well, but they are not related to one another at all. Hence the term A-V disassociation.

Also, more on-topic, a PVC is not interconnected with the SA node or the regular electrical pathway used by the heart.



So, again, you are asserting that one has a conduction defect if they have a PVC, or, for that matter, any other ectopy.

That is simply not true. Don't believe me, ask one of the other health-care professionals in the thread if rare PVC's are in any way an indicator of, how did you say it, "something (being) wrong with the proper impulse pathways."




So, you assert that when someone is ticking along in normal sinus rhythm with a perfectly normal cardiac output, stroke volume, minute volume, and systemic vascular resistance that somehow, the heart throws a PVC because it is compensating for....well, what?????

I just thought I'd quote this, since I replied to Hawk without reading the thread further, and saw this.

This is what Hawk wrote:



Just something to think about. Maybe, since it isn't coming from me, some of you might actually let it sink in a little.

C'mon man, he just said having a PVC means you have a conduction defect.

That is freaking internet gold. Pure gold.

But, yeah, time to watch the Wild get their asses kicked by the Caps.

One can, if he's that sort of person, nit-pick any statement he chooses. You're a prime example.

To be fair, it has been a LOT of statements.

But, you can only pick the nits if the nits are there to pick.

You could always try the "not arguing about stuff you don't know about" route.

What a jackass.

That is an odd way to admit you don't know WTF you are talking about regarding cardiac electrophysiology.

It is effective though. Clear and concise.

That's an excellent way of proving my point that you're a jackass.

PS I've already responded to your nitpicking objections, thus annihilating them. No point in going through the process all over again. Declare yourself the victor till you're blue in the face, if it gives you the warm and fuzzies.

Yeah, because everyone who has a PVC has a conduction defect.

You're amazing.

Just because it's really, really funny.

Try a calcium/magnesium supplement.

This is a bump for TRH, who now knows "next to nothing" about EKG'S.

Would you mind quoting where you believe I indicated otherwise? Thanks.

The part where you are asserting that a heart with a properly working electrical conduction system cannot, by definition, throw pvc's.

That is just for starters........

Hawkeye, did you ever deal with this odd little conflict issue you seem to have with your father?

Goalie you stupid SOB. TRH is factually correct with everything he's said. I've been passing ACLS certs for 15yr so you can't BS me. You just want to stir the fuggin' pot because that is what POS mofo's like you do for jollies.

This is BAD advice. Don't do anything that effects the heart without consulting a cardiologist.

A PVC is an electrical event, but there are a LOT more things than potassium that can cause PVC's. And potassium overdoses can be fatal; that's so dangerous chit.

And PVC's are not caused by deficient pathways, that's a ventricular rhythm. PVC's are when a foci located within the ventricles will emit an electrical pulse that creates an extra beat. There are just tons of things that can cause this, many of which cardiologists don't even know.

When a cardiologist tells you that PVC's are benign, just leave it at that. If you try to "fix" it with information gleaned off the internet, you could put yourself into actually dangerous heart rhythms.

Now that said...(270Winchester)

Individual PVC's are really nothing to worry about, but individual PVC's typically aren't something you feel (but some do). Runs of PVC's, (2,3 or more) can become problematic because ventricular rhythm's typically aren't coordinated enough to profuse blood effectively. So if you're feeling little runs of a rapid heartbeat, that is something to call your doctor about. You may require a change in medicine, or perhaps some cardiac observation.

What bothers me is your statement that they're bothering you more today; that sounds like an anomaly. And when there's a cardiac anomaly, you kinda want to know why you're having that anomaly and what that anomaly is.

the thread is 7 months old.

I'm hoping 270 winchester is feeling better by now.

Judging by his posts in the 223AI thread, I think he is....

Let us hope so, but Goalie's still a DH.

I guess the V-8 company needs a warning label, then. LMAO!

Thanks again, TAK.

JFC!!! Is there ANY subject that you're NOT an expert on???

Actually, he's not. Your ACLS instructors must have sucked.

Can't help as I've never even been cognizant of my heart. Good luck.

Just because someone has passed a weekend ACLS cert doesn't mean they're a "expert" at anything. Every 18D that didn't wanna get schidt-canned by his SGM had to pass 10wk NREMT-P course which included ACLS. It ain't rocket science.

PALS, ACLS, TNCC, and CCRN are my credentials.

