Re: Premature ventricular contractions

Posted By CCF CARDIO MD - CRC on October 01, 1998 at 11:38:29:

In Reply to: Re: Premature ventricular contractions posted by Stacey on October 01, 1998 at 01:04:07:






I realise that there have been many questions asked about PVC's on this
forum in the past, but mine is a bit different in that I had an ablation two yrs ago
to correct WPW.  I had these skipped beats before and after the ablation.
Recently I've noticed thatI have more PVC's before and during my period and have found
that they also increase when I don't eat at regular intervals.
My electrophysiologist is someone that I trust very much
and he tells me that my heart is healthy (I'm only 25)and that I should ignore the PVC's, but I remain afraid.
My real concern is that I was diagnosed by another physician before the
ablation as having MVP, but my electrophysiologist seemed to think it is a
very mild case since he can't even hear a murmur.  My real question is this:
I've recently moved to a new state and my insurance is going to be a
nightmare here.  My general practitioner wants me to see a cardiologist here
due to the fact that I've not had an echo since before the ablation.  She said
due to the large number of PVC's and PAC's that she captured on the EKG
the last time I was in her office, that she would feel better if I did.  
Given everything I've spouted off here are there any reccomendations you can give
me on how to try to reduce these PVC's on my own or should I just suck it up and pay
for the piece of mind by getting another echo?  Sometimes they really just
scare the heck out of me.  Thanks for your time.  






___
Dear Stacey,
Thank you for your questions.  You are right that we get many questions about PVCs and you can find previous answers on this web site.  You can also draw comfort from the fact that so many others have the same concerns that you do.    As far as specific advice about what you should do we always recommend following your local doctor's suggestions.
Below is a brief summary of what a PVC is, what causes them and the treatment (if any) for PVCs.  You can find additional information in an article in New England Journal of Medicine, May 7, 1998, Vol. 338, pages 1369-1374. Your local medical library will have a copy of this.  Hope this helps.
    PVCs (premature ventricular contractions) are extra heartbeats occurring out of sync with the normal regular rhythm of the heart.  PVCs may cause no symptoms at all or may be felt as a irregular heartbeat or as the sensation of a hard heartbeat.  PVCs  are common findings in persons with otherwise normal hearts, in which case the prognosis is excellent and there is no decrease at all in life expectancy.  On the other hand, they may indicate that there is an underlying abnormality of the heart muscle (from any number of reasons).  If there is an abnormality, then the prognosis and treatment depends upon the specific problem of the heart.  The usual evaluation of PVCs is a history, physical examination, and electrocardiogram (ECG).  Also your doctor may wish to check an ultrasound of the heart.  If all those tests are normal, then you would fall into the category of people who have PVCs but otherwise no underlying heart problem. In that case, treatment depends on how much the PVCs bother you. If they are essentially asymptomatic, then no treatment is required. If they bother you, then a medication called a "beta-blocker" may reduce the frequency of the PVCs. PVCs cant be "cured", but the medication can decrease their frequency. The potential side effects of beta-blockers are tiredness, impotence in men and breathing difficulties in individuals with underlying lung disease.  Be sure to discuss these issues with your doctor and under no circumstance should you take medications for the heart without the supervision of a doctor.
Below are some web sites with additional information about PVCs.
http://www.amhrt.org/Heart_and_Stroke_A_Z_Guide/prevent.html
http://www.nhlbi.nih.gov/nhlbi/cardio/other/gp/arrhyth.htm
http://www.MedicineNet.com/Forum.asp?li=USA&ag=Y&ArticleKey=1946
Information provided here is for general educational purposes only. Only your doctor can provide specific diagnoses and treatments. If you would like to be seen at the Cleveland Clinic, please Call 1 - 800 - CCF - CARE for an appointment at Desk F15 with a cardiologist



PVC'S