Frequent PVC's / Defibrillator question

[tlynn1205]

I am a 34yo female that has suffered from PVCs for years and have had numourous tests and the usual workups every year.

However my recent holter showed 46,000 PVCs which is a little more than previous but this time my echo showed my ejection fracton to be at 40%.  I have fatigue, dizzy and a few episodes of syncope.  My cardio is recommending an ep study for possible ICD.  My question is after my own research, why he recommends an ICD and not at leasting trying ablation.  He has not prescribed any medication due to slow heart rate and advised sometimes meds can cause more harm.
(???? I question why do they have these meds then)

Not sure what to expect.....the outcome or during the ep study.

[Jerry_NJ]

I am not going to try to defend the medical profession, but I know the litigation threat in the USA is very high and doctors are safer against malpractice suits if they have "done all the tests"  ---- needed or not.

I also understand PVC can be very troublesome and very difficult to stop.

You may get some help on PVC by making a post to the Hearet Rhythm community.  There are a couple of regular contributors there who have a lot of experience with PVC.

Best to avoid caffeine in all its forms..

[tlynn1205]

Disregard, all of a sudden I go from you need a defibrillator to your fine, its a miracle I was curred in 2 weeks.  Its really sad that doctors take advantage of PVC patients with lots of tests (ie-money) and in the end you get no results.  I know PVCs can be benign but when your ef is affected and have symptoms there has to be something that can be done but instead all I hear is your still young.  So I just have  wait before it gets worse, nice glimpse for my future.  

The conversation went from you need a defib., you have children that you need yo be here for,we have to do all these tests first because your insurance will not cover an ep without them, so he scared me half to dealth only to go in for a followup to be told your fine, mild cardiomyopathy caused by pregnancy (7 years ago) that for some reason hasnt gone away.....he said dont eat salt, wait eat more salt to raise your BP that should make you feel better.

So after countless out of pocket fees and god knows how much he charged my insurance company Im back to a 4.00 dollar bottle of magnesium and caffeine decrease to try and manage them myself.  

Once again lesson learned, frequent PVCs are just an outlet to bill insurance companies I am convinced.

[tlynn1205]

Resting heart rate can be as low as 38, do you think that has something to do with it?  Im so confused because he did not once mention ablation just possible ICD. I guess it will depend upon what happens during the ep study

[Jerry_NJ]

Okay, reading on I see you mention low heart rate, how low?  Is your resting HR below 40?

Sadly for some, many if not most blood pressure and anti-arrhythmic medications lower both the HR and BP.  For many of us, me, that is just what is needed.... my problem is a too high HR because of atrial fibrillation, and in my case old age...not your problem.

Uncomfortable as PVC can be (I don't feel the extra ventricle beats caused by my AFig) a heart stop is really bad news.  An ICD would provide protection against the heart just stopping.

I don't understand why your doctor hasn't recommended ablation, you will have to discuss that with him/her.