I think it depends on where you are in life. I have a high count of PVC's/PAC's (I can not tell them apart) ~20,000 to 25,000 per day and a high Agatston score of 1243 so I went to see a cardiologist last year and again two weeks ago. He did an Echo-cardiogram both times and said: "The second one looks even better than the first" referring to an RV enlargement that they had seen. "Otherwise everything else does not look like it requires any intervention. So, go home, you do not have to come back". I did not mention that I am 81 years old and I have heard similar statements from other doctors.
Golly, ill try answer address posters here.
Isolated Pvcs don't typically evolve into vtach.
PATTERNS of pvcs can though.
Basically vtach is caused by scar tissue in the heart or some similar abnormality. Well at least this is mostly true, the truth of the full explanation is that there are alot of factors that can be implicated but the shorter explanation is the best.
Essentially, these abnormalities make electricity in the ventricles spin around in a circle instead of moving forward. It's like the electricity is on a racetrack instead of the autobahn.
When electricity is on the racetrack what you may see are instances of bigeminy trigeminy quadrigeminy etc. In these cases 2 normal beats are followed by a pvc.. Or 3 normals 1 pvc or 4 and 1 etc. This is because the pvc isnt actually coming from the ventricular muscle..rather it's just one of the prior "normal" beats completing 1 "lap" around the track.
Another pattern of such a racetrack would be couplets or triplets, meaning 2 or 3 pvc's that happen back to back. In this case what were seeing is simply electricity taking 2 laps around the track instead of just 1, as we see in cases such as bigeminy.
Individual pvc's, generally speaking, are generated in the ventricles. Many explanations exist for these as well, but whats important here is that the electricity is still traveling straight.
In vtach what we see is not a bunch of ventricular impulses, rather its actually only 1 impulse that got stuck on the racetrack and can't move on. Therefore isolated pvc's (the majority of cases) aren't of much concern.
In terms of the second poster, the pvc's on their own aren't necessarily concerning for vt. Your case however may be special, because blocked arteries create new racetracks, when heart muscle os deprived of oxygen tissue is damaged and when tissue is damaged scars form. A person can have 25000 or even just 10 pvcs per day, but when their arteries get blocked a racetrack forms around one of thise focal points and you suddenly develop vtach.
The situation isbfurther comolicated by a high burden of pvc's. If you have 25000 per day, and that's say.. 30% of your heartbeats what can happen is the heart may start workinging harder to make up for it. Harder working hearts = more oxygen demand = more tissue damage due to blockage = more scars
Sorry to jump in but I am really concerned l.Holter shows V-Run 5 beats (157 bpm) 12:46:29 & 6 beats (116 bpm) 12:46:43. Does it mean V-tach?