Multifocual PVC's

[CareBear59]

Oh! I hope you can clear this up for me! Someone told me that multifocal PVC's were more harmful than regular or unifocal PVC's.  I have been to a cardiologist and he never mentioned which kind I had on my holter monitor.  Now I'm all paranoid again about these annoying things.!!  Can you help!  How would any of us really know what kind we have unless we all went to the cardiologist for skipped beats and not everybody does!!
Happy Holidays to you all!

[John Kenyon, EMT/MST]

According the studies of patients in ICU/CCU/telemetry units, multifocal PVCs are no longer the focus of concern that they once were. This is partly due to the statistical finding that they don't lead to dangerous arrhythmias any more often than unifocal or isolated PVCs, or none at all. In fact, it's been determined that the correct term to use should be "polymorphic" PVCs instead, since we now know that PVCs from a single site can have varied morphologies, depending on numerous factors, and the origin is not necessarily traceable by the shape of the premature beat on EKG. Just as R-on-T PVCs (early ones) were once much-dreaded, it's been found in the same sorts of studies,
that PVCs occurring early in the cycle are no more contributory to dangerous arrhythmias than late-ocurring ones, or none at all. Fully 50% of ICU/telemetry patients in studies had no dangerous arrythmias associated with polymorphic or R-on-T PVCs, while 50% of those who did have dangerous arrhythmias had only isolated or no PVCs at all. And of course, in an otherwise healthy heart the issue is moot, since PVCs have little to no diagnostic significance outside heart disease, and even then almost always only when the left ventricular function is severely compromised. Hope this helps clear up some concerns.

John

[Cleveland Clinic, MD]

It depends, but in general multifocal PVCs are not more dangerous and they can be identified on the Holter.

[marie]

Are Multifocal PVC's more dangerous that Unifocal?? ( Is that the name for it?).  Can a cardiologist tell from a Holter Monitor if they are Multifocal??

Thanks

Marie

[Cleveland Clinic, MD]

If it had been dangerous your cardiologist most certainly would have picked it up and notified you.  If you are still concerned you could call his office and have a copy of the test sent to you.