Criteria for PVC ablation.

[hankstar]

Thanks for taking my questions once again.

   What would be the criteria for recommending a PVC ablation? How many PVCs would one have to show in a 24 hour period for ablation to be recommended or does it depends on symptoms regardless of frequency?
    Once signing off on an  ablation for PVCs would a doctor be willing to perform such an ablation , even if it is not recommended and you are giving permission regardless of the outcome or does a responsible doctor ignore the patients plea and avoid a potential adverse reaction to the procedure?
     It is my understanding that even though one focus is responsible for about 60-80-% of all PVCs. Most person have mutifocal PVCs that occur from time to time. Is this true and the reason for most EP doctors not recommending ablation for PVCs?

    Would you agree that it is more abnormal not to demonstrate PVCs on a holter monitor for 24-48 hours, than to at least demonstrate a few.
    I also understand that sudden death is more likely to occur in person that hardly have any PVCs than in those that have them occasionally, have you seen any evidence to support this?

    i also understand that even though sometimes V-fib can be induced in a EP study in a normal heart, in these cases a ICD is rarely recommended or implanted, because of the very low risks of it occuring otherwise, Is this true?

    Thanks for taking so many questions, but I hate to see the  days when no questions are posted.

Thanks again.
        Hank.

  P.S. Do you think that the success stories of PVCs ablations in these far off land is true

[regan]

Hi Hank. You wrote that the atenolol you take might aggrevate the pvc's in the future. Can you elaborate on this for me. I just started taking this to minimize my pvc's. I really don't want to take it if it can make them worse. Please explain this to me. Thank you - April

[2monkeys]

HELLO I JUST STUMBLED ACROSS THIS FORUM AND WAS READING AND WAS SO IMPRESS WITH HANKSTARS ANSWERS THAT I JUST HAD TO WRITE. SO PLEASE EXCUSE ME BUTTING IN AND ASKING SOME QUESTIONS THAT MAY NOT BE PART OF YOU ALL'S DISCUSION. I HAVE ALWAYS BEEN SUCH AN ACTIVE PERSON IT ALL CAME TO A HUGE HAULT 10/13/03 WHEN I WENT TO ER THINKING I WAS HAVING HEART ATTACK EVER SINCE I HAVE BEEN SEARCHING AND TRING TO REMEMBER THE PERSON I USED TO BE.  I HAVE HAD EKG'S ABNORMAL BUT NORMAL WHAT DOES THAT MEAN?  BLOOD WORK LOOKS GREAT, ECHO LOOKS GREAT, TREDMILL LOOKS GREAT.  NOW I AM ON ZOLOFT THEY THINK IT IS STRESS RELATED, BUT I HAVE LIVED WITH WORSE STRESS THAN IN THIS MOMENT OF MY LIFE SO WHY NOW DO I HAVE THIS ATTACKS- MY HEART JUMPS!! IT RACES AND BOUNDS OUT OF CHEST SO FOR THE FIRST 2WEEKS I WAS GREAT ON MEDS THEN WAM!!! IT CAME BACK EACH TIME IT HAPPENS IT LASTS 5TO 10MIN. SCARES ME TO DEATH, MY QUESTION THEN IS DID ALLTHESE TEST MISS SOMETHING OR AM I HAVING THE WRONG TESTS DONE.  I LOOK AT MY CHILDRENS FACES AND WORRY I WONT BE THERE FOR THEM-IF YOU HAVE AND ANSWERS FOR ME I THANK YOU!! AND AGAIN I AM SORRY FOR JUMPING IN. WENDY

[2monkeys]

HELLO JUST WANTED AGAIN TO THANK HANK FOR WELL...EVERYTHING IT SOUNDS LIKE NOT ONLY FOR ME BUT FOR ALOT OF PEOPLE YOU ARE A SOURCE OF COMFORT. THANKS AGAIN AND BEST WISHES FOR YOU AS WELL!!!WENDY

[Momto3]

Hi Fred,

I hope you are able to post your question today. As you may remember, I have had 2 pvc ablations.  A few days ahead of the 2nd ablation, my pvc frequency dropped wayyyy down.  A mixed bag of emotions for sure...good that they dropped, bad that the ablation could be postponed.  I was concerned that I would not be having enough ectopic activity for the doctor to map the problem area.  I let her know what was going on and she checked with the "ablator". Their response: "As long as you are having some, we will be OK".  Don't know about the scientific theory behind this, but we also decided a little chocolate the night before could be "helpful".  I hope you are able to find some relief for your pvcs.  Are you in the Cleveland area?
connie

[Momto3]

WELCOME BACK!  I am so glad to see you have decided to post again!  Just wasn't the same without you!  Happy Valentines Day to a gal with a BIG heart!!  connie

[arthur]

The purring sensation...

When in afib, that sensation is the feeling you get from the atria fluttering away at a very high rate.  The ventricles only pick up some of the signals, so you get an irregular heart beat.  That's classic afib.  However, if you have a perfectly normal beat, and you still feel a purring sensation (at the center of your chest and deep), then you may have a pulmonary vein focus (located to the rear of the heart) which represents a small area of actively-firing cardiac muscle/electrical cells.  At times, this focus will affect your normal pacing, and at time it may not get its abberant signals through.  It's unusual to feel the focus, most people just feel the fluttering atria.  In may case, even after an rf ablation to remove one of the offending foci, there's still at least one left that's active enough to occassionally present itself as a purring sensation...disturbing but not dangerous.  Talk it over with you cardio or EP.

-Arthur