PVCs and ablation

[Malayabalaya]

Hi I was booked for an ablation today but after an ECG it was unable to go ahead because there were no ectopics whereas with the Holter monitor I had 22% ectopics. Has anyone else had this experience? Also the cardiologist is recommending Flecainide to try to deal with the ectopics as Bisoprolol hasn’t worked. Any experiences please? Many thanks 😊

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I'm sorry to hear your ablation couldn't go ahead - Please don't hesitate to contact the Arrhythmia Alliance for support & information should you ever need it: [e-mail] / 01789 867 501

[drooi]

I take Flecainide 125mg bd, and Bisoprolol 1.25 daily, which control my ectopics fairly well. Not really any side effects. My ectopics were difficult to control, and I find that combination the most useful.

[Malayabalaya in reply to drooi]

Hi there Thank you that’s useful to know 😊

[Jfelder]

I have on the order of 4,000-6,000 symptomatic PVC's/PACS a day (probably about a 1%-2% burden) . In addition I have a few very short runs of SVT per day...I am also an endurance athlete and maybe 2-4 times a year when I am out cycling my heart will go into SVT (to the tune of around 170-180 beats a minute) for a few hours. I will usually take a beta blocker and it will usually go back to normal rhythm...I cant take beta blockers regularly because it makes it impossible to work out. I am constantly terrified that my heart may go into SVT while out training. While I am told it is not life threatening but more a nuisance than anything it is still very unnerving...I have inquired about ablation for both. The doctor said given how infrequently my PVC's are (even if I was having one per minute) its hard to map the location exactly (for where they need to ablate) when they are that infrequent (of course they feel extremely frequent to me). The doctor also said when they have you under sedation it is very common for the PVC's to totally go away...So sometimes they have to lessen the sedation to arouse you so they can map them better. On the SVT side she said in only about 20%-30% of the instances they can actually get your heart to go into SVT even with drugs to stimulate while you are on the operating table. If they cant get your heart to go into SVT well they cant map the source and thus ablate. As you can see I live in purgatory ;)....Its either take beta blockers and not work out ever or risk ablation with zero results... Fun times!

[Malayabalaya in reply to Jfelder]

Hi Jfelder I feel for you as you seem to be between a rock and a hard place. On Wednesday I asked the cardiologist if there was a drug which could stimulate my ectopics so I could have the ablation and he said for me only a 20% chance of success in bringing them on but in a young athlete (you) there was a higher chance. May be worth checking out?? Thinking about drugs other than betablockers there are calcium channel blockers and then the antiarrythmics like flecainide to try to tackle ectopics. Do they all lower heart rate making endurance training hopeless?? Wonder if it’s worth a second opinion 🤷‍♂️