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Can Benign PVCs And SVTs Turn Into Atrial Fibrillation?
Question: .I have a question because I am confused.....today I went to see an Internist about my palpitations....I had them investigated 4 years ago and it came back as PVC's and SVT..short occasional runs....minimally symptomatic..also had a echocardiogram and stress test all normal .went in today because they redid an echo and ekg which are all normal. He put me on a monitor again just for reassurance even though he did say it is most likely the same thing happening the svt andpvc's. I mentioned that my mom has a fib and that I worry about that. He said that Pvc's can sometimes turn into a fib but yet I was told they are benign? I find this confusing....Being that I experience Pvc's and occasionally svt, which they are attributing to stress because I suffer from pretty severe anxiety disorder, do I have to sorry about this turning into a fib now or in the future? How would I know if it changed to fib without being constantly strapped to a monitor. I feel like everytime I feel a palpitation Im going to worry it is fib. Is there a change in the way I feel that I need to know about ....do I need to be regularly monitored for afib....Im kinda freakin out as my mom had a fib, high blood pressure and had a stroke at 53......my questions are
1. Can bengin pvc's and svt turn into a fib
2. how would I know they turned into a fib without being strapped to a monitor all the time
3. Do you recommend being rechecked periodically with pvc's and svt?
4. How does a fib present? Does a fib come in short bursts like my svt does and how would I know the difference?
5. Just because my mom has a fib am I going to get it? She had high bp, high cholesterol, thyroid problems etc
6. based on my history of minimally sypmtomatic svt and begin pvc's am I likely to get a fib
7. What can I do to prevent a fib
8.
1. Can bengin pvc's and svt turn into a fib
2. how would I know they turned into a fib without being strapped to a monitor all the time
3. Do you recommend being rechecked periodically with pvc's and svt?
4. How does a fib present? Does a fib come in short bursts like my svt does and how would I know the difference?
5. Just because my mom has a fib am I going to get it? She had high bp, high cholesterol, thyroid problems etc
6. based on my history of minimally sypmtomatic svt and begin pvc's am I likely to get a fib
7. What can I do to prevent a fib
8.
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello!
Thank you for asking on HCM!
I passed carefully through your medical history, and would like to explain as follows:
(1) PVCs may lead to other echo beats or ventricular tachycardia, but they are not considered triggers for atrial fibrillation. Whereas SVTs may be interchangeable with atrial fibrillation. In general, it is necessary for a favorable myocardial substrate to initiate an arrhythmia.
(2) Generally, it is difficult to differentiate an arrhythmia only by individual perception of heart palpitations. You can not be sure when you have those unpleasant beats, if it is SVT, VT, or frequent PVCs. Atrial fibrillation may be suspected when an irregularly irregular tachyarrhythmia is present.
But to confirm that, an ECG should be done that moment.
An ambulatory ECG monitoring would be helpful to document possible episodic arrhythmias,whichever they are.
(3) As you have a prior history of arrhythmia, it is necessary to recheck periodically cardiovascular system in general, and especially heart rhythm.
It is important to review the severity of your arrhythmia in the first rhythm monitoring. Could you upload the report please for a review.
(4) Atrial fibrillation may be presented with short paroxysms (some seconds to minutes or even hours); but may also be persistent, necessitating medical intervention for its conversion to normal sinus rhythm. it may be suspected when an irregular pulse (or palpitations) appears, and confirmed by ECG.
(5) It is not obligatory for you to have atrial fibrillation, just only that your mother did. From the other hand, a thyroid dysfunction may lead to cardiac arrhythmia. So, you need to be sure you haven't that risk factor.
(6) To answer correctly this question, it is necessary to review you prior Holter monitoring and the whole arrhythmia history.
Generally speaking, as long as you haven't a documented cardiomyopathy, ischemic, valvular, etc. dysfunction thyroid disorder, have a normal cardiac ultrasound and stress test, you don't look at increased probability for developing atrial fibrillation. BUT, you need to control your anxiety disorder, to be sure of that.
(7) You need to control all the above mentioned risk factor for arrhythmia development.
Hope to have been helpful to you!
Feel free to ask me whenever you need! Greetings! Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello!
Thank you for asking on HCM!