I will make you both look like idiots (again) later when not on a phone.

Well if it comes from TAK, then you know it�s probably wrong. Sorry Goalie is right and you are wrong.

PVC�s in and of themselves are NO indication of a conductivity deficiency, it�s an indication of the presence of some sort of irritant that is causing one or more foci to emit an electrical discharge in an effort to become or �help� the pacemaker. The PVC complex is wide and bizarre because the electrical transmission is not through the normal path; but that doesn�t mean there�s a problem with the pathway. It means that the impulse is just coming from somewhere it�s not supposed to. A normal sinus rhythm starts in the SA node and travels down the bundles. A PVC starts in the ventricles, crosses cardiac tissue and then hits the bundles. If there is a pathway (the pathway being the bundles) problem, it will show up in an EKG. A normal sinus rhythm will show that there is a healthy pathway through the bundles, otherwise one wouldn�t have a normal sinus rhythm. So since you often seen PVC�s interrupting a normal sinus rhythm, how can you have a deficient pathway (the bundles) if the PVC happens in a normal sinus rhythm?

A PVC takes an abnormal path to get to the pathway. The pathway is not deficient, it�s how the electrical pulse gets to the pathway. You seem to have a very fundamental misunderstanding of what a �pathway� is in the heart.

Now I�d like to call you on your ACLS certification. 5 questions:
1- What medication is the first line treatment of PVC�s?
2- On what phase of depolarization does Lidocaine work on?
3- On what phase of depolarization does Bretylium work on?
4- What ventricular rhythm do you treat with Magnesium Sulfate?
5- What rhythm would be appropriate to treat with Adenocard (Adenosine)?

SHOWDOWN!

Lido and Bretylium are "old school," but he did say 15 years.

We used to start the lido gtt for freq PVC's back in the day per protocol before calling the md. Toxicity anyone?????

Too easy. I Googled the answers in about 5 minutes.

TAK is the king of Google BS.

You know what I like best about this thread?

Having a prior ACLS, AEMT, and instructor certs and realizing that I know longer GAF other than to see who's left holding their own ass after its all said and done.

Rock on, my brothers....

Steelhead said one time that guys here would fight over the blessing.

He was right.

First off, ACLS rhythm interpretation is very basic. Lethal our not? Fast or slow? Wide or narrow?

My point about bumping out was TRH arguing semantics in another thread when he whined about me "nitpicking" the language here.

1) Amiodarone
2) Not used anymore and never was a 1st class drug
3) Ditto
4) Torades De Pointes
5) Wolf-Parkinson-White

LOL, if W-P-W is what you come up with FIRST for adenosine, you are the google-fu weenie they say you are.

That is awesome. I mean, it is correct, but out of the dozens of times I have pushed adenosine, not once was it for W-P-W.

You are amazing!!!!

I've known three different people with WPW dickhead, but thanks for admitting I was right.

I'll give him a half point on the WPW one. But it's most common use is SVT. Half point because WPW manifests in an SVT. But I put the Lido and Bretyllium in there because that question really isn't something you can Google up. If he's had ACLS for 15 years, he ought to know those.

He seems to know what Torsades is, I wonder if he knows what on the EKG could indicate that your patient may be heading towards a Torsades event?

I'll bet he's Googling his little heart out trying to find the answers to the Lido & Bretyllium question.

Oh and by the way, that was WRONG. I said the first medication of choice, not the first drug of choice. You should have caught that. So what's the first MEDICATION of choice?

Doesn't matter. He agreed with trh that a normal functioning heart cannot have pvc's, which, as many have stated, is absurd.

Prolonged QT interval. A late diastolic PVC can precipitate this event. TdP is francois for "twisting of the points" and that is what the EKG looks like.

MONA meets all cardiac patients at the door.

Huh?? Once again, you're making stuff up, my friend. It's becoming a habit with you.

At least twice this week you asserted, out of the blue, that I had claimed more than typical layman's knowledge regarding electrocardiograms. All I did was call you on this falsehood. So far you've failed to support your claim, and I've yet to see a retraction/apology for it. I assume, if you have a shred of integrity about you, that at some point one will be forthcoming.

No, nor am I googling down-draft carbeurators.

Yeah, that's pretty telling. ACLS protocols can be Google'd, but the A&P of the heart isn't something you can grasp in 5 minutes on Google.

Once again TAK=FOS.

