pvcs

[scooter01]

I was wondering why some people have an ablation for pvcs while others do not?

[ireneo]

Partly depends on how symptomatic a person may be. I have PVC's and PAC's all day long with a thump, thump here and a thump, thump there. But I'm so used to them it doesn't matter any more. Other folks get tens of thousands every day so that it's hard to concentrate, can't get any sleep and so on. It's a quality of life issue.

[sueinns]

If your PVC's are multifocal (more than one spot) they can be harder to treat wtih ablation and may require more than one procedure.  Since mine are, I have opted to live with them.  They only really bother me when I work out because I can't push myself like I used to be able to.  If it was really affecting my quality of life in other ways, I would most certainly consider the procedure.

[artskip]

I have a very high number of PVC's everyday. I've been to two EP's and both said the procedure is risky and they can't guarantee it will eliminate them. They also said if I happen to be having a quite PVC day, they may not be able to induce them for the ablation.  Right now untill something more solid is offered to me or I develope a life threatening problem I will just live with them.

[upbeat633]

I am of the same opinion as Artskip. I've had several very good doctors whose advice was the same: ablation is not intended for pvcs, and it can have serious complications including stroke while pvcs are benign. Additionally, ablation for pvcs is not curative, a person can still have pvcs and or develop a rhythm that is more dangerous.

For me, it IS a quality of life issue. I have tens of thousands of pvcs per day. When it gets really bad, it is like having someone turn the lights on and off over 20 times per minute. It's hard to concentrate. It's hard to believe the "house" is structurally normal when the electricity is going berserk. Beta-blockers can act like a dimmer switch, but it hasn't changed the issue much for me.

An E.P I recently saw said he would absolutely NOT do an abalation for pvcs, even while I have approximately 30,000 pvcs/day. So it is my understanding that it isn't a matter of number, not even a matter of quality, it is a matter of whether the doctor/patient believes the risk is acceptable. In my case, a specialist has deemed the risk to great for a benign condition, I have to give a lot of weight to that opinion.

[Momto3]

I had two ablations for PVC's because I developed PVC-induced cardiomyopathy.  At the time, the condition was rarely reported and didn't really have a name.  However my doctor's research pointed to the possibility that I had developed CM as a direct result of frequent and persistent PVCs. Because I have mitral regurgitation and my heart was not pumping efficiently, the doctor wanted to treat the PVCs aggressively.

Up until the CM, I had a structurally normal heart and after 25 years of dealing with PVCs, I had pretty much learned to live with them.  Once I developed CM, all bets were off and the benefit of an ablation outweighed the risk of the procedures.  Had I not developed CM, I'd still be flip-flopping away.  

[sueinns]

This is an interesting question and shows how different each individual is.  There is no cut and dry answer.   When I saw the EP specialist for my SVT, he also talked about PVC's.  He told me that there was an 80% chance that it would work if I had them in one spot but they wouldn't know whether I was multi-focal or not until they did an EP study.  Multifocal PVC's are very difficult because you need to be symptomatic during the procedure.  Unlike SVT, PVC's are not always easy to produce with medication.  And, of course, their location is crucial to the success of the procedure and no doctor wants to mess around with the AV node.

Personally, even though I have lots every day,  I don't feel I am symptomatic enough to want to take the risk of a procedure that, in all likelihood, will not work (I am multi-focal).  However, I gotta say that if I was really suffering, or developed CM as Momto3 did, I would probably go for it.  

[upbeat633]

Yes, momto3's situation is a little different than most of us. The pvc-induced cardiomyopathy is a reason to have ablation.

She was also fortunate to have good health care providers in the sense that her doctors monitored her situation, rare as it might be to develop CM from PVCs--it happened.

So a periodic echocardiogram when you have high frequency is very important. Keep in mind that 30/pvcs per hour is considered high frequency. What would most of us give for that eh? 30 an hour, heaven. Weren't you having over 1000/hr Connie?

But you still have a few hundred pvcs now and then don't you?even with the two ablations.

[Momto3]

Like all of your doctors, my doctor was NOT at all interested in trying to ablate for PVCs.  I was multi-focal,  and they were considered benign, a nuisance.  When the CM showed up, the benefits of an ablation outweighed the risks of a further reduction in my EF.  My choices were anti-arrythmics or ablation(s).  When I realized I would be on anti-arrythmics for the rest of my life, I decided to go for the ablation.

Yep, about 1000/hour was "normal" for me.  Now, I can go days/weeks....many a month or longer without any ectopics.  I don't know how many I get now, but if I have a "spell" of them it generally last under 5 minutes and it's very rare.  I just had an echo and bubble study done and at some point during the procedure, I started to feel some PVCs.  Two seconds later, the doctor said, "she's having PVCs".  I kinda chuckled and they disappeared as quickly as they came.

I think I would run pretty fast from any cardio who was eager to ablate for PVCs.  I've seen a number of cardios (different cities, different reasons) over the years and although they knew about the frequent PVCs, they were all clearly against anti-arrythmics and ablation to treat benign PVCs.  

I absolutely agree when Upbeat suggests periodic echocardiograms in the case of someone with frequent PVCs.

Enjoy the day everyone!

[lol7]

I had an ablation for PVC's last year because I was symptomatic with them. I suffered from continual dizziness, pre-syncope and syncope. According to my cardiologist this was because my heart was not pumping a sufficient amount oxygenated blood. I was having in the region of 20,000 PVC's per day, and when they occurred it was in a bigeminal pattern (every second beat).

The ablation was a complete success and I have not experienced dizziness since. On my last holter monitor my PVC reading was 1 in 24 hours! On a recent follow - up visit I was told that I am now too healthy to be seeing a cardiologist! Here's to PVC FREE!

[Momto3]

Hi lol7!!!

So happy to hear you are still PVC-free.  I'm PVC-less, but not quite free....Works for me!!  Hope you're having a great day!!!

[scooter01]

Thanks to everyone for your comments.I have pvcs for 6 or 7 years now meds worked for a while but seem to be wearing off. I had to have a pacemaker installed back in December.These pvcs are just hard to deal with.