I have been suffering painful pvc/pac since 5/01. Taking toprol xl 25mg a/day to alliviate PVC/PAC. I have app. w/Dr. Wilkoff @ Clev. for opinion. I'm 37-f/145 pounds-no smoke-no drink-no caffeine. Used run 6 miles a day, stopped cause afraid of pvcs. Here studies done- your opinion very appreciated.
6/01 Bruce protocol: achieved 10 mets, 95% age predicted heart rate-27,700 double product-no dyspnea-no chest pain. Occasional pvc seen. 1/2 - 1mm upsloping st depression was noted in the inferolateral lead at peak exercise w/resolution w/in 1 minute of recovery.
Echo 9/01 - The doppler study shows a trace of mitral, pulmonic and tricuspid insufficiency (regurgitation) - w/ normal velocity - all other values w/in normal ranges.
Holter Monitor 12/01
103395 tot beats noted: 12% were ventricular ectopic beats.
St activity: Max st depression of 2.4 mm in Channel A - no significant St changes in Channel B - Superventricular activity: 15 psv noted - no episode of irregular sv > 80 were noted. No sv tach > 150 noted - Bradycardic activity: 2 episode of sudden rate decrease from 96 bpm to 64 - no pause > 2.5 seconds noted - no episode of marked sinus bradycardia < 40 bpm noted - Ventricular Activity: 117 pvc noted at max rate of 9 measured over 10 minutes interval - 8 different ventricular ectopic forms were noted, mostly occuring form accounted for 68.21% of ventricular ectopic beasts noted. 2 ventricular couplets were noted.
01/15/02 Stress Echo Test - result not obtained yet.
02/14/02 Scheduled for Cardiolite stress test.
Dr. Wilkoff will be able to give you a much better overall opinion once all the test results are in and when he can see the actual tests but here is a brief overview. Both the stress test and echo are essentially normal. They noted some ST changes during the stress test and this is probably the reason for the additional testing. I suspect these will also be normal.
The Holter test reveals a large number of PVCs. The fact that there are 8 different morphologies decreases the chance of a completely successful ablation procedure. However, ablation may significantly decrease the number of PVCs. The other alternative would be medications, either antiarrhythmics or beta-blockers. Your discussion with Dr. Wilkoff should focus on the benefits and risks of ablation vs. medication and if you decide on medication which medicine would be best for you.
HI Hank, where in tests that I have done you see multifocal? Can't see that word spelled out in any of the report? what does multifocal means? is the interpretation of something else? curious about it. thanks, paola
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