Long warmup to reduce PVCs
 

I'm trying to reduce my PVC that occur on some rides.
A long warmup at a moderate pace seems to reduced the appearance of the PVCs
At the start of my usual ride, I have to go over a bridge with a 3% incline. If I keep my HR<120 I do not experience any PVC and my HR drops to 76 bpm on the bridge descent which is normal.
If I ride harder 140-145 bpm on the bridge ascent the PVC start and on the descent they remain at 125-128 bmp which is the frequency of the PVCs.
In the event, that the PVCs have started they remain even during the 45 min flat section after the bridge.
In the case where they have not started the HR is normal at 105-115 during the same flat section.
If the PVC start they remain for the rest of the ride (3 hours).
Once the ride has finished they remain for 2 to 3 hours before they disappear.
The Garmin measures the PVC bpm, but the frequency of the PVC occurance is roughly estimated by feeling the pulse every 5 to 10 bpm.
I have read that the occurance of the PVCs during training are "safe", but if they occur during the recovery they need further examination.

If anyone has had a similar situation any feedback is appreciated.

PVC for me stands for polyvinyl chloride. What's your definition of that acronym in the context you are using it?

Have you discussed this with your physician?
If not, I think you should.
If you don't have one, I think you should find one.

Three hours of continuous ventricular ectopy may not be PVC's, which are typically isolated (albeit sometimes frequent) events.
Your doctor could get you a monitor to see exactly what is going on. If truly PVC's, there are ways to try to suppress them.

the rapid changes in heart rate - in either direction - can increase arrythmia, but what you're describing are not isolated PVCs, bigeminy, or trigeminy. if your heart rate on an unpowered descent is remaining at 125 and is essentially continuous PVCs, you're actually in stable ventricular tachycardia. you will find many different opinions about the risk and meaning of lots of PVCs from various doctors, and you shouldn't get medical advice from random people on the internet, but what you're describing sounds worrisome to me (i have a heart rhythm condition and have had lots of various types of arryhthmia) and would merit a visit to an electrophysiologist. they can do an exercise stress test to determine exactly what your rhythm is, and how dangerous it may or may not be.

there are a number of antiarrythmic drugs which can be very effective at eliminating PVCs depending on the cause.

What he said, in greater detail than I gave,

Now I'm sure that I don't have that. Mine is definitely polyvinyl chloride. phew.

I have 'em too. Your experience is interesting to me. I do have a tendency to start off too hard. At rest, I have the more-or-less usual 1 PVC ~every 20". But if I push they get a lot more rapid. I only have a HRM on the bike, so it is hard to separate the sinus rhythm from the PVCs, but like you say, if I had a PVC session with HR on the monitor higher than it should have been, when I ease off it's still higher than it should be. I have been diagnosed with stable ventricular tachycardia, but my doctor says it's probably not life-threatening if I recognize it and back off. I am on a blood thinner. I'll try warming up much more slowly and report back sometime.

Another thing I could do but haven't is put a cell phone mount on my bars and run my HRV app during rides. It gives a visual like am ECG. easy to see the PVCs.

Thanks for responding.
I have been visiting a cardiologist for several years now, and do the regular yearly ultrasound exam and an occasion stress test. He keeps reminding me to reduce the intensity of my riding which I have.
I have worn a 24 hr holter in the past which did not show a problem.
When I talked to him recently about the increase in the PVC frequency he suggests the 24 hr holter. The problem is that in order for the PVCs to appear requires some intensity which means sweating and that causes the electrode suction cup to come off there position. I don't know if there is some special tape to prevent this.
After these test I am going to visit an electrophysiologist

Moved to Pills and Ills.

The Zio patch may be worn for up to 2 weeks, worn on the chest and ideal for athletes. When a symptom occurs, one presses a button and makes a notation on ones phone in an app. Once the patch is removed the prescribing doctor is provided with a complete report of the rhythms recorded. https://www.irhythmtech.com/patients/why-zio

Sometimes there are PVC / PAC that are recorded but not felt by the patient as well as other rhythms that are benign and some that are not.

