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ablation for benign pvcs
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MedHelp Member's Question

ablation for benign pvcs

by hankstar, Nov 01, 2001 12:00AM


Dear Doctor,

      I posted here before and I thank you very much for providing this most informing service.

      For the past five days I've been experiencing very frequent

pvcs , i have been to cardiologist and, had an ecg which showed the pvcs, had a stress test and did very excellent.

   The pvcs seem to appear right after i eat and go on for hours

sometimes one every other beat at times. I take atenolol 50mg bd, which i've been taken for sometime, but this doesn't seem to help.

   He told my heart is in good shape, but since the pvcs are benign he would not prescribe life threatening drugs for this condition, which i would not take anyway, but the pvcs are very intolerable and alarming when they occur with such frequency.

  Do you the the pvcs will deterioate in to a more serious arrythmia?

   I asked him about ablation, but says he doen't recommend it for benign pvcs.

    I have had this condition for years off and on and has lasted for months at a time, but always clear up and return,each time symptoms are more severe and intolerable, they do seem to

subside at night when my stomach is completly empty.

   Do you think i should try ablation, and do you think the atenolol could actually cause a worsning of the problem, because

i notice a increase in them after i take my medication.

  Thanks for your time and providing agreat service.

    Hank.
Doctor's Answer

by CCF-M.D.-CRC, Nov 01, 2001 12:00AM
Dear hankstar,



My opinion is that ablation is a good option for very frequent PVCs.  With the newer tools that we have the success rate is much higher than it previously was and oftentimes the individual is cured of the very frequent episodes of PVCs.  In general the PVCs do not deterioate to a more serious arrhythmia.  Atenolol should not be causing an increase in the PVCs.  If you would like to be considered for a PVC ablation at the Cleveland Clinic I would ask your doctor to refer you to Dr. Schweikert, Dr. Saliba or Dr. Natale.  If it is planned in advance for individuals from out of town the appointment can be done one day and the ablation the next day.  You can get more information by calling the number below.
Member Comments (41)

by snhn, Nov 01, 2001 12:00AM
Hello,



Can you please explain what PVC means and what is benign.  How do you tell if you are having any of these.  Is there a certain feeling you get.  How fast the heart rate needs to be in order to get them..  I know I have some thing going on.  I have non loping monitor these days, but it has not caught anything yet.



I dont take any meds.  My my hear rate is usually around 88 - 105 resting...



Appreciate the comments..



Thanks!

by arthur, Nov 01, 2001 12:00AM
I, too, have posted here many times.  I had PAF which was successfully ablated, however, a number of PV foci were left untouched (due to a prudent EP who wanted to minimize possible complications).  These remaining foci cause atrial premature depolarizations (which are synonymous with APCs, PACs and the incorrectly used term, PVCs).  They occur anywhere from 0-6 times per minute (my normal pulse rate is about 40...due to athletics).  When occuring at 6+/min for most of a day they are definitely a challenge to ignore. I keep telling myself that the PAF is gone and that's the main thing.



The rf ablation of benign "PVCs" like these is generally not done, however, I am willing to bet that centers that have done alot of them may suggest coming in for an evaluation.  Even my EP stated that "if they really bother you, then we may consider doing an ablation".  Of course, I took this as a challenge (thinking, hey, I am not going to whimp out just for a few skips).  So, my current strategy is to keep running my head off in competitive sports (soccer) and wait for one of three things to happen: (1) ablation technology gets to the point of being significantly safer, (2) I agitate the PV foci to the point of generating another PAF...then rf ablation is easily warranted, or (3) I burn out the foci by a constant stream of vigorous exercise (this last option seems least likely, but what the hell).



I'm very interested in what the good docs here suggest is the best course of action for extremely bothersome "PVCs".



by Jean27, Nov 01, 2001 12:00AM
To: Hankstar
You can actually feel the skipping in your chest? I sometimes feel like my heart thumps or bangs for a second but not like a skipping or turning over. Also some days I feel like every time I breath in and out I can feel my heart thump with each breath. Do you ever get that? I have not been able to figure out what this is, I ve been told it's anxity but I dont see how that is possible. Thanks so much Jean

by davem44, Nov 01, 2001 12:00AM
I'm a 58 year old male runner with morning resting pulse of about 42 bpm. I went atrial flutter about 2 years ago and had to electro cardioverted. Before that incident I had no problems,since then I have pacs.

My symptoms are very similar to those described by arthur,as I get them 0-6 times per minute,when I get them.

I had a six month period last year when I had none,but this past June they came back with a vengence.

