Symtomatic PVC's/Failed Ablation/2nd Opinion?

[Celeste2012]

Hello, I am an otherwise healthy 52 year female.  I began having symptomatic PVC's in about 2008.  Echo normal, scan showed mild attenuation on distal anterior wall, stress test negative, EKG normal aside from frequent PVC's.  These episodes have come and gone over the years, lasting a day to weeks at a time.  In January of this year they became quite severe and non-stop with holter monitor showing about 7000 in 18 hours.  I feel every one of them which effects my ability to fall asleep, causes SOB, chest tightness, fatigue and near syncope.  There has been no correlation to activity, caffeine, alcohol, stress, etc. Echo was then showing mild mitral and tricuspid regurgitation and mildly elevated RVSP (40's).  After failing at several medicinal trials my EP attempted an ablation...but the ectopic activity stopped a couple days before procedure and he was unable to induce a single one during a grueling non-sedated 5 hour period.  They have continued to be sporadic but seem to be increasing in severity again over the last couple of weeks.  EKG now shows a short PR interval in the 90's and has always been >120.  From what I have researched it sounds like this can put me at greater risk for life threatening arrhythmias.  I read one discussion regarding placing a pacemaker and ablating the AV node in certain cases.   QRS is normal and without delta wave so doesn’t fit WPW profile, but does appear to fit LGL.  Those are only 2 pre-excitation syndromes I could find.  I will be seeing my EP next week.  Does anyone have any further insight or am I being overly concerned?  Thank you!

[JamesC186282]

I also (had) thousands and thousands of PVCs every day and felt everyone of them.  Along with feeling normal heart beat it made it difficult to sleep.   Its also just scary.   I must have read the same thing you did about frequent PVCs increasing your odds of Heart Failure.   I don't see how it couldn't.   *I'm not an expert.  

I wanted to say a couple of things.   My doctor said that he has had a number of patients that just quit having irregular heartbeat and they had to do the procedure a second time.   I had a low number for a short time.  In my case when the heart is really hammering away (Like when working out)  My heart seems to override the PVCs.   And it was pounding away from fear I think.  Anyway - once I told the doctor this he switched from trying to make my heart race to trying to get it to normal or lower and it worked!

I just want to say to anyone reading this don't be afraid of Ablation.  It was not painful unless you count having the initial shot to numb you up ;-)   There was some question about it working but it looks like I had success with mine.  It was one area sending out these bad signals and once that was squelched things have been great.   I also don't feel my regular heartbeat like I did before.   It seems quieter.   *At first I thought it had stopped!  

The Doctors, Nurses, at U of MN Heart (Fairview) are the nicest / best folks ever.

[CCFHeartMD21]

Hello,

I am sorry that the PVCs have caused you such issues. Unfortunately, the questions you are asking about potential for a pre-excitation syndrome require actual evaluation of your ecg. It is difficult to speculate without being able to see the ecg. It would be unusual that you previously had normal appearing ecg and now have a shortened PR (sometimes computer misreads things) though not unheard of. If there is an accessory pathway, often ablation of the pathway is an option though not ablation of the AV node. I would recommend that you discuss your questions with your electrophysiologist.