I passed carefully through your medical history, and would like to explain as follows:
(1) PVCs may lead to other echo beats or ventricular tachycardia, but they are not considered triggers for atrial fibrillation. Whereas SVTs may be interchangeable with atrial fibrillation. In general, it is necessary for a favorable myocardial substrate to initiate an arrhythmia.
(2) Generally, it is difficult to differentiate an arrhythmia only by individual perception of heart palpitations. You can not be sure when you have those unpleasant beats, if it is SVT, VT, or frequent PVCs. Atrial fibrillation may be suspected when an irregularly irregular tachyarrhythmia is present.
But to confirm that, an ECG should be done that moment.
An ambulatory ECG monitoring would be helpful to document possible episodic arrhythmias,whichever they are.
(3) As you have a prior history of arrhythmia, it is necessary to recheck periodically cardiovascular system in general, and especially heart rhythm.
It is important to review the severity of your arrhythmia in the first rhythm monitoring. Could you upload the report please for a review.
(4) Atrial fibrillation may be presented with short paroxysms (some seconds to minutes or even hours); but may also be persistent, necessitating medical intervention for its conversion to normal sinus rhythm. it may be suspected when an irregular pulse (or palpitations) appears, and confirmed by ECG.
(5) It is not obligatory for you to have atrial fibrillation, just only that your mother did. From the other hand, a thyroid dysfunction may lead to cardiac arrhythmia. So, you need to be sure you haven't that risk factor.
(6) To answer correctly this question, it is necessary to review you prior Holter monitoring and the whole arrhythmia history.
Generally speaking, as long as you haven't a documented cardiomyopathy, ischemic, valvular, etc. dysfunction thyroid disorder, have a normal cardiac ultrasound and stress test, you don't look at increased probability for developing atrial fibrillation. BUT, you need to control your anxiety disorder, to be sure of that.
(7) You need to control all the above mentioned risk factor for arrhythmia development.
Hope to have been helpful to you!
Feel free to ask me whenever you need! Greetings! Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
HI there...thanks for your prompt response.
Im not sure I understood question 1...In general, it is necessary for a favorable myocardial substrate to initiate an arrhythmia??? I have been told that my svt is only occassional short bursts, minimally symptomatic so therefore benign. So can svt change into a fib?
My first workup for palpitations done on a loop monitor caught PVC's and occasional short runs of svt, minimally symptomatic...I had a normal echo, resting ekg and normal XXXXXXX stress test with no indications of active ischemia. I just had another echo and ekg done and it is all normal. I am currently wearing a loop cardiophone to try and catch the palpitations which my cardiologist believes that it will show the same thing...pvc's and svt. My svt only lasts seconds at best and self terminates although I can stop them by coughing or bearing down.
Im concerned that I won't be able to tell if my rythm switches over to a fib....are these episodes generally longer or cause different symptoms? How do I know when I need to have it rechecked....if epidsodes last longer or feel different from the documentated episodes of svt? My svt feels like a missed beat and then my heart races for maybe 4-10 beats at most and self terminates. I can usually count the beats.
When does a fib become a concern in regards to stroke risk....is this a risk with short bursts or when the heart remains in a fib for a prolonged time?
Im just confused as to know how to differentiate between my normal pvc's and afib to know when it has become more dangerous......I feel like I will be living on edge all the time?
I have been told my pvc's and svt are generally benign and I don't need to worry about them unless of course it becomes more symptomatic or prolonged.
What is the likelyhood that my pvc's or svt will change to a more troublesome a fib
Im not sure I understood question 1...In general, it is necessary for a favorable myocardial substrate to initiate an arrhythmia??? I have been told that my svt is only occassional short bursts, minimally symptomatic so therefore benign. So can svt change into a fib?
My first workup for palpitations done on a loop monitor caught PVC's and occasional short runs of svt, minimally symptomatic...I had a normal echo, resting ekg and normal XXXXXXX stress test with no indications of active ischemia. I just had another echo and ekg done and it is all normal. I am currently wearing a loop cardiophone to try and catch the palpitations which my cardiologist believes that it will show the same thing...pvc's and svt. My svt only lasts seconds at best and self terminates although I can stop them by coughing or bearing down.
