I've been dealing with the darn PVCs on a daily basis for 8 months now. It seems like they are becoming more frequent. I'm taking potassium and angstrom mg for 2-3 weeks with no improvement. Every time I have an active or stressful day I am punished at night with a string of PVCs that can last for hours. They appear to be adrenaline related. It has made my life miserable.
My EP gave me a special script for an EKG for when I got a bad episode, so last night I went to the ER and they hooked me up. They saw PVCs coming every few seconds, and the technician said they all looked identical, so it appears that they are unifocal.
I'm not sure what to do here. I don't have PVCs ALL day, but I do get them EVERY day. Some days are manageable, other days are very frustating. I am living right now for the moments when I am PVC free. Not a good way to live your life.
So my question to all you fellow sufferers is, is the ablation worth the possible risks? And what are they?
I'd look not at the risks, but whether it was worth it as far as results go, as well as financially. Ablation for PVC's is known to have mixed results. The procedure itself has minimal risks. Anytime someon goes sticking wires into your heart, there is risk involved. But it's pretty minimal. I guess everyone fears zapping the AV node, and while that is a possibility, it's fairly remote. Cost varies. Mine for AVRT ran $77,000 before insurance. Not bad for a few hours of work! :-)
I understand your point. In my situation, the PVCs seem to be activated by adrenaline. If I have a lazy, stress free day, I'm not too bad. If I workout, play in a softball game, have sex with my girlfriend, anything strenuous I'm getting bombarded with them afterwards for hours on end.
Yesterday I did yardwork and played softball. Sure enough, 7pm they fired up. When I went to ER a few hours later, I was getting them every 6-15 seconds, and felt every one of them. I've been forced to take Xanax to fall asleep during these episodes, otherwise I am up for hours.
If I can't find a non-surgical solution I will be forced to make a decision. Do all the acitivities I enjoy, and then be punished with PVCs every night at bedtime, or sit around and do nothing and have less of them. It's a depressing situation.
BTW. My dad's triple bypass cost around $50-$60k, and I don't understand why an ablation would be so much more expensive. Maybe it's the hospital in your area.
Well I dont have the answer for you. I know I have them every other beat at times.
Its not fun at all, especially when they feel different at differnt times. Recently I had another near faint following some sort of pvc or other...
Yes, the whole thing is frustrating. I dont have the answer but I can relate to the frustration.
when I had mine done back in 2009, I had almost met my yearly deductible and paid $300 for a 4 day stay that included my EP Study w/ablation a ton of testing and ICD implant; my total bill was >$325,000 when all was said and done (I think my ICD alone was $129,000)
For me it was worth every penny since it took me down from 50,000 pvc's that I'd been having for quite a while to none for the first few days; but as others have said there can be adverse reactions to the procedure such as I had. Was mine a success? yes and no; would I do it again? no because for some like me there just aren't any answers or fixes; except a new heart. Before, I had rare atrial problems, but after I started having problems both top and bottom in the heart.
I think much like you, mine are mainly adrenaline based and the ANS play a big part in my symptoms and problems. 2 years later I still don't have a lot of answers or relief from symptoms, so ablation was a help in one way but I think may have caused other problems.
I was willing to try anything after 35 years of having arrhythmia's and being in bigeminy most of the time from April 2007 to August 2009. Depends really on how much you can handle and cope with the symptoms versus the risk and cost of having it done and still may not have a cure.
You should consider yourself lucky since you know what triggers your PVC's .......solution reduce your stress....are you on a beta blocker? I get episodes of PVC's that last for a few hours every day and at times I think my heart isn't going to recover. I don't think I would really consider an ablation unless they were 24/7 and resulted in fainting . An ablation procedure destroys heart tissue and there is no guarantee that it will work or cause other problems. Dealing with your stress is the best solution.
I agree that stress triggers the PVCs, but also any type of strenuous activity. If I want to have less PVCs, then I have to stop doing the things that I enjoy like playing sports, working out, having sex, etc. Not how I want to live. I keep hoping that the mg will help lessen the PVCs, but I can't really say if it has yet.
It sounds like you had alot going on with your heart. In my case, it is structurally ok (no a-fib, svt) except for these adrenaline related PVCs that appear to be unifocal in nature.
