EP study in relation to pvcs and such

[heartcare]

Hi and thank you for taking time out of your busy schedule!

I was placed in the hospital, July 5 due to my heart rate going up and down.  It would drop into the 30's and then 50's 90's, back and forth...I hope you get the idea : )  I was having Pvcs every two beats.  this lasted for 7 wonderful hours...  I was on toprol 50 mg to try to regulate this heart rate, but dropped to 25 due to my heart rate going so slow.  I have had one more episode lasting again for approximately 7 hours a week after I got out of the hospital.  My cardiologist is sending me to another cardiologist for and EP study.  However, he said that he could find nothing wrong with my heart except the PVCs and the heart rate going up and down could be related to the pvcs.  I have had as high as almost 10.000 per 24 hours, (caught on holter moniter)
He said I had an irritable spot in the bottom of my heart causing the pvcs..

So my  questions are could the pvcs have caused the heart rate to bounce back and forth?  and why?  Can the EP study (with possible ablation (sp??)) fix pvcs?  Can they get the wrong arrythmia going instead of the one they are trying for and you end up worse off than you were before??  I have read about the EP study and know that is risks to it such as MI and stroke and such, but could not find out if they could trigger the wrong arrythmia or not...or whether they could fix pvcs...  Thanks so very much for your time.

[arthur]

PAF due to PV foci is generally treatable by ablation at a success rate of about 60%.  Success goes down with the number and location of those PV foci.  I definitely recommend going to a EP/cardio center specializing in this technology.

[LaurieD]

I wanted to post because I FINALLY got to an EP doctor after ten months of suffering with paroxymal atrial fibrillation and PAC's in the thousands per day. The man seemed very smart, for once didn't blame it on stress, stomach, menstruation etc. He said these things are triggers NOT the cause. He feels the cause is the pulmonary vein. He said there are new procedures to ablate around this vein but they are very risky. He did a holter and an echo, will get the results on the 13th of August, and he may start me on some other meds than the tenormin that I'm on. He said regular ablation wouldn't help this problem. I hope this may help some of you online, I've seen where some posted that they've had ablation and it hasn't helped...maybe this is why. Will keep you all informed of any breaking news on this. Good luck to all my fellow sufferers out there my prayers are with you all.

[CCF-M.D.-CRC]

Dear Heart,

Premature ventricular contractions (PVCs) can cause the heart rate to vary.  They do this by "blocking the conduction of the normal heart beat.  Thus, if the normal heartrate is 80 and there is one PVC for every normal beat the rate may drop to 40.  If there are many PVCs in a minute the "heart rate" may be elevated.  I don't know if this is what was causing the variation in your heartrate but it is one possible explaination.  

The EP study is a specific test and it would be unusual to misdiagnose an arrhythmia during the test.  There may be more than one arrhythmia and then it is necessary to determine which one is the clinical arrhythmia or to treat both arrhythmias. There are risks involved with an EP study but in general they are small.  Your EP doctor can give you specific risks and percentages.  

PVC ablation is possible and may be beneficial in your case.  It is not generally an easy ablation and it is not done in all centers.  If your EP doctor does not perform PVC ablations I would suggest coming to the Cleveland Clinic for an evaluation.  You can make an appointment in the "EP clinic" by calling the number below.  Ask for an appointment with Dr. Schweikert or Dr. Saliba.  Best wishes.