Im concerned that I won't be able to tell if my rythm switches over to a fib....are these episodes generally longer or cause different symptoms? How do I know when I need to have it rechecked....if epidsodes last longer or feel different from the documentated episodes of svt? My svt feels like a missed beat and then my heart races for maybe 4-10 beats at most and self terminates. I can usually count the beats.
When does a fib become a concern in regards to stroke risk....is this a risk with short bursts or when the heart remains in a fib for a prolonged time?
Im just confused as to know how to differentiate between my normal pvc's and afib to know when it has become more dangerous......I feel like I will be living on edge all the time?
I have been told my pvc's and svt are generally benign and I don't need to worry about them unless of course it becomes more symptomatic or prolonged.
What is the likelyhood that my pvc's or svt will change to a more troublesome a fib
Brief Answer:
You have a very low probability to be at risk form atrial fibrillation.
Detailed Answer:
Hello again!
What I was trying to explain with a favorable myocardial substrate to initiate and maintain an arrhythmia (for example atrial fibrillation, etc), is the possible presence of a cardiomyopathy, with underlying myocardium remodeling, possible ischemia, chamber dilation (atrial dilation), valvular dysfunction, etc. which consequently lead to electrical remodeling and maintenance of atrial fibrillation.
Fortunately, you have a structurally normal heart (as has been shown already by the performed cardiac tests). As a result, the probability of atrial fibrillation occurrence and especially maintenance is extremely low. So relax!
As, i said you before, besides some very few clinical elements like an irregularly irregular arterial pulse and heart beats feeling, it is quite impossible to differentiate atrial fibrillation from other atrial arrhythmias, like chaotic atrial rhythm, atrial tachycardia, atrial flutter with a variable block, etc.
The best reliable way to differentiate atrial fibrillation is by having a documented registration on the event (loop recorder, Holter monitoring) recorder.
As, you doctor has confirmed, your actual arrhythmic events (PVCs and short runs of SVT) have no important clinical consequences, and atrial fibrillation is much less likely to occur. So, relax! try to relieve your increased anxiety (which obviously seems to be the only risk factor for possible atrial fibrillation triggering).
In a hypothetical scenario of atrial fibrillation presence(short paroxysmal episodes), probability of a consequent stroke would be extremely low, as your CHA2DS2-VASc score is almost 0 (<2). So you don't need anti-coagulation at all.
If, in the worst scenario of a persistent atrial fibrillation, the odds of converting to normal sinus rhythm are very high (as you haven't a favorable myocardial substrate to maintain atrial fibrillation).
I would recommend again to look seriously after your increased anxiety (possibly to talk with a psychologist or psychiatrist for a better management strategy).
When palpitations become frequent to the extent, such as to cause disturbing complains, and associated limiting symptoms, you need to re-evaluate their quantitative importance by an ambulatory ECG monitoring.
Meanwhile, keep being in close contact with your attending physician periodically.
If you have further uncertainties, do not hesitate to ask me!
Best regards, Dr. Iliri
You have a very low probability to be at risk form atrial fibrillation.
Detailed Answer:
Hello again!
What I was trying to explain with a favorable myocardial substrate to initiate and maintain an arrhythmia (for example atrial fibrillation, etc), is the possible presence of a cardiomyopathy, with underlying myocardium remodeling, possible ischemia, chamber dilation (atrial dilation), valvular dysfunction, etc. which consequently lead to electrical remodeling and maintenance of atrial fibrillation.
Fortunately, you have a structurally normal heart (as has been shown already by the performed cardiac tests). As a result, the probability of atrial fibrillation occurrence and especially maintenance is extremely low. So relax!
As, i said you before, besides some very few clinical elements like an irregularly irregular arterial pulse and heart beats feeling, it is quite impossible to differentiate atrial fibrillation from other atrial arrhythmias, like chaotic atrial rhythm, atrial tachycardia, atrial flutter with a variable block, etc.
The best reliable way to differentiate atrial fibrillation is by having a documented registration on the event (loop recorder, Holter monitoring) recorder.
As, you doctor has confirmed, your actual arrhythmic events (PVCs and short runs of SVT) have no important clinical consequences, and atrial fibrillation is much less likely to occur. So, relax! try to relieve your increased anxiety (which obviously seems to be the only risk factor for possible atrial fibrillation triggering).
