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CAD and arrhythmias
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CAD and arrhythmias

I have CAD with mild ischemia from a mild heart attack from 1997.  Per a recent chemical stress test my LVEF is within normal ranges but I experienced frequent PVCs throughout the test. The results summary said Mets 1.0 (because of the arrhythmia?) but otherwise normal.  I was previously diagnosed with PSVT and the prescribed medication (metoprolol) does seem to pretty well control that atrial arrhythmia.  My concern is with the PVCs that have become so frequent in the last few months and at times become quite uncomfortable, causing wooziness and some angina.  I also have frequent syncope and bradycardia.  During 1 particularly bad spell my heart rate went down to 30-32 for a few minutes.  I know that any stress makes all of these symptoms worse so I try to avoid that, when possible.  My question is if the new frequency of PVCs combined with my mild ischemia puts me at risk for VT or VF?  
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Studies on this subject, arrhythmias in the presence of CAD, are all over the place.  Some say there is prognostic value, some say there is none.

There are other markers to predict if you are at higher risk for a malignant arrhythmia.  For one thing, have you ever had an episode of NSVT or VT?

I don't think the METs value had to do with the PVCs.  I'm pretty sure that's because you didn't do a traditional stress test on a treadmill.  It was chemically induced so there is no way to measure your work output (since you didn't do any work on a treadmill).

With the brady and your history, you might want to talk about getting an ICD/pacemaker with your cardiologist.  This will help too if you are at higher risk for VT.
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