So, I am wondering if an ablation would be a suitable solution to relieve them. I can't believe an ablation would cost my insurance company more than a triple bypass, but I suppose anything is possible.
i know how you feel about every 30-40 days my heart speeds up and skips every third or fourth beat and the Dr can't figure out why but my Dr is trying to get me to do the same thing and if i can make myself believe that there is a 20% chance it can fix me than that's what I'm going to do because I'm only 31 and i feel like i can't do the active things i love because of the fear of knowing what i may have to deal with that night. Your seen it may be a little worse than mine because i can't really find a pattern to mine they just show up once a month, i can almost even pin point the day it will happen. I can say this my wife grandfather just had this done for a very rapid heart rate a skips beats and he said his heart fills brand new again, hasn't had any problems. Good Luck
when i first went in back in July 2009, I went in to have the ablation for very frequent unifocal pvc's; and I only had rare psvt...it was going to be quick and easy >95% success rate quoted and I would no longer have any problems...I became my EP's worst nightmare and had him and all the others I've seen scratching their heads.
it depends on the day and what test was done whether my heart is "structurally" normal
Here's an example:
July 2009 my first echo - structurally normal heart
August 26, 2009 EP Study w/ablation
August 27 2009 Cardiac MRI structurally normal heart (nothing found)
August 28 2009 Cardiac catherization showed - nonischemic cardiomyopathy (HOCM); LVEDP was 34; systemic hypertension
April 2010 Echo - HOCM (lvis thickened and walls thinned)
March 2011 Echo - structurally normal
I've been told by 4 cardiologist and 2 EP's this is NOT my heart that it's my ANS system...2 cardiologists and 2 Ep's say it is my heart (HOCM) and I have classic symptoms of it. This is why I still have no answers; so I'm going to a doctor who deals with HCM patients at cleveland clinic in weston FL when the weather cools down some.
sometimes, until they go in and are actually working inside the heart they think things are normal until they run into problems like with me...most of the time though ablation may help and be a cure
When you had your ablation, were PVCs the only reason you got it? Or did you have other issues at the time? Did you have any SVT, myopathy, prior to the ablation? Do you believe that the ablation brought on these other issues, or were they already present?
My greatest concern is that I have the ablation done for the PVCs (which kept me up until 2am last night BTW) and then other problems arise.
I've fainted and had arrhythmia's since I was 9 years old and told nothing was wrong. Back in 2004 they termed them "palpitations" but testing showed nothing wrong except bradycardia; until 2007 which showed pvc's in a bigeminal pattern.
I went in for a broken foot in June 2009 and my primary heard pvc's and what he thought was valve damage. He sent me to a cardiologist who did an ekg, echo, holter and stress test. Tests showed nothing was wrong structurally; just minor things that didn't add up to anything. (stress test had red flags)
The first EP I saw who was head of the largest heart hospital here said if I didn't have an ablation to try and get rid of the pvc's I could develop cardiomyopathy but he was positive the ablation would get rid of my problem.
I didn't quite believe him and went in for other opinions; the other drs said it wasn't as severe as the first EP said and tried me on Toprol - big mistake; it sent me to the ER in distress and they gave me a shot to try to counter act the med - after 11 hours my BP wouldn't go above 70/40 and my hr 40 so I told them to let me go since they didn't find anything other than pvc's. (red flag) the EKG showed I had multifocal pvc's and cardiomegaly (heart enlargement) another red flag
I went in to have a tilt table test before my ablation and when they gave me Nitro, my heart stopped they told me that was "rare" to have that happen (another big red flag). Then a few hours later I had an EP study and ablation which found that I had problems in the RV Apex and RVOT; and I went into long runs of polymorphic VT 3 separate times. (huge red flag) my heart stopped and the first time was really bad and almost didn't start. I think what happened during my EPS was Propofol messed with my heart rhythm.
When I woke up they explained what happened and told me they thought it was ARVD or HCM but most likely ARVD with my symptoms and that I needed to have a MRI and Cathierzation and an ICD implant.
somewhere dr's have missed the mark; one day my heart is normal then not normal and I have something benign then malignant; then normal again? doesn't make much sense...for me, I think I've had something wrong my entire life and it's just been missed and different meds mess with my heart; which is consistent with HCM or HOCM patients.
I wasn't scared about ablation; I had major surgery before and knew it would be a pretty quick and easy procedure. for most patients, ablation can be an answer and cure and may even help diagnose a problem. I think it's better to go through with it and find out you have something wrong and be in a place if something does happen like with me, at least you're right there where they can treat it immediately.
It sounds like you had several issues to deal with at the same time. For me, the PVCs are benign and unifocal but have changed the way I live my life. I'm literally avoiding many of the things I enjoy out of concern that they will cause more PVCs. My nights are a struggle. Just about every time I have an active day, I get a string of PVCs starting around 8 or 9pm lasting for hours.