In a hypothetical scenario of atrial fibrillation presence(short paroxysmal episodes), probability of a consequent stroke would be extremely low, as your CHA2DS2-VASc score is almost 0 (<2). So you don't need anti-coagulation at all.
If, in the worst scenario of a persistent atrial fibrillation, the odds of converting to normal sinus rhythm are very high (as you haven't a favorable myocardial substrate to maintain atrial fibrillation).
I would recommend again to look seriously after your increased anxiety (possibly to talk with a psychologist or psychiatrist for a better management strategy).
When palpitations become frequent to the extent, such as to cause disturbing complains, and associated limiting symptoms, you need to re-evaluate their quantitative importance by an ambulatory ECG monitoring.
Meanwhile, keep being in close contact with your attending physician periodically.
If you have further uncertainties, do not hesitate to ask me!
Best regards, Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks dr illri you are very kind and helpful. Your demeanour is lovely
So is it likely that the episodes of fast heart rate I experience are still most likely to be the pvc's and svt as documented previously. Those tests were 4 years ago. I just redid the echo ekg and am currently wearing a monitor again. My Dr didn't even think it was necessary and just doing it for reassurance. When I feel what I think is the svt. I can almost feel a wind up to it and then there is a pause and then my heart races for a couple seconds and then stops. I can usually count the beats. I can also stop it by coughing or bearing down. Is this svt? Would a fib be able to be stopped by vagal maneuvers?
So just because my mom has a fib I don't have a higher risk of developing it because I have episodes of svt and pvc's?
Can my svt and pvc's be completely linked to my anxiety?
At what point does a fib become problematic in which is causes strokes?
When my Dr said that pvc's can lead to a fib did he mean that in the circumstance I did have an abnormal Heart structure or disease?
Can I really just stop worrying about this?
Thanks so much. XXXXXXX
So is it likely that the episodes of fast heart rate I experience are still most likely to be the pvc's and svt as documented previously. Those tests were 4 years ago. I just redid the echo ekg and am currently wearing a monitor again. My Dr didn't even think it was necessary and just doing it for reassurance. When I feel what I think is the svt. I can almost feel a wind up to it and then there is a pause and then my heart races for a couple seconds and then stops. I can usually count the beats. I can also stop it by coughing or bearing down. Is this svt? Would a fib be able to be stopped by vagal maneuvers?
So just because my mom has a fib I don't have a higher risk of developing it because I have episodes of svt and pvc's?
Can my svt and pvc's be completely linked to my anxiety?
At what point does a fib become problematic in which is causes strokes?
When my Dr said that pvc's can lead to a fib did he mean that in the circumstance I did have an abnormal Heart structure or disease?
Can I really just stop worrying about this?
Thanks so much. XXXXXXX
Brief Answer:
Nothing to worry about!
Detailed Answer:
Hi, dear XXXX!
I believe that all you recent palpitations are caused by the same arrhythmic events (PVCs and short runs of SVT). An atrial fibrillation, is not suppressed as a general rule by coughing or other vagal maneuvers.
You are not at increased risk of atrial fibrillation (because your mom had atrial fib), compared with other individuals without a similar family history. So, relax!
I believe that anxiety is an important factor for precipitating such arrhythmia events, but you need to exclude possible thyroid dysfunction implications.
As I have explained you before, at the worst hypothetical scenario of developing atrial fibrillation, you have a low CHA2DS2-VASc risk score for stroke.
So relax again!
You have a structurally normal heart, and no possible arrhythmia could be so persistent.
At the end, I am glad to advise you to stop worrying about!
Nothing dangerous is going to happen with your heart. Just relax!
Enjoy your life! And be happy!
Best wishes, Dr. Iliri
Nothing to worry about!
Detailed Answer:
Hi, dear XXXX!
I believe that all you recent palpitations are caused by the same arrhythmic events (PVCs and short runs of SVT). An atrial fibrillation, is not suppressed as a general rule by coughing or other vagal maneuvers.
You are not at increased risk of atrial fibrillation (because your mom had atrial fib), compared with other individuals without a similar family history. So, relax!
I believe that anxiety is an important factor for precipitating such arrhythmia events, but you need to exclude possible thyroid dysfunction implications.
As I have explained you before, at the worst hypothetical scenario of developing atrial fibrillation, you have a low CHA2DS2-VASc risk score for stroke.
So relax again!
