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VTAC
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VTAC

I am a 40 year old woman.  I have had a variety of symptoms for six years including light headedness and fatigue.  I have gone from Dr. to Dr. with little results.  All neuro tests and Cardiac tests are normal,( EKG's, T WAVE Alternate, Echos, MRI's MRA's, etc.). One doctor suggested I was too sensitive to my own adreline and placed me on 60mg of inderal. All prior holter monitors have been basically normal.Last week I asked for another Holter monitor, and over an 18 hr period the test showed one time(5:57pm) where I had a run of extra beats,total ventricular ectopy of 10 beats, with 3 total runs.The longest run was 4 and the fastest run was 3 with a heart rate of 120. This all occurred within 7 seconds while exercising.  It was explained that these were not just isolated PVC's but non sustained VTAC.The Doctor said my heart rate basically did not change during the episode. I felt the feeling in my heart and slowed down my pace. I was sent to a Cardiac electro specialist and he said I should have an EP study.  As this is an invasive procedure with risks, my question is, is this necessary? My cardio feels it is a liitle aggressive since I have had a negative t wave test and a structally normal heart, but is not dismissing the importance of this finding. Are there other tests to check into electrolyte abnormalities, thyroid, hormones or other causes of vtac without an invasive exam?Thank you so much for taking the time to read this question!
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In the setting of a structurally normal heart, isolated PVC's or even a run of NSVT (very short run with just 4 beats) is benign meaning not an issue.  One test that I did not see you mention is a cardiac MRI and if you are having lots of PVC's and an episode of NSVT I would possibly look into having this done to make sure no abnormalities in the right side of your heart that are not picked up by regular echocardiograms.  I do not believe I would recommend an EP study based off what you are describing, however I do not know your entire medical history and this is a difficult question to answer via the Internet.  
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