wow, you are very busy, high stress jobs. I think the twitchy heart comes with the territory. I'm the same way.
I elected not to go with BBs or CCBs.
I had a lot more PVCs than you. I was getting about 6,000 to 9,000 per day at the time. I'm also 100% Italian so I am genetically 4x higher risk for a disease called ARVD. Due to my race, and high PVC load, and strong family history they insisted that I get echos and we went one step further, a cardiac MRI. Also have strong family history for CAD, my father had a massive LAD MI when he was 42, somehow survived, ended up with a heart transplant. So i have everything working against me.
An experienced cardiologist probably already knows what they're going to find on an echo for you. That's probably why they aren't interested. If they have any clinical presentation indicating more tests, they will not hesitate. I would take that as good news.
My cardiac MRI confirmed findings on the echo. Cardiac MRI is nice too, because it can check for CAD really well, which they said at the time I was wide open, no restrictions in arterial blood flow. I had this done when I was my father's age when he had the MI, I was 42. strange how that lined up, perhaps it was in my head.
My suggested strategy for getting the echo, is to
-go to a new cardiology practice for a 2nd opinion
-Clinically it may not justify more tests, so then I would bring up risk factors instead. These are: stressful work life, family history, PVC load, any other risk factors you can think of such as lifestyle risk factors such as a high BMI, or smoker.
hope that helps