Well that one went right over my head; no idea what point you're trying to make.

Were PVCs normal, they would be termed NVCs, you boob.

And there, folks, is the argument of a subject matter expert.....

They are all obselete.

Hawk...love ya man; but you're wrong. PVC's have been found to be completely normal in most people. EVERYONE will experience PVC's at some point. Can be from something as innocuous as just drinking an extra cup of coffee in the morning.

Got it...now that makes more sense. Still, the fact that you agreed with TRH that PVC's aren't normal shows you just don't know the A&P of the heart. I just can't see anyone who has passed ACLS who wouldn't know that.

And by the way, you got the first medication wrong. It was a bit of a trick question that only someone who has ACTUALLY taken ACLS would get.

It's simple reason, in which you seem to be lacking.

Then they need to change the term to Normal Ventricular Contractions.

Do you know the meaning of the word premature?

PS abnormal doesn't imply pathology. Lots of abnormal things occur in the body absent pathology. If, for example, you get a twitch, this is abnormal nerve function, but it's not ordinarily pathological.

Ok, I've not read the whole thread admittedly, but I'll respond on the basis of giving patients anesthesia for some thirty-four years and also from my own personal experience. Without getting into the nuts 'n bolts of the biochemical causes, PVCs or VPCs (as some like to call them) essentially fall into two categories-benign (mostly not serious) and malignant (serious).

In the first category are PVCs caused by a major stress (many instigators) and stimulants such as caffeine presumably without any CAD (coronary artery disease) or other heart pathology.

However, PVCs can also be caused by myocardial ischemia or CAD, the heart muscle complaining due to too little 02 secondary to small vessel disease in the heart. This is serious.

I am iconic for the first case. My youngest brother died at age twenty-seven in Katmandu, Nepal in '83 and it fell to me to get his remains back to this country for autopsy and burial (a logistical nightmare) all the while mourning his loss. My PVCs started then and have been a constant companion since. Bottom line in two Mayo Clinic work-ups--manage your stress; your heart is, "ok." Thanks; that was easy. In regard to stress induced arrhythmias which you "feel," being conscious of these irregular beats can cause anxiety, thus more stress, thus more irregular heart beats. It can feed itself.

The short answer here is if you are bothered enough to post here about them get to you doc or cardiologist and have the necessary tests done to better define the problem. The two initial tests are usually wearing a holster monitor for 24-48 hrs; this records the number of aberrant beats. The second would be a treadmill or other stress test of your heart.

SIAP or redundant.

this friggen thread is giving me pvc's. time to pound some pbr's.

So, are you saying that I'm lying that I've attended, and passed, numerous ACLS certs?

Hawk you're not a medical professional, so you're taking literal meanings of words and extrapolating a whole lot of stuff that just isn't so. There are PVC�s that are normal and there are PVC�s that are abnormal. Some people have PVC�s of unknown etiology and they are completely harmless and thus normal. Some have them from the potassium imbalances you mentioned (low or high), some from toxicity to medications they�re taking. Lots of reasons. And while most are completely innocuous, there are some that are telling you something is wrong. You can get PVC�s from an infarction or cardiac ischemia, or even changes in intra-thoracic pressures.

Because the beat is pre-mature does not mean it�s an abnormal event.

It's been said that I used to cause ectopy in the hearts of many women.

I considered it normal....

Nonsense. You're confusing abnormal with pathological. A twitch, for example, is the result of abnormal nerve activity, but isn't ordinarily pathological.

So, elevated cortisol can precipitate PVC's, so maybe they aren't "normal", but merely a symptom of the avg american's schidt for a diet? Anybody got any idea what can cause elevated cortisol? If not, you might wanna check out the fish oil thread. All this heads back to diet, just like TRH initially suggested.

Hawk wouldn't know a malignant PVC from a ham sandwich.......

.........but he will damn sure keep googling and typing.......

I've yet to consult a search engine of any sort today, but I'll take the insinuation that I did as a complement.

PS Still waiting for your retraction/apology. Why don't you be a man and just do the right thing? You screwed up. Just admit it.

PVC is good for water lines.

And my post count soars.

Bob

Well I can't prove you're lying, but you don't have a great track record. Post your ACLS cert and that will pretty much clear it all up right there (although you'd still be wrong).

And before you ask me to post my creds, I haven't been ACLS certified in 19 years...yet I still seem to know it better than you...you ought to be a bit embarrassed about that.

