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Ablation for chronic PVCs. Worth the risk?
I've been dealing with the darn PVCs on a daily basis for 8 months now. It seems like they are becoming more frequent. I'm taking potassium and angstrom mg for 2-3 weeks with no improvement. Every time I have an active or stressful day I am punished at night with a string of PVCs that can last for hours. They appear to be adrenaline related. It has made my life miserable.
My EP gave me a special script for an EKG for when I got a bad episode, so last night I went to the ER and they hooked me up. They saw PVCs coming every few seconds, and the technician said they all looked identical, so it appears that they are unifocal.
I'm not sure what to do here. I don't have PVCs ALL day, but I do get them EVERY day. Some days are manageable, other days are very frustating. I am living right now for the moments when I am PVC free. Not a good way to live your life.
So my question to all you fellow sufferers is, is the ablation worth the possible risks? And what are they?
Thanks for your responses.
My EP gave me a special script for an EKG for when I got a bad episode, so last night I went to the ER and they hooked me up. They saw PVCs coming every few seconds, and the technician said they all looked identical, so it appears that they are unifocal.
I'm not sure what to do here. I don't have PVCs ALL day, but I do get them EVERY day. Some days are manageable, other days are very frustating. I am living right now for the moments when I am PVC free. Not a good way to live your life.
So my question to all you fellow sufferers is, is the ablation worth the possible risks? And what are they?
Thanks for your responses.
Best Answer
I would say it wouldnt hurt to talk to an experienced ep doctor about an ablation. You can always go in for a ep study just to see what they find,and to see if it would be beneficial to have an ablation. I just had a cryoablation 3 weeks ago for atrial tach & afib. So far..so good, no episodes. Only the occasional skipped beat. For the week after I had alot of skipped beats,but have subsided. I looked at it this way I was so sick of my life pretty much being run by my heart issues that I decided to just do it,and take the chance.If your doctor says they can be fixed ,then why not!!
You are facing the dilemma that many of us are in ...to deal with the PVC's or destroy heart cells and hope that works or doesn't cause additional problems. Neither my PC or Cardiologist think I have really reached the point to ablate. I relish the PVC-free time that I have. Therefore, I am choosing to deal with what I know and not take that chance with ablation. Are you continuing with the Potassium and Magnesium and since they don't seem to work why continue to take them? I am on 200mg BB (metoprolol) and 5mg CCB (Norvasc) which seems help reduce them to a tolerable level ( on and off for 2-4 hours/day).
As far as the meds, you said yourself that BB's didn't really help with PVCs so I didn't think it was worth it. My EP thinks that an ablation is a last resort for PVCs but will do it since I have visited him several times with the same issue. He said that he wasn't sure if it would help.
So I am still at square one, confused.
So I am still at square one, confused.
Given the current American diet, I'd say that sooner or later, the vast majority of us will be on a beta blocker and a statin. My primary care physician had me stay on a smaller dose of Metoprolol, the beta blocker I was on prior to my ablation as a prophylaxis, saying that if well tolerated (and it is), it keeps the BP low, and to some degee helps in the event of a heart attack. I don't know if there's been any studies regarding very long term use of a beta blocker, but I regard it as I do my daily dose of vitamins, and it's included with them in the handful I take each morning. I've been on it for about 6 years now. I experience no serious side effects other than the lag in getting my heart up to speed during physical activities. I am curious to hear about your aversion to drug therapy.
Keep in mind that when discussing ablation vs. drug therapy, my cardiologist came right out and told me that he and others felt that experimenting with different antiarrhythmic drugs, beta and channel blockers carried a much higher risk than the EP and ablation procedure. So, I think that eliminating the root of the problem is better than masking it with drugs ....... in most cases. The thing is, is yours one of those cases where ablation results in a better quality of life afterwards? Of course, this is something you and your physician need to discuss.
Keep in mind that when discussing ablation vs. drug therapy, my cardiologist came right out and told me that he and others felt that experimenting with different antiarrhythmic drugs, beta and channel blockers carried a much higher risk than the EP and ablation procedure. So, I think that eliminating the root of the problem is better than masking it with drugs ....... in most cases. The thing is, is yours one of those cases where ablation results in a better quality of life afterwards? Of course, this is something you and your physician need to discuss.
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I went in for a broken foot in June 2009 and my primary heard pvc's and what he thought was valve damage. He sent me to a cardiologist who did an ekg, echo, holter and stress test. Tests showed nothing was wrong structurally; just minor things that didn't add up to anything. (stress test had red flags)
The first EP I saw who was head of the largest heart hospital here said if I didn't have an ablation to try and get rid of the pvc's I could develop cardiomyopathy but he was positive the ablation would get rid of my problem.
I didn't quite believe him and went in for other opinions; the other drs said it wasn't as severe as the first EP said and tried me on Toprol - big mistake; it sent me to the ER in distress and they gave me a shot to try to counter act the med - after 11 hours my BP wouldn't go above 70/40 and my hr 40 so I told them to let me go since they didn't find anything other than pvc's. (red flag) the EKG showed I had multifocal pvc's and cardiomegaly (heart enlargement) another red flag
I went in to have a tilt table test before my ablation and when they gave me Nitro, my heart stopped they told me that was "rare" to have that happen (another big red flag). Then a few hours later I had an EP study and ablation which found that I had problems in the RV Apex and RVOT; and I went into long runs of polymorphic VT 3 separate times. (huge red flag) my heart stopped and the first time was really bad and almost didn't start. I think what happened during my EPS was Propofol messed with my heart rhythm.
When I woke up they explained what happened and told me they thought it was ARVD or HCM but most likely ARVD with my symptoms and that I needed to have a MRI and Cathierzation and an ICD implant.
somewhere dr's have missed the mark; one day my heart is normal then not normal and I have something benign then malignant; then normal again? doesn't make much sense...for me, I think I've had something wrong my entire life and it's just been missed and different meds mess with my heart; which is consistent with HCM or HOCM patients.
I wasn't scared about ablation; I had major surgery before and knew it would be a pretty quick and easy procedure. for most patients, ablation can be an answer and cure and may even help diagnose a problem. I think it's better to go through with it and find out you have something wrong and be in a place if something does happen like with me, at least you're right there where they can treat it immediately.