Your opinion

38 f - you can read my medical history in past posting (under Italia64 and Italia38).  I visited with Dr. Natale on Nov 7, 2002 and was told to take flecanite to reduce pvc. With time, if I can't stand it any more, Dr. Natale is willing to ablate. He did also confirm that the success rate for ablation of pvc originating from right ventricular outflow tract, is not 100%.  
I have a few questions that I did not get to ask to Dr. Natale. I hope you can answer them:
1. why is more difficult to ablate in the R.v. outflow tract?
2. with time should I expect the pvc to get worst?
3. should I opt to ablate now that I am 38 rather than wait for things to get worst and obviously older?
4. Would a large number of pvc make the ablation easier or more difficult?
5. How many times a year would you suggest to get an holter monitor to "monitor" the # of pvc and the their morphology?

We have been in a pretty bad cold spell lately, I have notice that in very cold weather I seem to have more pvc than usual. Is there a correlation between temperature and number of pvc?

Thank you and may you all have a happy and healthy holiday season.  
Regards,
Italia38

[CCF-M.D.-KE]

Dear italia,

I am glad you had a chance to see Dr. Natale and I hope things are going well for you. Dr. Natale is a world's expert in this area, I would also recommend asking him many of these questions at your next visit.
1. Did Dr. Natale say that the ablation was more difficult? He may have just been trying to say that nothing in medicine is 100%.
2. Following the initiation of flecanide hopefully your PVCs will improve.
3. I think the timing of the ablation is something that you and Dr. Natale should discuss. The plan you mentioned sounds great, upon the progression of your symptoms Dr. Natale is willing to perform the ablation.
4. A large number of PVCs with many different morphologies, suggesting that they are orginating from different areas of the heart, could make the procedure more difficult. However, if all of your PVCs have one morphology and the origin is felt to be in one location then the number of PVCs should not matter.
5.A holter monitor should be performed if you develop a dramatic change in your symptoms, otherwise once a year is reasonable.
6. It is possible for cold temperatures to worsen PVCs.

Thanks for your question,


CCF-MD-KE

[Linda123]

Dear Italia
My cardio thinks that I have RVOT and I would be interested in comparing our symptoms.  Please could you give me your email address.
Thanks.
Best Wishes
Linda