Treatment and risks of extra heart beats

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Submitted by Dr T on August 10, 2011 – 2:09pm

I am a 42yo female experiencing PAC and PVC per symptoms and heart monitor.  I had an echo, but unfortunately do not have the results.  I currently do not take any medication and prefer not to start.  My blood pressure is 90s/60s resting HR in the 60s.  My Internist MD would like me to start a beta blocker (low dose), but I am afraid I will feel like a slug.  I have also heard that runners experience pain when they run if their HR gets up above 120bpm.  I am confused between what I read and what my MD is telling me.  Sure the PAC and PVC are unnerving to a point, but I am also a rational person if they are doing no damage then I would rather not take a med.  I should mention I have family hx of HTN and atrial fib.  Thank you for your time.

Treatment of PAC and/or PVCs depends on their frequency, how bothersome they are and whether your heart function is OK. Beta blockers will reduce the frequency of extra beats, but not eliminate them. Since you have a low resting heart rate (HR), they might not be the best option in your case, since it would reduce your resting HR even more.

Your target heart rate (with exercise) ranges from 120-150 bpm, or about 70-80% of your maximum HR of 216-42 (your age), so you WANT your heart rate to go up with exercise if you have a normal heart function and no evidence of coronary artery disease (CAD).

Patients can have a normal heart function associated with CAD. A stress ECHO can demonstrate your heart valve functions as well as the presence of CAD.

Exercise PVCs are usually benign as opposed to recovery PVCs that often are related to coronary disease and/or previous myocardial infarction.

If you experience an arrhythmia with exercise, you can also calculate your risk for heart disease here:

You can read more about PACs and PVCs here, I have blogged about this a lot:

You can calculate your Target heart rate with this tool form the Mayo Clinic: Target heart rate calculator.

Hope this helps,
Dr T

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