I am writing on behalf of my 68 yo mother, who has a hx of PACs/PVCs for years controlled with medication (B-blockers). Approx. 4 mos ago, she began having more frequent palps (from a few/wk to several/hr to to several/min.) She has worn a 30d Holter which confirmed PVCs. She is very active--walks 1 hr/day, good diet, good wt--very healthy. She denies chest pain or SOB, but states that she feels some mild, localized pressure during the dysrhythmias occasionally. Her PMH is insignif. really--hysterectomy 15 yrs ago (no HRT), mild/mod OA. She has had elevated cholesterol but has taken Lipitor for years and it is well-controlled. Her cardiologist increased her Toprol XL fr/25 mg/d to 25 mg BID, which had some transient positive effect that lasted ~2d b/f degrading back to pre-increase frequency. She asked her cardio about an EP study, but he's opted to cath her instead. Would a less invasive procedure such as a stress test or cardiac CT be reasonable b/f cath? She just doesn't seem like a candidate for occluded arteries based on her S/S--Would an EP study be a reasonable place to start b/f a cath? Any thoughts would be greatly appreciated.