Exercise and recovery PVCs

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Submitted by Dr T on June 11, 2011 – 10:28am

Hi Dr T,
I am a 42 y/o male who was diagnosed with harmless PVCs in 2004 after several heart related tests (Stress test, Echo, ECG’s, cholesterol testing…..).
Since that time I am doing fine and these funny PVCs goes and come, sometime they do bother me and sometime I don’t feel them, however my mind is in total peace/calm as all info I have gathered about PVC’s from my docs and the medical sites in the internet confirms that these PVC’s in a normally structured heart are not a cause of any concern or worry and they do don’t involve any underlying issue nor predict future risk of developing heart diseasesI use to smoke and just quitted in Jan2011 after 20+ years of smoking. This Jan (about 6 month back) i went to a routine heart tests (ECG stress test, Echo and blood, and all related heart tests), everything come normal. I still have these funny PVCs come and go and frankly speaking I don’t know as we speak what trigger them to come and what let them go. I just thought it must be my stress level who plays a good role to feel them or not as they never went away even when you don’t feel them..Recently I have seen a study published in 2008 (see below) that put people who develop PVC during recovery after exercise at high risk of developing heart diseases and/or CAD down the road. My Q’s are:1- is the understanding regarding the PVCs being harmless still the same or its been changed2- Is this study that published in 2008 a general one or just for previously known heart patients?3- For people at my age with normally structured heart and who develop PVC after exercise as well as before are we at increase risk base on this study?4- Is recovery PVCs in specific and PVC in general have any clinical significant  or predict something in the future in normally structured heart.

Most people with PVCs and otherwise normal heart function don’t need treatment, only reassurance they are safe once their heart proves OK.

If you read the studies, you would know it involved military veterans, mostly male, and 60+ of age, of whom roughly 25% were treated for heart disease (1). In this group of patients, frequent exercise PVCs proved an additional risk factor for heart disease, whether during exercise or afterwards, not unlike many other cardiac risk actors such as smoking, hypertension, high cholesterol, obesity and/or diabetes. I expect the same to be true for women with similar risk factors.

Association (shown as hazard ratio and 95% confidence interval) between exercise capacity and hospitalization for myocardial infarction among patient
subgroups for those who achieved less than 85% compared with those who achieved greater than 100% of age- and sex-predicted exercise capacity.
CAD indicates coronary artery disease; ETT, exercise treadmill testing.

If you were one of those at risk patients (male or female), it would raise a red flag for me, and I’d recommend further studies, based not only on PVCs, but also on a host of other information a consultation would supply.

That is why this requires involvement of a cardiac specialist, who can look at these things, put them into context and order appropriate tests including an exercise tress test that might lead to further treatment.

I have written about this before in “PACs and PVCs”. You can also calculate your risk for heart disease. If you have known heart disease, you can also evaluate your cardiac treatment.

Hope this helps,
Dr T


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