You very well could have attended and passed ACLS. The sad reality is. AHA has made ACLS nearly impossible to fail anymore. It's really RARE that someone fails ACLS because the AHA wants everyone to pass, which promotes ACLS becoming universal (follow the money).

Also, I've never heard you say you were a medical professional and ACLS is restricted to certain scopes of practice.

So given that ACLS isn't hard to pass, I guess someone could not pay attention enough to miss that. The sad reality is, most who are ACLS certified these days wouldn't really know what to do for a cardiac patient in extremis.

Given the details you missed and your lack of the A&P of the heart, it sounds like if you took ACLS, you're one of the one's they passed just to get you through.

You big stud. Me, I just made then wish they were dead:)

Damn you to Hell Kevin.

Dood, S T O P...know when to stop.

Actually it sucks and blows for water lines. Copper rules.

But if you have had ACLS you should know that PVC's are normal in EVERYONE; more frequent as we age. Why don't you know that Mr. I'm ACLS certified? Were you awake in the class? Were you sober?

You typically pull that one out when you realize you've been beaten but don't wish to admit it. You're better than that.

Well, that wasn't nice.

I just don't know why people BS on the internet. There are just WAY too many people out there who can catch you. It's not like there are 5 iron workers sitting with you at a table in a bar so you're likely to get away with BS'ing them on ACLS. You're on an internet forum with over 20k members from all walks of life. If you BS, you're going to get called on it and caught. How is that not apparent to you?

I don't care what you do but, "three score and ten and if by strength, ten more ( that'd be 72 years by the Ultimate Cardiologist,") is what you get. If that much. In context, you could breath fish to no avail...

You're funny Hawk.

TAK may want to see some money first.

Okay so TAK and Hawk. Please tell me your ACLS backgrounds. What was your scope of practice / profession. And how often did you use those skills?

OK, I think I see the source of our difficulty. You're using the demographics sense of normal vs abnormal, i.e., looking at phenomena frequencies within populations, rather than the physiological sense, i.e., in relation to design function. The problem there is that all sorts of very bad medical issues (not saying PVCs are that, by the way, so resist the urge to twist) can then be described as normal, since at some point something is inevitably going to kill everybody. Therefore, I would suggest that when speaking of medical complaints, the demographics sense of normal is a far less appropriate choice than the physiological one.

You KNOW my background you fuggin' AZZWIPE! The one I'm accused of lying about you stupid SOB, by you among others. GFY!

I must say that, based on the cheap tactics he's been pulling lately, I've lost a great deal of respect for Kevin.

I haven't updated a medical cert. since 1989 but even I know that if TAK and TRH share an opinion it is by definition B.S.

mike r

I'd wager a small sum that you're a disgusting fat body.

Small sums are exactly that to which you are limited by nature.

mike r

Well perhaps you think I've been on threads where I wasn't. The only thing I'm aware of that you claim is a military background in some sort of elite unit. I've never heard you say what you claim you did in said unit. Were you a medic?

YOU and TAK assert that PVC's are evidence of an abnormal pathway in the heart; that's just patently wrong. Now with TAK I'm having a little fun at his expense because he's a POS who's always FOS...so easy target.

I have not denigrated you in the least bit; I have respect for you. But in this instance, you're just wrong Hawk. And I'm starting to lose respect because you don't seem to be man enough to just admit that your wrong. Now you've said several factual things, but the main point you made; you're just wrong on.

Me, if someone points out that I'm wrong on something and I can clearly recognize it. Not only will I admit it, but I'll thank that individual for educating me.

No as a former medical professional, I'm using the term "normal" as applied by the American Heart Association. Your argument on this matter should be with them, 'cause apparently you know more about cardiology than they do.

Are you a cardiologist Kevin?

It's ok, he's got me on ignore.

Twist, twist, twist.

The American Heart Association may well on occasion use the demographic sense of the word normal (such as when discussing phenomena frequencies within populations), but when speaking of the physiological function of a somatic system or structure, that's not the correct sense in which to use the word.

PS When using the word with regard to the latter, it's correctly in the sense of design function, i.e., is this how the system/structure in question is meant to function?

kinda hilarious that your just now noticing this after tearing into how many of us for thumping The Parrot upside the head when he doesnt know his arse from a hole in the ground

Now is that or is that not what you wrote? And if it is, it's just wrong. Why can't you man up and just say, my bad; I was wrong? Why is that so hard?

