PVC confusion

[ray1958]

I am a bit confused. As a long time follower of the forum the common advice for suffers of irregular heartbeats, PVC's in particular was that in the absence of heart disease and with a normal cardiac workup ie.' ekg, echo , stress test etc that PVC's were benign as long as they did not occur in huge numbers. Also I understood that many times PVC ablation was difficult due to the location of the foci within the venticles and subsequent access to the area to be ablated. Now as of late your advice seems to be different. As I read your responses you now seem to say even with a normal cardiac workup irregular beats in the lower heart chambers. ie the venticles can be a problem???Well by definition the PVC's originate in the venticles; ( the lower heart chambers) therefore are you now implying they are dangerous???Also you seem to be recommend PVC ablation more frequently. Is the procedure now morw predictable and the results more consistent? Please clarify this apparent change in your recommendations and thinking on these issues. You docs have me baffled.  Thanks

[ray1958]

Tickertock  I guess we  were left hanging hope you have Merry Christmas

[tickertock]

So do I, until clarification, like I said before on another thread PVCs being the main complaint attracts business, just my opinion.

[ray1958]

If he meant that he should have said that.I wish he would have simply answered my questiohs.I get the feeling that ablations are being sold as a cure all.Fact is they are not in many cases.If the CC is changing protocol then they should give their reasoning and my question provided an opportunity to do so. I remain disappointed and confused.

[tickertock]

Unless the Doc meant that in cases of PVC induced cardiomyopathy or in severe symptomatic palpitations the benefits of a PVC ablation outweigh the risks the procedure then I can't think of anything else, as you know Cleveland Clinic is rated one the best if not the best regarding cardiac issues.

[ray1958]

That answer made zero sense.I get the feeling that the doc avoided answering the question.I feel it was a straight forward question and a rather lame attempt at anwsering it. I just lost some faith in this forum.

[tickertock]

If they occur in structurally normal hearts they are more likely to be successfully ablated as well, so we are more likely to pursue an aggressive approach, because the risks of the procedure are smaller.

I take this to mean that even if PVCs occur in structurally normal, a more aggressive approach like ablation is recommend beacuse the PVCs pose a higher risk to the patient than the procedure  "um" now I'm really getting confused or am I reading/understanding wrong.

[Cleveland Clinic]

We advocate PVCs if they occur in frequent numbers or they are associated with significant symptoms such as palpitations or cardiomyopathy. If they occur in structurally normal hearts they are more likely to be successfully ablated as well, so we are more likely to pursue an aggressive approach, because the risks of the procedure are smaller.

[joanincarolina]

Oh those PVCs! I believe that this sign needs to be checked out as a baseline and are in most cases a benign problem and can be simply ignored or require treatment. In my case I had them for 20 + years with later years treated with a beta blocker. Then a few years after that I noticed a change; more PVCs especially in 'runs' and couplets all caught on Holter and related 'sometimes' to exertion. Later investigation, even 2 heart caths,echos detected nothing related to PVCs only a few continued complaints from me and when I laid in bed, at night, they weren't worse, I just noticed them more.After developing chest pain, chest tightness, SOB and worsening PVCs I got my answer. The PVCs were a sign that my heart vessels were not getting enough oxygen due to small heart vessel dysfunction. I was started on a CCB and 24/7 nitro patch and the PVCs went away as did the chest pain and tightness and SOB! I can state that the PVCs were NOTHING compared to the chest pain, chest tightness and SOB with minimal exertion. My case will be much different from others of course, but this is an example of good doctors trying to find an answer in an escalating problem with underlying symptoms, PVCs being the most obvious in my initial work-up. Joan.

[tickertock]

Great question, I actually commented about the same thing a few posts back.