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

[CCF-M.D.-RCJ]

This is a great quote, partially because it helps demonstrate a point about how statistics can be misleading.

The quote that you provided is:
" In fact more cases of sudden death occur in people who do not have frequent PVCs".

Similar, and also true points, are the following:
"more people who do not drive drunk die in car accidents than the drunks"
or
"more people who are healthy die of sudden cardiac death".

These statements both sound shocking, but the reason is pure strength of numbers.

There are just so many more non-DUI drivers that they die more frequently in car accidents on an absolute basis.  If there are 100 million drivers in the US, and only 100,000 DUI drivers, then even if the drunks are 10 times more likely to die in a car, there still will be many fewer drunks dying in accidents.

Make sense?

[Kristin391]

I am very confused about this whole notion of PVCs.  I have always understood and MDs have confirmed that PVCs in the absence of ischemia, cardiomyopathy etc. or symptoms are harmless.  I have had many PVCs for many years and have learned to ignore them. When my cardiologist listens to my heart, he always asks me if I can feel them because they are so prominent.  I can feel them but I refuse to give them much consideration. It is amazing to me that anyone would consider an ablation for something that is fairly benign. I really don't think I am such a tough person. It is just a fact of my life.

[nurse12hr]

What a great group of people here--pts. and Doc alike.

Hope the sniping at multiple posters ceases.  If you are persistent and try at the right times (between 8a-10a EST) you will get through eventually.  If you have an emergency, you should be calling your own doc, anyway.  This forum is for information, and we can all glean something from almost every post, no matter what the topic.

[pvcgurl]

Hi all. This is my very first time here.  I suffer with PVC's.  I get them alot.  Sometimes 3 in a row.  I have had an echo on my heart and they said it is normal and healthy.  I know very little about PVC's and why people get them.  I hate them.. I can feel everyone one and it sends me into a Panic.  I get them atleast every 15 minutes.  Usually one but sometimes more.  Does anyone else get them that frequently?  Or can anyone else feel them really strong like me.  It feels like my heart stops and then kick starts again.  I am scared that I am going to have a heart attack or something.  I was reading about the ablation.  What is that?  I would love to hear from anyone who is going throught the same thing as me.  You can also email me at ***@****

[CCF-M.D.-RCJ]

Please feel free to ask as many questions within a given post as you like (within reason -- I'm only human and do have to see patients on occasion).  It would be polite to other readers if a person grouped all of their questions within one post, as Hank so deftly did here today.

This site only accepts 2 posts from forum participants per day, but each of the 2 posts can contain a significant amount of text, certainly able to accomodate at least 4-5 questions.  So if you have multiple questions, place them all within your one post so that another person can also place a post.  Again, if you need a guide, check out what Hank did today.

As an aside, I've personally emailed Dotty to invite her back.  She was lambasted, somewhat rudely, because she placed 2 posts in one day (not 2 questions, but 2 posts).  We have corresponded, and I hope to see her name back on this forum soon.

[bigmick]

I will also be most interested to read the Doc's response to Hankstar's well-put (as always) questions. Keep up the good work HS.

BM