No sir I am not. But this is stuff that was well within my scope of practice as a paramedic. Understanding the pathophysiology of PVC's is just incredibly basic stuff for someone who is a provider of Advanced Cardiac Life Support; as I was.

Wow Hawk, you just don't know when to quit.

People that are ignorant, yet continue to argue about subjects then know "next to nothing" about amaze me.

Pretty much EVERYONE has PVC's. Their existence alone in no way indicates anything abnormal. You are trying to discuss something that has a very specific set of terms. For instance, TAK referred to end-diastolic PVC's, which is a textbook term not used often in clinical practice. In the real world, we worry about a long QT interval resulting in R-on-T induced dysrhythmias.

But, keep talking. It is amusing.

Wow, a guy who said he knows "next to nothing" about EKG's is now telling the AHA how to talk.

Hubris knows no bounds.

I remember when you used that line on me. Then backed off when I offered to do an Ironman with you to see who's the pussy.

Pussy.

Well I don't know about that. There are things that are a matter of opinion where I have agreed and disagreed with Hawk on. This is the first time I've ever seen Hawk just plain wrong, and refusing to just admit he's wrong.

then you havent been paying any attention during your defense of him cause he does this constantly....its just in the past if you werent familiar with the subject you assumed he was right instead of the rest of us....he is doing the same thing in this thread that he does 95% of the time.....

He ain't wrong. You are merely arguing over semantics.

There are a lot of threads where I just sit it out. If I don't decide to jump into a thread, then I just go away and I don't pay attention to what's said. That's why I don't know the first thing about what medical role TAK says that I know all about.

The difference is that you misquoted me as saying that PVCs were evidence of an abnormal pathway in the heart. That's stating it backwards and imprecisely. I assume you have a reason for doing that, and your reasons for doing things like that are usually in the service of twisting. Why not just quote what I've said if you wish to communicate what I believe, rather than rephrasing, if you don't have a twisting intention?

That's not an argument in support of PVCs constituting examples of normal heart function. Pretty much EVERYBODY occasionally suffers from twitches, yet twitching is, in each and every instance, an example of an abnormal function of the nerves.

You're quite funny.

So, once again, state exactly what PVC's indicate in terms of an abnormality in the electrical conduction system of the heart. Be specific.

Just a bump, since this is the corner you were in when you took your ball and left last time.......

Again, maybe concentrate on the part that isn't from me, since that obviously makes you too emotional to think rationally.....

Are you unable to read what I've already posted? If you wish to communicate what I believe, simply quote my exact words. They're quite clear. Otherwise I will suspect you have a twisting intention.

He's speaking of demographic normality, not physiological normality. It's demographically normal for one to occasionally suffer muscle twitches, for example, yet it's physiologically abnormal in each and every instance of its occurrence.

The difference is that you misquoted me as saying that PVCs were evidence of an abnormal pathway in the heart. That's stating it backwards and imprecisely. I assume you have a reason for doing that, and your reasons for doing things like that are usually in the service of twisting. Why not just quote what I've said if you wish to communicate what I believe, rather than rephrasing, if you don't have a twisting intention?

How am I mis-quoting you; it's freaking VERBATUM what you said!!

I quote your exact words and you said I was twisting them.

Look, either you're just FOS (and I've yet to hear your medical background), and you don't know when to stop. Or you're horribly misstating what you're trying to say. If it's the latter, for God's sake, step back and re-word your point. Because the literal meaning of your statement about the pathways is just incorrect.

And your advice to a cardiac patient under the care of a cadiologist is freaking scary. You don't tell a cardiac patient to increase his potassium intake until you know EXACTLY what his potassium levels are...AND YOU DON'T!!! And this stuff about it being benign at best is also freaking wrong. Stop giving out advice that can get someone killed!

Why are you pretending that I objected to quotes of my statements?

Where you quote me, I approve. Where you don't quote me, but rephrase my words, I (knowing you) suspect a twisting intention. Clear?

All my best friend did,was go in the hospital and have his heart stopped and restarted.
Took about 15 minutes from start to finish.
I drove both him and his wife home.
He had some soup and went to bed to get some rest and was at work the next day.
He has been loosing water weight that has accumulated for a while and is doing fine.

Been a while since i stayed at a hotel/motel but from where i set going to a heart doctor and following what they said saved him from taking a crapload of drugs.

