Mulitfocal PVCs

[Nurse2b1982]

I went to see a electrophysiologist at Barnes Hospital for a fourth opinion....I was hoping I could finally put my mind at ease at last with these PVCs, I figured that if a top doctor told me the same thing as the others, that I would just have to accept it. I have been told by three different doctors that my PVCs are unifocal, bigeminy/trigeminy, 9 triplets, and 200 couplets....but are BENIGN. Now this doctor told me that my PVCs are multifocal.....I have never been told this in past. She recommended me go on diltazem with possible ablation, etc. I was completely shocked. My questions are: I was told that multifocal PVCs are more dangerous, how true is that really? Also, How could one doctor find something new by looking at the same holter results as the others did? How could three other doctors miss that or is she really the one who is wrong? Should I really get all worried off of one person's opinion just because she is from a top hospital? I asked my electrophysiologist to review the results again and he AGAIN says unifocal. What would you do in my situation?

[is_something_wrong]

Hello :-) I came back for a little visit. I hope you are OK :-)

I think most of the things we read concerns people with severe heart disease (poor left ventricle function) - I doubt anyone care to do a lot of research on healthy subjects.

Multifocal PVCs makes ablation more difficult (as far as I know), and, of course, if multifocal VT (bidirectional or polymorphic) is more dangerous than unifocal (monomorphic), I would assume that there is a connection between this, and why multifocal PVCs are more "dangerous". In addition, if PVCs are caused by reentry (in people with heart disease) more reentry circuits are worse than one.

I think the problem is that we read stuff concerning people with heart disease, and relay to what we read. In my case, I've suddenly got some anxiety about CPVT, because I read about it and "compare" my symptoms to this and get some "match". It is - of course, not the right way to think :-)

[debbier]

I had an ablation in January for svt and afib,  my pvcs were not able to be ablated, they were orginating to close to my artery.  My EP was afraid if he ablated it I could have a heart attack.  I was fine with that so I went on Atenolol.    He did tell me PVC's change locations and if mine changed locations we could try another ablation.  Atenolol is doing the trick on my pvc's so at this point I am happy with the outcome.

[Nurse2b1982]

An EP study is when they go into a vein in your groin and go into your heart and try to induce abnormal rhythms. This allows then to map the location and type of arrythmia you may have. Hope this helps!

[Nurse2b1982]

I am going to my EP on the 23rd and will see what my opitions are with my meds. When did you have your ablation? Was it for PVCs? If so, how many and what type are they? Just curious sorry.

[Nurse2b1982]

I have been told both that they are dangerous and that they are not? Im not sure what is true and what is not. I am scared as well and I am sorry if I scared you. You can go to my profile and click on the PVC question and you can read the response of the doctor from Cleveland Clinic. Maybe together we can find a real answer? I am concerned at this point as well.

[chicky2001]

Can someone tell me what an EP study is?  I mean what do they do different than a regular cardio?

I have no idea what type of PVCs I have.  After a whole lot of tests all my life, just about, I am told PVCs that are benign.

[debbier]

I learned something new today!  I would try other meds,  I had pvcs 24/7 every minute, I tried Toprol it worked for a week and they were back.  I tried Atenolol after my ablation and it has worked great.   Now I get a few here and there.     I would try a few meds and see if you find one that works.  I know how you are feeling.  I have had pvc's for 6 years and they still scare me.   Good Luck!  Keep us updated I am curious if your second opinion says there multifocal

[jondsam]

I have multi focal pvc's and on the "lown grading scale" they are more dangerous than uni focal.  However, my cardio told me that my heart is normal and that I did not require any treatment.?? I hope that multi focal is ok , now im worried?

[Nurse2b1982]

Yes I am currently on 12.5 of XR Metoprolol and it helped at first but now the PVCs are virtually the same. I thought the same thing as you about the multi vs. uni focal until I talked to her and posted a question on the expert forum(see my above post ). I am going to investigate further b/c sometime in my gut is saying that she may be wrong here. I may need to talk to my dr. about an EP study to find out exactly! Thank you for the reply!

[Nurse2b1982]

Yes that is what I thought too, ubtil I talked to her and I also posted a question one the expert forum on this site and they told me mutifocal= more dangerous. I am just wondering if mine are truly mutifocal?? I find it hard to beleive that after 3 holters read by 3 doctors....that they could all somehow miss the multifocal part but she saw it so quickly...something doesn't seem right there. So now I feel the need to find out the truth b/c according to certain doctors, multifocal/unifocal make a big difference.
As far as an ablation goes, I was told that if in fact they are multifocal, they may be extremely hard to ablate, so I guess that is another reason why I would like to know for sure which they are. Based on my instinct, something seems wrong with what she was saying but I want to be sure before I make any decisions. Thank You for your reply!

[Nurse2b1982]

U are completely right! I have been having a hard time believing that something that feels so terrible could be harmless. I recently started see a therapist to deal with my anxiety over these and she actually told me to try to get into a doctor at Barnes, now I regret listening to her! I thought to myself "Well, if a top doctor actually says the same as the others, then I have to accept these as benign. She actually stirred up more concern/ anxiety than I previously had. I actually posted a question in the expert forum here about multi and uni focal and they also told me that multifocal are dangerous. At this point I just want to be sure what exactly mine are because it sounds like if they were mutifocal I may need to consider more drastic measures such as some of the more "heavy" meds. I have asked my cardio and EP to review my records again and I am going to work on trusting my own doctor and finally putting this to rest. Thanks for the reply!

[debbier]

I was never advised multifocal are handled any differently than unifocal in a healthy heart.  My EP advised ablation for multifocal is difficult.  If they are bothersome and you cant ignore them  maybe an EP study to verify where they originate might help.  Have you tried a beta blocker?  My pvc's were not ablatable.  I am now taking Atenolol.  

[jondsam]

From a Doctors post on here earlier he says "It doesn't matter if they are unifocal or multifocal PVCs--if you have a structurally normal heart, there is no need to worry about them.  I understand they make you feel uncomfortable, but it is not harmful. "

This may b why the others Doctors didnt worry about them.  In their minds your condition is benign and normal whether they are multi or unifocal.  Sometimes doctors dont give you all the information in order to keep you from freaking out.  What you dont know cant hurt you right?  Multi focal pvc's are a concern in patients with heart disease because they are a precursor for dangerous ventricular tachy arrhythmia's.  In your case you are healthy so it is not much of a concern.  However, I dunno maybe an ablation would help your situation out you know, maybe help you live a better life.

[rilesnic]

Could it be this dr. from the top hospital is younger than the others?  Maybe, she thinks they are worrisome b/c she has not seen as many cases as the others have.  Maybe the others see more of what you have and although each person is different, they can be almost completely certain yours are benign b/c their other patients are rocking along just fine.  Maybe the 4th doctor is just being very cautious.  People do get hired at places b/c of they are or who they know.... Maybe she didn't get hired just on her expertise, but who she is??? I don't know, just speculating as a  possibility.  I work in a top rated school district within a 200 mile radius, and I can tell you, not everyone who works there got hired based on their skills, but on who they are, or who they knew. Sad to say, but that's how our society works. I'm certainly not saying she is not a good doctor, I just think there are good doctors out there who don't work in top rated hospitals. I think if we continue to look for something wrong, we can definitely find it.  I would trust my doctors that have been taking care of me, and understand that although opinions vary, all in all, they all have one ultimate goal, to help their patients achieve a good quality of life.  They may not always have the best bed-side manner, or always seem to have sympathy for us, but overall they want to see us healthy.  Best to you!