You have a structurally normal heart, and no possible arrhythmia could be so persistent.
At the end, I am glad to advise you to stop worrying about!
Nothing dangerous is going to happen with your heart. Just relax!
Enjoy your life! And be happy!
Best wishes, Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you Dr. You are so nice.
Can short bursts of a fib cause stroke or is that when it is more prolonged?
Can people be born with a fib? I just found out that my mom has had an irregular rhythm most of her life? Does this change things for me?
As long as my symptoms don't change can I just assume that I am experiencing my regular pvc's and svt
Is all this being caused by stress and anxiety? I mostly notice it during times of stree
Also in my moms case....she had high bp, high cholesterol, a fib and smoked for 30 years and also drank every day.....are all these factors which played into her early stroke?
The fact that I had a negative stress test 4 years ago should be reassuring to me?
and thank you again ..... my anxiety is being treated via therapy and SSRI's - I am just experiencing a flare up .....:(
Can short bursts of a fib cause stroke or is that when it is more prolonged?
Can people be born with a fib? I just found out that my mom has had an irregular rhythm most of her life? Does this change things for me?
As long as my symptoms don't change can I just assume that I am experiencing my regular pvc's and svt
Is all this being caused by stress and anxiety? I mostly notice it during times of stree
Also in my moms case....she had high bp, high cholesterol, a fib and smoked for 30 years and also drank every day.....are all these factors which played into her early stroke?
The fact that I had a negative stress test 4 years ago should be reassuring to me?
and thank you again ..... my anxiety is being treated via therapy and SSRI's - I am just experiencing a flare up .....:(
Brief Answer:
Nothing to worry about.
Detailed Answer:
Hi again XXXX!
Prolonged atrial fibrillation periods may risk of complicating with cardio-embolic stroke, when some criteria are met (as I have explained you before) and when inappropriate treated. But, even short periods of atrial fibrillation may be sometimes dangerous as well.
I don't believe your mom had atrial fib from her early childhood, she possessed so many risk factors during her life, which may have leaded he to such an arrhythmia.
It is not the same to you. You have a structurally normal heart, and you are just in time to avoid possible cardiac risk factors. So relax!
As I explained you before, all your performed cardiac tests are reassuring that your cardiac conditions are stable. Don't worry about those PVCs and short SVT.
Try to leave anxiety out of your mind, as much as possible.
Regards,
Dr. Iliri
Nothing to worry about.
Detailed Answer:
Hi again XXXX!
Prolonged atrial fibrillation periods may risk of complicating with cardio-embolic stroke, when some criteria are met (as I have explained you before) and when inappropriate treated. But, even short periods of atrial fibrillation may be sometimes dangerous as well.
I don't believe your mom had atrial fib from her early childhood, she possessed so many risk factors during her life, which may have leaded he to such an arrhythmia.
It is not the same to you. You have a structurally normal heart, and you are just in time to avoid possible cardiac risk factors. So relax!
As I explained you before, all your performed cardiac tests are reassuring that your cardiac conditions are stable. Don't worry about those PVCs and short SVT.
Try to leave anxiety out of your mind, as much as possible.
Regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I just keep worrying that these short bursts I am feeling are going to come back as a fib and not svt .... I just don't remember feeling multiple beats in a row 4 years ago but maybe that is just my anxiety kicking in...as I understand a fib is very very fast right? I wouldn't be able to count the beats most likely..thanks for all your advice
Brief Answer:
Everything is going to be OK!
Detailed Answer:
Hi, XXXX!
In general, atrial fibrillation appears as a fast irregular heart rate, though other arrhythmias may appear like dhis as well.
If you feel similar palpitations, you just consult you attending doctor.
If you are going to have a persistent arrhythmia (I don't believe it will ever happen) you should direct to the nearest ER service.
Don't forget to look after your anxiety!
Wish you a good health! Dr. Iliri
Everything is going to be OK!
Detailed Answer:
Hi, XXXX!
In general, atrial fibrillation appears as a fast irregular heart rate, though other arrhythmias may appear like dhis as well.
If you feel similar palpitations, you just consult you attending doctor.
If you are going to have a persistent arrhythmia (I don't believe it will ever happen) you should direct to the nearest ER service.
Don't forget to look after your anxiety!
Wish you a good health! Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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