So, to be 100% clear, I quoted you clarifying your quote.

Now, please explain how one's pathways are "defective" because they throw a few PVC's after a cup of coffee.

Again, be specific.

While you're at it, just one example of how an "inefficient" transfer of electrical signals could result in a PVC.

Just one. Be specific.

Or just what you mean by, deficient pathways?

We've been through this, as you know.

If the signal followed its proper and non-defective pathway, no PVC will have occurred. This is by definition the case, essentially a truism. If the signal followed an improper or damaged pathway, one may occur. Multiple causes of the latter are possible. One example would be damage to certain nerves and/or tissues along the proper pathway, while another can be strictly temporary, such as the presence of caffeine in one's system, which is disruptive of normal nerve function.

Both words are in the dictionary. Simply apply those definitions to the subject matter under discussion, and you will have your answer.

Um, if a premature signal followed the "normal" pathway through the heart, it would be a PAC, not a PVC.

You really don't have a clue. Keep talking, it's amusing.

While you're at it, how about describing what the "normal" pathway of an electrical impulse through the heart is?

Laff'n

The reason a PVC may occur in the presence of a defective/damaged pathway is that it will then be required to take a more circuitous route, thus triggering the PVC.

Just one example of how an "inefficient" transfer of electrical signals could result in a PVC.

Just one. Be specific.

Sure. Inefficiency in signal travel can cause the signal to travel a more circuitous and improper route, thus triggering a PVC.

OK, now this is gold. Do you even understand what a PVC is? The idea that the "more circuits rout" is "triggering" the PVC is simply absurd.

Heck this statement is beyond awesome. I can't wait to show the cardiologists at work.

But, seriously, look logically at what you are saying:

The REASON the PVC occurs, according to your statement, is the pathway it will take after it does occur.

OK, I didn't think you could do it, but you did. You just topped yourself from a few posts ago.

Hint: the area in the heart the impulse originates just might have something to do with why it is traveling inefficiently. The actual impulse, on the other hand, is PREMATURE, or, to a layman like you, TOO efficient.

Keep digging. China is down there somewhere.

PS circuits rout above should be circuitous route. You were too quick on the draw, so it came through on your quote.

Sure, show your cardiologists.

Waiting. (Mainly because if you google it, you just might get a clue)

So, you stand by the assertion that the path a PVC travels CAUSES the PVC? What about PAC's? Does the pathway they travel cause them as well?

Edit: And, if, by "quick on the draw" you mean I don't need to look this chit up because it's what I do at work, yeah, you're right.

I'm uncomfortable with the way you chose to phrase that. I would rather you said that the path of the nerve signal, rather than that of the PVC (which seems a bit nonsensical to me) being defective is what triggers the PVC. Were pathways normal, no PVC would occur.

Go back and google the PAC part. It might help you figure out why you are wrong.

Hint: people with normal conduction systems in their heart have PVC's.

Seriously, google what the normal electrical pathway is, think about the PAC vs PVC thing, and maybe STFU until you know what you are talking about. There is a reason why people talking about this stuff use very specific language. One cannot opine in an intelligent manner without knowing the language.

I just want this saved for later.

I would disagree that an instance of normal signal travel through the heart could result in a PVC, since a PVC is premature by definition, and thus not normal.

Since you won't even agree with me on the meaning of normal in this context, however, I'm not sure of the utility of discussing it further.

By all means.

Have a great evening.

Just keep digging Hawk, you're the only one this makes sense to. There is no defective pathway in a PVC. There is nothing defective, because a PVC isn't a defect.

Your insistence in arguing a point of which you're clearly not informed is staggering.

Hey, why don't you tell us all about perfusion of PVC's while you're at it?

What amazing nonsense.

Unless that medic's name is Kevin Gibson, AKA GunGeek.

Exactly. Kevin's and Goalie's PVC's are "normal". You can't make this schidt up.

No, indeed you can't.

OK, I am going to be nice and tell you something so that you can stop saying things like "normal signal travel through the heart could result in a PVC." The path an impulse travels has nothing to do with why there was an impulse in the first place.

Also, go look up the PAC thing. Those actually do travel the normal pathway, they just occur "too soon" to be considered NSR.

