Exercise Induced NSVT, fitness, anxiety, catheter ablation and beta blockers...

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New Member

Date Joined Apr 2014
Total Posts : 5
   Posted 4/10/2014 2:18 AM (GMT -6)   
Hi all,

I am so happy to have found this forum. I feel like I don't know what to do.

I am a super active 37 year old male. about a year and a half ago I started getting pvcs while exercising (running, rock climbing, surfing). They started to get increasingly worse. They seemed to come on while I began exercising and would fade away as my heart found its rhythm. I thought this might have had something to do with the fact that I had returned from Nepal where I trekked and climbing to 20,000 feet and spent months at a time at high elevation. Prior to this, I was rangering and living at high altitudes in the Sierras.

So when I came back down to sea level and started running a couple of times a week and hitting the rock climbing gym - the pvcs showed up. I could hike 20+ miles a day and climb El Capitan before this without one skip. Ugh.

So 8 months ago I went and saw a cardiologist. He did a stress echo and found that I did get a lot of pvcs and even runs of nsvt. He said that my plumbing was fantastic but my electrical could use some work. He said I could do an ablation, but the skips were just a nuisance and that I could try and ignore them.

So I tried. I now take magnesium, coq10 etc. But about a month ago they got worse. I had two episodes, one after running and one after surfing - a week later - where my heart couldn't find its rhythm for an hour or a little more. Both of these episodes induced a panic attack and sent me to the ER. So scary.

So today I visited another cardiologist (I moved to SoCal and found a new one locally). He looked at my old stress echo and listened to my stories and suggested a cath ablation. Just like that. Not once have I been given the option to take beta blockers. Why is this? Honestly, poking around in my heart doesn't sound great - but I would really like to fix this issue. At the moment, I am so scared to exercise that I have completely fallen out of shape. And I'm anxious to all hell - walking up a hill is giving me skipped beats.

So Anxiety plays a role for sure. I do get anxiety when I run, surf, climb etc. I can't help but wonder if adrenaline and anxiety is to blame and some anti anxiety meds might help? I actually asked my cardio this and he said no this isn't anxiety, you have an arrhythmia etc. But one month ago (when I ended up in the ER due to an hour of skips after running) I switched jobs and moved south. And I was anxious about it and I went for a run and had a panic attack. That made me even more anxious and it's been terrible ever since. I can't help but feel like there is a connection.

Also I believe that there is a connection in fitness level. I am way less fit then I was 6 months ago and even less so than I was 1.5 years ago. The more I fall out of shape - the more skips I get when I run or walk up steep stairs etc.

Couldn't I see a shrink, get anxiety meds and slowly get myself back into shape? Or is it all really just that the electrical system in my heart broke 1.5 years ago - out of the blue - and no one knows why?

It's just all so confusing.

It is impeding my happiness and my life so I need to do something. Any advice from anyone with exercise induced NSVT with a structurally sound heart? If so, do you think it could be caused from anxiety? Have you noticed less skips the fitter you get?

Thanks so much for any help.

Post Edited (AnxiousAboutAblating) : 4/10/2014 1:25:34 AM (GMT-6)

Screaming Eagle
Veteran Member

Date Joined Sep 2009
Total Posts : 5005
   Posted 4/10/2014 7:29 AM (GMT -6)   
Good morning Anxious!….and Welcome to the Heart forum!

I see several things in your post that we both share,…..PVC's being on of them. You mentioned one of the possible treatments for it (cath ablation), but I think there are a few others as well.

I'm no expert on Heart problems, so I'm not going to be the best source of the information that your looking for.

While your waiting on possible responses from our members, about the information you requested, ……please do feel free to use the search button located here on this page in the upper righthand corner. I'm betting you will find several post on this subject, written by members right here on the forum.

Again, Welcome and Enjoy the forum!

SE wink
Moderator Chronic Pain Forum

Weekly Quote!