This is the weirdest, most bothersome thing I have ever had to deal with in my life and I want it to end asap. If an ablation can do that, I'm game. Taking pills for the next 10, 20 or 30 yrs doesn't appeal to me, and frankly I doubt they will help anyway.
I would bet that the costs vary depending on what type of insurance you have. Also the area you live in can be a factor. The docs and hospitals will milk everything they can out of the plan. The better your insurance, the higher the cost. Would you agree?
The cath lab is expensive...
The catheters themselves, I'm told are $5,000 each - disposable.
Docs have airplanes to fly and malpractice insurance to buy...
I have good insurance, and I like the way its structured. Cheap premiums. High deductible. It forces the patient to be a consumer and consider cost. How much would your health care habits change if your deductible was $5k?
I really don't think the doctors try to get the maximum payment...most of them bill by codes and there is a price list you can ask for at their office/hospital. How many of us shop around for a more reasonable price for lab tests or outpatient services? Not easy to do comparison shopping when you are in need of medical care. That said, the system is broken - costs are way to high and we the consumer get the shaft. I count my blessings that I have medical insurance and don't mind paying a small co-pay now and then.
I was under the impression that the insurance company has maximums or allowed amounts that a dr or hospital can charge for a specific procedure. I would assume that can vary depending on the part of the country you are in or the type of plan you have.
Hey saw something about a BB being written, and wondering if you have been on this type of medication before? If not, you should talk to your physician about it. In your case with the adrenaline rushes, it could help cut that down alot possibly leading you to a better night. I hear you about the life part being turned upside down. Pvc's are such a battle, such a mind battle, and pretty much a life battle. I wish there was an easier way to deal with these things!! Everyone has there triggers, some knowing, some not. I hope you can try and find the right path in dealing with yours, good luck!!
I would say yes to the ablation, but ONLY at a major cardiac facility that deals with this every day. IE Cleveland Clinic, Mayo, Johns Hopkins, etc...do your research about who is close to you.
I had mine done at the CC in my area last week, successfully. No PVCs at all as of 1 week later on a holter. There are multiple reasons for PVCs and at the very least over time, they CAN weaken your heart.
I would do the ablation again 10x over, but like I said, ONLY at the best of facilities. Good Luck!!
I just had an EP study and the Ablation. It was a "difficult" one, the Dr knew that going in.
He told me typically they take about 2-3 hours. He spend 5 hours in there (7 on the table)
It did not work for me, but the proceedure wasn't that bad. You may want to ask your Dr about the risks, I was under the impression that the risk of me not having one was not in my favor (to say the least)
I'm interested to know where it says over time pvc's weaken the heart? do you have any research for that? I would love the links if so to read and take to my dr.
I know I've found research that shows very frequent pvc's (>15% daily) may lead to cardiomyopathy and weaken the heart but so many discount this research.
I've had arrhythmia's since age 9 and from age 40+ had 50,000 pvc's found and have been told by numerous dr's if your heart is structurally normal; pvc's are nothing to worry about and won't do anything to your heart and the chance of developing CM was rare.
Hi! Have you considered giving the BBs a longer try? Many of the symptoms of taking them are "start up" symptoms, that can subside somewhat as time goes on. When I started on the toprol I had bad dreams, ringing in my ears, lethargy, low bp ad hr. All of that subsided as I continued with it, and now I tolerate it well.
"Have you considered giving the BBs a longer try? Many of the symptoms of taking them are "start up" symptoms, that can subside somewhat as time goes on. When I started on the toprol I had bad dreams, ringing in my ears, lethargy, low bp ad hr. All of that subsided as I continued with it, and now I tolerate it well. "
I most definitely agree. I still have to warm up significantly longer though to bring my heart rate up. It just doesn't want to get going in the beginning. Could be my age as well. I'm on 50-100mg Metoprolol per day. I'm currently on the smaller dose.
Given the current American diet, I'd say that sooner or later, the vast majority of us will be on a beta blocker and a statin. My primary care physician had me stay on a smaller dose of Metoprolol, the beta blocker I was on prior to my ablation as a prophylaxis, saying that if well tolerated (and it is), it keeps the BP low, and to some degee helps in the event of a heart attack. I don't know if there's been any studies regarding very long term use of a beta blocker, but I regard it as I do my daily dose of vitamins, and it's included with them in the handful I take each morning. I've been on it for about 6 years now. I experience no serious side effects other than the lag in getting my heart up to speed during physical activities. I am curious to hear about your aversion to drug therapy.
