Should I Be Concerned?

[blessd4lif]

I have a history of PVCs and I understand that they are common and benign.  I think the most I've ever had is about 10K in a 24 hour period.  I've tried several antiarrhythmic drugs before deciding to go another route after my cardiologist explained the risks to me (I was in my mid-40s at the time).  Aside from the risks, the drugs never worked for very long - my body adjusted to them very quickly.  I've had 2 unsuccessful ablation attempts in which the doctor wasn't able to locate the source of the issues.  After the last one several years ago, I decided to learn to live with them.  

Three years ago I was hospitalized for a suspected stroke and at the time, they discovered by my heart rate was very low.  In doing the workup at that time, I had every test you could possibly think of on my heart and they found that it was structurally sound.  Fast forward to today.  I went to see my primary about a month ago and she was concerned because she heard a pause and my heart rate was log again so she decided to do an EKG. As usual the PVCs showed but and she wanted me to see my regular cardiologist.  To be honest, I forgot to make the appointment.  I know that I have PVCs and that they are benign so I work really hard to ignore them, and when I can't, to grit my teeth and get through them.

Anyway, after a particularly bad dizzy spell, I remembered that I was supposed to see the doctor.  My cardiologist does the standard holter monitor.  I went back today for the results and was surprised to hear that I am having bigeminies, trigeminies, quadrigeminies, v-tacks (sp.?) and episodes of repeated PVCs.  My doctor said that they recorded 14K incidents which is more than what I had the last time I did the holder monitor a few of years ago.

Since I try so to hard to ignore these and my cardiologist told me I was sound, I was a bit unnerved that she is sending me back to the arrhythmia doctor and suggesting that I may have to try the meds again.  She told me something has moved to a moderate category now.  

If PVCs are always benign, why do I need to do anything about them?  What is a v-tack?  How do PVCs relate to my dizziness?  She specifically said that my dizzy incidents are most likely related to the PVCs.

[aabmtreasures]

Just wanted to ask how things went for you Wednesday? Iam suffering from pvcs as well

[blessd4lif]

Thanks for the suggestions.  It sounds like I actually am going to have to address the PVCs.  I think my reluctance comes from doctors acting like I'm over reacting or a hypochondriac.  

In any case, I have 2 beautiful grandchildren that I want to see grow up and I want to be active with them so I'm going to suck it up and see the doctor again. Hopefully I'll get some good options on Wednesday..  

[researcher09]

Since your PVCs have progressed to VTach and you have fainting spells, it is no longer benign.  Catheters for mapping PVCs and VT have come a long ways in the last few years so you may want to talk to your EP about giving it another try.  VT ablation requires the highest skills compared to other ablations we talk about here so you want to make sure that the EP you choose has done a lot of them and that he still do them frequently.  Centers that don't have the ablation expertize will offer ICD implant as an alternative but that really should be the last resort although you can still get an ablation after an implant.

[MichelleP_3811]

14K is a pretty high load of pvcs.  The threshold where doctors get concerned is generally 20K but others will attempt to ablate at lower numbers but as you experienced it can end up with nothing accomplished because they need to be active for the doctor to know where to ablate.  It is possible that now that you are having patterns of them that they may be able to successfully ablate this time.  VT is dangerous if it sustains.  It if only lasts a few beats or seconds then it may not be a concern to an EP.  It is when it get stuck in a reentry situation that it becomes most concerning but I do think it worth talking to an EP about it.  I can understand your hesitation about the meds since anti-arrhythmic meds do have risks but once you start venturing into the high load area then it can start to have adverse effects on your heart.  They say in general svt as well as ectopic beats in an otherwise healthy heart are benign conditions yet if a person was to have many episodes of svt a week and ones that start to last long then the wear and tear on the heart can cause it to fail sooner than normal. The same can be said for pvcs so if I were you I would consider trying another ablation since you do seem to be more active than you were for the last 2 unsuccessful tries.  Maybe the third time will be the charm.  Best of luck and I hope you can get this resolved.  

[caregiver222]

Those complications are common after an ablation, which should be a last-resort procedure. In fairness to the physicians this does not necessarily mean they were incompetent. An ablation destroys electrical pathways. They may suggest a pacemaker, which is not the end of the world.  "V" tach is an extraordinarily high heartrate. The rapid rate will not allow the heart to properly fill and refill so there is sometimes insufficient circulation of blood cells containing oxygen.