Most of us, swimming against the tides of trouble the world knows nothing about, need only a bit of praise or encouragement - and we will make the goal. ~Jerome Fleishman

Post Edited (Screaming Eagle) : 4/10/2014 6:35:05 AM (GMT-6)

New Member

Date Joined Apr 2014
Total Posts : 5
   Posted 4/10/2014 2:57 PM (GMT -6)   
Thanks Screaming Eagle, for the response :)

Well, heck. At the risk of seeming crazy I'm just going to keep talking. Has anyone figured out the high blood pressure is the cause of their palpitations? I can't help but think that mine might stem from there... anxiety gives me high blood pressure - I can feel it when my BP goes up. Yesterday at the doc i was 140/100 which is crazy high for me.

My years of exercise is what kept my blood pressure and anxiety low but now that I am too scared of the palps to exercise - my BP and palps are up.

It's tough to know whether to treat the palps, the blood pressure or the anxiety.

That's why - with a little research - I have come to propranolol. Has anyone tried this? It seems to treat all three issues... I am returning my holter monitor to the doc (that wants to do an ablation) today and thinking of asking him if I can try this for a few weeks.

Any one else tried it?

Again, thanks so much.

New Member

Date Joined Apr 2014
Total Posts : 5
   Posted 4/10/2014 3:12 PM (GMT -6)   
Well, heck again, I just read that you shouldn't take propranolol with a slow HR. My resting is 40-42.

If I want to avoid an ablation - I wonder if I should take an anti anxiety and just start slowly hitting the gym... build my fitness up gradually while lowering my BP and Anxiety (through exercise). Now I'm just thinking out loud. But I invite anyone else to join in!

Elite Member

Date Joined Apr 2007
Total Posts : 32602
   Posted 4/10/2014 4:50 PM (GMT -6)   
PVCs are supposed to go away with exercise. PVCs during exercise is not necessarily dangerous but they more often indicate heart disease than PVCs during rest (which almost never indicate heart disease).
Two conditions are known to cause PVCs during exercise. One is coronary artery disease and the other is myocarditis. I assume you have ruled out CAD, but infections may at some point in your life (maybe after a common cold) affect a small part of your heart, which may fire lots of PVCs. If your echo is clean, your heart isn't damaged, but a clean echo can't rule out microscopic infections (and remember, just a few cardiac cells may cause lots of PVCs).
That said, it should be kept in mind that most PVCs/PACs during exercise are caused by excess adrenaline and poor exercise condition. Did your doctor tell you to keep exercising or stop?
I know how devastating premature beats during exercise can feel. I controlled mine with beta blockers, and when I got into better shape they went away. If you can't control yours even with antiarrhythmics, I guess last option is ablation (or living with them). Of course, if you are choosing the last alternative, you can't let them ruin your life quality and that's not easy.
As far as your fear of the procedure that would be normal for anyone.
What are you doing to manage you symptoms ? Also we have a great Anxiety forum if you would like to post there too.
Please remember, I am not a Dr. so make another appointment and advocate for yourself.  Get a list of all your options. Reference - MedHelp

Moderator: Anxiety/Panic
and Heart/Cardiovascular Disease.

"She Stood in the Storm & When the Wind Did Not Blow Her Away, She Adjusted Her Sails."

New Member

Date Joined Apr 2014
Total Posts : 5
   Posted 4/10/2014 7:42 PM (GMT -6)   
Hi Kitt,

Thank you so much.

I'm just a little confused... are you saying I now, or at some point, have or had an infection in my heart? Neither cardiologist told me this. They both said exercise induced pvcs and nsvt during exercise are quite common and that "who knows why it develops?".

So your info is news to me. Yikes.

And yes, echo showed great cardiac output, no regurgitation nor abnormalities.

Cool to hear that fitness can curb these. That's what I'm after at the moment. But I just did a 24 hour holter with my new cardio and I guess we'll see what he says. He's a fancy Beverly Hills doc that looks great on paper and saw a celeb in his office while I was waiting haha. Hard not to listen to him.... Just keep reading about how the ablation is for afib and vt etc. Feels super intense for what I have. But what do I know?

