Few very symptomatic PVC.

[Karismatico]

Here it goes...

I have very very few PVC's confirmed in several holters (1 , 2 or 3 per day or none). My PVC happen while resting and also with exercise. I did a lot (like 10 stress test) (treadmill) with no isquemia but sometimes with PVC.
Also did several echo wich were all normal.
Did Heart MRI in 2012 normal.
Did angio-CORONARY-TC normal.

The problem is...
I FEEL EVERY SINGLE PVC
That is ruining my life, because it gives me severe anxiety (i feel like an adrenaline shot imediately after the pvc)
I stopped running and this thing has the control of my life.
I was given bisoprolol 2,5 mg a day by my cardiologist.
No one will do me an ablation for this because they say i have a ridiculous number of pvc.
What do you think about it??

Thank you very much for reading this.  

[Karismatico]

Thanks for your answer.
That's the problem. Doctors dont care about my quality of life...The PVC are so rare that they refuse to ablate.
But maybe the risks of doing an ablation are higher than my pvc's right? An ablation is not easy procedure and has secundary effects...
Did you see the exams that i did? a lot of them and all normal.
I got really anxious about exercise because PVC will appear sometimes in exercise (cought on treadmill stress test) and the doctors did not care about it. But for that reason i stopped exercise...
My story started in 2010 so you see i am stuck in this situation for a long time.
any advice?

[2210485]

As for ablation the risk of all complications is 3%-4%. The risk of serious complication (things that can kill you or permanently injure you) that chance is 1% or less.

When it comes to risk vs benefit, that determination is up to the individual physician. If an electrophysiologist does 100 ablations solely for patient comfort, statistically theres a chance that 1 could go horribly wrong.

Maybe the physician will determine that helping 99 people is worth the potential harm that may befall 1.. Especially if that singular individual was aware of the risk and insisted upon taking the chance and having the procedure.

For another physician a single bad outcome is 1 bad outcome too many, and thats not the kind of thing they want to have to live with, so they opt for a more conservative management strategy. This view predominates, which is why the recommendations in place seek only to treat those patients whose physical condition stands to deteriorate as a result of the pvcs and not so much those whose mental health and activities of daily living are effected.

In my opinion, neither physician is necessarily right or wrong for their point of view as, ultimately, the objective for every physician should be to ensure the greatest possible outcome for the greatest possible number of patients. In this case both strategies aim to accomplish this.

As for your particular case, unfortunately i cant advise anything that will improve your situation.. Youve exhausted your resources..

I can however say with confidence you dont need to be afraid of the pvcs.. Dont let them run your life.. If you get a few while exercising don't just let them intimidate you and prevent you from doing what you want. They will not kill you nor make you seriously sick in the quantity you're experiencing.

At this point the best thing you can do is learn to cope/live with them as best you can.

[Karismatico]

are you a doctor?
thanks for your answer!

[2210485]

No, i am not a doctor. I am a technologist specialized in a field of cardiology. So,please do take everything i say with a grain of salt. We study cardiology for 2 -4 years, your cardiologist studies for about 5.. Plus their med school.

I am happy to give educated opinions that you can bring up at your appointments though.

[2210485]

Theyre reluctant to do an ablation because the pvcs are actually very infrequent.

Initial diagnosis of a 15-20% pvc burden (1 out of every 5 heartbeats), or a diagnosis of 5-10% that doesnt respond to other treatments is usually a good justification to ablate. Thats the common philosophy anyways.

There are a precious few that will ablate really low percentages of pvc's for patient comfort, but in a society where everyones so afraid of accepting liability they're gonna be difficult to come by.

With 3 pvc's per day you might just be out of luck. It is worth mentioning though that in terms of your health, pvc's in that quantity will likely have absolutely no impact aside from making you uncomfortable.. Unfortunately sometimes people develop uncomfortable conditions.

Some people develop back pain, some people get arthritis... You got stuck with uncomfortable pvc's.. Unless you can find an electrophysiologist that acknowledges the mental health benefit from performing the ablation nothing will fully cure your problem.