Prognosis

I’m a 63 y/o male with MVP (minimal regurgitation). In 2001 I underwent ablation to alleviate my PVCs that I have had for 25 years (which had gotten very frequent and were no longer adequately controlled my meds), very successfully. At that time my cardiologist found that I had idiopathic cardiomyopathy, probably from a virus (I had a bad one with fever in the previous year which sent me to the hospital for cardioversion after I went into a-fib) – the previous echo I had done some two years before then was normal. They saw some wall motion abnormality and mild to moderate enlargement of the left ventricle; the EF was 42 at the time. At the time I was put on Lisinopril and Metoprolol, which I am continuing to take.
I never had a heart attack, I am a nonsmoker, don’t drink and my BP has always been around 110/65. My resting pulse rate is around 55.
Since 2001 my annual echocardiogram has shown that the left chamber size has remained the same and my EF had fluctuated between 43 and 50; the current one done two weeks ago is 45.
I have no heart related functional symptoms other than some occasional, infrequent PVCs if I have a particularly full stomach (a 35 year long symptom) and my exercise tolerance has remained the same (actually improved somewhat since my ablation).
What should I be doing to help in addition to the medications I am taking?
Most importantly, what is my long term prognosis with this condition?
Thank you for responding.

[Cleveland Clinic]

Your prognosis is relatively normal because your heart function is relatively preserved and you have no symptoms of heart failure.  It is very possible that the reason your heart function was slightly down not because of a viral process but because of the long standing history of PVC's.  How many of them did you have in a 24 hour period.  If more than 10 to 15 % of all the beats then it's actually highly likely that was the cause of the decline in heart function.  This is also consistent with how stable your heart function is.  I would stay that you should continue taking the meds as you are, see you doc on a regular basis and I think you should have a holter for 24 hours to see if there are any PVC's left.