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PVCs to Nonsustained V-tach
Calibean posted:
I am female, 39 and was diagnosed with frequent PVC's last summer, at that time I had 8000 pvc's per day but the echo and cardiac stress test showed a functionally normal heart. I was asymptomatic and therefore had no treatment. Several months ago, I had a run of PVC's that went on 15-20 minutes and I became lightheaded and short of breath. I went to the ER and my Magnesium was slightly low so was given Mag. Followed up with the cardiologist and was given a Beta Blocker (Atenolol). I ultimately stopped the atenolol because it was dropping my pulse into the 40's and making me feel like I was going to pass out. I am now feeling symptomatic all the time and requested to wear a cardiac monitor. The second cardiac monitor (10 months after the first) showed 11,000 pvc's (many runs of bi, tri geminy) over 2000 couplets, 9 triplets, a 5 beat run of vtach and a 15 beat run of vtach). Initial cardiologist seemed very concerned, referred me to an electrophysiologist. Insurance didn't cover the person he referred me to so I had to go elsewhere, 2nd cardiologist didn't see a huge issue, wants to put me on a calcium channel blocker. I am concerned about the huge change in the 2 monitors especially because the stress test confirmed that when I raise my heart rate I start having short runs of unsustained vtach. I scheduled an electophysiology study and possible ablation, but my husband is very concerned that it is the right thing to do and feels that it is too risky. Nobody can really say if these short runs of V-tach (up tp 250 beats/min) are an indicator of future sudden cardiac death. Perhaps if I continued on without any intervention they will just go away? I am confused because one cardiologist was very concerned by the changes where the other was not. I feel like maybe I should see a third? Any comments/suggestions would be appreciated.
cardiostarusa1 responded:

The most common type of palpitations, premature ventricular contractions (PVCs, occurs even in many heart-healthy individuals), has various causes or triggers, cardiac and non-cardiac in origin.

As reported, PVCs are typically harmless (benign), be it isolated (single), couplets (2-in-row), triplets (3-in-a-row) or salvos (short bursts of 3 or more in-a-row), bigeminy (occurring every other beat), trigeminy (occurring every third beat), quadrigeminy (occurring every fourth beat), etc., etc.

However, the main problem or concern (even more so, much more emphasized for those with certain major or serious heart conditions) with PVCs is if/when sustained ventricular tachycardia (runs of PVCs over 30 seconds) occurs.

Non-sustained ventricular tachycardia (runs of PVCs under 30 seconds, but typically not salvos) may/can become serious as well if it occurs frequently (episodes are grouped closely/tightly together).

PVCs may/can occur with/in the presence of bradycardia (heart rate under 60 BPM), tachycardia (heart rate over 100 BPM).

Symptoms that may/can occur wih PVCs includes chest pain/discomfort/pressure/tightness, difficulty breathing, lightheadedness/dizziness, and in uncommon to rare cases, near-syncope or syncope (temporary loss of consciousness, includes fainting and passing out).

Additionally, of the different types of heart conditions, various symptoms may/can be acute (occurring suddenly), be chronic (occurring over a long period of time), come and go (be transient, fleeting or episodic), or even be silent.

ALWAYS be proactive in your health care and treatment. Most important, communicate/interact well with your doctors.

Best of luck down the road of life. Live long and prosper.

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calyreay responded:
This is exactly what I had two years ago. I had the same course of treatment and shared your concerns. I saw and EP and had an ablation in March 2010. The ablation took 8 hours, as my "hotspot" was buried deep in the lower left side of my heart, but most take a few hours.
I am without symptoms and living a very active and fulfilling life.
The ablation has made a huge difference in my life - and I am not on any medication.
Best to you....
Sandyyyy replied to calyreay's response:
Your story has such a positive ending, very happy for you! I am experiencing all the same problems as you and the previous writer did. I was wondering where you had the ablation procedure done? Ablation is what I will choose also. Thank you!
Sandyyyy responded:
I was wondering if you had taken any other action on your heart problems since this post. I am experiencing the exact same symptoms as you, had all the tests, etc. The ablation procedure sounds like the most workable solution for me. Did you have it after all?
Calibean replied to Sandyyyy's response:
I did have the ablation. In the end there were three areas that were ablated and one was frozen due to its proximity to the hearts normal conduction pathway. I no longer have any PVCs and have been able to return to full physical activity. I ran two half marathons last year with no problems. I had my procedure done at Bethesda Naval Hospital (my husband is active duty military). I am so happy that I did it, I hated the effects of the medicine. Good luck!
Calibean replied to Sandyyyy's response:
I did have the procedure, I was at about 19,000 PVCs in a 24 hour period. I had it done at Bethesda Naval Hospital. They had to ablate 3 areas and freeze a 4th, but I no longer have PVCs or the symptoms I was having with them. I ran two half marathons in the last year without any problems.

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