But, again, to be clear: I have never said, nor will I say, that any pathway RESULTS in a PVC. We've already listed the CAUSES of PVC's in this thread. Most are benign, some are really, really bad. But, in 100% of them, THE PATH THEY TRAVEL IS NOT WHY THEY OCCURRED, but, simply the way the electricity travels through the myocardial tissue after the impulse is initiated for XXX reason.

So, Mr medic, does the route a PVC travels CAUSE the PVC like Hawk says?

Again, goalie, if I can't even get you to agree with me on the definition of normal in this context, there's little point in you and I discussing this further.

Trigger is a better word.

PS In place of "PVC travels," above, I would prefer "nerve signal travels." Your phrasing seems awkward, if not nonsensical, to me.

Just a little bump from page one.

OK, we can work with that. TAK, do you really agree that the route the electrical impulse will travel through the ventricles after an impulse is initiated TRIGGERS the PVC?

That is because you are ignorant of what we speak. I stick to using terms that are in common use in, oh, a cardiac cath lab or ICU. Your terms belong in your parents basement.....

Not sure that's correct. "PVC travel" is nonsensical.

I figured I would quote this, since some people are making assumptions about the discussion and seem to not be aware that CAUSES of PVC's have been discussed (and ignored by TRH) and they don't include the route they'll take AFTER they are initiated......

Hawk, the PVC is initiated for one of the many reasons stated in the post above. It then (the PVC) travels through the ventricles of the heart. As it does so, the heart muscle (depending on time since last depolarization) contracts.

So, yeah, the PVC travels through the ventricles of the heart.

Maybe, just maybe, the fact that me saying that seems nonsensical to you would make you think about your knowledge of the subject. Or lack thereof.....

The problem here is the logical defect from ambiguity with relation to the word "cause." Causation can be distant or proximate. The causes you're discussing would fall best into the prior category. What I've discussed (i.e., defective pathways) falls into the latter. You're not wrong in your stated causes. It's just that they're more distant causes than those I was discussing.

For example, you could say that a car accident was caused by the driver having one too many at the bar before he got in the driver's seat, or that the car accident was caused by the driver losing control of his vehicle. Both are true. One is more proximate, however, than the other. Even more distantly, you could say (and be equally correct) that the car accident was caused by the man's inheritance of the tendency towards alcoholism.

LOL

Woke up to this chit.

You two fellers are still at it?


... gotta love the web!

Based on the character you've displayed, I have scant little confidence in much of what you have to say, I'm afraid.

Um, no, there is no "problem" of ambiguity.

Things that CAUSE other things have to happen BEFORE the thing(s) they CAUSE.

The pathway a PVC travels AFTERan electrical impulse known as a PVC occurs cannot CAUSE the PVC.

We already went over what does cause them:

caffeine
cocaine
alcohol
cardiomyopathy
hypoxia
deep suctioning that stimulates the carina (we mess with new ICU nurses by doing this on vented patients then acting alarmed)
thyroid issues
valve issues
ischemia of cardiac tissue
psych medications (tricyclics IIRC, but could be wrong on type)
Etc...

It's amusing me. We are right about where Hawk takes his ball and goes home.

And you will again, tomorrow.

Don't listen to me. Go find a cardiologist and tell him/her that the path a PVC travels through the ventricle is what CAUSED the PVC to occur in the first place.

Please, please, please do it.

That would be quite foolish to say. Is that what you believe I said? More reason to doubt your acumen.

Yeah, it's what you said:



You stated that the fact that it will be required to take a more circuitous route (after it is triggered) is what triggers it.

Sounds pretty stupid, doesn't it?

Laffin'

...I know just enough about this stuff second-hand, to keep my trap shut.

You at Abbott?

If you're unable to discern the difference between my statement and your mischaracterization of it, I'm afraid, again, that there's little for us to discuss.

Again, your "clarified" quote. You say the PVC is a RESULT of defective pathways.

Not only is that wrong, as the pathway a PVC takes doesn't cause the PVC to occur, but the inefficient part is hilarious. It was 16 pages ago, and it still is......

Yeah, I am on the Rapid Response team there. Hopefully you won't ever have to meet me at work....at least not while I'm working, so to speak.

I think what you wrote is pretty damn clear. It's wrong and makes you look like an idiot who argues about stuff when you don't know WTF you're talking about, but the statement you made is pretty damn clear.....

There you go. Stick to quoting me rather than rephrasing it. It's always in the rephrasing that you get into trouble.