Edit: by the way Kitt, sounds like you curbed your adrenaline induced palps with fitness and not ablation? That's great news. My cardio said it has nothing to do with fitness level... again, I have pvcs and nsvt so maybe I have something diff than you. And yes. I'm okay to exercise. :)

Post Edited (AnxiousAboutAblating) : 4/10/2014 6:53:41 PM (GMT-6)

baseball fan
Regular Member

Date Joined Mar 2014
Total Posts : 57
   Posted 4/14/2014 11:44 AM (GMT -6)   
just came across this Post, I have the same problems. I'm a jogger too. I am 37 and just had an ablation back in July for atrial fibrillation. I have not had afib episodes any more after the ablation, but I have thousands of PVCs a day, sometimes they happen every 2-3 beats and can last for hours and hours, day after day. Sounds like you may have seen Dr. Natale in California, if you have ,he is one the best. I see him in Austin Texas and he has assured me to not worry about PVCs because they have done test after test and ruled out all the bad stuff. Just said to not let them bother me. I for one can tell you getting out of shape and ANXIETY, will make PVCs worse. I also have an enlarged ascending aorta with 2 bulges measuring 4.3, and a hole between the atrials, which is a right to left shunt. These aneurysms make jogging a bigger anxiety for me, and that has made the PVCs worse. Keep disccusing all this with your doctor and talk to him about all your concerns. Have you ever been in A-Fib, or just skipped beats? I have so many skipped beats happen it seems I'm out of rythym, but when you go into A-Fib, you know it.. A-fib is what can cause blood clots to form in your heart, so I had an ablation to stop the A-Fib...

New Member

Date Joined Apr 2014
Total Posts : 5
   Posted 4/14/2014 11:55 AM (GMT -6)   
Hi, thanks for the response. I have not been a fib, that I know of.... How different does it feel from normal palpitations (pvcs etc). I definitely feel an erratic pulse, thump and little and heavier beats etc. But after a stress echo the doc just told me they were pvcs with a few runs of nsvt.

That was 8 months ago and I just had a 24 hour holter done and waiting for those results.

Was your afib only during exercise?

Thx again!

baseball fan
Regular Member

Date Joined Mar 2014
Total Posts : 57
   Posted 4/14/2014 12:59 PM (GMT -6)   
You will definately know if you are in a-fib, just sitting down you can see my chest shaking from the erratic heart beat. When in a-fib my heart is beating at 180-over 200 beats per minute and completely erratic, blood pressure shoots up and down in extremes. Exercise has never started an a-fib episode, they just start out of the blue for no reason. But since the ablation I have not had any a-fib episodes, still have PVCs daily, but doc says not to worry about them, they are harmless for me. If I have PVCs every other beat, jogging sometimes makes them stop, but if I'm very anxious they get worse and alot more frequent... there are millions of anxious people that have PVCs and don't even know it, once they feel and are aware of them, they will notice them all, then they will get worse, because we are anxious and anticipating the next skip. 

baseball fan
Regular Member

Date Joined Mar 2014
Total Posts : 57
   Posted 4/14/2014 1:01 PM (GMT -6)   
glad you can still do those active things you love to do, I was a runner and weight lifter, also love hiking. the aneurysms have stopped all that for me, not the palpitations..

baseball fan
Regular Member

Date Joined Mar 2014
Total Posts : 57
   Posted 4/14/2014 1:04 PM (GMT -6)   
by the way, doing extreme sports like you have... If you consume energy drinks, get a little dehydrated or both at the same time can cause erratic heart beats... If I drink a caffeinated drink and try running, my heart goes crazy.. absolutley no caffeine, no even decaf stuff for me... and no energy drinks when exercising, just good ol water..

New Member

Date Joined Apr 2015
Total Posts : 5
   Posted 4/3/2015 1:48 PM (GMT -6)   
I had an ablation done for SVT 8 years ago. They found 3 locations, fixes 2. I was about 37 at that time. Ablation was not pleasant at all. Just scary, not painful. I always wondered of anxiety could belinked to SVT. I am much better now. Stull have extra bears (they can t fix extra bears anyways) that i feel, especially when tired, or if i over exercises. Ablation helped a lot.
I do suffer from anxiety and panic attacks but the fast pulse from anxiety is very different than the real tachycardia that would come when I was just sitting or riding or sleeping.
Ablation is great. And to gives answers to your problem. They check why is going and then they ask you while you are "on the table" if you want them fixed.
Hope this helps...
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