I also notice an increase in frequency after meals.

I take the following and it appears to help:

  500-750 mg magnesium and potassium aspartate daily

  1000mg taurine daily

  2-3 teaspoons of maalox after meals and at bedtime(a tip I got

  from this forum).

I'm not a doctor and I'm not recommending any of this, but it appears to help my situation.

If anyone, especially runners, would care to discuss how they handle their pac pvc problem,I would be interested in hearing from you.

email ***@****

dave

by arthur, Nov 01, 2001 12:00AM
The skip which appears to be in sync with breathing... I have in fact noticed this in myself.  It may be that a PV focus-generated skip can be triggered by the extra pressure of the lungs expanding against the pulmonary veins.  It's not a 100% kind of  thing, but more often than not, there does seem to be a relationship.



As I believe a lot of interested people may be perusing this string of comments, I would like to ask if anyone out there has ever come across a reference source re. arrhythmias which actually addresses symptoms?  I have searched some of the best medical libraries in NJ, and plunged into the Web, but have not yet found a single medical resource which actually describes the range of symptoms reported by people with various types of arrhythmias.



by Blu, Nov 01, 2001 12:00AM
I have had the same experience. I have had pvc bouts for years, since I was in my twenties. They come on something terrible, but after a few months have gone away. This is my fourth major bout and they have been with me since June. This time it's worse becasue I am in peri-menopause and I really see the difference. My heart is other wise healthy and I am taking 200mg. a day of Atenolol which does nothing for my pvcs but controls my BP. I wish to God that doctors could come up with something safe for this miserable and life altering condition. It may be benign physically, but mentally it is devastating. My only hope now is that my pvcs will go away like they have done before. I pray to God this happens.

by Roys, Nov 01, 2001 12:00AM
I guess I should feel lucky I have only been experiencing PVCs for the past 2.5 years. I am a 43 year old male. Like others, mine come and go over a period of months. When they come on strong, I will get 5 to 10 per minute and this will go on for weeks. It sometimes feels like my heart is trying to move to a different location in my chest.



From my own experience, anxiety does sometimes bring them on. However, I also suffer from hypo-thyroid. When my thyroid hormone levels are low, I also end up with long bouts of PVCs even though I am not experiencing any stress in my life at that time. My doctors don't seem to think there's any connection but I'm not so sure since it's happened several times now as confirmed by thyroid blood testing. Are there any other PVC sufferers who are also hypo-thyroid?

by jan, Nov 01, 2001 12:00AM
Arthur, why is PVC 's an incorrect term? I thought it all depended upon the location as to whether they were PAC's or PVC's. I was told I have both, premature atrial contractions and premature ventricular contractions. I do not have them bad, but I do hate when they last 45 mins. or longer and I can't stop them. Usually coughing or getting up moving around will stop them and so I usually only have a few. I am taking atenolol and Tiazac but for inappropriate sinus tachycardia and neurocardiogenic syncope. I for one do believe the PVC's have gotten worse with the atenolol. I have had bigeminy and tri. recorded since being on these meds.(I have MVP/with MR and TR, also, all mild).

by Blu, Nov 01, 2001 12:00AM
Interesting Jan. I also have bigeminy and trigeminy. Miserable. I took Atenolol, for five years at 100mg. When this last bout started my doctor increased it. The bigeminy and Tri came on for the first time with this bout. The doctor said I had so many pvcs, he recommended Beta-Pace. After reading about the side effects, I said no. The doctor and his nurse also said the pvcs can suddenly go away, and that is my hope now. They have before, but this time they are so much worse. Each time they did go away, the remission lasted two years. Hope it happens again!

by heartbuddy, Nov 02, 2001 12:00AM
I had an ablation in January.  Two days after my heart went in to A-flutter.  They went in again and did another ablation in my pulmonary vein.  Rythum problem was fixed.  Bad news, I was sick for the next 5 months.  After switching docs, it was determined that I had pulmonary vein stenosis.  Underwent an angioplasty and now have periodic testings to make sure it's still open.  I too have tried several different places to find someone with this problem and also want to know about their side effects.  I have been unable to locate anyone with "pulmonary vein stenosis".  I have a lot of pain/pressure/discomfort in my chest around my heart.  It does seem to be anything, but it's somewhat bothersome.  I'd love to hear comments.

by arthur, Nov 02, 2001 12:00AM
PVC is a term people seem to use regardless of what kind of skip is occurring.  It's incorrect and misleading to use the term when you are describing premature contractions in general.  It is correct to use ther term when referring to a