I have an irregular heartbeat and PVC's, but I can never feel them when they occur. I've felt a palpatation in the past but never a PVC. I would suggest a cardiologist too. Mine has me on Flecainide 50mg (probably a generic) twice daily and I'm having no issues and I guess it's controlling my PVC's since all checkups have been good. Previous to that I was on a similar drug that was supposed to stabilize heartrate and I would get short-winded when I exercised. That was called Acebutolol and I got off it quickly.

Thanks for yr info.
How long do yr PVCs last after you have completed yr ride? Mine last 3 to 4 hours and at a decreasing frequency of occurrence and bpm, and then the HR becomes normal.
When they occur, and I have stopped for a rest by feeling my pulse they occur they are about every 7 to10 bmp at about 125 bmp which shows on the Garmin.

Some times ya dont know if they are in fact PVCs. PVCs are often accompanied by PACs and other arrhythmias. One of your big dangers is small blood clots thrown off during the PACs and some PVCs. Either way I think you need to find a Cardiologist who rides a bicycle and will take an interest in your particular case. Note that I said CARDIOLOGIST. Either way just remember...

They may not be PVCs...

​​​​​​ Why a cardiologist and not an electrophysiologist?

I don't know. I turn my Garmin off as soon as the ride is done. We're doing another group ride this Sunday. I'll try to remember to leave my Garmin on and put it n my jersey pocket. However I don't remember my apparent HR staying high for long after a climb. I'll look for that, too.

Electrophysiologists are cardiologists, but they specialize in arrhythmias and are interventional. They do recordings of activity in the heart through catheters, and can do ablations of abnormally active areas or conduction pathways which sustain arrhythmias.
The first order of business is to determine what the rhythm is; depending on the answer an electrophysiologist may or may not be the next appropriate step.
As the OP is under the care of a cardiologist, that person should be able to determine what is going on.

agree that the cardiologist is a starting point, but strongly disagree that they will be able to figure out what’s going on. an electrophysiologist is needed for all but the most common and simplest rhythm issues. i have seen many of both.

flecainide has been very effective for me - but i take 150mg twice a day! it’s the only drug i’ve tried that was effective at reducing PVCs and VT.

Thanks for responding.
Today I did my usual test ride watching my HR on the ascents to <130. Pulse dropped to normal on descents, flat sections or rest periods, and only on spike on the steepest section of one of the ascents 141.
No PVC during or after the ride.
I am going to consult with my cardiologist before I see an electrophysiologist. The cardiologist will have me wear a 24 hr holter.

Sad as it is... In most cases ya can't get to a Cardiologist without going through a Primary, and ya can't get to an Electrophysiologist, without going through a Cardiologist.

I did note the dark circles on the back of my wifes Electrophysiologist's hands. I also noted Road Bike memorabilia around his office. Really thats not unusual for an Austin based cardio-group... Ha

lol! my heart failure guy (who also focuses on arrhythmia although he’s not an EP) looked at the data for a bunch of my rides (hr, power, cadence, speed) and concluded some interesting things from the relationship of power and hr and speed. he actually opted not to do a couple tests since in his opinion the ride data was pretty conclusive.

For me personally I need 10-15 minutes at a moderate pace (15 mph) to avoid any problems with intense riding on sections of the road. Runners will warm up as a matter of practice but on a bike there is less of an inclination to do the same. The 10 minute slow pace reduces my overall time on a route as I can push harder later in the ride.

I wore a 24 holter and did a 30 moderate session on the trainer to see if the PC increased. They did not.
The 24 test showed multiple premature atria contractions of short duration.
The cardiologist was not concerned about them unless the duration increased.
He again reminded me to curve the intensity of my rides which I have during the past year.

I'm not happy about the PVCs, vTach really. HR just keeps climbing, except it's not really HR, it's vTach, bunches of PVCs. Soon as I quit pedaling, they disappear. I have an appointment for an ablation on Dec. 22. My atria seem to be OK.

epi or endo?