Pre Ventricular Contractions Diagnosis

[Marga53]

Hi everyone! I am new here and this is my first post/question. I was recently diagnosed with PVCs by a cardiologist. He prescribed Metoprolol but my heart beats were still 18.9% PVCs, so he recommended me to an Electrophysiolgist for ablation consideration. Now reading posts here I see that people are on medications for irregular heart beats. My doctor did not offer any other medication options - just referred me to the specialist. I'm afraid that the specialist will focus mostly on doing the ablation, rather than other options. Has anyone seen an electrophysiologist and are they the one to discuss all treatment options? Or should my cardiologist have covered this? Thanks!

[Hidden]

With the caveat that I’m not medically qualified. PVCs, and their atrial counterparts PACs, are generally considered benign and not in need of major intervention with the exception of two specific circumstances. The first is where you have runs of three or more PVCs without a normal beat in between, as this can lead to ventricular arrhythmia, which can be very serious if it becomes sustained. The second is where the burden, meaning the total number of PVCs/PACs experienced in a day, is more than 10% of all heartbeats. At 18.9%, you would fall into the latter category, which is why they’re immediately recommending ablation to deal with the issue rather than just giving you medication that you’ve already tried and isn’t doing the job: the only two medical options that currently exist for dealing with ectopics are meds (usually a beta blocker, or if betas can’t be tolerated, a calcium channel inhibitor) or ablation. Meds alter heart rate and block adrenaline, impacting on frequency of ectopics that way, but only significantly if they’re adrenaline mediated. Ablation destroys the electrical pathways causing the PVCs, preventing them from happening. Lifestyle changes can also be helpful for some people, but they don’t work for everyone, and at the point that you’re having 12 thousand plus PVCs a day, I suspect they’re unlikely to make that much difference. I got my mix of PVCs and PACs down from several hundred a day to around a dozen using a combination of lifestyle changes and meds, but what you would need to achieve to avoid an ablation is more akin to a miracle than cutting out certain foods and substances, and getting enough sleep, is likely to achieve. That’s not to say it’s not worth having a go, as it may reduce them, but I doubt it’ll get you down anywhere near enough under the circumstances.

[Marga53 in reply to Hidden]

Very insightful! Thank you. This is my first medical issue and so I'm not used to dealing with doctors or medicines!

[Hidden in reply to Marga53]

You’re welcome. Hopefully this will be your one and only issue - unfortunately, I’ve got a little too much practice with medics for my own good! Don’t be afraid to ask questions here, and there are a fair few people that have had ablations that frequent the board, although more for arrhythmias triggered by PVCs rather than purely high levels of PVCs. There are at least two or three others I’ve seen post that have had it done for that reason, though, so hopefully one of them will see your post and say hello.

[Marga53 in reply to Hidden]

Thanks again!