Keep in mind that when discussing ablation vs. drug therapy, my cardiologist came right out and told me that he and others felt that experimenting with different antiarrhythmic drugs, beta and channel blockers carried a much higher risk than the EP and ablation procedure. So, I think that eliminating the root of the problem is better than masking it with drugs ....... in most cases. The thing is, is yours one of those cases where ablation results in a better quality of life afterwards? Of course, this is something you and your physician need to discuss.
As far as the meds, you said yourself that BB's didn't really help with PVCs so I didn't think it was worth it. My EP thinks that an ablation is a last resort for PVCs but will do it since I have visited him several times with the same issue. He said that he wasn't sure if it would help.
You are facing the dilemma that many of us are in ...to deal with the PVC's or destroy heart cells and hope that works or doesn't cause additional problems. Neither my PC or Cardiologist think I have really reached the point to ablate. I relish the PVC-free time that I have. Therefore, I am choosing to deal with what I know and not take that chance with ablation. Are you continuing with the Potassium and Magnesium and since they don't seem to work why continue to take them? I am on 200mg BB (metoprolol) and 5mg CCB (Norvasc) which seems help reduce them to a tolerable level ( on and off for 2-4 hours/day).
I would say it wouldnt hurt to talk to an experienced ep doctor about an ablation. You can always go in for a ep study just to see what they find,and to see if it would be beneficial to have an ablation. I just had a cryoablation 3 weeks ago for atrial tach & afib. So far..so good, no episodes. Only the occasional skipped beat. For the week after I had alot of skipped beats,but have subsided. I looked at it this way I was so sick of my life pretty much being run by my heart issues that I decided to just do it,and take the chance.If your doctor says they can be fixed ,then why not!!
I have not been on the board for quite some time. I had an ablation Jan 2010. I had 24/7 pvc's. I seen an EP he recommended an EP study. I also had one episode of A-fib and occasional runs of svt. I was more concerned with the PVC's than anything else. I tried metatoprol it did not work for me either. The pvc's could not be ablated since they were orginating too close to my artery. I was ablated for the afib and svt. The pvcs lighted up he assumes from the disturbance caused by the ablation. I was also placed on 25mg of Atenolol. The Atenolol was a miracle. Two days later my pvcs were completely gone. I am now down to 12.5 mg of Atenolol and get the occasional pvc's. Pvc's unforantely can move locations and once you get them you always have them. I have days were I get my share but I know not to get crazy anymore and it passes. Good Luck to you!!!
Im also on 25 mg of atenolol also,and it seems to work well for me too.Mzak69- maybe you could try atenolol and see if it works for you as well.Atenolol does make you tired ,but if your on a low dose it shouldnt be a problem.
I would suggest having it done. If you can reproduce the problem, timing and whatnot. The EP specialist should be able to do this as well in an EP study. The success rate, I've been told is either 100% or 0%, no inbetween stuff. It either works or it doesn't. After the 1st one, if it comes back, your chances are greater that they can pinpoint it and get it.
I wish my problem was like yours, in that you can nail it down to being active/adrenalin etc...
My Ep specialist just told me to quit caffeine, cigs, and lose the stress. (we all know that's easier said than done.) did the holter monitor, 30 day event monitor, 1 cardiolite stress test, 1 w/o cardiolite, had an angiogram done... I finally took his advice and cut back on stress/cigs/caffeine but still have the PVCs. all i can do is laugh at their suggestions sometimes. (by the way all previous tests were negative for anything, minus last stress test that showed PVCs) Am now getting ready for my 2nd 30 day event monitor.
He is really reluctant to do ablation or even an EP study. My PVC's do not happen as frequently as most people IE 50k a day or even 25k a day. I would put them at about 4 to 5k a day on days that I'm active and out walking around in stores etc...
But like i've told him it's not that frequency that bothers me, it's the profound symptoms that come with them, to the point of the feeling of passing out. Not sure what else to do here, as there's a definite electrical signal issue, and they don't want to do anything about it. Another problem is the closest 2nd opinion dr is 150 miles away. otherwise it's a close co-worker of his that is at the same hospital...
I would recommend having an ablation. Had mine last August. Befor ablation, 30,000 pvcs per day!! Now, maybe 10-20. Doctor said I am very lucky to not have permanent heart damage. Insurance is great in paying the majority of the expenses. Best of luck.
I've been on Flecainide since Feb after lopressor didn't work. It was doing the trick up until a few weeks ago and now I have symptomatic PVCs again with chest pain/SOB during work outs. I've tried an increased dose of the Flecainide only to find that I could not tolerate the SEs. I plan to get an ablation in the hope of not having to take daily meds and the desire to work out like normal 35 year olds do. I would at least try an antiarrhythmic if you fear invasive procedures.
Can you tell me about the procedure and recovery? I too have about 10K PVCs daily and have not a quality life right now. am thinking about having the ablation but have heard stories that it didn't work or got worse.
So glad to hear about yours. Where did you have it done at?
To give you basic answers, the procedure takes anywhere from 2-6 hours. You may or may not be sedated for the procedure. I was under general anesthesia for the entire 4 and half hours of mine. Recovery is minimal. You walk out under your own power most of the time the same day you arrive. You take it easy for a couple of days, and get back into it slowly. I was out of work 3 days plus the weekend. Jannie and I had the procedure for SVT, but it's nearly identical for your situatiuon. See the previous posts for additional information, charges, etc.
I had no symptoms of pvc's until my family doc noticed an abnormal heart rate. I went on Holter monitor and had 22,000 in 24 hours. Quit caffeine for a month and had it again, then I had 33,000 in the 24 hours!! No risk factors, low bp, no history, not overweight, but I have worked straight overnights for 16 years, I also have ran 33 + ultramarathons which are 50K's, 50 milers, and 100 milers in the past 8 years. No idea what is causing these pvc's. Going in a couple weeks to see EP for possible ablation. Any ideas of why I get these? Anyone else work nights or run ultras that have these?
I have 18,000 a day. I will be getting the MRI next, but I expect it will be normal. I have a BB that lowers my heart rate too much (I run marathons and train a lot), so the doctor told me to cut them in half. I also have Adavan that I cut in half (equals 1/2 mg). That is the best. It calms me down and enables me to handle them as they happen every few beats basically. I am very fit and do not want to reduce my activity. I have lowered my stress and even go to meditation class now. Short naps are good too as well as deep breathing. We'll see how it goes, but the Adavan is the best. Unfortunately, I do not want to live on anti anxiety medication forever, even if it is a teeny tiny amount.
a doctor told me PVC's are stress. mine seem to go waves. for awhile I get them and then I don't. he told me to find things to keep me busy. I used to get them bad at bedtime. now I read just before sleep and its cut them right down so I'd say the doctor is right and yes I suffer from anxiety and stress which the heart reacts to
Hi My name is jack,
I had ablation for SVT 5 years ago since then my SVT are under control but my PVC<PAC are not since your post in 2011 how does your PAC,PAC been? are you cured..Please let me know .
I would like to know how it goes and if it helps your PVCs.? Mine aren't terribly bad all day but they get SOO bad when I exercise to the point it skips constantly. I live an active life and since they have got so bad while exercising I have completely stopped in fear I will drop dead! I have 3 small children so I have stress about anything happening to me. My EP has suggested the ablation but I'm hesitant to know it will actually help.
I would ask your EP if he has done ablations before for this type of problem. Try to use an EP who does a lot of ablations and has experience. The more PVCs you get, the more likely they will find the spot that is causing them. I never went through with my ablation because my PVCs weren't flaring up when I was scheduled to have it. My problem is they come and go and I can't get the ablation at the exact time they are occurring. Good luck!
I have the exact same problem for the last 6 months, I get pvcs soon as I start to move, even walking slowly to the letterbox causes me to have them. If I play with my kids to 3 mins or so I get them for the next couple of hours. And like you I think my are adrenaline related. Even walking to my car after work I have to stop and let it settle down before I continue.
Just want to see how you are getting on right now, have yours got better or worse, and is there any advice you could give me who is new to this.
Thanks so much
I run marathons/triathlons and i get 5-10K PVCs per day, i had an ablation to correct SVT about 14 years ago and after the ablation is when the PVCs came on bad. th EP says they are not related but i don't believe it. the good news is i have never had a run of svt since. Exercise has always helped reduce the PVCs until i started to train heavy. I think this might be causing them, i am trying to decide on having another ablation to correct the PVCs, i don't want to cut out the training, but i can't live with these anymore!
Chris, see chat below from a couple of weeks ago.-----
Aug 19, 2015
Your EF is great and you sound really healthy so good for you. If you are in PA, then Callans and Marchlinski are great resources to have around if you decide to do something about your PVCs. There just aren't many EPs around that do ablations on those things. 50 procedures/yr is considered a lot and required to be included in clinical trials. Don't know if you saw the article on espn regarding endurance training and heart issues for some people. My sister emailed me after I shared it and mentioned many of her life guard friends that are into endurance training are having heart issues as they got older.
Aug 20, 2015
There's data on runners, Their mortality / morbidity rates decline until about 10 - 15 miles per week at 10 minute pace. More than this and the rate start to go back up. People that train 50+ miles per week have the same rates at smokers with diabetes.
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